First-Time Submassive Pulmonary Embolism Likely Caused by Testosterone-Enhancing Supplement

Area of Science:

• Cardiology
• Pharmacology
• Toxicology

Background:

• Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
• Identifying novel risk factors for PE is crucial for prevention and management.
• Erectile dysfunction supplements are widely available but poorly regulated.

Observation:

• A 75-year-old male presented with acute pulmonary embolism (PE) and signs of right heart strain.
• The patient reported using an erectile dysfunction supplement containing fenugreek for six months.
• No other typical risk factors for PE were identified.

Findings:

• Fenugreek, an ingredient in the supplement, may increase PE risk by enhancing testosterone levels.
• Testosterone can lead to polycythemia and increased platelet aggregation, promoting clot formation.
• The patient's PE was likely triggered by fenugreek-induced thrombogenesis.

Implications:

• Dietary and herbal supplements can harbor unlisted ingredients and pose serious health risks.
• A thorough patient history, including supplement use, is essential for diagnosing unexplained conditions.
• Testosterone-related effects should be considered as a potential thrombogenic risk factor.