PUBLISHED: 14:25 GMT, 25 February 2019 | UPDATED: 18:41 GMT, 25 February 2019
The man, who lives in Scotland, bought melanotan, which is illegal to sell in the UK, at a bodybuilding shop. He injected it into his abdomen.
The synthetic hormone, also known as the 'Barbie drug', triggered the unidentified man's case of priapism, the medical term for a prolonged erection, which usually lasts four to six hours.
The patient had to endure a barrage of injections into his sore penis to relieve the erection, narrowly avoiding surgery.
But four weeks later, the man was suffering with erectile dysfunction - a permanent side effect in severe cases of priapism.
Doctors said they had never seen a case like it, and said it served as a warning about dodgy tanning products on the market.
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A 41-year-old man needed hospital treatment for an erection that had lasted 22 hours after he injected an illegal tanning supplement that he bought in a bodybuilding shop
The team at Queen Elizabeth University Hospital, Glasgow, led by Dr Barend Albert Dreyer reported the story in BMJ Case Reports.
Melanotan is a synthetic hormone used for tanning that works by increasing the levels of melanin, a natural dark pigment in the skin.
The doctors revealed the man had been purchasing the melanotan solution over the counter for several months and he usually had a very good tan response.
Products such as melanotan, steroids and image enhancing drugs such as clenbuterol to lose weight, are common among the bodybuilding scene and increasingly in the general population, too.
But melanotan is not legal in the UK because no-one is sure of its dangers.
WHAT IS MELANOTAN?
Melanotan is a synthetic hormone used for tanning that works by increasing the levels of melanin, a natural dark pigment in the skin.
This pigment is part of the body’s natural response to the sun, and increasing levels of melanin results in skin darkening or tanning.
There are 2 types of Melanotan – Melanotan I and Melanotan II.
It is currently illegal to sell tan injections such as Melanotan, as this product is unlicensed.
Melanotan is illegal in the UK because it has not been tested for safety, quality or effectiveness and no one knows what the possible side effects are or how serious they could be.
The MHRA (Medicines and Healthcare products Regulatory Agency) tests medical products in the UK. They are warning people not to use Melanotan and they say that the product is being 'advertised and sold illegally'.
The drug is sold online or under the counter at gyms and beauty salons and because the drug is self-injected, there are fears that users are putting themselves at risk of infections such as hepatitis or HIV.
Source: Cancer Research UK and NHS.
The man said that the label or seller didn't give any indications of major side effects, and dosage was in 'number of phials', so it was unclear how much medication was in each injection.
He had suffered with two-hour erections after using it previously. But this time, after injecting a phial into his stomach, his penis was painful and 'unable to be used' within an hour.
He arrived at A&E after 22 hours, after attempting to soothe the pain with ice at his home.
Tests confirmed that the man had low-flow priapism, which is the result of blood being trapped in the erection chambers.
It can occur without a known reason in men who are otherwise healthy, but it also affects men with sickle-cell disease.
After injections every five minutes by doctors for around half an hour, the man finally saw his erection subside.
The International Society of Sexual Medicine recommends that penile shunting procedures be considered when first line treatment has not worked or as a first option for priapism episodes lasting more than 72 hours.
The doctors said the man avoided a surgical shunt, which is a passageway that is surgically inserted into the penis to divert the blood flow and allow circulation to return to normal.
The report said: 'Although this patient claimed he did not take any other drugs, concomitant substance misuse was not definitively ruled out as he self-discharged before a toxicology screen could be performed.
'It may be possible that he also misused other drugs from the body-building store and these may have contributed to his erectile dysfunction.'
The patient had approximately two weeks of swelling after returning home and initially no erections whatsoever.
'In the last week, however, he had started to have some spontaneous erections though they were shortlived and unable to be sustained for use,' the report said.
Dr Dreyer added: 'Priapism is an uncommon presentation to the accident and emergency department, and in my one year of urology in Glasgow this is the only case that I have seen.
'We chose to write this case up as it presented a rare/unheard of cause of an uncommon disease.'
Forms of melanotan has been suggested as a possible therapeutic for the treatment of erectile dysfunction, but the doctor's said cases such as this unfortunate man's needed to be taken into account.
Dr Dreyer said: 'Our patient said that if he had known about priapism as a potential side-effect he would never have considered using Melanotan.
'More widespread knowledge around this side effect may help decrease Melanotan misuse. He will avoid melanotan use in future and stick to sun-beds.'
WHAT IS PRIAPISM?
Priapism is a long-lasting painful erection which can cause permanent damage to your penis if not treated quickly, including scarring and permanent erectile dysfunction.
Priapism can occur in all age groups, including newborns. However, it usually affects men in two different age groups: between the ages of 5 and 10, and 20 and 50.
The condition develops when blood in the penis becomes trapped and is unable to drain.
There are two types of priapism: low-flow and high-flow.
Low-flow priapism: This is the result of blood being trapped in the erection chambers. It often occurs without a known cause in men who are otherwise healthy, but it also affects men with sickle-cell disease, leukemia (cancer of the blood), or malaria.
High-flow priapism: This is more rare and is usually not painful. It is the result of a ruptured artery from an injury to the penis or the perineum (the area between the scrotum and anus), which prevents blood in the penis from circulating normally.
Do:
try to urinate
have a warm bath or shower
drink lots of water
go for a gentle walk
try exercises such as squats or running on the spot
take painkillers like paracetemol if you need to
Don't
do not apply ice packs or cold water to your penis – this can make things worse
do not have sex or masturbate – it won't make your erection go away
do not drink alcohol
do not smoke
The goal of all treatment is to make the erection go away and preserve the ability to have erections in the future, and may include surgical ligation, intravenous injection and surgical shunt.
Research links it to genital deformations in young boys, and leukemia, lymphoma and ovarian and thyroid cancers, but the US still allows it to be in your water and food. A whopping 75 percent of Americans have detectable levels of this and similar compounds in their urine. Here's one way to help your body break it down.
Story at-a-glance
Atrazine is the second most commonly used herbicide in the U.S., with more than 73 million pounds being applied to golf courses, lawns and food crops each year
Testing reveals 85 percent of male smallmouth bass in American wildlife refuges now carry eggs. The lowest incidence of feminization or intersex was 60 percent; the highest was 100
Atrazine is the one most commonly found pesticide in U.S. drinking water, and studies have linked atrazine exposure to impaired sexual development, some cancers, birth defects, insulin re
October 19, 2016
By Dr. Mercola
Atrazine, which was approved for use in 1958, is the second most commonly used herbicide in the U.S. More than 73 million pounds of it are applied to golf courses, lawns and food crops each year.1 As just one example of its prevalence, as much as 80 percent of all the herbicides used in Vermont are atrazine-based.
Meanwhile, Europe banned atrazine in 2005 due to suspected health concerns and environmental damage, including the high risk of water contamination.
Indeed, research clearly shows that atrazine has a potent "gender-bending" impact on marine life, including fish, alligators, turtles and frogs, and many scientists suspect it may be equally harmful for humans.
Most recently, testing reveals a shocking 85 percent of male smallmouth bass in 19 American wildlife refuges, including the Missisquoi National Wildlife Refuge located near the U.S. and Canada border, are carrying eggs.
Gender-Bending Chemicals Are Turning Male Fish Into Females
In other words, a vast majority of the male fish are turning into females, and the primary culprits are estrogenic compounds such as those found in birth control pills, bisphenol A (BPA, a chemical used in plastic) and the herbicide atrazine.
Smallmouth bass are known to be very sensitive to pollutants, hence researchers use them as an "indicator species" when evaluating the ecological impact of environmental pollutants. In the case of water pollution with endocrine disrupting chemicals, the situation appears severe.
The lowest incidence of feminization or intersex in the wildlife refuges tested was 60 percent. The highest was 100.2
While some fish species are hermaphrodites, meaning they can change sex in order to protect the continuation of the species, non-hermaphroditic fish that turn into females do not contribute to species survival. On the contrary, it contributes to sterility.
By lowering immune function, this type of endocrine disruption also contributes to infections, diseases and die-offs. According to National Geographic:3
"Over the past decade, feminized male fish have been discovered in 37 species in lakes and rivers throughout North America, Europe and other parts of the world.
Experts say the new discovery in protected wildlife refuges is worrisome because it suggests that pollution may be even more pervasive than previously thought.
'There are no truly untouched areas. I think the take away here is that everything we do, everything we use or put on the land, ends up in the water at some point,' says Luke Iwanowicz, a U.S. Geological Survey fish researcher … who led the wildlife refuge study."
Intersex prevalence among largemouth bass at these 19 sites were about 27 percent, and in previous testing done at eight U.S. river basins, including the Mississippi, Rio Grande and Columbia Rivers, about 33 percent of male smallmouth bass had changed gender.
Atrazine Is a Common Pollutant in Drinking Water
Perhaps most disturbing is the fact that in wildlife refuges, there are no identifiable sources of the contamination, which means the pollutants are spreading into the environment far more readily and/or in ways currently unknown.
This in turn raises serious questions about the extent of human exposure, and the potential effects of such exposure. As noted in the featured article:4
"Exposures to endocrine disrupting chemicals in drinking water, food and household products have been linked to health problems in people too, including reduced fertility, developmental delays in children and some cancers."
In fact, as far as pesticides go, atrazine is the one most commonly found pesticide in U.S. drinking water. In 2012, Syngenta AG and its U.S. subsidiary were ordered to pay $105 million to filter the chemical out of Midwestern community water treatment operations providing drinking water to 52 million Americans.5,6
The legal proceedings revealed that as many as 1 in 6 Americans were drinking atrazine-contaminated water. The $105 million settlement was really just a drop in the bucket when compared to the actual cost of filtering this chemical.
In 2010, the plaintiffs' attorney, Stephen Tillery, said the 16 cities included in the original lawsuit had already spent about $350 million to filter it out. Since 2012, at least 1,085 other compensation claims over atrazine contamination have been filed against Syngenta, suggesting the problem is incredibly widespread.7
Atrazine Linked to Harm in Humans
The legal limit for atrazine in drinking water, set by U.S. Environmental Protection Agency (EPA), is 3 parts per billion (ppb). This is the equivalent of three drops in an Olympic-sized swimming pool.
Syngenta and other atrazine proponents insist that atrazine is safe for the simple fact that it's been used for over 50 years, but mounting research suggests otherwise. For example:
Research has linked atrazine exposure in utero to impaired sexual development in young boys, causing genital deformations, including microphallus (micropenis)
The evidence also suggests atrazine exposure may contribute to a number of different cancers, specifically ovarian cancer, non-Hodgkin's lymphoma, hairy-cell leukemia and thyroid cancer8,9,10
Elevated concentrations of atrazine in drinking water have been associated with abdominal birth defects, including gastroschisis (in which the baby's intestines stick outside of the baby's body) and others
Animal research also suggests long-term exposure to atrazine may induce insulin resistance and weight gain by lowering energy metabolism11
Endocrine disrupting chemicals like atrazine are also implicated in lowered fertility and infertility12
EPA's New Risk Assessment Acknowledges Serious Hazards
On June 6, 2016, the EPA released a new risk assessment for atrazine.13 Its current view of the chemical suggests the agency might lower allowable levels and issue tighter regulatory limits on the chemical. There's even the possibility of an eventual ban.
The risk assessment concluded the chemical may cause reproductive harm to mammals, fish and birds, with the level of concern surpassed nearly 200-fold using real-world scenarios for mammals. (An EPA "level of concern" describes the threshold above which a chemical may be expected to cause harm.)
For fish and birds, atrazine exceeded the level of concern by 62- and 22-fold, respectively. A number of organizations, including the Organic Consumers Association14 (OCA) and Beyond Pesticides,15 created petitions urging Americans to push for a complete ban on atrazine. As noted by Beyond Pesticides:
"In July, California's Office of Environmental Health Hazard Assessment (OEHHA) announced that atrazine, its chemical cousins propazine and simazine, and its breakdown triazine compounds would be added to the list of chemicals known to the state to cause reproductive toxicity for purposes of the state's Proposition 65.
The evidence is clear. Atrazine harms wildlife, persists in soils and moves easily through waterways."
Big Ag Fights to Keep Atrazine
The EPA's public comment period ended on October 5. Time will tell whether the agency will take appropriate measures to protect environmental and human health from this pernicious endocrine disruptor. Not surprisingly, the pesticide and agriculture industries are up in arms over the EPA's new assessment.
ChemChina, which has bid to acquire Syngenta, said the EPA's report "contains numerous data and methodological errors and needs to be corrected."16
The Iowa Corn Growers Association has also spoken out against the report, saying it would "effectively ban the product from most uses" if finalized as currently written. As noted by Journal Sentinel:17
"Farm groups, including the Wisconsin Corn Growers Association, the Cooperative Network, Wisconsin Pork Association, Midwest Food Processors, the Dairy Business Association, Wisconsin Farm Bureau Federation and the Wisconsin Soybean Association, have asked farmers to contact the EPA and urge the agency to reconsider its position …
'For more than 50 years, atrazine has been a safe and effective crop protection tool to control the spread of resistant weeds and improve crop yields. … EPA's action would drive up the cost of production to Wisconsin corn growers and would reduce our yields,' said Casey Kelleher, president of the Wisconsin Corn Growers Association."
Harmful Toxin or Conservation Aid?
A ban on atrazine would be the BEST scenario for farmers and consumers alike, yet some farm groups have gone so far as to say the EPA's plan to limit atrazine's use would actually HARM the environment! According to Tom Liebe, president and CEO of Cooperative Network, an alliance of co-ops in Wisconsin and Minnesota:18
"Atrazine plays an important role in conservation tillage,19,20 a farming practice that reduces soil erosion and runoff. An atrazine ban would require more soil tillage to control profit-robbing weeds and will be a net-negative for the environment."
Conservation tillage refers to the practice of applying atrazine to suppress or kill leftover vegetation in the field before the new planting season. The use of the chemical allows farmers to till the soil less, which reduces soil erosion and related problems. As explained by Penn State's introduction to weed management for conservation tillage systems:21
"An important benefit of tillage is weed control. In conservation tillage agriculture, the grower relies on the same weed management practices as in more conventional tillage systems but eliminates most or all of the tillage operations. Therefore, in limited tillage systems, there is greater dependence on cultural and chemical control options …
Chemical weed control remains an important pest management tactic in reduced-tillage agriculture. Regardless of how effective cultural control strategies are, herbicides provide a way to manage weeds successfully with little or no tillage … Chemical approaches are based on timing of herbicide application and include burndown, soil residual, and postemergence treatments."
True Regenerative Farming Is Non-Toxic
The idea that a toxin like atrazine would somehow be necessary for environmental conservation is ludicrous of course, and this is a perfect example of spinning a negative into a positive by appealing to people's growing concern about the harm being done by conventional agriculture.
Some conventional farmers also worry that increased restrictions on atrazine might result in lower yields and loss of income at a time when crop prices are already at a record low. While financial concerns are valid, at some point the greater good really must come into the equation, and when it comes to atrazine, that time is now.
There are other, far safer ways to reduce soil erosion and chemical runoff than using atrazine. Besides chemical application, strategies that facilitate no-till farming include:22
Crop rotation
Pasture cropping
Use of livestock on the land
Mulching
Non-Toxic No-Till Can Work Just as Well
This lecture by Gabe Brown, who is an international leader in soil health and sustainable farming techniques, describes processes that help build healthy soils and the importance of no-till. By 2012, Brown's family farm, which consists of 5,400 acres in North Dakota, had reduced its herbicide use by 75 percent.
His intention is to eliminate it entirely by introducing other weed control techniques. Importantly, from a financial perspective, by cutting input costs, Brown has decreased his production costs, which has resulted in higher profits.
How this was accomplished is described in the Brown's Ranch no-till case study published by the National Sustainable Agriculture Information Service in October 2012.23 I've also interviewed Brown on his techniques, which you can read about in my previous article, "How to Regenerate Soil Using Cover Crops and Regenerative Land Management."
The take-home message is that you do not need toxins to farm profitably. Atrazine, which like DDT and PCBs is chlorine-based, can persist in soil for 22 years!24 Considering the clear danger it poses to marine life, and the impact it might have on human health over time, it's unconscionable to suggest atrazine is a farming necessity or a critical conservation aid. It is a toxic pollutant that threatens the entire food chain.
How to Protect Yourself From Atrazine and Other Pesticides
According to data from the U.S. Centers for Disease Control and Prevention (CDC), more than 75 percent of the U.S. population has detectable levels of pesticides in their urine, and unless you're a farmer, your diet is one of the most likely routes of exposure, along with your drinking water.25
Eating organic is one of the best ways to lower your overall pesticide burden. The largest study26 of its kind found that people who "often or always" ate organic food had 65 percent lower levels of pesticide residues compared to those who ate the least amount of organic produce. Organic produce also had, on average, 180 times lower pesticide content than conventional produce.27
If you need to prioritize, refer to the Dirty Dozen list and buy organic as much as possible when you're choosing foods that are listed as the most-contaminated. If you shop at farmers markets, which I strongly recommend, you can also ask the farmer directly about pesticide usage.
It's possible to find produce that is not certified organic that may still have a lower pesticide burden than typical conventional produce depending on the farmer. So if you can't find organic produce, look for a local farmer who has eliminated pesticide use (or uses a minimal amount of such chemicals).
Filtering Your Tap Water Is Important to Reduce Atrazine Exposure
As mentioned, atrazine is the most commonly detected pesticide in U.S. water supplies, so I recommend filtering your tap water — both for drinking and bathing. To remove atrazine, make sure the filter is certified to remove it. Fortunately, since it is a relatively large organic molecule it is easily filtered by a quality carbon filter. As noted by the Natural Resources Defense Council (NRDC):28
"Consumers should make sure that the filter they choose is certified by NSF International to meet American National Standards Institute (ANSI) Standard 53 for VOC (volatile organic compounds) reduction and therefore capable of significantly reducing many health-related contaminants, including atrazine and other pesticides."
Finally, if you know you have been exposed to pesticides, eat fermented foods like kimchi. The lactic acid bacteria formed during the fermentation of kimchi may actually help your body break down pesticides. In addition, there is some evidence that the antioxidant lycopene, found in watermelon, tomatoes, red bell peppers and more, may protect against some of atrazine's toxic effects.29
