Review Article

Dietary Supplements as Source of Unintentional Doping

Table 1

Information of studies showing proof of analytical analysis of undeclared substances banned by WADA in dietary supplements.

Number of analyzed dietary supplementsNumber of dietary supplements that contain undeclared substancesUndeclared substancesMain resultsMethods for detectionCountry of originRef.

63494Теstosterone, 4-norendionon, 4-аdendion, 5-adendiol, nandrolone, boldenone, dehydroepiandrosterone (DHEA)14.8% positive supplements showed anabolic steroid concentrations from 0.01 μg/g up to 190 μg/gGC-MSGermany[36]
757DHEA, 19-noranrostenedione, ephedrineSeven products had hormones that were not listed on the labels, and two more products contained ephedrine and caffeine that were not clearly labeledGC-MSSwitzerland[23]
1033Nandrolone, testosterone, 4-androstenediol, androstenediol, androstenedione, bolasterone, boldenone, clostebol, DHEA, dihydrotestosterone (DHT), drostanolone, fluoxymesterone, mesterolone,4-norandrostenediol, 5-androstenedione, 5-norandrostenediol, 19-noranrostenedione, metandienone, metenolone, methyltestosterone, norethandrolone, oxandrolone, oxymesterone, stanozol, oxymetholone, testosterone propionate, 5-norandrostenedioneAn amount of metandienone in three supplements in a range from 0.41 mg/g up to 17.30 mg/g was foundGC-MSSwitzerland[37]
1211Testosterone, 5-androstenediol, 4-androstene-3,17-dione, 5-androstene-3,17-diol, 19-androstene-3b, 17b-diolSupplements did not meet the labeling requirements. One supplement contained 10 mg of testosterone; another contained 77% more than the label stated; 11 of the 12 contained less than what was indicatedHPLC, GC-MSUSA[38]
648Nandrolone decanoate, testosterone decanoate, 4-androstendion, ephedrine, DHEAConcentration range: 1–25 ng/gLC-MS/MS
GC-MS
Italy[39]
1915Тestosterone, beta-boldenone, alfa-boldenone, beta-nortestosteroneConcentrations between 0.01 mg/g and 2.5 mg/per capsule or tablet were found. Testosterone was in most samples (50%)LC-MS/MS
ESI
Belgium[40]
1691,3-Dimethylamylamine (DMAA)Concentration range: 3.1 mg/g-415 mg/gNMRGermany[28]
1126Dehydroepiandrosterone (DHEA)Concentration range:1-500 ng/gAndrogen bioassayNew Zealand[41]
192HigenamineConcentrations 6.42 ng/mL and 18.93 ng/mg were found in two samplesUHPLC-MS/MSSerbia[42]
245HigenamineDosages of up to  mg per serving were foundUHPLC-MS/MSUSA, Netherlands[43]
66D6-Methyltestosterone, methasterone, prostanozolAfter positive doping samples, 6 dietary supplements were tested and all have undeclared substancesGC-MSGermany[44]
102SibutramineMore than 20 mg per tablet was foundUltra-high-performance liquid chromatography-high-resolution mass spectrometry (UHPLC-HRMS)
UHPLC-MS/MS
Bulgaria[31]
2014Andarine, ostarine, ibutamoren, arimistaneThe amounts of these undeclared analytes ranged from 0.6 mg per capsule to 6.8 mg per capsuleUHPLC
LC-HRAM (high-resolution accurate mass)
UK[26]
18829SibutramineConcentrations of detected sample range from 0.03 mg/g up to 132.40 mg/gLC-MS/MSSouth Korea[32]
12324SibutramineSibutramine contents in green coffee samples were 0.014–2 438 mg/kg; the highest content of sibutramine was found in one capsule sample (26 410 mg/kg)LC-ESI-MS/MSCroatia[33]
20027Synephrine, yohimbine, 5-hydroxytryptophan, DHEAThe concentrations of detected samples ranged from 0.51 mg/g up to 226 mg/gLC-MS/MSSouth Korea[35]
1313DMAAConcentration range from 0.1 mg/g to 110 mg/gHPLC-MSUSA[29]
87Sibutramine, phenolphthalein, bumetanide, phenytoinConcentrations of sibutramine ranged from 6 mg up to 57 mg per capsuleLC-MS
GC-MS
Iran[34]
5024Sibutramine, rimonabant, desmethylsibutramine, didesmethylsibutramine, sildenafilConcentrations of sibutramine ranged from 0.1 mg up to 21 mg per capsuleHPLC-DAD-MS/MSNetherlands[45]
5211Theobromine, theophylline, pseudoephedrine, caffeine, hydrochlorothiazide, yohimbinеHydrochlorothiazide content found: 0.01 mg-0.37 mg
Pseudoephedrine content found: 0.03 mg-11 mg
UHPLC-DADSaudi Arabia[48]
55Sibutramine, 4-hydroxyamphetamine, caffeine, theophyllineSibutramine content found: 15 and 26 mg/g
Theophylline content found: 0.2-0.3 mg/g
HRAM screening
LC-MS/MS
Italy[49]
Dietary supplement DexaprineSynephrine, oxilofrine, deterenol, yohimbine, caffeine, theophyllineOxilofrine content found: 1-5 mgUltra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS)Netherlands[50]
2718Demelverine, hordenine, N, N-dimethyl-phenethylamine, synephrine, N-methyl-β-phenethylamine, methylsynephrineUnlisted DMAA was identified in three products with concentrations ranging from 18 to 120.9 mg/daily dose, while unlisted DMBA was found in one product with a concentration of 108 mg/daily doseLC-QTOF-MSUSA[51]
30114-Androstenedione4-Androstenedione was found in a range of 1.04 ng/g-2.52 ng/gUPLC-MS/MSIran[53]
108531,3-Dimethylamylamine, sibutramine, methylphenidate, synephrineDMAA was present in 20% of the dietary supplements. Out of the 108 samples, almost 50% were positive for sibutramine and 10% for methylphenidateDART-MS/MSBrazil, USA[54]
113SibutramineConcentrations of sibutramine ranged from 3.5 mg/g to 4.08 mg/gElectrochemiluminescence (ECL)China[55]
1613Benfluorex, fluoxetine, pseudoephedrine, tiratricolPseudoephedrine 2.6-55.56 mg
Fluoxetine 0.14-7.53
Benfluorex 0.01-0.07
Tiratricol 0.01-0.67
LC-UVItaly[57]
12029Sibutramine, fluoxertineSibutramine 0.26-113.22 mg per capsule
Fluoxetine 1.80-101.08 mg per capsule
UHLPC-LTQ-Orbitrap MSChina[58]
1781,3-Dimethylamylamine (1,3-DMAA), 1,4-dimethylamylamine (1,4-DMAA), 1,3-dimethylbutylamine (1,3-DMBA), higenamine, deterenol, phenpromethamine, oxilofrine, octodrine, beta-methylphenylethylamineConcentration range for detected stimulants were 2.7-17 mg of deterenol, 1.3-20 mg of phenpromethamine, 5.7-92 mg of beta-methylphenylethylamine, 18-73 mg of octodrine, 48 mg of higenamine, 18-55 mg of oxilofrine, 17 mg of 1,3-dimethylamylamine, 1.8 mg to 6.6 of 1,3-dimethylbutylamine, and 5.3 mg of 1,4-dimethylamylamineUHPLC quadrupole-Orbitrap MSNetherlands[59]
3216Phenethylamine, synephrine, oxilofrine, hordenine, beta-methylphenethylamine, N-methyltyramine, octopamine, deterenolHigh concentrations of phenethylamine were found in two products (29.9 and 26.8%, respectively). Synephrine was detected in 15 products with various contents ranging from 0.5 to 5.7%. The concentration of oxilofrine in these products ranged from 0.2 to 11.6%; deterenol with a content of 4.1%. The potential intake of the compound was estimated to be 28.7 mgNMRUSA[60]
4032Тestosterone propionate, testosterone phenylpropionate, testosterone isocaproate, testosterone decanoate, testosterone cypionate, testosterone undecanoate, stanozolol, drostanolone propionate, trenbolone acetate, oxymetholone, methandrostenoloneEight of the 40 samples analyzed lacked all or some of the components listed on the labelNMRBrazil[61]
16089Sibutramine, fluoxetine, phenolphthalein, orlistatSibutramine was detected in 26% of the capsules, with sibutramine concentration ranging from 0.1 to 22 mg per dosage unit (capsule). The dosages found in this study varied from 0.05 to 56 mg per capsule, with phenolphthalein 0.8 mg-29 mg per capsule fluoxetineNMRFrance[62]
483Nandrolone, testosterone, dehydroepiandrosterone (DHEA), 5α-androstan-3,17-dione, 19-norandrostendione, progesteronePositive tests included substances at values ranging from 0.022 to 0.398 mg/kgTwo-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC×GC–TOF-MS)Czech Republic[63]
205Phenethylamine, N, N-diethyl phenethylamine, N-ethyl-α-ethyl-phenethylamineN-Ethyl-α-ethyl-phenethylamine was found in a range of 6.48-23.4 mg per capsule
Phenethylamine in a range of 1.39-24.7 mg
LC-MS-MSUSA[64]
96EphedrineEphedrine range: 1.08-3.54 mg per capsuleHPLCUSA[65]
771,3-DimethylamylamineDMAA range from 1.1 mg/g to 32 mg/g was foundUPLC-MS/MSUSA[66]
22Sibutramine, phenolphthalein24.71 mg sibutramine and 48.20 mg phenolphthalein were foundHPLCRomania[67]
103Sibutramine, fluoxetineAll three adulterate supplements were manufactured in China and labeled as food supplements containing only plants—“100% natural products”Fourier-transform infrared spectroscopy (FTIR)
GC-MS
Romania[68]
203Ephedrine, caffeineEphedrine range: 31–90 mg/doseHLPCRomania[69]
2618Sildenafil, tadalafil, vardenafil69% of the analyzed products that are found on the Romanian market turned out to be adulteratedLC-MSRomania[70]
8076Diphenoxylate, tramadol, codeine, sertraline, fluoxetineDiphenoxylate and tramadol are found at concentrations of 1.4–4 mg/capsule and 67–150 mg/capsule, respectivelyGC-MSIran[72]
13874FluoxetineIn comparison to supplements produced and purchased in South Africa (5194 ng/g), supplements imported and purchased in South Africa showed a greater amount of fluoxetine contamination (20052 ng/g)LC-MSSouth Africa[73]
241613 anabolic steroidsAmount of found substances per capsule:
DHEA: 16 mg-28 mg
Androstenedione: 1 mg-9 mg
Methasterone: 2.4 mg-8 mg
Testosterone: 7 mg
Furazabol: 31 mg
Androst-4-ene-3,11,17-trione: 61 mg
GC-MS
HPLC
DAD
UV-VIS
NMR
UK[74]
1985Testosterone, stanozolol, 5α-hydroxylaxogeninAccording to the detected concentration and daily serving size, it was found that 0.34 μg of stanozolol would be consumed per day.LC-MS/MSKorea[75]
368Ephedrine, pseudoephedrineEphedrine at a concentration ranging from 370 ng/g to 1000 ng/g (in one case, ephedrine was not declared in the label) pseudoephedrine in 540 ng/gLC–HRMSItaly[76]
5226SibutramineHalf of the supplements included sibutramine in levels as high as 35 mg per capsuleHPLC-UVSwitzerland[77]
1246DiureticsNearly 5% of the samples were found to be contaminated with diuretics at values ranging from 0.051 to 162 mg/gUHPLC-Q-OrbitrapRepublic of Korea[78]
33SibutramineA new method was developed for the identification and quantification of the sibutramine by HPTLCHPLC
HPTLC
Turkey[79]
1884-Androstene-3β,17β-diol, 5α-androstane-3β,17β-diolConcentration that was around or above 0.01 mg per capsule or tablet was foundLC-MS/MSNetherlands[80]
22Мetandienone, StanozololMetandienone with a concentration of 16.8 mg/tablet and stanozolol 14.5 mg/tablet were identified. Norandrostenedione was also found in both products, along with small levels of numerous additional steroidsGC-MS
HPLC-DAD
Germany[81]