Survival after profound acidosis and rhabdomyolysis due to dietary supplement use

Pourmand, Ali; Li, Annabel; Yiu, Allen J.; Mazer‐Amirshahi, Maryann; Shokoohi, Hamid

doi:10.1016/j.ajem.2016.05.052

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…To the best of our knowledge, serious adverse outcomes have only been described in males and only in case reports. These adverse outcomes included renal dysfunction [ 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 ], increased lower leg compartment syndrome [ 104 , 116 ], rhabdomyolysis [ 116 , 117 , 118 ], ischaemic stroke [ 119 ], haemorrhagic stroke [ 120 ], liver injury [ 121 , 122 ], atrial fibrillation [ 123 ], acute cholestatic liver injury [ 124 ] and toxic hepatitis [ 122 ]. These events are not replicated in placebo controlled clinical trials [ 125 , 126 , 127 , 128 , 129 ].…”

Section: Discussionmentioning

confidence: 99%

Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis

et al. 2020

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Creatine Monohydrate (CrM) is a dietary supplement routinely used as an ergogenic aid for sport and training, and as a potential therapeutic aid to augment different disease processes. Despite its increased use in recent years, studies reporting potential adverse outcomes of CrM have been mostly derived from male or mixed sex populations. A systematic search was conducted, which included female participants on CrM, where adverse outcomes were reported, with meta-analysis performed where appropriate. Six hundred and fifty-six studies were identified where creatine supplementation was the primary intervention; fifty-eight were female only studies (9%). Twenty-nine studies monitored for adverse outcomes, with 951 participants. There were no deaths or serious adverse outcomes reported. There were no significant differences in total adverse events, (risk ratio (RR) 1.24 (95% CI 0.51, 2.98)), gastrointestinal events, (RR 1.09 (95% CI 0.53, 2.24)), or weight gain, (mean difference (MD) 1.24 kg pre-intervention, (95% CI −0.34, 2.82)) to 1.37 kg post-intervention (95% CI −0.50, 3.23)), in CrM supplemented females, when stratified by dosing regimen and subject to meta-analysis. No statistically significant difference was reported in measures of renal or hepatic function. In conclusion, mortality and serious adverse events are not associated with CrM supplementation in females. Nor does the use of creatine supplementation increase the risk of total adverse outcomes, weight gain or renal and hepatic complications in females. However, all future studies of creatine supplementation in females should consider surveillance and comprehensive reporting of adverse outcomes to better inform participants and health professionals involved in future trials.

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Section: Discussionmentioning

confidence: 99%

Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis

et al. 2020

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“…That patient had relative circulatory stability. 18 Alcohol was implicated in another patient’s acidosis with pH 6.67. 19 The cause, in addition to magnitude, of acidosis is thought to contribute heavily to prognosis.…”

Section: Discussionmentioning

confidence: 99%

Recovery from profound acidosis (pH 6.685) in multi-organ dysfunction syndrome

Davies

Saleh

Bannard‐Smith

2019

Journal of the Intensive Care Society

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Acidosis is a common feature of patients referred to critical care from the emergency department. We present the case of a 49-year-old female with multi-organ dysfunction syndrome (MODS) and an arterial pH of 6.685 on arrival to the emergency department. This case is unique as the patient was in circulatory shock with MODS from rhabdomyolysis on arrival and had not suffered a cardiac arrest. We believe this to be the first reported case of full recovery from such an extreme metabolic disturbance in this context, and discuss the relevance of profound acidosis to early clinical decision-making.

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“…Such high number of combinations is alarming because it may bring unexpected side effects either due to an additive or synergistic effect of the combined substances. It is well known that the side effects of ephedrine and other phenylethanolamines can be potentiated by caffeine [20,23]. Combinations ▶ Table 1 RASFF-registered occurrences of alkaloids, their derivatives, and the plants that contain them in food supplements.…”

Section: Rasff Database Searchmentioning

confidence: 99%

“…Besides synephrine, the supplement also contained yohimbine and caffeine [83]. It is worth noting that this combination is particularly concerning because caffeine alone can cause rhabdomyolysis when taken in extremely high doses, and combination with synephrine appears to have a synergistic effect [23]. A supplement containing synephrine with other similar-acting substances was removed from the Dutch market due to the severe adverse events as described before [35].…”

Section: Synephrinementioning

confidence: 99%

Getting More Than You Paid For: Unauthorized “Natural” Substances in Herbal Food Supplements on EU Market

Končić

2018

Planta Med

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As the population in the industrialized world develops preference for what is perceived as a natural and holistic way of disease treatment, the popularity and the number of food supplements on the market, including herbal ones, is experiencing an unprecedented rise. However, unlike herbal medicinal products, intended for treating or preventing disease, current legislation classifies food supplements as products intended for achieving nutritional or physiological effect and to supplement the normal diet. Accordingly, most food supplements are not to be associated with specific health claims. However, either due to the subtle suggestions by the producers or the wishful thinking of the consumers, certain pharmacological effects from food supplements are often expected. Medicinal plants included in food supplements usually do not produce dramatic and instant pharmacological effects. Therefore, in order to meet the expectation of their customers, some producers have turned to the illicit and dangerous practice of adulterating their products with synthetic adulterants, including naturally occurring molecules, having the desired activity. Such practice is prevalent in, although not limited to, food supplements intended for use as weight-loss aids, as well as for sport performance and libido enhancement. The review is focusing on naturally occurring alkaloids, phenylethanolamines, and their semi-synthetic derivatives in food supplements in the European Union as reported by the Rapid Alert System for Food and Feed. Their desired and undesired pharmacological effects, as well as the methods for their detection and quantification in food supplements, will be reviewed.

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Survival after profound acidosis and rhabdomyolysis due to dietary supplement use

Cited by 3 publications

References 22 publications

Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis

Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis

Recovery from profound acidosis (pH 6.685) in multi-organ dysfunction syndrome

Getting More Than You Paid For: Unauthorized “Natural” Substances in Herbal Food Supplements on EU Market

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