02:36 - Source: CNN
You may rethink your dietary supplements
CNN  — 

Lori McClintock died in what the Sacramento County Coroner determined was an accident. On the section of the form that asks the coroner to “describe how injury occurred” it lists “subject ingested white mulberry leaf.” Death after consuming this leaf was “unusual,” according to the experts.

The 61-year-old died in December. Her husband, US Rep. Tom McClintock, a conservative Republican representing Northern California, found her unresponsive inside their locked home.

The paperwork from the coroners’ office dated March 10 lists dehydration due to gastroenteritis and “adverse effects of white mulberry leaf ingestion” as her cause of death.

It’s unclear why she ingested the leaf. It’s also unclear how she consumed it. CNN’s emailed request for comment to the congressman’s office in Washington D.C. went unanswered. A family statement on the congressmen’s Facebook page at the time did not mention anything about the cause of her death.

Some people drink white mulberry leaf tea, others take it in the form of a supplement that comes in both capsule and liquid form.

The plant is native to parts of India and China and has been used by natural medicine practitioners for several millennia. Some practitioners think it can help with weight loss by lowering a person’s blood sugar. The theory has been tested by a small number of small studies that showed participants lost some weight. But more research is needed.

A few studies have also tested to see if it can help with diabetes by lowering insulin levels. Other studies have shown it lowered cholesterol in animal studies. But none of these studies are large enough to determine if white mulberry plants have these effects.

The day before McClintock died, the report says that she complained about an upset stomach.

Studies have shown that the consumption of white mulberry can cause gastrointestinal problems including nausea, cramping, bloating and gas.

Typically, most of the symptoms seem “pretty mild,” according to Kaitlyn Brown, the clinical managing director of the American Association of Poison Control Centers.

“Generally white mulberry as a plant is pretty safe and have a lower order or risk of human toxicity,” Brown said. A death would be unusual.

Brown said the Poison Control line has had some calls about the plant over the years.

Since 2018 until the end of December 2021 they had 100 single substance ingestions of white mulberry plant, meaning it wasn’t mixed with anything else. Out of those 100 about 89% were accidental in nature in children under the age of 12.

“Most of these exposures were judged by our specialists who managed the cases to be non toxic, or only expected minimal symptoms, if anything, and only five patients in that 100 patients reported symptoms. And those are pretty mild,” Brown said.

They had no reports of life threatening symptoms or reports of deaths.

Brown said there are limits to what science knows about overdoses. It’s not a commonly used, regulated drug. There is a study where patients took it as a supplement that cited side effects like bloating, flatulence, and diarrhea, and some constipation, she said. But those symptoms resolved with time.

“No life threatening symptoms have really been described before from this,” Brown said.

While it is unclear why this plant could be linked to McClintock’s death, Dr. Josh Trebach, a medical toxicologist and emergency room physician said that there is a common phrase in his profession.

“The dose makes the poison,” Trebach said. “This is true for things like water, or things like ketchup, anything in the right amounts can be toxic and if this were something like a supplement that are poorly regulated, anything could be in it.”

There are limits to what people can know about what goes into a dietary supplement, if that’s the form McClintock took it in. There are plenty of cases in which dietary supplements have been adulterated with something else.

The US Food and Drug Administration regulates supplements not as medicine, but as a “conventional” food so these products in whatever form they take, as a supplement or a tea, would not be as closely monitored as a medicine would.

The companies that make dietary supplements do not have to register their products with the FDA. Supplement companies don’t have to provide any premarketing safety or efficacy data either. The FDA has cracked down on companies that have adulterated their supplements with actual drugs.

“So that’s not out of the realm of possibilities with any sort of dietary supplements,” Brown said.

The Natural Products Association that does advocacy work for the supplement industry did not return a request for comment.

Brown said that when cases like this arise its important for people to remember something described as “natural” isn’t always safe.

“Even though they’re considered natural products, they may still be dangerous if they’re used in an inappropriate dose or in the wrong patient,” said Brown. “We always recommend that if you are considering using an herbal or dietary supplement that you talk with your primary medical provider to weigh your personal risks and benefits.”

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She also said that if someone ingests a product and they are not feeling well, they can always call the experts on the Poison Help line (1-800-222-1222) to provide confidential help or they can also visit poisonhelp.org.

“I think of the patients I used to speak to, if they saw a news article about white mulberry leaf and they said, ‘oh my goodness, I’m taking white mulberry leaves, am I going to have this happen to me’ and they will call the poison center. You know, just to talk about anything that they’re experiencing. We’re very helpful resource and these type of situations.”