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Over-the-Counter “Adrenal Support” Supplements Contain Thyroid and Steroid-Based Adrenal Hormones

      Abstract

      Objective

      To assess whether dietary supplements that are herbal and/or animal-derived products, marketed for enhancing metabolism or promoting energy, “adrenal fatigue,” or “adrenal support,” contain thyroid or steroid hormones.

      Methods

      Twelve dietary adrenal support supplements were purchased. Pregnenolone, androstenedione, 17-hydroxyprogesterone, cortisol, cortisone, dehydroepiandrosterone sulfate, synthetic glucocorticoids (betamethasone, dexamethasone, fludrocortisone, megestrol acetate, methylprednisolone, prednisolone, prednisone, budesonide, and triamcinolone acetonide) levels were measured twice in samples in a blinded fashion. This study was conducted between February 1, 2016, and November 1, 2016.

      Results

      Among steroids, pregnenolone was the most common hormone in the samples. Budesonide, 17-hydroxyprogesterone, androstenedione, cortisol, and cortisone were the others in order of prevalence. All the supplements revealed a detectable amount of triiodothyronine (T3) (63-394.9 ng/tablet), 42% contained pregnenolone (66.12-205.2 ng/tablet), 25% contained budesonide (119.5-610 ng/tablet), 17% contained androstenedione (1.27-7.25 ng/tablet), 8% contained 17-OH progesterone (30.09 ng/tablet), 8% contained cortisone (79.66 ng/tablet), and 8% contained cortisol (138.5 ng/tablet). Per label recommended doses daily exposure was up to 1322 ng for T3, 1231.2 ng for pregnenolone, 1276.4 ng for budesonide, 29 ng for androstenedione, 60.18 ng for 17-OH progesterone, 277 ng for cortisol, and 159.32 ng for cortisone.

      Conclusion

      All the supplements studied contained a small amount of thyroid hormone and most contained at least 1 steroid hormone. This is the first study that measured thyroid and steroid hormones in over-the-counter dietary “adrenal support” supplements in the United States. These results may highlight potential risks of hidden ingredients in unregulated supplements.

      Abbreviations and Acronyms:

      ID (identification), LC-MS/MS (tandem mass spectrometry), OTC (over-the-counter), T3 (triiodothyronine), T4 (thyroxine)
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      Linked Article

      • Over-the-Counter Adrenal Supplements: More Than Meets the Eye
        Mayo Clinic ProceedingsVol. 93Issue 3
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          A large number of patients (some estimates are as high as 115 million people) are currently consuming over-the-counter (OTC) dietary supplements to relieve symptoms of chronic disease and illness.1 Sales of OTC supplements have exceeded $20 billion per year.1 Despite this widespread use, OTC supplements remain largely unregulated. The Dietary Supplement Health and Education Act of 1994 classified dietary supplements as being exempt from having to prove safety or efficacy as long as the product does not claim to prevent, treat, or cure a specific disease.
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