The state Health Department says a cluster of liver disease that began in May has sickened 32 people, and of those, 24 were found to be using the dietary supplement OxyELITE Pro.
However, the supplement is only being called a common denominator at this point, bot the root cause of the outbreak.
Doctors at the Queen’s Medical Center who have been treating liver disease patients said Thursday they can only speculate as to the cause of the cluster.
"Can I tell you if it's one specific drug? I couldn't tell you,” said transplant surgeon Dr. Linda Wong. “I mean it might be something in the race, it might be an ethnicity that has something to do with it. You know it might be genetic."
So far, two patients have received liver transplants, but doctors say several others could be put on a waiting list for a new liver. One woman died while awaiting a liver transplant.
“You just have to wait for your liver to see if it can regenerate enough to fix itself,” explained Wong. “Some of them that are not so sick, some of them are pretty angry.”
Unlike prescription medicine or over-the-counter drugs, dietary supplements don't receive the same government scrutiny. Doctors at the center of the liver disease cluster say that's a major problem.
"As a medical man I prescribe medicine, but my advice is don't take it if you don't need it," said Dr. Naoky Tsai, medical director of the Liver Center at Queen’s. "I really think that it's very important that our Congress will act to make sure that whatever the supplement, they put it under the same standards as the drugs that we use."
Doctors at Queen’s were also surprised as to why some patients were taking OxyELITE Pro. Some patients said they began using the product for an energy boost, not weight loss or muscle gain.
"So, there's a huge segment of the population that's taking this medication for the purpose that it was really not originally designed for," said Dr. Marina Roytman of the Liver Center.
Wong expects the number of liver disease cases to continue to grow in the coming days and weeks, partly due to the sheer number of people who may still be using OxyELITE Pro.
“Yeah there's more,” said Wong. “They're scheduling appointments in the office now even."
On Tuesday, the state Health Department asked retailers who are selling OxyELITE Pro to voluntarily pull the product from their shelves. On Thursday, health inspectors were going to individual stores to make verify compliance.
“We just want to make sure what they have on premise is inventoried and may be used further in this investigation,” said Peter Oshiro of Environmental Health Division. “That's why we're actually embargoing the products.”
Food and Drug Administration spokesman Steven Immergut said the federal agency is still in the preliminary stages of its investigation into the outbreak of liver disease in Hawaii, which includes a review of medical records and histories. The FDA is also reviewing production and product distribution records of OxyELITE Pro from associated manufacturing sites.
“FDA will make regulatory decisions based on the collective results and conclusions drawn from all of these activities,” Immergut wrote in an email.
USPLabs, which manufactures OxyELITE Pro has stopped all distribution of the product, but maintains the supplement is safe.
“The cluster of liver issues in Hawaii is a complete mystery and nothing like this has ever been associated with OxyELITE Pro in all of the years our products have been in the market,” read a statement Tuesday from USPLabs. “We know of no credible evidence linking OxyELITE Pro to liver issues.”