Chong Serena, Woolnough Catherine A, Koyyalamudi Sundar R, Perera Nimalie J
Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
Department of Chemical Pathology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
JCEM Case Rep. 2024 Aug 14;2(8):luae148. doi: 10.1210/jcemcr/luae148. eCollection 2024 Aug.
Commercially available performance-enhancing supplements can contain banned performance-enhancing drugs (PEDs) and undisclosed steroid hormones that can induce hormonal abnormalities with associated clinical signs. We present a case of a 40-year-old male who developed bilateral gynecomastia and biochemical hypogonadotropic hypogonadism with a corresponding 6-month history of consuming commercially available performance-enhancing supplements for gym workouts. These performance-enhancing supplements were found to contain amounts of RAD-140, a selective androgen receptor modulator, MK-677, a GH secretagogue and cardarine, all of which are banned PEDs. In vitro analysis also detected undisclosed hormones testosterone, estradiol, and GH in all 3 supplements, with further steroid analysis using liquid chromatography mass spectrometry identifying an unidentified compound coeluting close to the testosterone peak. Cessation of these supplements led to full resolution of symptoms including normalization of hypogonadotropic hypogonadism. This case highlights the need for clinicians to consider commercially available performance-enhancing supplements as potential sources of PEDs and exogenous steroid hormones that can have adverse clinical consequences.
市售的增强运动表现的补充剂可能含有违禁的增强运动表现药物（PEDs）和未公开的类固醇激素，这些物质可导致激素异常并伴有相关临床症状。我们报告一例40岁男性病例，该患者出现双侧乳腺增生及生化性低促性腺激素性腺功能减退，其有6个月服用市售增强运动表现补充剂进行健身锻炼的病史。这些增强运动表现的补充剂被发现含有一定量的RAD-140（一种选择性雄激素受体调节剂）、MK-677（一种生长激素促分泌素）和卡地那非，所有这些均为违禁PEDs。体外分析还在所有3种补充剂中检测到未公开的激素睾酮、雌二醇和生长激素，使用液相色谱质谱联用仪进行的进一步类固醇分析鉴定出一种与睾酮峰共洗脱的未知化合物。停用这些补充剂后，症状完全缓解，包括低促性腺激素性腺功能减退恢复正常。该病例强调临床医生需要将市售增强运动表现补充剂视为可能含有可产生不良临床后果的PEDs和外源性类固醇激素的潜在来源。
