Unapproved Weight Gain Supplement as a Cause of Avascular Necrosis: A Cautionary Report



1 Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran

2 Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran



Avascular necrosis of the femoral head (AVNFH) is a leading cause of end-stage joint disease in the young population
that can lead to total hip replacement in early life. There are various risk factors, including trauma, corticosteroids,
thrombosis, hypertension, and alcohol. There is a growing number of patients with AVNFH and history of self-medication
with herbal supplement used for weight gain in Iran. The present study aimed to demonstrate the prevalence rate of
using unapproved weight gain supplements (UWGS) in patients with AVNFH.
An observational and cross-sectional study was conducted to estimate the prevalence rate of using UWGSs in patients
with osteonecrosis at Imam Khomeini Hospital, Tehran, Iran, from January 2012 to 2018. The data were analyzed in
SPSS software (version 24) through descriptive statistics and tests of means.
Out of 207 patients with AVNFH, 115 cases were male. In total, 44 patients (20.95%) had a history of using UWGSs,
and there had no other risk factors of osteonecrosis of FH.
In conclusion, UWGSs can be a risk factor for AVNFH, and it is necessary to develop educational programs to alert
young population about the side effects of these supplements.
Level of evidence: III