HSA warns of banned substances in herbal products

SINGAPORE – Consumers are advised not to use three products that are marketed as supplements or herbal products, as people reported falling sick after using them.

The products are C-Nine Dietary Supplement Product, Xue Ya Gao Zhong Feng Qing Cao Yao Cao and B-Lian-S Herbal Cream, the Health Sciences Authority (HSA) said in a statement on July 23.

Those who have bought these products should not use them. Consumers who are taking C-Nine Dietary Supplement Product should stop taking it immediately and see a doctor if they feel unwell.

Those who are using Xue Ya Gao Zhong Feng Qing Cao Yao Cao and B-Lian-S Herbal Cream should not stop using these products on their own, said HSA, as they contain potent steroids that can cause withdrawal symptoms such as fatigue, weakness and low blood pressure if their use is stopped suddenly. Instead, these consumers should see a doctor immediately.

Hallucinations, mood swings among side effects

C-Nine Dietary Supplement Product is marketed as a diet supplement for slimming, containing chia powder and chilli pepper powder.

A woman experienced heart palpitations, nausea, a constant feeling of thirst and a loss of appetite after consuming the product.

HSA tests found that the product contains sibutramine, a banned substance, as well as sennosides, an undeclared laxative.

Sibutramine is a prescription-only weight-loss medicine that was banned in Singapore in 2010 because it increases the risk of heart attacks and strokes. It is associated with serious side effects such as high blood pressure, irregular heartbeat, hallucinations and mood swings.

HSA found listings of C-Nine Dietary Supplement Product on online platforms Shopee, Lazada, Carousell, Facebook and TikTok. The agency has asked platform administrators to remove listings of the product, it said.

Signs of Cushing’s syndrome

Xue Ya Gao Zhong Feng Qing Cao Yao Cao is marketed as a herbal remedy.

PHOTOS: HEALTH SCIENCES AUTHORITY

Xue Ya Gao Zhong Feng Qing Cao Yao Cao, meanwhile, is marketed as a herbal remedy that claims to remove blood vessel blockages, relieve back pain and limb stiffness, and help with chronic conditions such as hypertension, stroke and diabetes.

A woman in her 60s bought the product at a market in Bentong, Malaysia, and took it regularly for 10 days for her knee pain and back pain, as well as to improve her blood circulation.

She experienced signs of Cushing’s syndrome – characterised by a rounded “moon face” appearance and abnormal fat accumulation on the upper back – and became lethargic when she stopped using the product.

A family friend who is a pharmacist suspected that the product had been adulterated and reported the case to HSA.

HSA’s analysis revealed that it contains dexamethasone, a potent prescription steroid that should be used only under strict medical supervision.

Long-term, unsupervised use of such steroids can lead to increased blood sugar levels, high blood pressure, cataracts, muscle and bone disorders, an increased risk of infections and Cushing’s syndrome, HSA said.

The agency added that discontinuing these steroids without medical supervision can lead to withdrawal effects and adrenal insufficiency, a serious condition where the body does not produce adequate amounts of steroid hormones after stopping long-term steroid use. This may cause fatigue, generalised weakness, muscle and joint pain, low blood pressure, fits or shock.

The woman has since recovered after she sought treatment at an accident and emergency department and stopped using the product, said HSA, adding that from its investigations, there are no known local suppliers of the product.

12-year-old boy developed stretch marks

B-Lian-S Herbal Cream is marketed as a “natural extract formula” with “zero steroids” to manage conditions such as psoriasis and eczema.

A 12-year-old boy applied it regularly for two months to treat his eczema, after his mother placed an order with a vendor based in Malaysia over Facebook Messenger.

The boy rapidly gained 6kg over this period and developed stretch marks on his legs.

The boy developed stretch marks on his legs after applying B-Lian-S Herbal Cream regularly for two months for his eczema.

PHOTO: CONTRIBUTED BY PATIENT

HSA’s tests found that B-Lian-S Herbal Cream contains clobetasol, a potent steroid that should be used only under strict medical supervision, as well as miconazole, an anti-fungal agent.

The agency’s investigations found that the overseas vendor’s social media account was linked to a Shopee store. HSA worked with the platform administrator to disable the online store, and the relevant Malaysian authorities were alerted to the Facebook account.

The public is advised to steer clear of health products or supplements from unverified sources, especially those sold online, as these may contain harmful ingredients.

Sellers and suppliers are liable to prosecution and, if convicted, may be jailed for up to two years, fined up to $10,000, or both.

Those who have any information on the sale or supply of such illegal products may contact HSA on 6866-3485 during office hours from Monday to Friday, or via e-mail at hsa_is@hsa.gov.sg

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