{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T02:01:14Z","timestamp":1780538474308,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,8,4]],"date-time":"2016-08-04T00:00:00Z","timestamp":1470268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Drug Testing and Analysis"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:p>In September 2013, the Hawaii Department of Health (HDOH) was notified of seven adults who developed acute hepatitis after taking OxyELITE Pro\u2122, a weight loss and sports dietary supplement. CDC assisted HDOH with their investigation, then conducted case\u2010finding outside of Hawaii with FDA and the Department of Defense (DoD).<\/jats:p><jats:p>We defined cases as acute hepatitis of unknown etiology that occurred from April 1, 2013, through December 5, 2013, following exposure to a weight loss or muscle\u2010building dietary supplement, such as OxyELITE Pro\u2122. We conducted case\u2010finding through multiple sources, including data from poison centers (National Poison Data System [NPDS]) and FDA MedWatch.<\/jats:p><jats:p>We identified 40 case\u2010patients in 23 states and two military bases with acute hepatitis of unknown etiology and exposure to a weight loss or muscle building dietary supplement. Of 35 case\u2010patients who reported their race, 15 (42.9%) reported white and 9 (25.7%) reported Asian. Commonly reported symptoms included jaundice, fatigue, and dark urine. Twenty\u2010five (62.5%) case\u2010patients reported taking OxyELITE Pro\u2122. Of these 25 patients, 17 of 22 (77.3%) with available data were hospitalized and 1 received a liver transplant. NPDS and FDA MedWatch each captured seven (17.5%) case\u2010patients.<\/jats:p><jats:p>Improving the ability to search surveillance systems like NPDS and FDA MedWatch for individual and grouped dietary supplements, as well as coordinating case\u2010finding with DoD, may benefit ongoing surveillance efforts and future outbreak responses involving adverse health effects from dietary supplements. This investigation highlights opportunities and challenges in using multiple sources to identify cases of suspected supplement associated adverse events. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.<\/jats:p>","DOI":"10.1002\/dta.2036","type":"journal-article","created":{"date-parts":[[2016,7,1]],"date-time":"2016-07-01T15:40:34Z","timestamp":1467387634000},"page":"68-74","source":"Crossref","is-referenced-by-count":27,"title":["Hepatotoxicity associated with weight loss or sports dietary supplements, including OxyELITE Pro\u2122 \u2014 United States, 2013"],"prefix":"10.1002","volume":"9","author":[{"given":"Kevin","family":"Chatham\u2010Stephens","sequence":"first","affiliation":[{"name":"EIS officer  1600 Clifton Road NE MS C\u201009 Atlanta GA"},{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethel","family":"Taylor","sequence":"additional","affiliation":[{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Peterson","sequence":"additional","affiliation":[{"name":"Division of Integrated Biosurveillance Armed Forces Health Surveillance Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnni","family":"Daniel","sequence":"additional","affiliation":[{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Deuster","sequence":"additional","affiliation":[{"name":"Department of Military and Emergency Medicine Uniformed Services University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Noe","sequence":"additional","affiliation":[{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Kieszak","sequence":"additional","affiliation":[{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Schier","sequence":"additional","affiliation":[{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Klontz","sequence":"additional","affiliation":[{"name":"Office of Analytics and Outreach, Center for Food Safety and Applied Nutrition Food and Drug Administration"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Lewis","sequence":"additional","affiliation":[{"name":"Division of Environmental Hazards and Health Effects National Center for Environmental Health, Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.110.133025"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2006.12.009"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6882-14-143"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1240006"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27317"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2013.774371"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12109"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.159"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/dta.1894"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2014.987397"},{"key":"e_1_2_7_12_1","unstructured":"Food and Drug Administration.MedWatch: the FDA safety information and adverse event reporting program. 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