SACRAMENTO, Calif. — The wife of a Northern California congressman died late last year after ingesting a plant generally considered safe and used as an herbal remedy for a variety of ailments, including diabetes, obesity and high cholesterol, KHN learned. .
Lori McClintock, wife of U.S. Representative Tom McClintock, died of dehydration due to gastroenteritis – inflammation of the stomach and intestines – which was caused by “adverse effects of ingesting leaves of white mulberry,” according to a Sacramento County coroner’s report that is dated March 10 but not immediately made public. KHN obtained this report – in addition to the autopsy report and an amended death certificate containing an updated cause of death – in July.
The coroner’s office ruled his death accidental. The original death certificate, dated December 20, 2021, listed the cause of death as “pending.”
Tom McClintock, a Republican who represents a district that spans several northern and central California counties, found his 61-year-old wife unresponsive at their home in Elk Grove, Calif., on December 15, 2021, according to the coroner’s report. He had just returned from Washington, DC, after voting in Congress the night before.
It is unclear from the autopsy report whether Lori McClintock took a dietary supplement containing white mulberry leaves, ate fresh or dried leaves, or drank them in a tea, but mulberry leaf “partially intact” white was found in his stomach, according to the report.
McClintock’s death underscores the risks of the vast and burgeoning market for dietary supplements and herbal remedies, which have become a $54 billion industry in the United States – an industry that lawmakers and health experts say health care, requires further government scrutiny.
“A lot of people assume that if this product is sold in the United States of America, someone has inspected it and it must be safe. Unfortunately, that’s not always true,” the US senator said. Richard Durbin (D-Ill.) in the Senate this spring when he introduced legislation to strengthen oversight of dietary supplements.
Daniel Fabricator, CEO and president of the Natural Products Association, which represents the dietary supplement industry, wondered if McClintock’s death was supplement-related.
“It’s completely speculative. There is a science to this. It’s not just how a coroner feels,” said Manufacturer, who oversaw dietary supplements at the FDA during the Obama administration. “People unfortunately go through dehydration every day, and there are a lot of different reasons and a lot of different causes.”
Manufacturer said it would have been ideal for the coroner or family to report his death to the FDA so the agency could launch an investigation.
These reports are voluntary and it is not clear if anyone reported his death to the agency. FDA spokeswoman Courtney Rhodes said the agency was not discussing possible or ongoing investigations.
The FDA, added Manufacturer, has a system in place to investigate deaths that may be linked to a supplement or drug. “It’s case work,” he said. “It’s good old-fashioned policing that needs to be done.”
Tom McClintock has remained mostly silent about his wife’s death since releasing a statement on December 19, 2021, announcing it and paying his respects at her funeral on January 4. Until now, the cause of death had not been communicated.
Tom McClintock, contacted several times by phone and email on Wednesday, was not immediately available for comment.
At his wife’s funeral, McClintock told mourners she was fine when he spoke to her the day before he returned. She had told a friend that “she was on a roll” at a new job she loved at a Sacramento real estate agency, he said, and was “on a careful diet.”
“She just joined a gymnasium,” he said. “At home, she was counting down the days until Christmas, wrapping all the presents and making all the plans to make it the best family Christmas ever, and it would have been.”
According to the coroner’s report, however, the day before she died, “she complained of stomach aches”.
Sacramento County spokesman Kim Nava said via email Wednesday that the law prohibits the coroner’s office from discussing many details of specific cases. As part of any death investigation, the office “attempts to locate and review medical records and speak to family/witnesses to establish the events leading up to and surrounding a death,” she said. declared.
If any medications or supplements are found at the scene or relevant information is in the person’s medical records, those are forwarded to the pathologist to help establish the cause of death, Nava said.
“Any information the office obtains from medical records cannot be released to a third party, except by court order,” she said.
The leaves and fruits of the white mulberry, native to China, have been used for centuries in traditional medicine. University studies over the past decade have shown that an extract from its leaves can lower blood sugar and aid in weight loss. People take it in capsule or pill form, as an extract or powder. They can also infuse the leaves as a herbal tea.
Lori McClintock’s reaction seems unusual. According to the American Association of Poison Control Centers, no deaths from white mulberry have been reported to poison control officials in the past 10 years.
Since 2012, 148 cases of white mulberry plant ingestion have been voluntarily reported to poison control officials nationwide, most involving accidental ingestion by children 12 and younger, said Kaitlyn Brown, clinical chief executive of association. Only one case required medical follow-up, she said.
While poison control centers track white mulberry exposures, the FDA oversees dietary supplements, such as products containing white mulberry leaf extract. Since 2004, two cases of people made ill by mulberry supplements have been reported to the FDA, according to its database that tracks “adverse events.” It relies heavily on voluntary reports from healthcare professionals and consumers. At least one of these cases resulted in hospitalization.
According to research, white mulberry leaf may have side effects, including nausea and diarrhea. Independent lab tests ordered by the coroner’s office showed McClintock’s body had elevated levels of nitrogen, sodium and creatinine – all signs of dehydration, according to three pathologists who reviewed the coroner’s documents, which KHN redacted to remove McClintock’s name.
White mulberry leaves “have a tendency to cause dehydration, and part of the uses for this may be to help someone lose weight, primarily through fluid loss, which in this case was just a bit excessive “said Dr. D’Michelle DuPre, a retired medical examiner and former medical examiner from South Carolina who reviewed the documents.
Dietary supplements, which include a wide range of vitamins, herbs and minerals, are regulated by the FDA. However, they are classified as foods and do not undergo the rigorous scientific and safety testing that the government requires for prescription drugs and over-the-counter drugs.
Lawmakers aren’t proposing to put supplements in the same category as pharmaceuticals, but some say they’re alarmed that neither the FDA nor industry knows how many dietary supplements exist, making it nearly impossible for the government to monitor them and punish bad actors.
The FDA estimates that 40,000 to 80,000 supplements are on the market in the United States, and industry surveys estimate that 80% of Americans use them.
Legislation by Durbin and U.S. Sen. Mike Braun (R-Ind.) would require manufacturers to register with the FDA and provide a public list of ingredients in their products, two provisions backed by the Council for Responsible Nutrition, another industry group that represents supplement manufacturers.
But the council is pushing against a provision that would require supplement makers to provide consumers with the amounts of ingredients – or the mixture – in their products, which they say is akin to giving competitors a recipe. This is proprietary information that only government regulators should have access to, said Megan Olsen, the group’s senior vice president and general counsel.
Olsen explained that supplement makers are regulated like other food companies and are subject to strict labeling requirements and inspections by the FDA. They must also notify the agency of any adverse reactions reported by consumers or physicians.
“Companies test products throughout the process, looking at how they’re made and what’s in them,” Olsen said. “All of this is overseen and dictated by FDA regulations.”
The dietary supplement provisions have been incorporated into a broader Senate Health Committee bill that reauthorizes FDA programs, and senators are currently in negotiations with the House of Representatives. The Natural Products Association opposes all provisions relating to dietary supplements.
Because diet pills, teas, and other supplements are regulated as food products, manufacturers cannot advertise them as treatments or cures for health conditions. But they can make claims about how supplements affect the body. So, someone who wants to lose weight or control diabetes might seek out a bottle of white mulberry leaf extract, as some supplement makers promote it as a natural remedy that can lower blood sugar and promote weight loss.
These types of claims are appealing to Americans and have been particularly powerful during the pandemic as people seek to boost their immune systems and fend off covid-19, said Debbie Petitpain, registered dietitian nutritionist and spokesperson for the Academy of Nutrition and Dietetics. .
But dietary supplements can be dangerous and don’t affect everyone equally. Mixing supplements and prescription drugs can make the problem worse, according to the FDA.
“I think a lot of people think, ‘Oh, it’s a plant.’ Or, ‘Oh, it’s just a vitamin. That definitely means it won’t hurt me,” Petitpain said. “But there’s always a risk in taking anything.”
It is unclear why Lori McClintock was taking white mulberry leaves. Friends and family who gathered for her funeral described a vibrant and happy woman who loved her family and her work and had already wrapped Christmas presents under the tree in mid-December. She was considering buying an RV with her retired husband.
“We mourn the loss because of all the things she looked forward to and all the years to come,” Tom McClintock told mourners. “And we mourn something else, because we’ve all lost a really good person in our lives.”
This story was produced by KHNwho publishes California Healthlinean editorially independent service California Health Care Foundation.