August 28, 2012
Who's spiking your supplements?
HEATH STEVISON just wanted to put on a bit more muscle. He had a vacation in Cabo San Lucas coming up, and he hoped to make a good show of it at the beach. Weighing in at just 155 pounds, he felt he needed “a little more oomph” at the gym. That “oomph” nearly killed him. Stevison’s saga began in the spring of 2009, when he laid down $29.99 for a bottle of M-Drol from tfsupplements.com. He read the label and took the supplement for a month before cycling off. Then he cycled back on again. The results were pretty impressive: 15 pounds of muscle in just weeks. Along with the terrific change in his physique, however, he noticed something else: His legs and sides began to itch. By mid-July, he was waking up to bloody sheets from nights of scratching himself raw. He asked his girlfriend, who had taken charge of his laundry, whether she had switched detergents. She hadn’t. Then came the day, maybe a week later, when Stevison looked in the bathroom mirror and saw that his eyes were yellow. At the time, he was working 12-hour shifts in Lake Charles, Louisiana, for a company that supplied equipment for drilling rigs. Maybe I’m just exhausted, he told himself.
When Stevison’s skin developed the same mustardy hue, and he felt so bone-crushingly tired that he could hardly lift himself out of bed, his mother carted him to the emergency room. Days of tests and one biopsy later, his physicians determined that his liver was shutting down. His chart suggested the cause: steroid ingestion. Instead of sunning himself on the beach at Cabo, Stevison found himself tethered to IV poles at Methodist Hospital in Houston. A doctor mentioned the waiting time for a new liver. “When he started talking about transplants, all I could do was pray,” Stevison says. “I was 24 years old and thought I was healthy.” Less than 3 months after Stevison checked into Methodist, the retailer bodybuilding.com recalled M-Drol and 64 other supplements for containing “ingredients that are steroids.” Though M-Drol had been marketed as a supplement, the FDA had classified the product as an unapproved drug. By law, dietary supplements must contain at least one vitamin, mineral, amino acid, enzyme, or other substance used by the body. But a growing number of supplements have also been spiked with prescription, banned, or completely untested drugs that you won’t find listed on the label. Makers of these suspect potions often claim they’re confused by overlapping government jurisdictions over what is and is not legal. More often the adulteration is deliberate and criminal, carried out by sellers who want to grab a share of a $27 billion market by touting a pill that really delivers. A single product can become an instant blockbuster: Before Competitive Edge Labs discontinued M-Drol, the company’s gross annual revenue totaled more than $4 million-an impressive haul for an outfit with a payroll of four. Products most likely to be spiked are those sold for weight loss, bodybuilding, and “sexual enhancement”-categories pitched largely to men. The labels use the word “supplement,” but the capsules might contain steroids, erectile-dysfunction drugs such as sildenafil (the active ingredient in Viagra), or any of a number of weight-loss drugs, some of which have been pulled from the market over safety concerns. It’s an old scam, but with the globalization of drug manufacturing and the ease of Internet retailing, your odds of coming across a tainted supplement are higher than ever. “We started posting recalls and warnings in 2002,” says Tod Cooperman, M.D., who runs ConsumerLab.com, an independent supplement-testing company that reports on product quality. “Only occasionally would you see this kind of recall or warning come out when we started. Now it’s almost weekly.”
Industry reps lay the blame on a small number of products that come from a few shadowy, mostly foreign operators. But the truth is, no one really knows how many spiked supplements are out there. “We have no way of measuring this,” says Michael Levy, the FDA’s director of new drugs and labeling compliance.”But we’re aware of dozens of illegal products that have been marketed. We are confident we could find dozens more.”The products usually come from sophisticated operations that combine the knowledge of science with the shrewdness of organized crime, Levy says. Often the drugs are chemically modified-with atoms added or removed like Tinkertoy pieces-in order to evade detection in lab tests. The problem is, a seemingly slight change in molecular structure could have disastrous consequences. Consider that the difference between ethanol (a substance you may ingest at happy hour) and methanol (a chemical that will swiftly blind and then kill you) is one carbon atom and a couple of hydrogens. Or that removal of a single oxygen-hydrogen pair turns a decongestant into methamphetamine.With remodeled drugs, “you’re seeing not only a pharmaceutical product but an illegal one, and the side effects are unknown,” says Pieter Cohen, M.D., assistant professor of medicine at the Cambridge Health Alliance, a Harvard medical school teaching affiliate. “The danger is extremely serious.” Even if the drug is not chemically cloaked, it could still be risky. One common ingredient in adulterated weight-loss supplements is sibutramine, a prescription weight-loss drug that was withdrawn from the U.S. market because users developed greater risks for heart attacks and strokes. Also, a juiced supplement may contain a much higher dose of a drug than its legitimate counterpart, and be produced with little if any quality control. The FDA acknowledges that consumers have died and that it’s impossible to know how many. Officials believe the victims are vastly undercounted because doctors don’t always know what their patients are taking. (One study found that 69 percent of patients using supplements along with their prescription meds don’t volunteer that information.) Consumers may also fail to connect the dots when symptoms arise-Heath Stevison tried to blame detergent, not M-Drol, when his health went haywire. Part of the appeal of supplements is their apparent naturalness, so they often have a veneer of being safer than prescription drugs. Last December the FDA announced a crackdown on spiked supplements; it sent a letter to industry trade groups and implemented faster posting of tainted-product warnings on the Web. The stricter standards for production and safety aim to hold all the links in the supplement supply chain-importers, manufacturers, and ingredient suppliers among them-more accountable for any product-tainting slipups. In addition, supplement manufacturers, worried that shady suppliers may threaten their image and sales, have vowed to work with the FDA to try to rid their ranks of criminals. Whether these actions will make a difference is unclear. Until this year, the FDA didn’t have the authority to order a mandatory recall, relying instead on voluntary cooperation from distributors. Dr. Cohen checked that strategy in August 2010, by shopping online for 72 spiked supplements that were part of a March 2009 consumer alert. He was able to proceed to checkout with 36 of them.