Hypoglycemia Due to the Consumption of an Unidentified Compound for Weight Gain: A Case Report

Abstract

This case report highlights the adulteration of over-the-counter weight gain supplements with undeclared glyburide, culminating in a life-threatening episode of hypoglycemia in a healthy young adult. A previously healthy 23-year-old man was admitted to the emergency department on April 10, 2022, following a brief episode of unconsciousness. Upon arrival, his blood glucose was found to be 30 mg/dL. He reported having taken one herbal weight-gain tablet daily for the preceding three days. His blood glucose level quickly returned to normal after an intravenous dextrose infusion. Liquid chromatography-mass spectrometry (LC-MS) analysis of the tablets detected the presence of glyburide. The patient did not experience any further hypoglycemic episodes while being monitored and was discharged in stable condition after a four-day hospitalization. This case highlights the significant risk posed by undeclared sulfonylurea adulteration in unregulated herbal supplements, as well as the importance of implementing routine post-market quality control and toxicological screening to protect public health and prevent serious adverse events.