A healthy 53-year-old woman in good condition suffered an exercise-induced hemorrhagic stroke shortly after beginning her regular, vigorous gym routine. After studying her case, a team of doctors led by Dr. Pieter Cohen of Harvard Medical School say BMPEA, a stimulant found in her work-out supplement Jacked, could be to blame. Cohen says consumers and physicians should be on high alert — especially since BMPEA was not listed as an ingredient on the label.

Not Natural

First synthesized in the 1930s, BMPEA is amphetamine’s beta-isomer. Created as a potential replacement for the original drug, researchers became discouraged and abandoned the product when they discovered it increased blood pressure and heart rate in cats and dogs. The Food and Drug Administration lists 13 names under which BMPEA is sold to consumers. According to the agency, BMPEA is not a vitamin, mineral, herb, amino acid, or other approved substance that commonly meets the definition of a "dietary supplement." Nevertheless, this synthetic compound is often billed as a "natural compound" with further claims that it is found in the shrub Acacia rigidula. BMPEA, as the FDA vigorously states, is not found in any shrub.

For the current study, Cohen and his colleagues investigated the case of the healthy, well-condition woman who reported sudden numbness and clumsiness in her left hand 45 minutes after beginning her exercise routine. Always a normal weight, she was physically active with low blood pressure. She did not use illicit drugs, though she drank alcohol occasionally and previously had smoked cigarettes (but quit 22 years ago). Importantly, her family history did not include stroke or coagulation disorders.

Shortly before exercising, the healthy and fit woman took the supplement, Jacked Power, as directed on the label. Though she worked out several times a week, she had never tried sports supplements before this. She went to see her doctor the following day, numbness and clumsiness in her left hand. A 2-centimeter hemorrhage was found in her right parietal lobe. Tests and scans revealed no underlying abnormalities, aneurysms, or other malformations.

She was discharged from the hospital after five days with residual, though minor, symptoms.

Researching this patient's case, Cohen and his colleagues analyzed the supplement in the lab and found it contained a high dose of the stimulant BMPEA. Since amphetamine has been identified as a cause of hemorrhagic strokes in many case reports, the researchers concluded, “Exercise combined with BMPEA, an isomer of amphetamine, probably caused this patient’s stroke.”

Source: Cohen PA, Zeijlon R, Nardin R, et al. Hemorrhagic Stroke Probably Caused by Exercise Combined With a Sports Supplement Containing β- Methylphenylethylamine (BMPEA): A Case Report. Annals of Internal Medicine. 2015.