Epi investigation finds steroid-laced vitamins and minerals; Purity First offers product recalls

What was the problem?

In March 2013, the New York State Department of Health (NYSDOH) began investigating an unusual cluster of symptoms among persons taking dietary supplements from a single manufacturer, Purity First. Reported health effects varied, ranging from unusual hair growth in women, to fatigue, muscle pain, and anxiety. Some patients had elevated liver enzymes and cholesterol levels.

The NYSDOH laboratories tested several supplements produced by Purity First, which revealed that there were anabolic steroids present in some of the products, specifically the vitamin B-50 and multi-mineral supplements.

By July 2013, NYSDOH had received 29 reports of adverse events associated with the contaminated supplements, including one hospitalization. NYSDOH identified more than 1,000 persons who might have taken the supplements, most of whom were patients of a single chiropractor who regularly recommended Purity First products. At that point, NYSDOH asked CDC’s Health Studies Branch to:

• Conduct an epidemiology investigation to determine the extent of the outbreak;
• Characterize the clinical issues of exposed individuals and explore associations between exposure to Purity First and clinical abnormalities;
• Assess information on exposure status and risk factors for illness
• Evaluate exposure of non-recalled nutritional supplements and associated illness, if any.

What did CDC do?

The team conducted a medical record review of the chiropractor’s patients to determine the extent of exposure and describe health effects associated with taking Purity First supplements. Information about patient characteristics, symptoms, diagnoses, supplement and medication use, and social history was collected through a telephone questionnaire for all of the patients residing in New York. The team then compared health characteristics of patients who took Purity First B-50 or Multi-Minerals to those of patients who took a supplement not manufactured by Purity First.

Participants exposed to Purity First B-50 or multi-minerals experienced liver injury, hair loss, and hot flashes – more health effects those reported in the original outbreak -- while the other group of participants did not. NYSDOH also worked with the Food and Drug Administration (FDA) and CDC to issue health alerts and press releases about the contaminated supplements.

What was the public health impact? 

Due to the results of the investigation, Purity First issued a voluntary recall of its Healthy Life Chemistry B-50 supplements, Multi-Minerals, and vitamin C on July 31, 2013. These supplements were removed from the market. CDC, along with the help of volunteers, made efforts to call every patient who may still have had any Purity First supplements at home to inform them of the recall and to advise them to discontinue use.

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