Usnic acid article in NY Times

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    Usnic acid article in NY Times


    In today's New York Times:

    Seeking to Shed Fat, She Lost Her Liver
    By DENISE GRADY


    The capsules, recommended by a friend, sounded wonderful: they were supposed to increase metabolism to help the body burn off fat.

    "It was like you're doing aerobic exercise while you're just sitting there," said Jennifer Rosenthal, 28, a truck dispatcher and the mother of a 4-year-old in Long Beach, Calif.

    The capsules, sold over the Internet at $39.95 for a bottle of 90, had just one ingredient, usnic acid, a chemical found in certain species of lichen plants. The chemical is not approved for any medical use, but the label on the bottle said it would make the body burn calories "at an accelerated rate."

    In early October, Ms. Rosenthal began swallowing four 125-milligram capsules a day, half the maximum dose recommended on the label. She took them for two weeks, skipped two weeks as the label directed, and then started again. She was not overweight; she just wanted to stay in shape. She took the capsules for a total of 17 days.

    By Nov. 8, Ms. Rosenthal was in a coma, connected to a respirator and a web of tubes, her skin a dusky yellow.

    Her liver had failed, and her swift decline put her at the top of the waiting list for a transplant at the University of California at Los Angeles. On Nov. 12, a liver became available from a cadaver.

    Without it, Ms. Rosenthal's surgeon said, she would probably not have lasted another day. Her liver was so badly damaged that it had shriveled to about a third of what it should have weighed.

    Ms. Rosenthal's doctors said they thought usnic acid was almost certainly to blame. Before taking it, she had been perfectly healthy, and they could find no other explanation for her illness. But the doctors said they did not know how the chemical could have killed so many liver cells so quickly.

    "This is a young woman who almost lost her life," said Dr. Ronald W. Busuttil, her surgeon. "Although she's got her life back now, she has to be under life-long medical care. Her life has been altered forever. The fact that you can get these things over the Internet is mind-boggling."

    Usnic acid is one of hundreds of substances sold either alone or with other ingredients as "dietary supplements," a loosely regulated category of products that includes vitamins, minerals, herbs, amino acids, enzymes and other chemicals found in plants and foods. Though many are harmless and some may be beneficial, others have been linked to serious health problems.

    Among the most notorious is another substance promoted for weight loss, ephedra, which is suspected of playing a part in the death of Steve Bechler, a 23-year-old pitcher for the Baltimore Orioles who collapsed during a workout on Feb. 16 and and died the next day in a Fort Lauderdale hospital.

    The Food and Drug Administration has received more than 100 reports of deaths among ephedra users, as well as 16,000 reports of other problems, including strokes, seizures, heatstroke, heart disorders and psychotic episodes.

    On Friday, the government called for new labels for ephedra to warn consumers of the risk of heart attack, stroke and death. Tommy G. Thompson, the secretary of health and human services, said he was considering banning ephedra outright. But by law, the government must prove an unreasonable risk of harm to ban a dietary supplement.

    The true extent of illness caused by supplements is not known, because while the worst cases attract attention, less serious ones may go undiagnosed or unreported. The F.D.A. itself estimates that it gets reports on fewer than 1 percent of the severe adverse effects linked to dietary supplements.

    A study published in January based on 489 reports to American poison control centers in 1998 found that various supplements were also implicated in heart attacks, bleeding, seizures and deaths.

    The supplement industry, with sales of more than $17 billion a year, is so loosely regulated that products can be marketed without the proof of safety and efficacy required for drugs by the food and drug agency, which cannot take a supplement off the market unless there is proof that consumers have been harmed. As long as manufacturers do not claim that their products can be used to treat or cure disease, they are not regarded as drugs.

    "With supplements, the burden of proof is on the agency to show a product is unsafe," said Monica Revelle, a spokeswoman for the F.D.A. "We have to prove a causal link."

    F.D.A. officials declined to discuss usnic acid, Ms. Revelle said, except to say that they were "monitoring it very closely."

    Though usnic acid supplements have been blamed in other cases of liver failure, Ms. Rosenthal's doctors said they did not know of other cases of liver failure from the product she took. It was sold by a company called AAA Services in Frazier Park, Calif., but the company's owner, Jerry Parker, said in an interview that he stopped selling it as soon as a doctor at U.C.L.A. called to tell him about Ms. Rosenthal.


    Mr. Parker said he had used his own product with no ill effects. He added that he had sold 500 to 600 bottles of it and that as far as he knew Ms. Rosenthal was the only person to develop liver failure.

    But another weight-loss product, Lipokinetix, which contained a form of usnic acid called sodium usniate, and other ingredients, has been blamed for a death from liver failure, two liver transplants and seven cases of liver failure from which patients recovered.

    Doctors suspect that usnic acid played a role. Lipokinetix is no longer on the market, but other products containing usnic acid are still available.

    The supplement industry has grown rapidly in the past decade, and so have doctors' worries about side effects from poorly understood ingredients. Recently, liver damage has been a particular concern. In the past year, several medical journals and government publications have described liver problems, including hepatitis, cirrhosis and acute liver failure requiring a transplant, from dozens of supplements.

    Kava, a root extract widely promoted to help people relax, has been blamed for several deaths from liver failure in the United States and Europe since 1999, about a dozen cases of liver failure that led to transplants and dozens of other reports of liver damage.

    Even though such reactions are thought to be rare, kava has been taken off the market in the European Union and Canada.

    It is still available in the United States, though in March 2002 the F.D.A. issued warnings to doctors and consumers about potential liver problems linked to kava.

    The supplement industry has questioned the reports on kava, noting that it has been used safely for centuries in the South Pacific. Nonetheless, a trade group has recommended that kava labels be changed to warn consumers to stop taking it if they develop signs of liver problems like jaundice, vomiting, abdominal pain or dark urine.

    What some doctors find particularly troubling is that supplements are popular among people who may be especially vulnerable to harm from them, for example, patients who already have liver disease.

    Dr. Bill McGhee, a clinical pharmacy specialist at Children's Hospital in Pittsburgh, said that 25 to 30 percent of people with liver disease take supplements to treat themselves. He tries to talk them out of it, he said.

    In November 2001, the F.D.A. warned doctors and consumers that Lipokinetix had been linked to liver problems in about half a dozen people. The agency wrote to the manufacturer, Syntrax Innovations, in Chaffee, Mo., to "strongly recommend" that the product be taken off the market. It is no longer available.

    The president of Syntrax, Derek Cornelius, who is being sued by former customers with liver failure, refused to be interviewed.

    Syntrax also ran afoul of the F.D.A. earlier in 2001, for marketing a weight-loss product that contained a powerful thyroid hormone. The drug agency said the product was a drug and not a supplement, seized it and obtained a court order to stop its distribution.

    According to its Web site, Syntrax continues to market a variety of pills and powders that it promotes as muscle builders and fat burners.

    Dr. Joya Favreau, an internist at Cedars Sinai Medical Center in Los Angeles who treated five patients who had severe liver problems after taking Lipokinetix, said she thought usnic acid was to blame, but could not be certain. The other ingredients in Lipokinetix, Dr. Favreau said, had been used in the past without being linked to liver failure.

    "With usnic acid, we don't have a lot of data in humans," she said. "We don't necessarily know how it harms the liver."

    Dr. Neil Kaplowitz, a researcher at the University of Southern California who tested usnic acid in cultures of mouse liver cells at the request of the F.D.A., said it was "fairly potent" and could kill all the cells in less than a day. But that does not mean the chemical would act the same way in people, Dr. Kaplowitz said, adding, "There may be individuals who are more susceptible for reasons we're not certain about, but that all remains to be seen."

    When Jennifer Rosenthal took usnic acid, she said, it never occurred to her to wonder whether or not the product had been tested, studied or approved by the F.D.A.

    "I didn't think about that kind of stuff," she said. "Not very smart."

    In fact, the product she took was not regulated by anybody. Mr. Parker, who produced the capsules, does not have a college degree or any training in pharmacology. He sells promotional T-shirts for a living. He said usnic acid was "just a little sideline."

    Mr. Parker said that bodybuilding was a hobby of his, and that taking usnic acid for weight loss had been "a buzz in the health and fitness community for years."

    About a year ago, he said, he found a supplier in China via the Internet, ordered the usnic acid in 11-pound lots, had it tested for purity and then sent it to a local company to have it put in capsules and bottled.

    He wrote the dosage instructions himself, he said, based on Internet research and feedback from people who used the compound. He then sold it, mostly via the Internet but also through a few health food stores.

    Mr. Parker said he was so alarmed by what happened to Ms. Rosenthal that he stopped selling usnic acid as soon as he heard about her case.

    "I obviously feel horrible about it," he said.

    Ms. Rosenthal has recuperated from her operation, and last month she returned to work. But like all recent transplant recipients, she needs many medications to prevent rejection and other problems: for now, that means 47 pills a day. She has hired a lawyer and said she plans to sue Mr. Parker.

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    I believe that is the same girl that made a post about it on, here's the thread

    IMO, that article is poorly written and has no real merit to show usnic acid is the cause of any problems. It jumped all over the place from ephedra, to kava, to slamming the supplement industry.

    I still suppose you need to be careful with usnic acid, it seems to be very potent and if it is similar in action to DNP, this could explain it.

    Funny how Derek declined the interview.

    Once again, I advise BDC to add some Milk Thistle or rALA to his weight lose brew to help guard against free radical liver damage produced by usnic acid.
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    I remember that thread and whether or not its the same case as the above article, it shows how poorly people use supps.

    Uncoplars works by mechanism resembling cyanides, just they have a greater uptake in other tissues and disrupt ATP creation to a lesser degree. The person from that thread was running a very high dose for her weight and was stacking that with a low energy diet, lacking carbs. That is a very dangerous way to test an uncoplar.

    Secondly there are very few cases related to SU/UA compared to any pharmaceutical. I'd be pissed as hell if SU/UA is banned because of a few dumbasses who don't research and follow proper procedures.
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    good post bro. im starting to feel the "better safe than sorry approach". im even reconsidering if i want to continue taking my ECA. i have been off of eca for last month or so. but i have been to the point of actually feeling twitches on the ****, and im not trying to get a seizure. so im done with this ****. flame away if you want.
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    By the way, "Mr. Parker" is a member over at BB.com with nearly 700 posts. Just some trivia for you.
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    thought I saw that name over there... no need to worry about bein flamed Institutional , doesn't generally happen around here (disregard that Toolbox fella ) I hear ya, although I'd say there's much more data supporting safe moderate use of ECA than UA, simply been out around and in the spotlight longer in terms of media coverage and supp company distribution... like it's always mentioned, it only takes one fella's head exploding who has trace amounts in his system to cause Universal Pukes of Fear... remember too, it IS used in prescrip weight loss meds, literally millions of scrips filled and consumed I'd wager, not to mention unregulated supp industry use (which is where most of the problem lies unfortunately)
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    "Mr. Parker" is his real name. He uses an alias on BB.com.
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    Of course she plans to sue Mr. Parker. People are so greedy. As for her dosage who really knows? All we have is her word. And lets face it if some one gets hurt using something then there prob. not going to admit that they abused it.
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    Originally posted by institutional
    good post bro. im starting to feel the "better safe than sorry approach". im even reconsidering if i want to continue taking my ECA. i have been off of eca for last month or so. but i have been to the point of actually feeling twitches on the ****, and im not trying to get a seizure. so im done with this ****. flame away if you want.
    no flaming here, you are doing it the correct way, something doesnt seem right than stop taking it
    if more people would follow your lead maybe there would be less probs - kind of like if you see your ass getting bigger than fat alberts quit eating Mcdonalds
    Again this seems to be a case of if x amount works good than 2x will work better
    And still we have no proof that UA actually did anything, it just opens up the market to the FDA. I am really tired of the government trying to save me from myself.
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    Originally posted by 2demon2
    By the way, "Mr. Parker" is a member over at BB.com with nearly 700 posts. Just some trivia for you.
    What's his user name??
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    Complete Muscle.
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    I'd like to take this time to comment on the current article released and potentially shed some light on the topic. While I don't like how the writers stray from the topic and bring epehdra and kava kava into the debate and also associate Lipokinetix, a product that contained many different ingredients, with usnic acid alone, I will elaborate on the facts as they are known to us. We have had fairly extensive discussions with the UCLA medical staff who treated Rosenthal and are currently seeking more information about the study performed by Dr. Neil Kaplowitz. Upon having these discussions with the doctors, it was brought to our attention Jennifer Rosenthal was indeed barely over 100 pounds and had a rather poor diet. In addition, the doctor informed us that there was no way for them to attribute her problems to usnic acid.

    Jennifer Rosenthal was not using the product for fat loss, but rather to "stay in shape" and at 100lbs, she undoubtedly had little fat to lose. We must also point out that she commented on consuming up to 500mg of usnic acid, a dosage sufficient for a 220lb male. In addition, she did not appear to have assessed her tolerance at a lower dosage but rather, started at 500mg.

    We sympathize with the magnitude of the pain and misfortune that Rosenthal had to deal with and will continue to deal with in the future. Of course, no one would wish this on anyone. We just feel it is necessary to comment that this isolated incident took place in a person who arguably abused the product through a unfit dosage for her size and combined it with a body structure and diet that is clearly not suitable for an uncoupler of oxidative phosphorylation. This, ontop of the lack of the UCLA medical staff's ability to attribute liver problems to the use of usnic acid, not to metion the lack of any studies to show liver toxicity, and the numerous accounts of positive feedback from people who have used the product effectively and safely leads us to believe that usnic acid is safe for use in people who do not abuse the product in regards to dosage or any other physical attributes of the individual.

    BDC Nutrition continues to investigate any and all claims, articles, and studies regarding all aspects of usnic acid use. We will continue to do so and encourage everyone to look at the factual information in an educated and logical manner before making conclusions about the use of usnic acid in dietary supplements.

    Thank you
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    Originally posted by whosyourdaddy02
    Jennifer Rosenthal was not using the product for fat loss, but rather to "stay in shape" and at 100lbs, she undoubtedly had little fat to lose. We must also point out that she commented on consuming up to 500mg of usnic acid, a dosage sufficient for a 220lb male. In addition, she did not appear to have assessed her tolerance at a lower dosage but rather, started at 500mg.
    How did you come to the conclusions about the dosing amount? According to the article, it sounds like most information about usnic acid is anacdotal and based on user feedback. Any comments on this?
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    Correct Pogue...From a considerably amount of feedback, we determined that a 500mg dosage had rather significant fat loss results on males in that weight range. Of course, we know that people often go higher than that, but at the same time, have never had anyone report an irreversible side effect from people who weighed less than 220lbs and used UA at 500mg. This was the first case documented where someone who happened to be using UA reported a problem. We do not have enough data to state that 500mg for a male over 220lbs would be sufficient, although we speculate greatly that it would be. Nonetheless we used the information collected over many trials to make this assessment.
  

  
 

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