HEALTH-SUPPLEMENT CONCERNS RISE

Cases Of Death, Illness Blamed On Unregulated Herbs,
Chemicals

Mounting evidence suggests that increasing numbers of Americans are
falling seriously ill or even dying after taking dietary supplements
that promise everything from extra energy to sounder sleep.

The victims include men and women of all ages, as well as children
whose parents are feeding them snacks, drinks and nostrums made with
herbal supplements that are neither regulated by the federal
government nor tested for their effects on the young.

While the Food and Drug Administration issues periodic warnings about
the dangers of individual supplements, no organization or agency has
ever made a comprehensive analysis of the sickness and death
associated with them.

Some Findings

But in attempting the first national survey, the Washington Post
collected statistical snapshots from health officials, researchers and
advocates reaching almost every state in the country. Among the findings:

Abuse of the bodybuilding supplement gamma-hydroxybutyrate (GHB) and
similar substances has skyrocketed in recent years. In 1997-98, Texas
recorded 86 hospital visits involving GHB. In 1999, three Florida
poison centers logged 549 GHB incidents and two deaths. Last December,
basketball player Tom Gugliotta of the Phoenix Suns took a GHB-related
supplement, collapsed on the team bus and nearly died.

Tests continue to reveal dangerous contaminants and poor quality
control in supplement ingredients. California investigators in 1998
found that nearly a third of 260 imported Asian herbals either were
spiked with drugs not listed on the label or contained lead, arsenic
or mercury.

The weight-loss and energy supplement ephedra, also known as ma huang,
and its derivatives are producing a stream of complaints from many
states. New, previously unreleased FDA data implicates about two dozen
ephedra products in 134 cases involving everything from nervousness,
chest pains and insomnia to addiction, stroke and death.

Poison-control centers in various states are reporting adverse
reactions to a broad range of supplements. Pittsburgh documented 198
incidents involving herbal supplements in the 15 months ending in
March 1999, with ginseng and St. John's wort, an antidepressant, the
most frequently mentioned substances. In Georgia, ephedra and
melatonin, a sleep aid, led the list in 1999.

Children are increasingly becoming the victims of supplement abuse.
Last year, pediatrician Hillary Perr reported on children from wealthy
California families who were malnourished from eating snack food
spiked with supplements. In Long Island, a mother gave her
18-month-old baby a teaspoon of eucalyptus oil last year because a
store clerk told her it was good for a fever. The child suffered
permanent neurological damage and almost died.

Unreported Incidents

While health care providers concede that diet supplements are not as
dangerous as automobiles, which killed 41,826 people nationally in
1998, or illnesses such as kidney disease, which killed 26,295,
experts consulted by the Post suspect their data vastly understates
the incidents that actually occur.

This is because a 1994 federal law, fiercely pushed by the industry
through an acquiescent Congress, exempts supplement companies from
almost all federal regulation, including any requirement that they
file reports when the use of one of their products goes wrong. Unlike
pharmaceuticals or food additives, supplements do not have to be
screened by the FDA, nor do they have to demonstrate through
peer-reviewed science that they are safe before they can be sold.

And once on sale, the burden of proof now is on the FDA to show that a
supplement is dangerous before it can be taken off the market.

The industry is also expanding rapidly, with hundreds of herbal
products and product blends. Since 1994, supplement sales have grown
by nearly 80 percent, from $8.8 billion to a projected $15.7 billion
for 2000, according to the Nutrition Business Journal. Ephedra, for
example, is sold as a ``natural'' way to increase human metabolism.
St. John's wort is fast becoming a Prozac competitor. Melatonin is
touted as an elite cure for jet lag. Ginseng is a purported key to
sexual stamina and youthfulness.

46aced with the federal government's inability to regulate
supplements, many states have passed their own restrictive laws. They
also are collecting data on an industry that experts such as Lee C.
Vermeulen, director of the University of Wisconsin Poison Control
Center, expect will keep growing, along with its attendant problems,
until ``the economy goes south.''

Prosy Abarquez-Delacruz, regional administrator for the California
Health Services Department's Food and Drug Branch, said companies have
hastened to take advantage of the dearth of regulation.

`The Wild, Wild West'

``It's the John Wayne industry, like the wild, wild West, and the
practices of the few have tainted the many,'' said Abarquez-Delacruz.
In the past year, her office temporarily halted sales of $1.5 million
in exotic teas and beverages because of misleading label claims.

Many health professionals, including strong critics of supplements,
acknowledge that they can be both useful and safe, if taken in
reasonable doses.

But many consumers become victims because they ``believe that if a
product wasn't safe, the government wouldn't allow it to be sold,''
said consumer advocate Bruce Silverglade, legal-affairs director of
the Center for Science in the Public Interest. ``In this case that's
just a false assumption.''

In fact, cautioned New York City Poison Center Director Robert
Hoffman, many supplements ``are drugs. There's no doubt about it.''

And in essence, said pediatrician Howard Mofenson, director of the
Long Island Poison Center in Mineola, N.Y., public consumption of
supplements has become the clinical trial: ``Nothing will be done
unless a tremendous outbreak occurs,'' Mofenson said. ``This law is
the greatest uncontrolled experiment that the United States has ever
undergone.''