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Banned dietary supplement still causing deaths, study says

(CNN) -- Jan Ciampi remembers with special horror the week before her son graduated from high school.

The 17-year-old and a few of his friends took a dietary supplement called "Zen," which contained the since-banned substance 1,4-butanediol, or BD. Within an hour, he started vomiting and became unconscious.

"His color was ashen and he was trembling," said Ciampi. "His fingers and toes - his extremities - were bluish purple. His breathing rate was depressed, as was his heart rate, pulse and blood pressure."


Study author Deborah Zvosec discusses the misuse of the drug GHB

WAV Consequences of using the drug
WAV Importance of public awareness

The teen-ager eventually recovered. But a study in this week's New England Journal of Medicine reports on two deaths and six people who experienced severe illness linked to the drug, which is still available commercially in industrial solvents.

"Depending on the dose, it can be immediately toxic," said lead study author Deborah Zvosec, a researcher at Hennepin County Medical Center in Minneapolis, Minnesota. "It is a (poison)."

The U.S. Drug Enforcement Administration has identified 71 deaths associated with GHB, a cousin of BD.

And, because most people who use the drug don't seek treatment, the researcher suspects the actual number to be much higher, she said.

In the body, BD converts to gamma hydroxybutyrate, or GHB, commonly known as the "date rape" drug. GHB is now illegal, but doctors say using 1.4-butanediol has the same effect. In addition to the "high," there are some awfully big lows.

Physicians say BD can cause vomiting, incontinence, dizziness, agitation, combative behavior, seizures and coma.

"These compounds are involved in overdose and death," Zvosec said, adding "sexual assault and driving while intoxicated" to the list of risks.

Proponents of BD -- no longer sold legally in the U.S. as a diet or nutritional aid but widely available on the Internet as a solvent -- tout it as a natural and nontoxic way to build muscle, improve athletic performance, increase libido and sexual performance, reduce stress and wrinkles, reverse baldness and combat depression and insomnia.

"There is absolutely no basis or proof" to such claims, said Zvosec.

The substance is often listed on ingredient labels as tetramethylene glycol, butylene glycol or sucol-B. Another suspect chemical name is gamma-butyrolactone, or GBL, which is also considered a controlled substance in the United States.

The U.S. Food and Drug Administration issued a warning about BD last year, Zvosec said.

"If you talk to 100 doctors, maybe 10 have heard about this," study co-author Dr. Stephen Smith, who is Zvosec's husband, told Reuters. Symptoms of BD intoxication can include sudden swings between wild, combative behavior and abrupt loss of consciousness, Smith said.

"It is absolutely critical for the public and for health practitioners across the country to know about GHB and its precursors such as 1,4-butanediol," added Zvosec.

Hadi Ghandour's company, Gena/Pharm manufactured and sold one of the products cited as dangerous in the most recent study, a product called "Thunder Nectar." He doesn't sell anything with 1,4-butandiol anymore, but he claims the product was safe if used properly, and would like to see it back on the market.

"The problems really came when the products crossed over into the recreational arena," said Ghandour. "When it was in the recreational arena and mixed with other drugs, that is when you had a problem."

Zvosec doesn't agree, and neither does Ciampi.

"This stuff is really scary," Ciampi said.

CNN Medical Correspondent Holly Firfer and Reuters contributed to this report.

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U.S. Food and Drug Administration
New England Journal of Medicine
GenaPharm Inc.
U.S. Drug Enforcement Administration
Hennepin County Medical Center
International Chemical Safety Cards: 1, 4-butanediol
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