• Logo
  • SBMUJournals

Determining Undeclared Synthetic Pharmaceuticals as Adulterants in Weight Loss Herbal Medicines

Babak Salahshour, Sajjad Sadeghi, Hajar Nazari, Kambiz Soltaninejad



Background: The popularity and use of herbal medicines and supplements are growing worldwide. Herbal anti-obesity products have been considered as suitable alternatives to synthetic pharmaceuticals as they are introduced as harmless natural products. However, some manufacturers often add undeclared synthetic pharmaceuticals to the anti-obesity herbal medicine products to improve their efficacy and potency. The present study aimed to analyze herbal weight loss products collected from the drug market in Bojnurd City, Iran.
Methods: Ninety-six herbal drug samples, as weight loss products, were obtained from herb shops and pharmacies in Bojnurd City, Iran. All samples were analyzed to detect undeclared active pharmaceutical ingredients using High-Performance Liquid Chromatography with Diode Array Detector (HPLC-DAD) and Gas Chromatography-Mass Spectrometry (GC-MS) techniques.
Results: Caffeine, trimethoxyamphetamine, and vitamin E were identified in herbal weight loss products. Caffeine was detected in 21.8% of the obtained samples, as the most common undeclared active pharmaceutical adulterant.
Conclusion: Undeclared active pharmaceutical ingredients in herbal weight loss products could threaten patients’ health. Thus, it is necessary to create awareness through health authorities in this regard.


Adulteration, Caffeine, Trimethoxyamphetamine


Skalicka-Woźniak K, Georgiev MI, Orhan IE. Adulteration of herbal sexual enhancers and slimmers: The wish for better sexual well-being and perfect body can be risky. Food and Chemical Toxicology. 2017; 108:355-64. [DOI:10.1016/j.fct.2016.06.018] [PMID]

Ekor M. The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety. Frontiers in Pharmacology. 2014; 4:177. [DOI:10.3389/fphar.2013.00177] [PMID] [PMCID]

Farrington R, Musgrave IF, Byard RW. Evidence for the efficacy and safety of herbal weight loss preparations. Journal of Integrative Medicine. 2019;17(2):87-92. [DOI:10.1016/j.joim.2019.01.009] [PMID]

Poswal FS, Russell G, Mackonochie M, MacLennan E, Adukwu EC, Rolfe V. Herbal Teas and their health benefits: A scoping review. Plant Foods for Human Nutrition. 2019; 74(3):266-76. [DOI:10.1007/s11130-019-00750-w] [PMID]

Mateescu C, Popescu AM, Radu GL, Onisei T, Raducanu AE. Spectroscopic and spectrometric methods used for the screening of certain herbal food supplements suspected of adulteration. Advanced Pharmceutical Bulletin. 2017; 7(2):251-9. [DOI:10.15171/apb.2017.030] [PMID] [PMCID]

Posadzki P, Watson L, Ernst E. Contamination and adulteration of Herbal Medicinal Products (HMPs): An overview of systematic reviews. European Journal of Clinical Pharmacology. 2013; 69(3):295-307. [DOI:10.1007/s00228-012-1353-z] [PMID]

Kalman DS. An acute clinical trial evaluating the cardiovascular effects of an herbal ephedra-caffeine weight loss product in healthy overweight adults. International Journal of Obesity and Related Metaboilc Disorders. 2004; 28(10):1355-6. [DOI:10.1038/sj.ijo.0802418] [PMID]

Zheng EX, Navarro VJ. Liver Injury from herbal, dietary, and weight loss supplements: A review. Journal of Clinical Translational Hepatology. 2015; 3(2):93-8. [DOI:10.14218/JCTH.2015.00006] [PMID] [PMCID]

Lee YX, Kwan YH, Lim KK, Tan CS, Lui NL, Phang JK, et al. A systematic review of the association of obesity with the outcomes of inflammatory rheumatic diseases. Singapore Medical Journal. 2019; 60(6):270-80. [DOI:10.11622/smedj.2019057] [PMID] [PMCID]

Carbone S Canada JM, Billingsley HE, Siddiqui MS, Elagizi A, Lavie CJ. Obesity paradox in cardiovascular disease: Where do we stand? Vascular and Health Risk Management. 2019; 15:89-100. [DOI:10.2147/VHRM.S168946] [PMID] [PMCID]

Avgerinos KI, Spyrou N, Mantzoros CS, Dalamaga M. Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism. 2019; 92:121-35. [DOI:10.1016/j.metabol.2018.11.001] [PMID]

Fakhri S, Mohammadi B, Jalili R, Hajialyani M, Bahrami G. Screening and confirmation of different synthetic adulterants in slimming products. Asian Journal of Pharmaceutical and Clinical Research. 2018; 11(2):260-4. [DOI:10.22159/ajpcr.2018.v11i2.22516]

De Carvalho LM, Cohen PA, Silva CV, Moreira AP, Falcão TM, Dal Molin TR, et al. A new approach to determining pharmacologic adulteration of herbal weight loss products. Food Additives & Contaminants: Part A: Chemistry, Analysis, Control, Exposure & Risk Assessment. 2012; 29(11):1661-7. [DOI:10.1080/19440049.2012.706834] [PMID]

Cianchino V, Acosta G, Ortega C, Martínez LD, Gomez MR. Analysis of potential adulteration in herbal medicines and dietary supplements for the weight control by capillary electrophoresis. Food Chemistry. 2008; 108(3):1075-81. [DOI:10.1016/j.foodchem.2007.11.042] [PMID]

Pamukcu Gunaydin G, Dogan NO, Levent S, Kurtoglu Celik G. Herbal weight loss pill overdose: Sibutramine hidden in pepper pill. Case Reports in Emergency Medicine. 2015; 2015:213874. [DOI:10.1155/2015/213874] [PMID] [PMCID]

Khazan M, Hedayati M, Kobarfard F, Askari S, Azizi F. Identification and determination of synthetic pharmaceuticals as adulterants in eight common herbal weight loss supplements. Iran Red Crescent Medical Journal. 2014; 16(3):e15344. [DOI:10.5812/ircmj.15344] [PMID] [PMCID]

Moreira AP, Motta MJ, Dal Molin TR, Viana C, de Carvalho LM. Determination of diuretics and laxatives as adulterants in herbal formulations for weight loss. Food Additives & Contaminants: Part A: Chemistry, Analysis, Control, Exposure & Risk Assessment. 2013; 30(7):1230-7. [DOI:10.1080/19440049.2013.800649] [PMID]

Reeuwijk NM, Venhuis BJ, de Kaste D, Hoogenboom RL, Rietjens IM, Martena MJ. Active pharmaceutical ingredients detected in herbal food supplements for weight loss sampled on the Dutch market. Food Additives & Contaminants: Part A: Chemistry, Analysis, Control, Exposure & Risk Assessment. 2014; 31(11):1783-93. [DOI:10.1080/19440049.2014.958574] [PMID]

Dastjerdi AG, Akhgari M, Kamali A, Mousavi Z. Principal component analysis of synthetic adulterants in herbal supplements advertised as weight loss drugs. Complementary Therapies in Clinical Practice. 2018; 31:236-41. [DOI:10.1016/j.ctcp.2018.03.007] [PMID]

World Health Organization. Counterfeit drugs: Guidelines for the development of measures to combat counterfeit drugs [Internet]. 2019 [Updated 2019 July 2]. Available from: http://apps.who.int/medicinedocs/en/d/Jh1456e/2.1.html

Viana C, Zemolin GM, Müller LS, Dal Molin TR, Seiffert H, de Carvalho LM. Liquid chromatographic determination of caffeine and adrenergic stimulants in food supplements sold in Brazilian e-commerce for weight loss and physical fitness. Food Additives & Contaminants: Part A: Chemistry, Analysis, Control, Exposure & Risk Assessment. 2016; 33(1):1-9. [DOI:10.1080/19440049.2015.1112040] [PMID]

Tabrizi R, Saneei P, Lankarani KB, Akbari M, Kolahdooz F, Esmaillzadeh A, et al. The effects of caffeine intake on weight loss: A systematic review and dos-response meta-analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition. 2019; 59(16):2688-96. [DOI:10.1080/10408398.2018.1507996] [PMID]

WebMed. Caffeine [Internet]. 2019 [Updated 2019 Jan 30] Available from: https://www.webmd.com/vitamins/ai/ingredientmono-979/caffeine

Pendleton M, Brown S, Thomas CM, Odle B. Potential toxicity of caffeine when used as a dietary supplement for weight loss. Journal of Dietary Supplements. 2013; 10(1):1-5. [DOI:10.3109/19390211.2012.758215] [PMID]

Nieddu M, Boatto G, Pirisi MA, Azara E, Marchetti M. LC-MS analysis of trimethoxyamphetamine designer drugs (TMA series) from urine samples. Jornal of Chromatography B. 2008; 867(1):126-30. [DOI:10.1016/j.jchromb.2008.03.027] [PMID]

Bryant SM, Lozada C, Wahl M. A Chinese herbal weight loss product adulterated with fenfluramine. Annals of Emergency Medicine. 2005; 46(2):208. [DOI:10.1016/j.annemergmed.2005.03.021] [PMID]

Bersani FS, Coviello M, Imperatori C, Francesconi M, Hough CM, Valeriani G, et al. Adverse psychiatric effects associated with herbal weight-loss products. Biomedcal Research Intrnational. 2015; 2015:120679. [DOI:10.1155/2015/120679] [PMID] [PMCID]

Malik A, Eggersdorfer M, Trilok-Kumar G. Vitamin E status in healthy population in Asia: A review of current literature. International Journal for Vitamin and Nutrition Research. 2019:1-14. [DOI:10.1024/0300-9831/a000590] [PMID]

Wong SK, Chin KY, Suhaimi FH, Ahmad F, Ima-Nirwana S. Vitamin E as a potential interventional treatment for metabolic syndrome: Vidence from animal and human studies. Frontiers in Pharmacology. 2017; 8:444. [DOI:10.3389/fphar.2017.00444] [PMID] [PMCID]

DOI: https://doi.org/10.32598/ijmtfm.v10i1.26253