In a disturbing report published in the Annals of Internal Medicine today, the death of a healthy 53-year-old woman was linked to a dietary supplement, β-methylphenylethylamine, which when combined with exercise, can cause hemorrhagic stroke.

 BMPEA is found in dietary supplements used to promote weight loss and improve exercise performance. The woman, who was of normal weight, physically active, with no history of high blood pressure, had taken the supplement, called "Jacked Power," 30 minutes prior to her workout. Within an hour, the woman reported numbness to her left arm. When she was seen by her physician, her blood pressure was significantly elevated and a CT of her head showed a 2 cm hemorrhage in her right parietal lobe. The woman later died. Hemorrhagic stroke occurs when a blood vessel bursts in the brain, leading to bleeding, tissue damage, and possible death. An MRI revealed no underlying abnormalities in her brain.

 According to the report by Dr. Pieter Cohen, from Harvard Medical School, and colleagues, the sport supplement did not list BMPEA on the label, but when the substance was tested, it was confirmed to contain 290 mg per dose.

BMPEA acts as a stimulant. When taken in combination with intensive exercise, stimulants can have deleterious effects on heart rate and blood pressure.

According to Dr. Steven R. Levine, professor of neurology and emergency medicine at the SUNY Downstate Medical Center in Brooklyn, "A lot of these are sensitized by exercise because you're already giving a cardiovascular stimulant. It's not unlikely that the combination of exercise with the drug was provocative because the heart rate and blood pressure are already up," Levine told Forbes.

"So, if you're taking it for weight lost and it's sensitized by exercise and other cardiovascular stimuli, maybe they should have a warning," said Levine, who has published extensive studies about drugs such as amphetamines in relation to stroke.

BMPEA was first synthesized in the early 1930s and has never been evaluated for safety in humans. Recently, the FDA has reported finding BMPEA in dietary supplements labelled as containing Acacia rigidula. In a recent report in the journal Drug Testing Analysis, researchers tested supplements containing Acacia rigidula and found more than half contained BMPEA. Their report also found that the stimulant was present in quantities considered to be pharmacological dosages of the product, which is an amphetamine isomer. The authors recommended the FDA take immediate action to warn consumers of the potential dangers of BMPEA and to eliminate the substance from dietary supplements.

Cohen and team provide a stark warning: "Exercise combined with BMPEA, an isomer of amphetamine, probably caused this patient's stroke."