In that context, the bit about Ackman foregoing personal profit struck some as disingenuous. Walsh then offered evidence of consumer demand while asserting the genuineness of the business opportunity. They are vitamin D from sun but not from tanning beds see also here , here , here , here , here , here , here and vitamin B12 see also here , here , here , here , here. But jaundice is a sign that something is wrong with the liver, and it therefore needs to be taken seriously. During the past several years, many physicians have begun selling health-related multilevel products to patients in their offices. At the time of the presentation, Herbalife was already a well-known name on Wall Street.
A number of our panel member attorneys are familiar with the controversy surrounding Herbalife and its supplements so please do not hesitate to call 24 hours a day, 7 days a week to discuss you issue.
The disease is usually secondary to some preliminary and often untreated liver disease such as toxic hepatitis and non-alcoholic steatohepatitis. Due to the dormant nature of these less serious liver ailments they are often unrecognized until they have attacked your liver and progressed into HCC.
More often than not it cannot be treated and eventually leads to complete liver failure. In these cases the only way to survive HCC is with a liver transplant. Like many other liver diseases there is an established link to Herbalife supplements. Correctly or not, doctors around the world hold the Herbalife company responsible for certain cases of HCC.
For example, if toxins in the Herbalife supplements cause non-alcoholic steatohepatits that eventually develops into hepatocellular carcinoma then it is not a very big leap to say Herbalife should be held accountable. Healthspanlife Posted on March 17, 4 Comments. Chemopreventive potential of black cohosh on breast cancer in Sprague-Dawley rats. Our results suggest that black cohosh may have chemopreventive potential for mammary cancer.
Revisiting acute liver injury associated with herbalife products. In the November 27, issue of the World Journal of Hepatology WJH , three case reports were published which involved patients who had consumed various dietary supplements and conventional foods generally marketed as weight loss products. The reference to Herbalife products as contaminated and generally comparable to all dietary supplements or weight loss products is not scientifically supported.
The authors provided an insufficient amount of information regarding patient histories, concomitant medications and other compounds, dechallenge results, and product specifications and usage. This information is necessary to fully assess the association of Herbalife products in the WJH case reports. Therefore, the article does not objectively support a causal relationship between the reported cases of liver injury and Herbalife products or ingredients.
Misconceptions regarding the association between Herbalife products and liver-related case reports in Spain. Epub Aug There have been recent reports of GNC products such as hydroxycut and herbalife , causing drug-induced hepatitis. Herbal medications are over-the-counter products and are not investigated thoroughly by the FDA. Given that the most common outpatient laboratory abnormality is elevated liver transaminases, a sign of hepatocellular toxicity; it is not surprising that some of these products end up causing hepatic dysfunction, especially when taken in large volume.
We present a rare case of drug induced hepatitis secondary to herbal medications used to treat HIV and elucidate the role of glutathione depletion in immunocompromised patients. Herbs and healthy livers. Few consumers hear about the reports in the medical literature of liver and other toxicities from herbal products.
His concerns about the growing numbers of medical cases were similar to an earlier comprehensive review for the European Association for the Study of the Liver in the Journal of Hepatology , led by Dr. Most evident is that women are at greatest risk not only because they use more herbals, but because of their higher susceptibility to herbal- and pharmaceutical-induced liver damage.
Because many practitioners and consumers believe herbals are safe, the doctors noted the many times patients will even continue to take them as their liver diseases worsen. Another problem is that herbals are usually mixtures of several ingredients or plants harvested during different seasons and extracted through variable procedures, which makes the identification of both the pharmacologically active and toxic compounds difficult.
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. Case 2 A year-old woman presented to our hospital with a 1-mo history of diffuse abdominal pain, mild nausea, and painless jaundice.
She denied any past medical or surgical history, family history of liver disease, or any alcohol or illicit substance abuse.
She admitted that she had been taking Herbalife dietary supplements for the past 3-mo in an attempt to lose weight. The patient was afebrile with normal vital signs on presentation. Her physical exam was noticeable for bilateral scleral icterus and generalized jaundice.
Her abdominal exam revealed a non-tender, non-distended abdomen with no stigmata of liver disease. All other laboratory values, including amylase, lipase, and INR, were within normal limits.
Given these lab abnormalities, the patient was admitted to the hospital for further work-up. Serum ceruloplasmin, ferritin, iron studies, and immunoglobulins were all within normal range.
A computerized tomography CT scan of the abdomen and pelvis with intravenous IV contrast showed multiple low-density lesions in the liver measuring up to 8-mm. However, her liver biopsy specimens also showed evidence of bridging fibrosis, which suggest some degree of chronic liver disease but with drug-induced injury in addition.
Liver biopsy was performed and showed periportal bridging fibrosis, ductal metaplasia, cholestasis, moderate intralobular lymphocytic infiltration, and troxis necrosis and apoptosis consistent with drug-induced hepatitis on top chronic liver disease. The patient was treated supportively with fluids and nutrition. The only laboratory value to increase was the patient's serum TB, which was at The patient did not develop encephalopathy, hypoglycemia, or any other complications.
The patient was followed for several months, throughout which her symptoms continued to improve. At her 2-mo follow-up, the patient's icterus and jaundice had resolved completely. Case 3 A year-old previously healthy woman presented with a 3-wk history of painless jaundice and pruritus. She denied any family history of liver disease, or any alcohol or illicit substance abuse. She had not been taking any new prescribed medications. On further questioning about over-the-counter supplements she divulged a 4-mo history of consuming various Herbalife weight loss products in the form of shakes, teas and pills.
On general inspection she had scleral icterus and jaundice, with evidence of excoriations. A 2-cm palpable liver edge could be appreciated, that was tender to touch. There were no other signs of chronic liver disease. An ultrasound showed borderline hepatomegaly of cm.
A liver biopsy revealed acute hepatitis characterized by hepatocellular injury, with periportal fibrosis, cholestasis, ductal metaplasia and diffuse intralobular and periportal troxis necrosis consistent with a drug-induced etiology. Acute liver injury induced by over the counter weight-loss herbal supplement Hydroxycut and Herbalife products have been reported previously[ 3 - 6 , 8 - 11 ]. These case reports were limited by the fact that liver biopsies were performed in only a few patients, confirming clinical suspicions histologically.
In terms of our patients, all three had liver biopsy performed and all showed some common morphological features including diffuse lymphocytic infiltration of sinusoids and portal tracts, ductal metaplasia and toxic necrosis. Some variations of morphological features could be explained by predominance of intrinsic or idiosyncratic mechanisms of hepatic injury, individual patient response to the affecting drug and duration of injury.
No hyaline globules were identified in any of the three cases. The absence of histological findings and the fact that our patients had no history of chronic obstructive pulmonary disease excluded diagnosis of alphaantitripsin deficiency in all three cases. Prussian blue and copper stains did not reveal excessive iron or copper depositions in the hepatocytes and Kupffer cells. Only one previous case of Hydroxycut-induced acute liver injury had reported findings on liver biopsy.
Although the most likely explanation for the mechanism of liver injury caused by these herbal products is idiosyncratic reaction, one of the ingredients in Hydroxycut, green tea extract Camellia sinensis , has been linked with acute liver injury in other over the counter weight-loss herbal supplements[ 12 - 20 ].
In fact, the weight-loss herbal supplement Exolise Arkophama, Carros, France , which also contained C. Furthermore, several cases of hepatotoxicity were associated with another herbal weight-loss supplement, Cuur Scandinavian Clinical Nutrition, Sweden , which also contains the ethanolic dry extract of green tea C.
Rechallenging patients with the same product led to hepatotoxicity, confirming the role of C. However, there have been cases of liver failure caused by green tea extract C. The liver biopsy obtained in our patient who took Hydroxycut showed multi-lobular necrosis consistent with acute toxic necrosis and fulminant hepatitis.
These findings are similar to the findings in patients with liver injury associated with green tea extract C. The exact mechanism of hepatotoxicity induced by Hydroxycut is unknown. However, as this product contains green tea extract C. Prior investigation into the mechanism of hepatotoxicity by green tea extract was inconclusive[ 21 ]. Others have hypothesized that a possible allergic reaction to the green tea extract, contamination during the production of the extract or a metabolic idiosyncrasy are possible mechanisms of liver injury in these patients[ 16 ].
Both of our patients took several Herbalife weight-loss herbal products concurrently, similar to most of the previously reported cases of hepatotoxicity due to Herbalife products[ 8 - 11 ]. Therefore, it is difficult to identify the exact ingredient or mechanism that causes the liver injury, as in the previously documented cases[ 8 - 11 ]. In a previously reported case, one investigator was able to isolate contamination with Bacillus subtilis , in which the bacterial supernatant caused dose-dependent increase of LDH leakage in HepG2 cells[ 8 ].
Although not commonly known as a human pathogen, B. Investigators have also suggested that another explanation for hepatotoxicity due to Herbalife products could be secondary to locally restricted contamination with chemicals such as softeners, preservatives, flavor enhancers, pesticides, or heavy metals either intentionally added during the production process or contained in the unrefined raw herb extracts[ 24 ].
This contamination hypothesis could also explain the different patterns of pathology seen on liver biopsy specimens previously observed in patients with hepatotoxicity from Herbalife products as both predominantly cholestatic injury pattern and acute hepatitis pattern have been reported[ 8 - 11 ]. Our patients had findings consistent with acute hepatitis due to drug-induced liver injury on their liver biopsy specimens. Due to the obesity epidemic, the usage of weight-loss herbal supplements has flourished.
Green tea extract is one of the key components in many of the over-the-counter weight-loss herbal supplements. Although significant liver injury induced by herbal supplements taken for weight loss purposes is a rare event, we cannot ignore the fact that there have been multiple reported cases in the medical literature of hepatotoxicity associated with weight-loss herbal supplements including Hydroxycut and Herbalife products.
Even though our patients successfully recovered from the adverse reactions, we must bear in mind that the hospitalization and medical care of these patients were associated with significant cost and healthcare resource utilization, while there is no evidence that herbal supplements can help with weight-loss[ 26 ].
We must also consider the impact on patients with underlying chronic liver disease, in whom herbal weight loss medications could cause worsening in their synthetic function and even fulminant failure. In May of , the US Food and Drug Administration warned consumers to immediately stop using Hydroxycut products, citing linkage to liver damage in one patient who died due to liver failure[ 27 ].
However, Hydroxycut products are currently still available in many parts of the world. Likewise, Herbalife products are widely available globally. In , Hughes attempted to take the company private after asserting that Wall Street was undervaluing the company. While the board approved the buyout offer, shareholders of the company filed a suit against the firm because they believed the share price they were offered was unfair. Hughes eventually abandoned his attempt to buy the company and settled the suit with shareholders.
On April 9, , the company's long-time auditor, KPMG , resigned after the KPMG executive who oversaw Herbalife audits admitted to providing insider information to a golfing friend about several companies, including Herbalife and Skechers. In March , Herbalife came under investigation by the U. Federal Trade Commission and the state of Illinois. The company also announced that its shareholders had approved a two-for-one stock split. Herbalife's "nutrition" products include weight-loss and protein shakes.
Other products include products for heart health , digestive health , skin care, and the 24 sports line. Some products are vegetarian, kosher , allergen free,  or halal. Herbalife's products are produced at the company's five manufacturing facilities in the U. As of , 58 percent of the company's nutrition products were manufactured at Herbalife owned facilities.
In China, the company's manufacturing sites are located in Suzhou , Nanjing. Herbalife's claims of health benefits from its products have met scrutiny from the medical community, consumers, and government agencies. In May , an organization known as the Fraud Discovery Institute reported that laboratory test results of Herbalife products showed lead levels in excess of limits established by law in California under Proposition Multiple independent labs reported finding lead in Herbalife products.
On May 10, , a civil lawsuit was filed on behalf of a woman who developed lead-related liver complaints that she claimed were a reaction to a combination of Herbalife products.
In , Israel's Health Minister began an investigation into Herbalife's products after four persons using Herbalife's products were found to have liver problems. Herbalife was accused of selling products containing toxic ingredients such as Qua-qua, Kompri, and Kraska. D , to a private U. A study of the cases funded by the Israeli Ministry of Health concluded that a causative relationship  is suggested by the evidence, which included the temporal association between exposure to Herbalife products and the development of liver injury, the negative evaluation of other potential causes of liver injury, the normalization of liver function when Herbalife products were discontinued, and the return of liver injury symptoms in three patients who resumed using Herbalife products after recovery.
Herbalife withdrew one product, which was only marketed in Israel, but not all of the Israeli patients had consumed this specific Herbalife product. The Israeli Ministry of Health advises individuals with compromised liver function to avoid dietary supplements. Scientific studies in by doctors at the University Hospital of Bern in Switzerland and the Liver Unit of the Hadassah-Hebrew University Medical Center in Israel found an association between consumption of Herbalife products and hepatitis.
Hospitals in Israel, Spain, Switzerland, Iceland, Argentina, and the United States had reported liver damage in a number of patients, some of whom had used Herbalife products.
After reviewing cases implicating Herbalife products in Spain, Switzerland, Israel, Finland, France, Italy, Iceland and Portugal, the member scientific panel issued a report concluding: The panel attributed the cases to metabolic changes from overzealous and unsupervised dieting.
A July peer-reviewed study published in the World Journal of Hepatology reexamined known cases of hepatoxicity that had previously been linked to consumption of Herbalife products and concluded that using "the liver specific Council for International Organizations of Medical Sciences scale, causality was probable in 1 case, unlikely and excluded in the other cases.
Thus, causality levels were much lower than hitherto proposed. Herbalife is a multi-level marketing company. As a result of the FTC settlement, the company is required to prove that at least 80 percent of its sales are made to individuals outside of its distributor network.
Distributors are responsible for providing receipts for sales and proving they have legitimate customers. In the past, company management considered the number and retention of distributors a key parameter and tracked it closely in financial reports.
By January of each year, sales leaders are required to requalify. In February of each year, individuals who did not satisfy the sales leader qualification requirements during the preceding 12 months are removed from that rank.
For the latest month requalification period ending January , approximately In a California class action suit Minton v. Herbalife International, et al. In a West Virginia class action suit Mey v. More specifically, the plaintiffs' complaint alleges that several of Herbalife International's distributors used pre-recorded telephone messages and autodialers to contact prospective customers in violation of the TCPA's prohibition of such practices.
Herbalife management insisted they have meritorious defenses in both cases and that, in the West Virginia case, any such distributor actions also went against Herbalife's own policies.
Management also contends that any adverse legal outcomes Herbalife might suffer would not significantly affect their financial condition, particularly since they have already set aside an amount that they "believe represents the likely outcome of the resolution of these disputes". As of April , a series of commercials featuring a large red animated fox advertising home-based business opportunities has been running on American television.
The advertisements direct viewers to a website that allows them to purchase a "success kit". The kit also provides no information about how the business opportunity works.
These advertisements have been found to be run by independent Herbalife distributors, as a method of recruiting new downline distributors. A settlement resolved a class action suit on behalf of 8, former and current distributors who accused the company and distributors of "essentially running a pyramid scheme. Einhorn said the short had been closed before the end of On December 20, , Bill Ackman of Pershing Square Capital presented a series of arguments outlining why his firm believed that Herbalife operates a "sophisticated pyramid scheme".
Ackman claimed that Herbalife distributors "primarily obtain their monetary benefits from recruitment rather than the sale of goods and services to consumers. Herbalife operates with the highest ethical and quality standards, and our management and our board are constantly reviewing our business practices and products. Herbalife also hires independent, outside experts to ensure our operations are in full compliance with laws and regulations.
Herbalife is not an illegal pyramid scheme. Herbalife also countered that Ackman based his accusations on a misunderstanding of the company's distributor base. At an investor conference in January , the company released results of a Nielsen Research International survey showing 73 percent of Herbalife distributors never intended to make money by reselling the product. Instead, they wanted to buy products at a discount for personal use.
Shortly thereafter, Icahn bought shares of Herbalife Intl. As Icahn continued to buy up HLF shares, the stock price continued to show strength. In March , Federal prosecutors and the FBI revealed that they were investigating whether or not individuals paid by Ackman and otherwise had made false statements about Herbalife's business model to regulators and others in order to lower the company's stock price and influence authorities to conduct an investigation.
In November , Ackman closed out his short position replacing it with a less aggressive put option. In March , the FTC opened an investigation into Herbalife in response to calls from consumer groups and members in both houses of Congress. We are confident that Herbalife is in compliance with all applicable laws and regulations.
The documentary Betting on Zero is about Herbalife, exploring the allegation from Bill Ackman that the company is a pyramid scheme and personal stories of Herbalife distributors who have lost their life savings due to the company. Filmmaker Ted Braun says that he "was making a film that looked at all sides," but believes that "the company instructed them [current Herbalife distributors] not to talk.
Oliver criticises Herbalife for its exploitation of Latino communities,  and overstatement of their product's health benefits. The book When The Wolves Bite: From Wikipedia, the free encyclopedia. This article may lend undue weight to certain ideas, incidents, or controversies. Please help improve it by rewriting it in an neutral presentation that contextualizes different points of view. July Learn how and when to remove this template message.