Bodybuilding supplements leading to copper toxicity, encephalopathy, fulminant hepatic failure and rhabdomyolysis

Am J Emerg Med. 2020 Nov;38(11):2487.e1-2487.e5. doi: 10.1016/j.ajem.2020.05.096. Epub 2020 Jun 2.

Abstract

Millions of people worldwide use nutritional and dietary supplements, such as vitamins and minerals. These and other performance-enhancing substances are also used by high school, college, and professional athletes, bodybuilders, and amateur sports enthusiasts. The constituents of these supplements and their metabolites may be harmful and not listed on the product label. We present a case report of a 32-year-old bodybuilder using myriad nutritional, performance-enhancing, and weight-loss supplements with life-threatening encephalopathy, hepatic failure, rhabdomyolysis, and copper toxicity mimicking Wilson's disease. Emergency physicians and nurses should be aware of these potential deleterious effects and inquire about supplement use by patients with unexplained multiorgan failure. Family, friends, or acquaintances should be asked to bring the actual products to the hospital for analysis.

Keywords: Bodybuilding; Copper; Herbal; Liver; Rhabdomyolysis; Supplements.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Obesity Agents / poisoning*
  • Brain Diseases / chemically induced*
  • Chemical and Drug Induced Liver Injury / etiology*
  • Copper / poisoning*
  • Creatine Kinase / metabolism
  • Diagnosis, Differential
  • Dietary Supplements / poisoning*
  • Hepatolenticular Degeneration / diagnosis
  • Humans
  • Liver Failure, Acute / chemically induced*
  • Liver Failure, Acute / metabolism
  • Liver Function Tests
  • Male
  • Performance-Enhancing Substances / poisoning*
  • Rhabdomyolysis / chemically induced*
  • Rhabdomyolysis / metabolism
  • Trace Elements / poisoning*
  • Weight Lifting

Substances

  • Anti-Obesity Agents
  • Performance-Enhancing Substances
  • Trace Elements
  • Copper
  • Creatine Kinase