Clinical Toxicology

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The scoop on brain health dietary supplement

products containing huperzine A

Cindy Crawford, Yan-Hong Wang, Bharathi Avula, Ji-Yeong Bae, Ikhlas A.

Khan & Patricia A. Deuster

To cite this article: Cindy Crawford, Yan-Hong Wang, Bharathi Avula, Ji-Yeong Bae, Ikhlas
A. Khan & Patricia A. Deuster (2020): The scoop on brain health dietary supplement products
containing huperzine A, Clinical Toxicology, DOI: 10.1080/15563650.2020.1713337

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CLINICAL TOXICOLOGY
https://doi.org/10.1080/15563650.2020.1713337

CLINICAL RESEARCH

The scoop on brain health dietary supplement products containing huperzine A

Cindy Crawforda,b, Yan-Hong Wangc, Bharathi Avulac, Ji-Yeong Baec, Ikhlas A. Khanc,d and Patricia A. Deustera
a
Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hebert School of Medicine,
Uniformed Services University, Bethesda, MD, USA; bHenry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD,
USA; cNational Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA; dDivision of
Pharmacognosy, Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, University, MS, USA

ABSTRACT ARTICLE HISTORY

Context: Public health concerns are emerging surrounding huperzine A commonly found in dietary Received 12 November 2019
supplements. We sought to determine the actual content of products claiming to contain huperzine A Revised 30 December 2019
and whether the ingredients on the supplement facts labels matched the analyses. Accepted 30 December 2019
Methods: We identified and analyzed 22 dietary supplement products listing huperzine A on product
KEYWORDS
labels. We found these products were listed in Natural Medicines and Dietary Supplement Databases Adulterated; Chinese club
and being queried by Military Service Members for enhanced mental focus, alertness and energy. moss; cognitive health;
Analyses were conducted by using Liquid Chromatography-Quadrupole Time of Flight Mass cognitive performance;
Spectrometry. dietary ingredients;
Results: Sixteen (73%) products had at least one ingredient claimed on the supplement facts label Huperzia serrata
not detected through analysis. Compounds not reported on the label were detected in 16 (73%) prod-
ucts analyzed. Nine products (41%) listed ingredients not meeting the regulations for being a dietary
supplement ingredient according to the FDA. Ingredients of most concern detected include stimulants:
demelverine, 1,5-dimethylhexylamine, 1,3-dimethylhexylamine, N-phenethyl dimethylamine, halosta-
chine, higenamine, noopept, b-PEA, vinpocetine, sulbutiamine; and hordenine, currently on the FDA
advisory list. Quantitative analysis showed the presence of huperzine A in the range from detected
under the limits of quantification (DUL) to 267.1 mg/serving. Only two supplements showed huperzine
A content within 10% of the declared amount.
Conclusions: In a study of dietary supplements claiming to contain huperzine A, we found products
that had at least one ingredient claimed on the supplement facts label not detected through analysis.
Moreover, some ingredients not on the label could be dangerous and likely do not meet the definition
of a dietary supplement ingredient according to the FDA. Quantitative analysis of huperzine A showed
the amount detected was not in line with what appeared on the product label. Consumers should be
aware of deceptive label claims and warned not to purchase products containing potentially danger-
ous ingredients.

Introduction Preliminary evidence suggests huperzine A may have

Huperzine A is a common ingredient found on many dietary beneficial effects on cognitive function in Alzheimer’s dis-
supplement facts labels, especially in products being mar- ease; however, methodological quality of studies to date has
keted for brain health and cognitive performance. Huperzine been reported as poor [7–10]. The most common doses
A is a lycopodium alkaloid which can be isolated from club studied among this population are 200–500 mcg daily, over
moss Huperzia serrata (Thunb.) Trev., or Lycopodium serratum approximately eight to 36 weeks duration [9]. To date, no
Thunb., a traditional Chinese remedy; it has been shown to randomized controlled trials studying the safety, efficacy or
exhibit strong anticholinesterase activity in pharmacological optimal dose of huperzine A for cognitive performance in
studies [1–3]. As the natural source of huperzine A, Huperzia healthy adults have been published.
serrata also contains various other alkaloids, such as the Huperzine A may be labeled as Huperzine A on product
huperzine B, huperzine J/M, huperzine I, phlegmariurine B, labels, but is also commonly referred to as a “Huperzia ser-
huperserine A, 12-deoxyhuperzine O, huperserine D and rata extract” OR “HupA”. Some people regard huperzine A as
other lycopodine type of alkaloids [4]. Huperzia serrata has a drug, and argue it stretches the regulations put forward in
been used traditionally in China for contusions, strains, swel- the Dietary Supplement Health and Education Act (DSHEA)
ling, schizophrenia, and myasthenia gravis [5,6]. Today, of 1994: dietary supplements are not intended to “diagnose,
huperzine A is being marketed with claims of enhancing treat, cure or prevent any disease.” [11] In some countries,
brain power, memory, concentration and focus. this ingredient is an approved “drug”. For example,

CONTACT Patricia A. Deuster [email protected] Consortium for Health and Military Performance, Department of Military & Emergency Medicine,
F. Edward Hebert School of Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
Supplemental data for this article can be accessed here.
This work was authored as part of the Contributor’s official duties as an Employee of the United States Government and is therefore a work of the United States Government. In
accordance with 17 USC. 105, no copyright protection is available for such works under US Law.
2 C. CRAWFORD ET AL.

huperzine A is a prescription drug in China (Chinese excluded because: (1) the product was discontinued; (2) no
Pharmacopeia, 2015 version), the suggested use is brain health claim was found on the bottle or product
100–200 mcg per serving with two servings per day, not to description; (3) huperzine was not found on the product
exceed 450 mcg/day [12]. Since 1995 at least six different label; or (4) a variation of a product was already included
companies in the US have filed new dietary ingredient notifi- (e.g., same manufacturer). One container of each product
cations (NDIN) for this ingredient referred to as “Huperzine was purchased over the internet and sent to National Center
A”, three as “Huperzine A (Huperzia serrata extract)”, and one for Natural Products Research (NCNPR), University of
as “Huperzine A (Huperzia serrata extract) combined with soy Mississippi, MS, for analysis. See Supplemental Material A for
isoflavones”. According to the FDA, regulations for dietary details on the qualitative and quantitative analysis of huper-
supplements and NDIs are not the same as for drugs [13]. It zine A. These methods have also been reported upon in ear-
is not clear from the FDA’s files if the FDA acknowledged lier publications [14].
any of these NDIs or not. Therefore, it remains unclear as to
whether huperzine A is a legal ingredient in any dietary sup-
plements in the US. In addition, the authors are unaware of Results
any studies that have either qualitatively or quantitatively Product analyses
analyzed huperzine A found in dietary supplement products.
As the dietary supplement market rapidly expands and Twenty-two products were selected for analysis. Sixteen
brain health becomes more prominent in the news, public (73%) products had at least one ingredient claimed on the
health concerns will continue to emerge with regard to supplement facts label not detected through the analysis. In
ingredients commonly labeled as huperzine A on supple- addition, compounds not reported on the manufacturer label
ment facts labels. Military Service Members are a unique were detected in 16 (73%) products analyzed. Many of these
population that may use dietary supplements claiming to detected but not reported ingredients were various amino
enhance health and/or performance. This unique population acids (e.g., phenylalanine or its derivatives; carnitine and its
is commonly targeted to take products marketed for enhanc- derivatives), and other acids used as flavoring agents or pres-
ing power, focus and energy, and many such products con- ervatives (e.g., citric acid, homocitric acid, succinic acid). It is
tain huperzine A. We sought to determine the actual content unclear whether these ingredients were added or whether
of select products that Service Members asked questions they came from any plant extract not reported. Other ingre-
about and assess whether the ingredients on the labels dients detected but not reported found in three products
matched the analyses. These findings are not only inform- were: (1) synthetic (e.g., demelverine); (2) not registered in
ative to Service Members inquiring about the safety of prod- the NDI and considered adulterated according to FDA (e.g.,
ucts but also to the public at large interested in brain health. 1,5-DMHA); and/or (3) on the FDA advisory list (e.g., horde-
nine). A fourth product, with a label claiming to be decaffei-
nated was found to contain caffeine.
Materials and methods
We first identified dietary supplement products that listed Product labels –qualitative and quantitative analysis
“huperzine”, on supplement facts labels by searching Natural
Medicines database commercial products (N ¼ 494 products Upon inspection of the product supplement facts labels, nine
retrieved) and the Dietary Supplements Label Database pro- products (41%) listed ingredients not meeting the regula-
vided by the National Institutes of Health (N ¼ 291 products tions for being considered a dietary supplement ingredient
retrieved) on January 9, 2019. A combined list of approxi- according to the FDA. Despite this, the products are being
mately 477 products was produced after removing obvious marketed and readily available for purchase to the public.
duplicate or discontinued products. Next, questions submit- Stimulants shown on labels and detected were listed as:
ted by Service Members between January 2018–February DMHA or 2-aminoisoheptane, N-phenethyldimethylamine,
2019 to the Operation Supplement Safety (OPSS.org) website halostachine, higenamine, noopept (detected as omberace-
about specific products with claims for enhanced mental tam), b-phenylethylamine (b-PEA), vinpocetine, hordenine
focus, alertness and energy, and the ability to boost memory and sulbutiamine.
and brain power were highlighted. Operation Supplement Although 1,3-dimethylamylamine (1, 3-DMAA) was listed
Safety is the Department of Defense resource for Service on the label for one product, it was not detected. Other
Members provided by the Consortium for Health and Military stimulants including demelverine, caffeine, b-PEA, hordenine
Performance at the Uniformed Services University of the and N-methylphenethylamine were detected but not listed
Health Sciences. The OPSS website offers evidence-based as an ingredient on the products’ labels. All these ingre-
information on dietary supplements and ingredients, as well dients, whether reported on the product labels or not, are
as an Ask-The-Expert button where Service Members can ask listed in Table 1.
questions about specific products. Forty-seven products iden- Other ingredients of concern listed on the labels included
tified through the database searches as containing huperzine Mucuna pruriens extract found in three products, when listed
had also been queried. Twenty-two products with claims to as “standardized for L-Dopa”. Depending on how this was
enhance cognitive performance and available to purchase on actually done it could be considered a drug. Rauwolfia vomi-
the internet were selected. The remaining products were toria root bark extract (yohimbine) or “standardized for
 CLINICAL TOXICOLOGY 3

Table 1. Ingredients of concern either claimed on the product label or missing from the label and detected through analysis.
Range of
daily dose FDA FDA advisory
Ingredient (N Products) (mg/day)c Stimulants notice list Drug
Demelverine (2)a – X
DMHA (1,5-Dimethylhexylamine) (2)a,b 32.0–55.8 X X X
DMAA (1,3-Dimethylamylamine) (2)b Not detected X X X
N-Phenethyl Dimethylamine (2)b 7.0–79.4 X
Halostachine (N-methyl phenylethanolamine) (2)a,b 15.0 X
Higenamine (3)b 35.2–51.2 X X World Anti-Doping Agency Listed
Hordenine (N,N dimethyltyramine) (3)a,b 66–73.9 X
Noopept (Omberacetam) (2)b 3.9–15.4 X X
b-Phenylethylamine (b-PEA) (2)a,b 67.8 X
Vinpocetine (5)b 0.9–8.3 X
Sulbutiamine (1)b 11.8 X X
a
Not present on label; bPresent on label; cDaily dose tested for those products with stimulants listed on product label.

yohimbine” was also listed on two products. There have studies have reported beneficial effects on cognitive func-
been reports of severe side effects from taking Yohimbe, as tion. However, systematic reviews assessing the quality of
it interacts with many other dietary supplement ingredients these studies caution interpretation of results due to poor
including caffeine and other stimulants [15,16]. Only one methodological quality of the trials [9,10,17]. In addition, as
product had a third-party certification seal present on the of yet, the long-term effects of huperzine A are not under-
product bottle, which indicated that an outside party, stood. Although no official evidence-based recommendations
Banned Substances Control Group, had verified that the on the use of huperzine A are available, the Alzheimer’s
product and ingredients met regulatory expectations for Association recommends not taking huperzine A, especially if
quality and was not contaminated with drugs on the World you are taking a prescribed cholinesterase inhibitor, such as
Anti-Doping list. donepezil (Aricept), rivastigmine (Exelon) or galantamine
The ways in which huperzine was listed as an ingredient (Razadyne) [18,19]. From the Alzheimer’s Disease Cooperative
in products varied widely (Table 2): four products listed Study, Class III evidence showed huperzine A had no demon-
“Huperzine A” (with no claim for the plant material), six strable cognitive effect for patients with mild to moderate
“Huperzia serrata extract (standardized to 1% huperzine A)”; Alzheimer’s disease [20].
and others listed aerial plant parts or an extract of Huperzia This study sought to determine the actual content of 22
serrata. When looking at what was detected for huperzine select products containing huperzine A and whether the
compared to what appeared on product labels, seven prod- ingredients on the supplement facts labels matched the anal-
ucts claiming to contain the plant or extract showed the yses. Over 400 products were identified from database
presence of other components of the plant as well. Eight searches that contained huperzine as an ingredient. To date,
products containing the plant or extract of Huperzia serrata no published randomized clinical trials on huperzine in an
showed the presence of huperzine A only. otherwise healthy population support enhancement of cog-
Nine products (41%) listed huperzine as part of a propri- nitive performance, despite such claims being made on the
etary blend, matrix or formulation with no claimed amounts product labels. Knowing that the military is an elite popula-
on the label. The remaining 13 products claimed to contain tion, they often are a prime target for marketing products
anywhere from 10 to 400 mg/serving size. Quantitative ana- claiming to enhance focus, concentration and energy.
lysis showed the presence of huperzine A in the range from Performing product analyses in the absence of any evidence
detected under the limits of quantification (DUL) in four can help address the overall safety of products on the
products (two of which were part of a blend with no claimed market.
amount on the product label) to 267.1 mg/serving size The majority of these products did not match the label
(Table 2). The variation ranged from 0% (DUL) to 96% (within claims, meaning that what appears on the product label did
range of what was measured compared to that amount not match the analysis. In addition, some of the product
declared on the label), with an average of 46% total variation labels, although claiming to be a dietary supplement, con-
in the amount of actual content from what was declared tained ingredients that did not meet the regulations for
across products. In all cases, the amount detected was less being a dietary supplement ingredient according to the
than what was declared on product labels. Only two of 13 DSHEA, yet they are being sold as such to consumers. The
(15%) products had a label content within 10% of that quantity of huperzine and the part(s) of the plant extract
declared. noted on the labels did not align with what was detected
through analysis. Even if scientific evidence points to the effi-
cacy of huperzine A, the products being sold with this ingre-
Discussion
dient may not relate to the ingredients under scientific
Huperzine A is an ingredient commonly found in dietary sup- investigation (e.g., as per dose, preparation, formulation, or
plements purported to aid in cognitive function, mental how the other ingredients interact together in a product).
focus, alertness and attention, and boost memory. Through quantitative analysis, we found that all products
Researched mostly in patients with Alzheimer’s disease, contained less than what was stated on the label. Overall the
4 C. CRAWFORD ET AL.

Table 2. Huperzine A products, ingredient label and what was detected through analysis.
Ingredient information Huperzine A content
claimed amount Max
Product code Ingredient Label (mg/serving size) Serving size servings/day mg/serving mg/day
NCNPR392PR a
Huperzine A (from Huperzia serrata extract) – 2 caps 2 46.1 92.2
NCNPR393PR a
Huperzine A (extract of Huperzia serrata; – 4 tablets 2 15.9 31.8
aerial parts)
NCNPR394PR a
Huperzine A – 2 caps 1 10.4 10.4
NCNPR395PR Huperzine A (aerial plant) 10 1 cap 2 5.7 11.4
NCNPR396PR Huperzine A (aerial plant) 20 2 caps 1 10.2 10.2
NCNPR399PR a
Huperzia serrata (aerial parts) extract 400 2 caps 1 267.1 267.1
NCNPR400PR a
Huperzine A (Huperzia serrata) extract (whole – 2 caps 1 51.2 51.2
herb) [Std. 1% Huperzine]
NCNPR401PR a
Huperzine A (from Toothed Clubmoss – 1 scoop (8.5 g) 1 27.4 27.4
(Huperzia serrata) aerial parts extract)
NCNPR402PR a
Huperzine A – 1 scoop (14 g) 2 DUL DUL
NCNPR403PR a
Huperzia serrata extract – 1 scoop (8.5 g) 1 40.3 40.3
(std. min. 1% Huperzine A) (club moss)
NCNPR404PR Huperzine A 1% (Huperzia serrata aerial) 200 1 scoop (11.7 g) 2 DUL DUL
NCNPR405PR a
Huperzine serrata leaf std. extract – 1 scoop (6.1 g) 1 DUL DUL
NCNPR406PR Huperzine A – (Huperzia serrata leaf 200 1 scoop (7.05 g) 2 DUL DUL
standarized extract)
NCNPR407PR Huperzine A ( (Huperzia serrata) (moss) 300 1 scoop (13.5 g) 1 4.9 4.9
NCNPR408PR Huperzia serrata Extract (std. min. 1% 100 1 scoop (6.17 g) 2 74.3 148.6
Huperzine A)
NCNPR410PR a
Huperzine A – 1 scoop (14 g) 1 4 4
NCNPR411PR Huperzine A 200 1 scoop (10.3 g) 1 192.5 192.5
NCNPR412PR Huperzine A (from Huperzia serrata whole 50 1 tablet 1 17.5 17.5
plant extract)
NCNPR469PR Huperzia Leaf Extract (Huperzia serrata) (Stdz. 100 1 scoop (3.02 g) 1 50.5 50.5
To 1% Huperzine A)
NCNPR482PR Huperzine A (Huperzia serrata) extract 50 1 scoop (26 g) 1 13.5 13.5
NCNPR483PR Huperzine-A (Huperzia serrata) 50 1 caps 2 22.7 45.4
NCNPR484PR Huperzine-A (as Huperzia serrata) (aerial parts) 20 2 scoops (14 g) 1 18.8 18.8
a
Huperzine listed as part of a proprietary blend, matrix or formulation. DUL ¼ detected under limits of quantification; limits of detection ¼ 10 ppb and limits of
quantification ¼ 30 ppb.

majority of these products were not consistent with the manu- FDA and found that among “products that were found to be
facturer’s label claims for ingredients listed and the amount adulterated more than once, 19 (67.9%) had new drug ingre-
declared on the label and hence were of poor quality. In add- dients reported in their second or third warning” and yet the
ition, the ways in which huperzine is reported on the label of products continued to be sold [21].
products vary considerably. Some labels claim the ingredient is Besides huperzine, this study detected stimulants that
derived from plant material but without any claim for huper- should raise concern – and they were either claimed or un-
zine A. Others state the presence of huperzine A but have no claimed on product labels. Higenamine, being a WADA pro-
plant source specifications. Still others claim huperzine A only, hibited ingredient, might have profound effects on the heart
without any labeled amount. Lastly, consumer satisfaction is and other organs [22]; hordenine has been shown to pro-
typically determined by the quality and price of the products; duce a positive inotropic effect on the heart, increase systolic
we found prices ranging from $16–$122 per product and yet and diastolic blood pressure, and increase the volume of per-
only two products were within 10% of the manufacturer’s ipheral blood flow, as reported in healthy dogs and mice
claimed amounts for huperzine A. [23]. Additional experiments concluded that hordenine acts
It is unclear whether huperzine A should be legally mar- indirectly as an adrenergic agent to produce pharmacological
keted as a dietary supplement. In our review of the FDA effects by releasing norepinephrine (NE) [23]. PEAs (often
NDIN database where companies submit paperwork to the referred as phenylethylamine or beta-phenethylamine
FDA so new ingredients can become “legal dietary (b-phenethylamine)), and other stimulants including DMAA,
ingredients”, we found at least six companies that had sub- DMHA (otherwise known as octodrine), and caffeine appear
mitted NDINs for huperzine A to be a dietary ingredient. to be very popular ingredients in these brain supplements.
However, we could not find an FDA “Acknowledgement” for Octodrine is an ingredient acting in a very similar manner to
any of them. Of interest was the finding that the Alzheimer’s the popular DMAA, a central nervous stimulant shown to
Organization submitted a NDIN for huperzine A in 2015 and increase the uptake of dopamine and noradrenaline [24]. For
the FDA responded that their notification was incomplete most of these compounds, the authors were unable to find
and suggested that huperzine is a drug and intended for use any human studies supporting their claims, with only in-vitro
as a drug for treating those with Alzheimer’s. Thus it is likely and/or animal studies reported.
huperzine A should not even be in dietary supplements. In Vinpocetine, a prescription drug in countries like
2018, Tucker et al. examined trends across adulterated diet- Germany, Russia, and China, has been used for acute stroke
ary supplements associated with a warning released by the and cognitive impairment [25]; Adverse effects include
 CLINICAL TOXICOLOGY 5

flushing, headaches, and decreased blood pressure [26]. In metals and toxins that might be present in these products
July of 2019 the FDA issued a warning to consumers about unknown. It is possible that our findings may not reveal the
the ingredient called vinpocetine stating specific concerns full hazards associated with these products.
about women of childbearing age using it, as it could cause
a “miscarriage or harm fetal development”. Also, Noopept (N-
phenyl-acetyl-L-prolylglycine ethyl ester) is a dipeptide
Conclusion
shown to have nootropic, neuroprotective and anxiolytic In a study of dietary supplements with claims of containing
activities [27]. Lastly, sulbutiamine is a synthetic derivative of huperzine A, we found products with at least one ingredient
thiamin used by athletics to enhance their performance [28]. listed on the supplement facts label that was not detected
A growing body of evidence shows that products adver- through the analysis. We found compounds hidden from the
tised and sold to consumers may be deceiving. Even though label, some of which are ingredients not meeting the defin-
manufacturers are required to list the exact ingredients on ition for being a dietary supplement ingredient according to
product labels, these labels are not always truthful. Products the FDA. Ingredients detected of most concern included
may contain ingredients that are “hidden” from the label, stimulants: demelverine, 1,5-dimethylhexylamine, 1,3-dime-
considered dangerous, and/or do not even meet the current thylhexylamine, N-phenethyldimethylamine, halostachine,
definition for being considered a dietary ingredient accord- higenamine, noopept, b-PEA, vinpocetine and sulbutiamine;
ing to the DSHEA of 1994. Only one product appeared to be and hordenine which is currently on the FDA advisory list.
verified by a third-party. In February 2019, the FDA released The method presented for quantitative analysis of huperzine
a statement to address the ever growing dietary supplement A was shown to be sensitive, reliable and reproducible.
market, and suggested that new steps are being proposed Quantitative analysis of the ingredient huperzine A showed
for requirements around the dietary supplement manufac- that the amount detected and which parts of the whole
ture and labeling of these products in hopes of plant it contained were rarely consistent with what appeared
“modernizing” and improving its oversight [29]. In November on the product supplement facts label. Consumers should be
2019, the FDA announced the formation of the Botanical aware of deceiving label claims and warned not to purchase
Safety Consortium with the mission to “provide a forum for products containing ingredients that could be considered
scientists from government, academia, consumer health dangerous.
groups, industry and nonprofit organizations to work collab-
oratively to generate a sound scientific basis for integrating
existing safety data and the latest toxicology tools to evalu- Acknowledgments
ate botanical safety in dietary supplements”. With increasing The authors would like to acknowledge Ms. Andrea T. Lindsey, Director
consumer exposure to dietary supplements and no overall of Operation Supplement Safety (OPSS.org), for her contributions.
global consensus on how to define dietary supplements or
regulatory expectations for quality, safety and labeling,
Disclosure statement
industry, the government together with others are develop-
ing strategies to enhance approaches to evaluate the safety The opinions and assertions expressed herein are those of the author(s)
of botanicals used in dietary supplements [30]. and do not necessarily reflect the official policy or position of the
Uniformed Services University, US Special Operations Command, or the
Studies like this are required to raise awareness of this
Department of Defense. The contents of this publication are the sole
continual and growing public health concern about ingre- responsibility of the author(s) and do not necessarily reflect the views,
dients contained in dietary supplement products being opinions or policies of The Henry M. Jackson Foundation for the
advertised and purchased everyday by consumers while we Advancement of Military Medicine. The authors have no financial inter-
await further action. ests or relationships to disclose.

Limitations Funding
Funding for this work was provided by the Preservation of the Force
Several limitations are worth mentioning. The authors
and Family Behavioral Health Program, Uniformed Services University
selected 22 products queried by Service Members. This is award number HU0001-15-2-0053 and the Consortium for Health and
only approximately 4.6% of those listed in databases such as Military Performance.
Natural Medicines and Dietary Supplement Label database
that contain the ingredient huperzine. Conducting a market
analysis of the most popular products available on the mar-
ket to the general public was outside the scope of the work. References
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