Original. Kenichi KUMASAKA*, Maki MIYAZAWA, Ayako MATSUZAKA, Yoriko ASO and Takashi KOJIMA

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1 Original GC MS LC MS MS Analysis of Undeclared Pharmaceutical Ingredients Found in a Dietary Supplement-Type Product for Weight Loss, So-Called Hospital Diet, Using GC MS and LC MS MS methods Kenichi KUMASAKA*, Maki MIYAZAWA, Ayako MATSUZAKA, Yoriko ASO and Takashi KOJIMA Kanagawa Prefectural Institute of Public Health, Shimomachiya, Chigasaki, Kanagawa , Japan Abstract We investigated the undeclared pharmaceutical ingredients in a dietary supplement-type product, composed of six types of tablets and two types of capsules. The appearance of this product was closely similar to that of the so-called hospital diet that was marketed on the internet and advertised for weight loss. Thus, appearances and imprints of the samples were used to determine the pharmaceutical ingredients in the tablets and capsules because warnings, photographs, and health risks of similar products were shown on the website of the Japanese Ministry of Health, Labor and Welfare. In fact, a histological study revealed that thyroid gland powder was contained in two types of the tablets. In addition, GC MS and Qtrap LC MS MS methods revealed the presence of thyroid hormones and the following five pharmaceutical ingredients: bisacodyl, hydrochlorothiazide, fluoxetine, diazepam and phentermine. Keywords: hospital diet, weight loss, undeclared pharmaceutical ingredients, GC MS, Qtrap LC MS MS * : kumasaka.z3aa@pref.kanagawa.jp :: : Kenichi Kumasaka : kumasaka.z3aa@pref.kanagawa.jp : , :

2 [1 4] L T L T LL PRONASE Protease, Streptomyces griseus HPLC Table 1 [1] mg µm HE GC MS ml ml min ml ml Table 1 Details of sample appearances and speculated and detected pharmaceutical ingredients No. Appearances pharmaceutical ingredients Form Color Shape Imprints Speculated Detected 1 tablet pinkish round bisacodyl bisacodyl 2 tablet lime greenish round bisacodyl 3 tablet brownish elliptical T or T T thyroid gland powder thyroid gland powder 4 tablet light blue rhomboidal H hydrochlorothiazide hydrochlorothiazide 5 tablet pale brownish round T. ov thyroid gland powder thyroid gland powder 6 capsule brown and yellowish fluoxetine 7 tablet cyanic round 5 and GREATER diazepam diazepam 8 capsule brown and grayish DUROMINE 30 phentermine phentermine

3 Original AgilentN GC JMS GCmate DB 5ms mmm µm J&W ml min min µl EI m z NIST Qtrap LC MS MS [5, 6] mg mg T T µg ml µm µg ml µm No DUROMINE No mol L v vml ml ml ml mol L ph ml µg ml µm Agilent HPLC Qtrap LC MS MS system HPLC Cadenza CD C mm mmµm ml min µl ESI [5, 6] v v EPI M H m z T m z T CEV A mol L ph B A B v v B min A B A B B mina B EPIEMS EPI M H M H CE V V V EMS CE V V No DUROMINE mol L ph v v EPI EPI M H m z CE VV

4 Table 1 [1] Fig. 1 Fig. 1 Structures of the detected ingredients

5 Original [5, 7] No. Fig. 2 No. No. GC MS EI GC MS Fig. 3 No. M m/z m z No. M m z m z No. M H m z M CH N m z Qtrap LC MS MS No. No. Qtrap LC MS MS T T Fig. 4 No. m z T m z T M H CO H O m z Tm/z T No. No. T T Fig. 2 Histological study of thyroid gland powder obtained in sample No. 3 (A) and the positive control (B) stained with hematoxylin-eosin. EPI EMS LC MS MSEPI GC MS M H M H MS MS Fig. 5 No. M H CH COOC H CH CO m z No. M H CHN

6 Fig. 3 GC MS analysis of the ethyl acetate extract of samples. No peak was obtained from sample No. 3, 4, 5, and 8. Fig. 4 Qtrap LC MS MS analysis of thyroid hormones in protease-digested solution of sample No. 3 scanned in the EPI mode. (A) 3, 5, 3 -triiodo-l-thyronine ; (B) L-thyroxine.

7 Original Fig. 5 Qtrap LC MS MS analysis of the methanol extract of samples scanned in the EPI mode. (A) Sample No. 1 ; (B) sample No. 2 ; (C) sample No. 4 ; (D) sample No. 6 ; (E) sample No. 7. No peak was obtained from sample No. 3, 5, and 8. *Initial ratio of the gradient mobile phase for sample No. 4 (C) was 0.01 mol/l ammonium formate (ph 3.0)/acetonitrile mixture (90 : 10, v/v), while the ratio for others was (70 : 30, v/v). M H CHNSO m z No. M H CF C H OH m z No. M H CO CH CH M H CO Cl M H CO CH CH Cl M H CO PhCN m z EMS No. No. No. M H M H No. M H

8 Fig. 6 Qtrap LC MS MS analysis of sample No. 8 extracted with a mixture of methanol/0.9% NaCl/1 mol/l NaOH (10 : 9 : 1, v/v) scanned in the EPI mode. EPI No. No. No. No. DUROMINE No. mol L Qtrap LC MS MS Fig. 6EPI m z [1] No. No.H Hydrochlorothiazide No. GREATER No. DUROMINE [8] No.T T T No.T.ov Thyroid grand No. No. Table 1 [5, 7] T T [5, 6] TLC PDA HPLC GC MS LC MS [2,3,9 14] EI GC MS DART Direct Analysis in Real Time EI CI LC MS [3] DART TOF MS TLCTLC HPLC [11] GC MS ESI Qtrap LC MS MS No. No.

9 Original Fig. 2 4 [7] Qtrap LC MS MS T T [5, 6] EI GC MS NIST No. No. No. No. Fig. 3 No. m z EI No. No. Qtrap LC MS MS Fig. 5 No.EMS M H GC MS No. DU- ROMINE [8] mol L EPI Fig. 6 No. No. mg mg No. mg No. mg No. mg No. mg PDA ODS HPLC No. No. [2] [1] available from <http : // 1.html>, (accessed ) [2] 2003, 2, [3] Saka K., Konuma K., Asai S., Unuma K., Nakajima M.,

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