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Blackmer K, Elsayad C. The Dangers of Unregulated Weight Loss Supplements: Tejocote-Induced Acute Liver Injury. Cureus 2024; 16:e57970. [PMID: 38738065 PMCID: PMC11086658 DOI: 10.7759/cureus.57970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/14/2024] Open
Abstract
Tejocote, a product of the hawthorn tree and a common staple of Hispanic culinary practices and traditional medicine, has recently gained traction in the United States and Mexico as a means to achieve rapid effortless weight loss. This herbal supplement has largely evaded regulation by governing bodies in both countries despite documentation of several potentially serious adverse effects associated with its use. The present report describes the case of a middle-aged Hispanic female who ingested Tejocote with famotidine and presented with acute gastrointestinal symptoms and transaminitis, an unexpected symptom that warrants further investigation.
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Affiliation(s)
- Kyle Blackmer
- Internal Medicine, Nassau University Medical Center, East Meadow, USA
| | - Chris Elsayad
- Internal Medicine, Nassau University Medical Center, East Meadow, USA
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Assi H, Najera C, Aboudawoud O, Nadella S, Bies JJ, Hassan M, Roongsritong C. Tejocote Root's Role in Symptomatic Mobitz Type 1 Heart Block: A Compelling Case Report. Cureus 2023; 15:e45228. [PMID: 37842399 PMCID: PMC10576468 DOI: 10.7759/cureus.45228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
The clinical presentation and diagnosis of Tejocote root toxicity causing Mobitz Type 1 remains a scarcely clinical phenomenon, often resulting in delayed diagnosis and treatment. This case report highlights a 30-year-old female presenting with a constellation of symptoms, including fatigue, dizziness, chest pressure, myalgias, nausea, vomiting, and peripheral tingling. Significantly, the patient had been using Tejocote root as an over-the-counter laxative acquired from Mexico. Laboratory findings revealed detectable Digoxin levels in her bloodstream, while an electrocardiogram (EKG) indicated sinus bradycardia with Mobitz Type 1 heart block. The patient was treated with a single dose of atropine 0.5 mg IV push. A repeat EKG before discharge showed resolution of the Mobitz type 1. This case underscores the potential cardiovascular repercussions of Tejocote root consumption and emphasizes the importance of heightened clinical awareness, especially in regions where such herbal supplement usage is prevalent.
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Affiliation(s)
- Heabah Assi
- Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Carolina Najera
- Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Omar Aboudawoud
- Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Sahithi Nadella
- Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Jared J Bies
- Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Mariam Hassan
- Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Chanwit Roongsritong
- Cardiology, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
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Shin D, Kang HS, Park EM, Kim J, Kwon J, Suh J, Moon G. Authentication of tejocote ( Crataegus mexicana) dietary supplements based on DNA barcoding and chemical profiling. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2021; 38:1985-1994. [PMID: 34415825 DOI: 10.1080/19440049.2021.1964701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Tejocote (Crataegus mexicana, Mexican hawthorn), known as a weight-loss supplement, has been marketed online and is easily available for overseas direct purchase. Alipotec (brand name) is known as one of the most popular products containing tejocote in Mexico and other countries. However, adverse effects have been reported by users of these supplements. Therefore it is necessary to find the reason for the side effect. Dietary supplement samples labelled as containing tejocote were analysed using mass spectrometry and DNA barcoding analysis. Our results demonstrate that Alipotec samples contained ingredients from different species, yellow oleander instead of tejocote. The rpoB barcode region was able to differentiate between tejocote and yellow oleander species. Moreover, it was also observed that three compounds, including thevetin B, neriifolin, and digitoxigenin, clearly distinguish between tejocote and yellow oleander samples. This is the first and preliminary investigation to use an integrated approach of both chemical and genomic profiling for the authentication of dietary supplement containing tejocote.
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Affiliation(s)
- Dasom Shin
- New Hazardous Substances Division, National Institute Of Food And Drug Safety Evaluation, Ministry Of Food And Drug Safety, Osong, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Hui-Seung Kang
- New Hazardous Substances Division, National Institute Of Food And Drug Safety Evaluation, Ministry Of Food And Drug Safety, Osong, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Eun Mi Park
- New Hazardous Substances Division, National Institute Of Food And Drug Safety Evaluation, Ministry Of Food And Drug Safety, Osong, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Jungju Kim
- New Hazardous Substances Division, National Institute Of Food And Drug Safety Evaluation, Ministry Of Food And Drug Safety, Osong, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Jeongeun Kwon
- New Hazardous Substances Division, National Institute Of Food And Drug Safety Evaluation, Ministry Of Food And Drug Safety, Osong, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Junghyuck Suh
- New Hazardous Substances Division, National Institute Of Food And Drug Safety Evaluation, Ministry Of Food And Drug Safety, Osong, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Guiim Moon
- New Hazardous Substances Division, National Institute Of Food And Drug Safety Evaluation, Ministry Of Food And Drug Safety, Osong, Cheongju, Chungcheongbuk-do, Republic of Korea
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Persaud S, Singh B, Angelo D. An Atypical Etiology of Acute Pericarditis: A Case Report. Cureus 2021; 13:e13440. [PMID: 33763323 PMCID: PMC7982003 DOI: 10.7759/cureus.13440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Acute pericarditis is caused by inflammation of the pericardial sac and is characterized by sharp and pleuritic chest pain, which is accompanied by a pericardial friction rub and serial electrocardiogram (ECG) changes. Although there are many known etiologies of pericarditis, we present the first known case of a herbal supplement, the Tejocote root, causing acute pericarditis in a previously healthy 23-year-old female. Her ECG showed t-wave inversions that resolved with colchicine and non-steroidal anti-inflammatory drug therapy. Prior studies have demonstrated that it can cause adverse cardiovascular effects, but this is the first documented case of the Tejocote root causing acute pericarditis. This case report reinforces the importance of inquiring about supplements patients may be taking, especially when looking for the etiology of pericarditis.
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Affiliation(s)
- Shelley Persaud
- Internal Medicine, HCA Medical Center of Trinity, Trinity, USA
| | - Bir Singh
- Internal Medicine, HCA Medical Center of Trinity, Trinity, USA
| | - Debra Angelo
- Internal Medicine, HCA Medical Center of Trinity, Trinity, USA
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