When you join a gym, you'll likely receive advice from trainers and fellow gym-goers to take various supplements. The supplement industry has expanded enormously over the past few years. Although it's essential to meet your micronutrient and macronutrient needs, not every gym supplement is suitable for everyone. Alongside legitimate products, the market is flooded with supplements that can do more harm than good. Some contain unwanted ingredients, others promise unrealistic overnight results, and some may be adulterated. According to Dr. Dhrumitsingh Rao, a neurosurgeon, "the supplement industry made billions last year, but those who paid the real price ended up on the operating table."

In an Instagram post, Dr. Rao shared a case study of a 22-year-old who suffered a stroke after consuming 2 scoops of pre-workout six days a week for 18 months straight.

But "one morning the rush was different. He experienced a pounding heart before starting his exercise regimen and felt a pain behind his right eye. After that, his left arm stopped responding. When we saw him, BP was 210 over 130. Scan showed a deep bleed in the brain. This is called hypertensive intracerebral haemorrhage," Dr. Rao revealed.

What happened?

"He was 22. Fit. No family history. No heart condition. Just a pre-workout with 300 mg of caffeine. Taken on an empty stomach. For 18 months straight."

"The stimulants triggered a hypertensive crisis. His blood pressure spiked to levels his brain vessels couldn't handle. One of them gave way. He had a stroke. In the gym, on a Tuesday morning. He survived surgery. He's still rebuilding his left hand," the doctor revealed.

He also explained the mechanism:

High-dose stimulants (caffeine + synephrine + DMAA, etc.) → massive catecholamine surge → acute hypertensive crisis → rupture of a cerebral vessel.

What you need to know

Pre-workout supplements, often just called pre-workouts, are designed to temporarily boost your energy, focus, and athletic performance. They are typically taken about 30 minutes before exercising.

However, Dr. Rao says that "pre-workout supplements are largely unregulated. Many contain caffeine doses equivalent to 3-4 espressos - in one scoop. Some contain synephrine, DMAA, yohimbine, and other stimulants that stack on top of each other."

"In someone with an undiagnosed weak vessel, an underlying AVM, or simply bad luck, that's enough. This isn't anti-gym. This is pro-brain. Train hard. But know what you're putting into your body," he explained.

How to choose the right pre-workout

Here's a step-by-step list to help you choose a safe, effective formula:

1. Check for third-party testing

Most supplements are certified by independent testing organisations. These labs verify that the product actually contains what is on the label and is free of banned substances or heavy metals.

2. Avoid proprietary blends

If a supplement label lists a "Proprietary Blend," "Performance Matrix," or "Pump Blend" without breaking down the exact milligrams of each ingredient, do not buy it.

  • Companies use blends to hide under-dosed ingredients.
  • It makes it impossible to know exactly how much caffeine or other stimulants you are consuming, which poses a safety risk.
  • Ensure every single ingredient is clearly listed with its precise metric weight.

3. Match the ingredients to your fitness goals

Different ingredients serve different styles of training. Pick a formula that matches your fitness level.

4. Manage your stimulant tolerance

Caffeine is a powerful performance enhancer, but excessive amounts can cause heart palpitations, anxiety, and insomnia. A standard pre-workout with 150mg to 250mg of caffeine will likely suffice. Always start with a half-serving of a mild formula to assess your body's tolerance.

Do you really need a pre-workout?

No, a pre-workout is not essential for health or fitness. While key ingredients like caffeine and creatine have proven athletic benefits, a well-balanced meal, plenty of water, and a good sleep cycle are far more foundational to a great workout. Pre-workouts do not directly burn fat or build muscle on their own; they simply give you the energy boost required to train harder.

You should never take a supplement without consulting a doctor, especially if you have high blood pressure, a heart condition, or are sensitive to stimulants.



Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.