DISTRIBUTION CHANNEL … OR SCAM?
Investors were understandably skeptical of any company-ordered surveys. Furthermore, the investigators did not enumerate the levels of B. Hughes wrote for Herbalife a comically complex, page compensation plan. Fulminant hepatitis during self-medication with hydroalcoholic extract of green tea. And poultry workers have been found to have an excess of liver cancer , among other types of cancer. Retrieved December 11, J Hepatol 0:
Also, contamination of herbals with microorganisms, fungal toxins such as aflatoxin, with pesticides, heavy metals and synthetic drugs has been described. Interactions between herbs and chemical drugs are another source of problems associated with the intake of herbal compounds. While liver damage appears infrequently, the consequences are serious enough for patients that these cases are getting the notice of doctors.
Incredibly, after three patients recovered, they resumed taking Herbalife products and succumbed to a second bout of hepatitis. The products promoted as remedies are either bogus, unproven or intended for conditions that are unsuitable for self-medication Most supplement companies get their raw ingredients from the same bulk wholesalers and merely repackage them During the past several years, many physicians have begun selling health-related multilevel products to patients in their offices.
Doctors are typically recruited with promises that the extra income will replace income lost to managed care During the past 20 years, more than 25 health-related MLM companies have faced regulatory actions for false advertising, operating a pyramid scheme, or both. Although such actions usually improve future behavior, they rarely provide adequate redress for victims. Moreover, the number of MLM frauds known to Federal Trade Commission vastly exceeds its capacity to prosecute them on a case-by-case basis.
The growing reports of life-threatening health risks among users of these products remind us to not to be taken in by claims of magical benefits of any dietary intervention. Beyond preventing deficiencies — which is easily achieved by virtually everyone simply when enjoying all sorts of foods — no food or supplement is supernatural. When we hear claims that optimal or personalized nutrition is science-based and can improve our heart, digestive or immune health; help us age healthfully, improve our memory or eyesight, or remove wrinkles; increase our energy and fitness; or manage weight, control our appetite or boost metabolism Three new studies, however, have documented liver toxicity among healthy people using natural herbal supplements — more than 20 cases were just among Herbalife customers in two small countries.
The identification of earlier cases in which the culprit agent could not be established raised the hypothesis of a possible contamination of some specific batches of Herbalife products.
We searched the Spanish Pharmacovigilance Centres' database of adverse reactions for reports of liver injury associated with the use of Herbalife products from , when the first case was submitted, through September Two patients experienced a positive rechallenge. One patient developed cirrhosis, whereas all the others recovered. Causality assessment by the Karch and Lasagna modified algorithm showed a category of definite in 1 case, probable in 14, and possible in 5.
Analysis of the different Herbalife products that each patient had taken did not enable us to identify any commonly known hepatotoxic ingredient. Our results support the relationship between the consumption of Herbalife products and hepatotoxicity, underscore the concern regarding the liver-related safety of this dietary supplement, and emphasize the need to establish further regulatory measures.
Two years ago liver doctors sounded the alarm about cases of liver damage in users of Herbalife products. They were unable to say which component in Herbalife products was causing the liver damage, but researchers at the University of Bern made an attempt to do so in an article published this year in the Journal of Hepatology. They found the bacteria Bacillus subtilis in Herbalife products.
In the article the doctors discuss two cases of people who became ill after using Herbalife products: The man's urine had turned dark brown, he had hepatitis and had been feeling unwell for a couple of weeks. According to the analyses, the man had a liver complaint.
When the doctors took him off the shake his blood values recovered, but they deteriorated again later. The doctors gave the man corticosteroids and ursodeoxycholic acid , after which he recovered completely. The woman sold Herbalife supplements. She had stomach pain and hepatitis and the doctors found signs of liver damage in her blood.
They got the woman to stop taking the supplements and the graph below shows how the liver values in her blood improved. The researchers examined samples from the livers of the man and the woman and found signs of damage in both. The doctors turned the supplements that the men and women had used inside out, but found no contaminants: But when they examined the Herbalife products for micro-organisms, they did come across something.
The meal substitutes the man and woman had been using contained the bacteria. As far as we know, B. It would seem pretty unlikely then that B. Bodybuilder drugs his liver to oblivion — twice. A medical case study that will give you goose bumps, this report from doctors at the US Massachusetts General Hospital. The article tells the story of a year-old competitive bodybuilder and part-time policeman who turned up at the Emergency Department. For a start, the concentration of the enzyme ALT is units per litre: The bodybuilder says he injects nandrolone and takes androstenedione.
The scan the doctors make of his liver shows a real mess, shown in Picture A below. The light patches are swellings, the biggest of which measures 10 x 10 cm. The doctors operate and discover that the liver is in an even worse state than they had feared. The organ contains swellings that are filled with blood.
The doctors also found a swelling with a diameter of 23 cm. The doctors decide to amputate part of the liver. After the operation the bodybuilder recovers and is allowed home. When the doctors make another scan three months later they see that the swellings in the remaining part of the liver have shrunk by 40 percent, Picture B above.
After three years the bodybuilder returns to the doctors. Six weeks previously he had treated himself to injections of a nandrolone derivative. When the doctors make another scan — the picture above on the right — they see that his liver is in a bad way again. The swellings have started to grow again, and the liver has a protuberance that has started to bleed. The doctors discuss briefly whether they should give the guy a new liver, but reject the idea.
It would be a waste: Alcoholics are not given a new liver either. So they just stop the bleeding and send the bodybuilder home again. Thinking about it, we find it difficult to believe that the bodybuilder was only using deca and androstenedione.
True, a number of cases have been published of bodybuilders who, as the result of a mild course of deca, developed a blood clot the size of a brick in their stomach, or became psychotic after one single deca injection. Moreover, neither androstenedione nor nandrolone is harmful to the liver. Laboratory research on liver cells has shown this.
And, by the time the doctors were seeing their patient, George Bush had already outlawed androstenedione. Although androstenedione is still on the market, bodybuilders hardly ever use it. In countries like the US there are much more effective legal anabolic steroids available. But among these, there are a number of substances that are notoriously bad for the liver. The most dangerous is Superdrol, an anabolic that was developed at the end of the fifties by Syntex. Doctors have recorded damaged livers and destroyed kidneys in users of Superdrol more than once.
This is what makes us suspect that the bodybuilder in this case study used stronger stuff than androstenedione and deca. Bodybuilders are often not entirely honest about what they have been using when they visit a doctor about medical problems.
Even when being honest could have saved their life. Bodybuilder gets jaundice from creatine and protein supplements. A healthy man of 27, a fanatical bodybuilder, developed liver damage and jaundice after using sports supplements containing creatine and whey protein.
The man in the case study had no pain and did not feel unwell, but because he showed signs of jaundice he went to hospital. There the doctors discovered that his blood contained high levels of bilirubin, a substance that should have been removed by the liver. The first substance can be an indication of liver malfunction. The second is a waste product of creatine. In people with jaundice, the skin and whites of the eyes turn yellow [see pic below], but this is not necessarily cause for alarm.
Bilirubin is not a dangerous substance, and may even be an endogenous antioxidant. But jaundice is a sign that something is wrong with the liver, and it therefore needs to be taken seriously. The ducts that should have been doing so were blocked. The scientific term for this is cholestasis. The bodybuilder had been taking creatine for nine months and whey protein for one month. The doctors thought that this might be responsible for his condition.
When the man stopped taking the supplements, his liver returned to normal and the jaundice disappeared. If doctors come across healthy athletes with an abnormal liver, the researchers write, then they should ask whether the athletes are using potentially 'dangerous' supplements like whey protein and creatine.
We agree with the opinion of a blogger — who by the way also works at Gaspari Nutrition — at bodybuilding. But these reports are probably the result of silent use of forbidden substances — and in high quantities. For example, there was the bodybuilder who said he had developed gyno from using Tribulus terrestris supplements.
A preparation made by Natterman, which supposedly protects the liver and which chemical athletes are using more and more often: Greek researchers refer to it in their study as compound N. The researchers, at Thessaly University, set up an experiment to determine whether compound N really works. After a bit of surfing we worked out that Compound N is Essentiale forte. A packet contains a couple of dozen capsules, each of which contains mg of polyene phosphatidylcholine. This is choline-phosphoric acid with two unsaturated fatty acids attached, usually linoleic acid.
It probably resembles the phosphatidylcholine found in soya. In addition, each capsule contains 6 mg of vitamin B1, 6 mg of vitamin B2, 6 mg of vitamin B6, 6 mcg of vitamin B12, 30 mg of nicotinamide and 6 mg of vitamin E.
The Greeks, who by the way have also done research on the psychological effects of anabolic steroids, did an experiment with three hundred and twenty athletes.
Half of them, one hundred and sixty athletes, used steroids. Of these chemical athletes, the researchers gave forty Essentiale forte: All of the chemical athletes took steroids and the researchers monitored them for eight weeks.
The list below gives you an idea of what the Greek bodybuilders were using. Yes, the list puzzled us too. And where are the 'new' designer steroids? Surely athletes in Greece use products like 1-Test and Madol too? The more enzymes in the blood, the harder a time the liver is having. The figure below shows what happened to the liver enzyme concentrations. They suspect that the mixture strengthens the membranes of the liver cells.
The livers of steroids users have to work hard to break down all the extra substances they are subjected to. The liver gets fattier because the liver cells are no longer burning fat well [beta-oxidation — Ed. The supplement helps the liver cells to perform these functions. Reading between the lines you can also see that the Greeks had trouble getting their study published. More damaged livers from superdrol and madol. Liver specialists at the Henry Ford Hospital in Detroit have reported another three cases of bodybuilders who developed liver damage as a result of using designer supplements.
The Superdrol user was He was nauseous, had stopped eating, had jaundice and itched all over. When the symptoms had got worse after two weeks, the doctors gave him prednisone.
The anti-inflammatory worked and after another six weeks, he'd made a pretty good recovery. Superdrol is a steroid whose structure and synthesis resemble those of oxymetholone. It was also developed and tested in the late fifties by the makers of oxymetholone, the American pharmaceutical company Syntex.
Although superdrol [see structural formula below] looked like a promising anabolic steroid in animal tests, in subsequent tests potential side effects showed up.
The effects of this move are clearly seen in the medical journals. In doctors in Phoenix, Arizona published an article on the case of bodybuilder who became fatally ill after using superdrol. What patient 2 used was not clear, but it contained at least DHEA. Of the three men referred to in the study, number 2 got off the most lightly. He recovered spontaneously a couple of weeks after he had stopped using the supplement.
Patient 3 used M-Test 2, a designer supplement containing the steroid madol. Madol was also developed by Syntex, a manufacturer that carried out promising animal tests on it in the sixties. Not much is known about the side-effects of madol. It is not carcinogenic, say German researchers.
But they did discover that it enlarged the heart muscle in animal tests. The enlargement itself was not dangerous, but the researchers were not entirely convinced. In the bodybuilding circuit however there are few stories around of users who have developed liver problems as a result of using madol. The sick madol user had to be given prednisone in the end, after which he recovered. The doctors did not test the preparation the patient had used. And we wonder quite honestly if it only contained madol.
According to the study, the bodybuilder became ill after he had taken 57 capsules over a period of a few weeks. That would be impossible with. The Canadian government has issued warnings about these.
Maybe something went wrong during the production of M-Test 2. Or perhaps the doctors got it wrong that Patient 3 used the BMF product. The doctors also read a couple of articles written by colleagues and summarized the information they found.
This resulted in the table you see here below. Liver specialists should get extra training on designer supplements that contain oral anabolic steroids, the article concludes. Published online November Abstract We report three cases of patients with acute liver injury induced by weight-loss herbal supplements.
One patient took Hydroxycut while the other two took Herbalife supplements. Liver biopsies for all patients demonstrated findings consistent with drug-induced acute liver injury. To our knowledge, we are the first institute to report acute liver injury from both of these two types of weight-loss herbal supplements together as a case series.
The series emphasizes the importance of taking a cautious approach when consuming herbal supplements for the purpose of weight loss. Hydroxycut, Herbalife, Hepatotoxicity, Herbal, Weight-loss. We have seen a significant increase in the popularity and usage of over the counter herbal supplements over the past few years[ 1 ].
Unfortunately, the majority of these herbal supplements are not regulated by drug administrations worldwide. Many herbal supplements contain compounds that carry potentially severe side effects including hepatotoxicity. We report three cases of acute liver injury induced by weight-loss herbal supplements.
Hydroxycut is a popular dietary supplement consisting of a variety of herbal mixtures that claims to enhance the weight loss process[ 2 ]. Acute liver injury associated with Hydroxycut use has been previously reported, but only one case had liver biopsy data showing cholestasis and portal inflammation[ 3 - 6 ].
Similarly, Herbalife weight-loss dietary products are popular supplements consisting of a variety of herbal mixtures that claim to facilitate weight reduction[ 7 ]. Cases of acute liver injury after consumption of Herbalife products have been previously reported, with two patients developing fulminant liver failure requiring liver transplantation. The first patient survived while the second died[ 8 - 11 ].
In all of our cases, we were able to demonstrate drug-induced acute liver injury on liver biopsy specimens. Case 1 A year-old woman presented to our hospital complaining of 2-wk history of fatigue, jaundice, and nausea. She denied any prior medical or surgical conditions, family history of liver disease, and acetaminophen or prescription medication use.
She further denied history of blood transfusion, tattoo, alcohol use, or recreational drug use. She had been taking Hydroxycut for one year to enhance her weight loss. She had been taking the recommended dose of 2 tablets twice a day. The patient was afebrile with normal hemodynamics upon presentation.
Her physical examination was remarkable for generalized jaundice, scleral icterus, and mild upper quadrant tenderness to palpation without rebound or guarding. Given these findings, patient was admitted to the hospital for a higher level of care. Serum acetaminophen and urine toxicity screens were negative. Serum ceruloplasmin, ferritin, iron studies, and immunoglobulins were all within the normal range. Right upper quadrant ultrasound showed diffuse echogenicity of the liver.
Liver biopsy showed extensive patchy areas of multilobular necrosis with only bile ducts remaining, extensive ductal metaplasia, severe lymphocytic and macrophages infiltration of portal tracts and lobular parenchyma and patchy plasma cell infiltrates. She did not develop evidence of hypoglycemia or portal-systemic encephalopathy.
Her jaundice and scleral icterus resolved over the following 2-wk. Her liver tests gradually improved within the following few months. Relevant discussion may be found on the talk page. Please do not remove this message until conditions to do so are met. Archived from the original on December 3, Retrieved 15 July Retrieved December 22, Retrieved March 19, The New York Times.
Retrieved May 4, Retrieved June 8, Concerning Mischaracterization in Advertisement". Archived from the original on Hughes, 44; Founded Nutrition Supplement Concern". Archived from the original on March 13, Form K - Annual Report, ".
The Big Short War". Retrieved March 13, Retrieved 4 November Retrieved 19 March The Wall Street Journal. Deutsche Gesellschaft für Ernährung. Retrieved 16 November Los Angeles Business Journal. Archived from the original on June 17, Retrieved 2 February Archived from the original on 3 December Retrieved 26 Apr Ten cases of severe hepatotoxicity associated with dietary supplements from Herbalife products". Esther; Duque, Jose M. Pharmacoepidemiology and Drug Safety. World Journal of Hepatology.
Retrieved 31 July Archived from the original PDF on Evaluation of cases with positive reexposure tests". World Journal of Hepatoxicity. Retrieved 2 May Retrieved 6 December Retrieved 22 January Retrieved 19 December Retrieved 26 December Retrieved 13 March Will Force Major Changes". Retrieved 17 January Retrieved December 11, New York Business Journal. Retrieved July 2, Retrieved February 3, Retrieved 3 February In two private equity firms—W.
They went looking for a turnaround team to spruce it up and take it public again. A headhunter approached Michael Johnson, then in his 17th year at Disney. But the private equity guys promised him he would be in control, stressed that it was about nutrition, and offered him a slice of the company. In April , Johnson made the move.
Johnson tried to quickly launch a new product without consulting the distributors. And they deeply mistrusted him. What does he know? A lot of them felt that when the company went public I would exit.
The company could annul their distributorship, but that meant forfeiting a business the distributor had built over years. If expelled, the distributor might take his whole downline—sometimes thousands of people—to another MLM.
Top Herbalife distributors ran several dozen such side businesses at the time. They worked like this. They, in turn, would contact the prospective recruits and send them a video that showed testimonials of top distributors describing astounding wealth they had purportedly amassed in very little time and with no discernible skills. Herbalife shut down Newest Way to Wealth in , before CEO Johnson was hired, and reached a tentative settlement of the suit a few months after he got there.
That fall, he considered quitting. He went to see his mentor, Jerry Perenchio, who was then chairman of Univision. Perenchio asked him a series of rhetorical questions, Johnson recalls: You can stick your tail between your legs and go back to Disney, or you can go in there and exercise your desires and will. The plan was about product, brand, image, and the business opportunity.
The company needed its own upgraded manufacturing facilities, he felt, plus labs to ensure that the products really contained the herbs the labels claimed they did. To tout the brand, Johnson wanted to sponsor sporting events, teams, and star athletes.
It now sponsors more than of them, including Cristiano Ronaldo, the Portuguese soccer star. Finally, and most important, Johnson wanted changes in the way the business opportunity was pursued. That meant curbing some practices while also embracing positive ideas being urged by other distributors, he says. At a videotaped global management retreat in June , viewed by Fortune , Johnson appeared to walk a tightrope, discussing the need for these changes while trying not to alienate powerful distributors.
It puts distributors in debt up to their ears. Johnson also wanted to embrace changes being urged by two top distributors, which were designed to reduce the high rates of turnover then being experienced among level-five distributors—those beginning to pursue the business.
The company phased in changes. It rolled out its own online software tools, supplanting those sold by distributors. Herbalife charged less and could exercise control over content. Over time, most top distributors exited that business. The rule changes easing the qualification hurdles for level-five distributors were introduced on a test basis in Russia in , and then globally in As a result, according to statistics provided by Walsh, the percentage of U.
Purchasing patterns also changed, these statistics show. Throughout the Johnson era, the size of the average purchase has been getting smaller, while the number of orders has been increasing.
Though the impetus for the changes was apparently not regulatory, its impact could be. In an Herbalife distributor introduced nutrition clubs into the U. The charge entitled the customer to consume on premises servings of three prepared Herbalife products: Herbalife CEO Johnson first heard about nutrition clubs three years earlier, he says, when certain distributors were complaining about them. Johnson and Walsh went to look at a club in Zacatecas, Mexico. Today there are about 6, nutrition clubs in the U.
Herbalife nutrition club owner Edgar Montalban, shown in June , prepares a meal-replacement shake in Queens, N. They became particularly popular in Spanish-speaking communities of the U. As successful as the model was, not everyone was thrilled with it.
Because the clubs let Herbalife sell its products and business opportunity to lower socioeconomic strata than had been previously possible—more vulnerable populations—a former financial journalist named Christine Richard found them to be diabolical. By the summer of , indeed, Richard had concluded that a great deal was wrong with Herbalife.
Above all, she thought, it was a pyramid scheme. Richard worked for the Indago Group, a research boutique that sold much of its work to short-sellers. When Richard first spoke to investors about shorting Herbalife, many were wary, she recounts in an interview.
In , Ackman took a massive public short position predicated on the audacious theory that the then triple-A-rated bond insurer MBIA—whose guarantees were propping up the ratings of countless other financial obligations that Wall Street was flogging across the globe—was catastrophically overleveraged and destined to collapse. She declined, and the call ended. At lunch afterward DeSimone went from table to table.
At one, the woman next to him, who turned out to be Richard, started asking him similar questions. Einhorn is widely revered as perhaps the smartest investor on the Street. The company realized he might be preparing a public short. After its May 1 earnings announcement, Herbalife executives took questions by phone. If Einhorn was contemplating a public short, DeSimone says, he felt that was material information the public ought to have.
It was a variant of the same questions Richard and Schulman had been asking. Herbalife had no lawyer in the room. Live complex, just across from the Staples Center. They had allies inside the hall with open phone lines. But Einhorn was just messing with their heads. Which posed a quandary for Bill Ackman. Then Einhorn never surfaced. Ackman deliberated for months whether to go public, he says, preparing possible presentations. And then in September, and then in November.
Most of these put buyers were effectively betting that the stock would drop markedly sometime before Dec. He had simply borrowed common stock and sold it—the conventional short position. There was a lot about Herbalife that was suspicious. How could that be? What the company really sold in all these countries, Ackman explained, was not Formula 1 but a fictitious business opportunity. Then he played a creepy, officially produced Herbalife video. Subsequently, however, CEO Johnson had started toning down such claims, voluntarily disclosing the average gross compensation the company paid its distributors and requiring that income testimonials include disclaimers at least in the U.
The FTC, for its part, does not require such disclosures, nor explain how comprehensive they must be, if provided.
At the time of the presentation, Herbalife was already a well-known name on Wall Street. It had enjoyed 12 straight record quarters, and its stock had quadrupled in the previous two years. Then there was the issue of timing. Ackman presented just 11 days before the end of the year, when hedge fund positions are marked to market for the year.
Given the holiday season, there was no way Herbalife could respond that calendar year. In that context, the bit about Ackman foregoing personal profit struck some as disingenuous. He explained on his blog: As for the notion that Herbalife was desperately expanding into foreign countries because of market saturation, the company had a simple answer: Walsh then offered evidence of consumer demand while asserting the genuineness of the business opportunity.
After Einhorn asked his questions in May, the company had had a reputable corporate survey firm, Lieberman Research Worldwide, perform two 2,person surveys. People who did pursue the business could really make it, Walsh insisted, though it did require very hard work. In it had made 46 of them in the U. In it would also begin paying return shipping costs.