DIETARY AID'S DANGERS COME TO LIGHT

A MUSCLE builder. A fat burner. A sleep aid. An aphrodisiac. A natural
"high."

Claims like those helped boost sales of gamma butyrolactone (GBL), a
dietary supplement that the Food and Drug Administration asked
manufacturers to recall in January because of at least 55 cases of
serious illness, including users who suffered seizures, coma and
respiratory arrest.

At least one person has died after taking GBL, which the FDA considers
a dangerous, unapproved drug.

Sold over the Internet and in gyms and health food stores, products
containing GBL gained popularity last year because the supplement
produced the same effects as gamma hydroxybutyrate or GHB, a banned
chemical cousin.

Never an approved drug, GHB had attracted bodybuilders and wrestlers
as an alternative to steroids for "bulking up" muscles, as well as
recreational users intrigued by its odd combination of sedative and
stimulatory effects on the brain. It also became notorious as a date
rape drug. GHB's production and sale were banned in 1991 after it was
linked to numerous cases of serious illness and some deaths.

Variety of uses

Last summer, cases like those associated with GHB -- comas,
unexplained seizures, people with dangerously slow heartbeats or
breathing -- began showing up in GBL users, said Mary Palmer, a
toxicologist working on a large study of illness and poisoning in
dietary supplement users. There are no reliable figures on how many
people have taken GBL, whose primary use is as a solvent in products
such as floor stripper, paint thinner and nail-polish remover. It goes
by various chemical names and is an ingredient in several dietary
supplement products.

The similar symptom profile is easy to explain: GBL is chemically
converted by the body into GHB, the banned drug. "The seemingly
less-worrisome supplement becomes converted into something that's very
worrisome," said Gary I. Wadler, an associate professor of Clinical
Medicine at New York University School of Medicine and lead author of
a textbook on drugs and the athlete.

Wadler said the recent popularity of GBL resembles the situation with
androstenedione, another over-the-counter supplement taken by some
athletes, which the body converts into testosterone, a prescription
hormone. In both cases, he noted, the laxity of the law regulating
dietary supplements allows people easy access to substances that can
act like powerful drugs and may pose serious risks to their health.

The banned GHB has a dual action on the brain. Like cocaine, it
stimulates nerve cells that respond to the chemical messenger
dopamine, producing an excitatory effect. Like heroin, it activates
natural opium-like substances within the brain, causing sedation.
Taking GHB "is sort of like taking heroin and cocaine at the same
time," Wadler said.

The result can be a perplexing set of symptoms. Palmer recalled the
case of a New York topless dancer. "She did her dance, got offstage
and she dropped. She came into the emergency room in a coma." Doctors
inserted a breathing tube. They discovered that her heart rate was 50
- -- alarmingly slow. Then she developed an irregular heartbeat. When
she woke up, she admitted that she had taken GHB.

Examples of its effects

GBL apparently can produce a similar spectrum of effects. Arizona
doctors reported the case last September of a 36-year-old man who was
stopped for driving erratically and was found to be sweating, vomiting
and lethargic. He acted drunk, but tests for alcohol and illicit drugs
were negative. He recovered within an hour and reported that he had
taken two ounces of RenewTrient, a GBL-containing product.

GBL never should have been marketed as a dietary supplement because it
was a new ingredient that had been clearly shown to have dangerous
effects in human and animal studies, said Annette Dickinson, vice
president for scientific and regulatory affairs of the Council for
Responsible Nutrition, a trade association representing about 100
supplement manufacturers.

"We don't see how anyone could reasonably conclude that it would be
safe at the kind of levels that were recommended" on product labels,
she said.

In January, the FDA announced that three manufacturers of
GBL-containing supplements -- G.H. Distributors Inc., Trimfast Group
Inc. and Conan Corp./Castlewood Nutritional Systems -- had agreed to
the voluntary recall. The agency has sent letters to four other
companies, warning of possible legal action against their products if
they do not cooperate.

Paul A. Cotton, a sports nutritionist and the head wrestling coach at
Howard University, said GBL is "mildly popular" in the wrestling
community, whose athletes often are attracted to substances that they
believe will give them a competitive edge. He said he had counseled
athletes who had tried GBL but hadn't encountered any cases of illness.

They're "a little bit secretive about what they're taking," he added.
Cotton said he warns his athletes that purity and manufacturing
standards for dietary supplements have not been set by the government.

"I kind of equate it to buying street drugs," he said.