/cdn.vox-cdn.com/uploads/chorus_asset/file/19164429/GettyImages_167348248.jpg "Toxic substances found in weight loss supplements, CDC reports")
After a New Jersey boy suffered a serious heart complication linked to weight-loss supplements bought by the child's mother, tests revealed that a product claiming to contain tezacoat root actually contained the highly toxic bay rose, researchers said. of the CDC.
In September 2022, an emergency room physician contacted the New Jersey Poison Information and Education System (NJPIES) regarding a 23-month-old child who had ingested Eva Nutrition's Mexican Techoto root, marketed as a supplement. for weight loss and reported nausea and vomiting. . Noah Burland, MD, NJPIES and Newark School of Medicine, and colleagues.
In the Morbidity and Mortality Weekly Report, the child had age-appropriate bradycardia (heart rate 90 bpm vs. 98-135 bpm) and hypotension (blood pressure 71/60 mm Hg).
ECG results showed sinus bradycardia, frequent premature ventricular complexes, and ST segments consistent with cardenolide toxicity. A serum digoxin assay showed a level of 0.5 ng/L, "which the NJPIES interpreted as causing cross-reactivity with a non-digoxin cardiac glycoside," Berland and his team wrote.
Despite FDA regulations, "mislabeled dietary supplements often contain potentially harmful substances," they noted, adding that yellow oleander contains the cardenolide tevecin B, "which has clinical effects similar to those of other cardenolides such as digoxin and can be toxic in high doses.
"This is of concern to public health officials because these supplements contain a highly toxic substance and are available from a variety of vendors," they wrote.
The child was treated with 40 mg of digoxin-specific antibody fragment (FAB; an antidote for digoxin overdose), and the ECG and blood pressure normalized. A repeat ECG 12 hours later again showed signs of cardenolide toxicity, so the patient received a second dose of FAB and the ECG results normalized.
In December, NJPIES purchased 10 products labeled Tezocot Root and sold online as weight loss supplements and sent them to a laboratory in Oregon that specializes in analyzing the chemical compounds found in dietary supplements. The lab used ultra-high pressure liquid chromatography with precision time-of-flight mass spectrometry to compare purchased supplements with the Tezocoat root, which was collected and confirmed by an anthropologist.
Nine out of ten products contained yellow oleander without any trace of tekoto root.
Last week, the FDA extended a consumer warning about toxic yellow oleander, also known as cashew, to some botanical weight loss products.
"Physicians should be aware that individuals with signs and symptoms of exposure to cardiac glycosides may be exposed to products labeled as tezocot, nutmeg, or other supplements marketed for weight loss and may benefit from treatment with similar treatment regimens. Cases," wrote Berland and colleagues. "Individuals exposed to oleander yellow who show signs of toxicity may have positive serum digoxin results in cross-reactive immunoassays and respond to FAB, such as the patient in this report. "
"However, higher doses of FAB may be required, unlike yellow oleander toxicity, which is commonly used for digoxin toxicity," they added.
Serum digoxin assays are unreliable for detecting tevet B and cardiac glycosides other than digoxin, they explained, noting that "laboratory levels of digoxin do not accurately reflect serum levels of other cardiac glycosides."
"Future prevention efforts should include notifying the FDA and alerting retailers who are unknowingly selling these dangerous products," Berland and his team concluded. "Physicians should instruct people concerned about cardiac glycoside toxicity to use dietary supplements for weight loss and consider treatment of FAB."
DISCLOSURE
The researchers reported no conflict of interest.
main source
Morbidity and Mortality Weekly Report
Source link: Berland N, et al. “Online Weight Loss Supplement Labeled Crataegus Root (Crataegus mexicana) Substituted for Yellow Oleander (Cascabella thevetia) – United States, 2022” MMWR 2023; DOI: 10.15585/mmwr.mm7237a3.