A Unique Presentation of Creutzfeldt-Jakob Disease in a Patient Consuming Deer Antler Velvet
*Joseph Wiedemer, *Yanely Sanchez Ceja, An Cao and Ibrahim Mustafa Department of Neurology, Wright State University Boonshoft School of Medicine, USA Article history
Received: 17-02-2021 Revised: 08-03-2021 Accepted: 13-03-2021
Corresponding Author: Joseph Wiedemer Department of Neurology, Wright State University Boonshoft School of Medicine, USA
Email: Wiedemer.2@wright.edu
*These authors contributed equally to this work and are considered to be co-first authors
Abstract: Creutzfeldt-Jakob Disease (CJD) is a rare rapidly progressive neurodegenerative prion disorder that is usually sporadic but may also be acquired from exposure to infected sources, classically via infections of bovine or human etiology. Cervid transmission of CJD is of particular concern in North America given the rapid spread of Chronic Wasting Disease (CWD)- the Cervid version of CJD. We present a 61-year-old male patient admitted to our service with a one month history of progressive confusion and gait instability, which led to an initial suspicion of Corticobasal Syndrome (CBS) with unusually rapid progression. CJD was also suspected upon learning that the patient began taking deer antler velvet and bovine colostrum supplements roughly two months prior. The diagnosis of CJD was subsequently confirmed by MRI and RT-QuIC CSF assay. Providers should consider Creutzfeldt-Jakob Disease in the differential diagnosis of a patient with cervid exposure and/or in patients with a presentation resembling corticobasal degeneration, especially if symptom onset is rapid. Although it is unclear how this patient acquired CJD, the potential for prion transmission from cervids to humans should be further investigated by the academic community with considerable urgency.
Introduction
Creutzfeldt-Jakob Disease (CJD) is a rare, rapidly progressive neurodegenerative prion disorder that is inevitably fatal within a year of diagnosis (Iwasaki, 2017). In the US, 5,212 cases of prion disease demonstrated a median age of death of 67 years, an even gender distribution and an increased annual incidence among those >65 years of age between 2003-2015 (Maddox et al., 2020). CJD most-commonly presents in a sporadic form, but is observed in ~15% of cases as acquired variant-CJD (vCJD), in which prions are transmitted to humans from bovine, cannibalistic, or iatrogenic origins (Iwasaki, 2017; Maddox et al., 2020). Acquired prion disease in humans is also known as Transmissible Spongiform Encephalopathy (TSE) and is most famously exemplified by the bovine-derived TSE outbreak in the United Kingdom-commonly referred to as “mad cow disease”-which occurred in 1986 and peaked in 1993 (Casalone and Hope, 2018).
Prion disease of elk and deer is known as Chronic Wasting Disease (CWD) and is also known to be inevitably fatal (USGS National Wildlife Health Center, 2020; Hannaoui et al., 2017). Unlike human prion disease, CWD is highly contagious among cervids and has been expeditiously spreading throughout North America (USGS National Wildlife Health Center, 2020; Hannaoui et al., 2017; Waddell et al., 2018; Moreno and Telling, 2017). Furthermore, in contrast to CJD, prion disease in cervids typically has a subtle clinical presentation, which makes diagnosis and ecological analyses extremely difficult (Hannaoui et al., 2017; Moreno and Telling, 2017). In the United States, documented cases of CWD have spread from 2 to 26 states since 2000 (USGS National Wildlife Health Center, 2020; Osterholm et al., 2019). Attempts to develop an oral vaccine for livestock against CWD have shown recent promise, but the risk of transmission to humans remains poorly understood (Taschuk et al., 2017). A statewide epidemiological study in Colorado in 2006 was equivocal in discerning an increased risk of CJD in areas heavily impacted by CWD between 1979-2001 (RR 0.81, CI 0.40-1.63) (MaWhinney et al., 2006). Such studies have been unable to determine the risk of prion transmission by cervids largely due to the rare frequency of CJD, diagnostic difficulties and variability of symptom onset following exposure (MaWhinney et al., 2006; Nemani et al., 2020).
Although there are no confirmed cases of prion transmission from Cervids to date, there have been several published cases of CJD suspicious for cervid etiology (Angers et al., 2009). The concern of prion transmission from cervids was raised as early as 2001 in a case series that highlighted three separate occurrences of unusually young patients diagnosed with vCJD in the United States (Belay et al., 2001). Two of the patients were frequent hunters and one of the patients was a daughter of a hunter. All three patients had regularly consumed deer and elk meat, which prompted the suspicion for cervid transmission in the absence of any alternative etiology (Belay et al., 2001). Nonetheless, a causal link between the patients’ CJD and their histories of cervid exposure could not be definitively concluded (Belay et al., 2001). A comprehensive review by (Waddell et al., 2017) highlighted two additional case series collectively highlighting 5 patients with CJD who had similar exposures to Cervids without any alternative source explaining their disease.
Prions in deer and elk with CWD are primarily derived directly from antler velvet, which is a highly innervated and vascularized tissue layer that sheds cyclically upon antler ossification (Angers et al., 2009). However, CWD-infected cervids are also capable of shedding prions into the environment through feces, urine and saliva (Hannaoui et al., 2017). In all species, prion disease is caused by the conversion of cellular prion protein (PrPC ) to a pathological “scrapie” prion protein (PrPSC) which rapidly propagates and accumulates in tissue, primarily in the CNS (Iwasaki, 2017; Moreno and Telling, 2018). In humans, this conversion is believed to be from a sporadic or acquired mutation of the PrPC gene PRNP located on the short arm of chromosome 20, which codes for 253 amino acids prior to post-translational modification (Iwasaki, 2017). Multiple mutations of the PRNP gene have been identified that can both cause CJD or increase a host’s susceptibility to prion propagation (Iwasaki, 2017; Nemani et al., 2020). Thus, there is growing concern that stronger CWD variants may exist or arise in cervids breaking ostensible species barriers that may exist (Hannaoui et al., 2017; Nemani et al., 2020; Moreno and Telling, 2018).
Several in vivo animal models have demonstrated plausible cervid to human prion transmission, which is most effectively summarized by (Moreno and Telling, 2017; Angers et al., 2009). Most notably, a 2015 study successfully transmitted CWD prions from elk and mule deer via intracerebral injection into transgenic mice expressing human PrP (Kurt and Sigurdson, 2016). Three published studies- the most recent of which in 2014- have demonstrated successful CWD prion transmission to non-human primates (Waddell et al., 2018). The time from prion exposure to symptom onset varied significantly between studies from 70 days to several months (Waddell et al., 2018). Moreover, (Waddell et al., 2018) also highlighted three successful in vitro studies published demonstrating a strong conversion efficiency of CWD prions on human PrP, the most recent of which published in 2015.
Case Report
A 61 year-old right-handed Caucasian male presented with a one-month history of progressive confusion and gait instability ultimately leading to a 13 day admission. He was found to have moderate cognitive impairment, apathetic affect, left-sided alien hand phenomenon and apraxia, positive Romberg and a dystonic gait pattern with short stride length. The patient was unable to walk without assistance, which prompted an initial suspicion of CBS with unusually rapid progression. The patient also had an extensive history of exotic supplement use going back several years, but notably began taking deer antler velvet and bovine colostrum supplements roughly two months prior. He had no recent travel history, potential occupational exposure to CJD, or family history of prion or neurologic disease. His medical history included hyperlipidemia, distant tobacco use and an incident of diverticulitis several years ago, all of which was considered noncontributory. The patient worked in an office setting, had never been hunting and did not eat deer or elk meet.
Initial Head CT and MRI imaging were unremarkable. A lumbar puncture was performed to evaluate meningitis, autoimmune markers and later 14-3-3 and Rt-QuIC when CJD was suspected (Table 1). A 3-day trial of 1g of Methylprednisolone failed to yield symptomatic improvement and the patient’s presentation continued to progress. Repeat Brain MRI w/ and w/o contrast on day #4 of admission demonstrated asymmetric hyperintense cortical ribboning on diffusion-weighted imaging in the right paramedian frontal and parietal cortex as well as a hyperintensity in the right caudate nucleus (Fig. 1). A subsequent EEG demonstrated periodic triphasic waves typical for CJD patients, which was only transiently attenuated by a trial of benzodiazepines without corresponding symptomatic improvement (Fig. 2) (Iwasaki, 2017; Steinhoff et al., 1996). A third MRI obtained on day #6 of admission showed findings similar to the previous MRI with slightly more hyperintense signal.
The patient continued to demonstrate a progressive decline in neurological status throughout his admission. A Montreal Cognitive Assessment (MoCA) on admission day #5 yielded a score of 17/30 demonstrating significant cognitive impairment (Fig. 3). After failing to reach a definitive diagnosis despite an extensive workup, the patient and his family agreed to discharge to hospice with a likely CJD etiology. Following discharge to hospice, CSF results for protein 14-3-3 and RT-QuIC came back positive, which confirms CJD with 100% specificity (Iwasaki, 2017). A further post-mortem workup is tentative to date and it remains unclear whether this patient’s CJD was sporadic or acquired from exposure to prion-infected cervids or otherwise.
An extensive data query using the lot number and manufacturer information obtained from the patient’s supplements revealed no recalls or reported adverse events of any form from either supplement. Investigation into these supplements showed that the deer antler velvet supplement was curated from a farm in Idaho. There are several known areas significantly impacted by CWD near the Idaho border, which is diligently monitored by state and federal agencies (USGS National Wildlife Health Center, 2020).
Discussion
The bovine-derived CJD outbreak in the United Kingdom of the late 1980s was met with a robust public health and regulatory response and only rare, isolated bovine-derived cases of CJD have been reported in the last 20 years (Iwasaki, 2017). Thus, we believe that it is highly unlikely our patient acquired CJD from the bovine colostrum supplement. Prions specifically from deer antler velvet have been shown to be capable of human transmission through transgenic mouse models, in one case as early as 70 days from inoculation (Moreno and Telling, 2017; Angers et al., 2009). This timeline would support the theory that this patient acquired CJD from the deer antler velvet supplement, as his exposure began at least 60 days prior to the onset of symptoms. It is worth noting that this is the first known case of CJD in which a patient directly consumed deer antler velvet, which is believed to be the primary location of prion propagation in Cervids (Moreno and Telling, 2017; Nemani et al., 2020). This is particularly notable because all other published cases describe cervid exposure from animal meat consumption or hunting.
It is also notable that the patient’s clinical presentation was uniquely similar to Corticobasal Degeneration (CBD) with rapid progression for several reasons. Although myoclonus can be appreciated in both diseases, CJD is known to have a significantly more rapid progression and the diseases are largely distinguishable. However, recently published literature has demonstrated that CBD and CJD share many histological similarities (Iwasaki, 2017). Moreover, it is conceivable that a potential case of CJD acquired from Cervids could yield a unique clinical presentation like that observed in bovine TSE (Moreno and Telling, 2017).
Conclusion
We believe that our patient’s case of CJD is highly suspicious for cervid etiology given the circumstances of the case as well as the strong evidence of plausibility reported in published literature. This is the first known case of CJD in a patient who had consumed deer antler velvet. Despite the confirmed diagnosis of CJD, a causal relationship between the patient’s disease and his consumption of deer antler velvet cannot be definitively concluded.
Supplemental data including molecular tissue sample analysis and autopsy findings could yield further supporting evidence. Given this patient’s clinical resemblance to CBD and the known histological similarities of CBD with CJD, clinicians should consider both diseases in the differential diagnosis of patients with a similarly esoteric presentation. Regardless of the origin of this patient’s disease, it is clear that the potential for prion transmission from cervids to humans should be further investigated by the academic community with considerable urgency.
''We believe that our patient’s case of CJD is highly suspicious for cervid etiology given the circumstances of the case as well as the strong evidence of plausibility reported in published literature. This is the first known case of CJD in a patient who had consumed deer antler velvet. Despite the confirmed diagnosis of CJD, a causal relationship between the patient’s disease and his consumption of deer antler velvet cannot be definitively concluded.''
i believe that there is more than enough evidence to think of this cases as highly possible cwd zoonosis from deer antler velvet... imo...terry
SUNDAY, JULY 24, 2016
Chronic Wasting Disease Prions in Elk Antler Velvet and Marketing of this Product in Nutritional Supplements for Humans?
Research Project: TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES: THE ROLE OF GENETICS, STRAIN VARIATION, AND ENVIRONMENTAL CONTAMINATION IN DISEASE CONTROL
Title: Chronic Wasting Disease Prions in Elk Antler Velvet
Authors
item Angers, R - UNIVERSITY OF KENTUCKY item Napier, D - UNIVERSITY OF KENTUCKY item Seward, T - UNIVERSITY OF KENTUCKY item Green, M - UNIVERSITY OF KENTUCKY item Spraker, T - COLORADO STATE UNIVERSITY item O'Rourke, Katherine item Balachandran, A - CANADIAN FOOD INSPCTN AG item Telling, G - UNIVERSITY OF KENTUCKY
Submitted to: Emerging Infectious Diseases Publication Type: Peer Reviewed Journal Publication Acceptance Date: February 1, 2009
Citation: Angers RC, Seward TS, Napier D, Green M, Hoover E, Spraker T, et al. 2009. Chronic wasting disease prions in elk antler velvet. Emerg Infect Dis 15(5):696-703.
Interpretive Summary: Chronic wasting disease (CWD) is a fatal neurologic disease of deer and elk in the United States and Canada. The disease is associated with accumulations of infectious proteins in the brain, nervous system, blood, and a limited number of other tissues. In this study, the investigators examined elk antler velvet, the covering that grows on elk antlers every year. Antler velvet is rich in blood and nervous supply and may represent a source of infectious material as the velvet is shed every year. Antler velvet and brain tissue from four infected elk was examined by immunohistochemistry and biochemical methods, with no evidence of the abnormal prion protein in antler velvet. The same preparations were tested in genetically engineered mice susceptible to CWD. Mice in both inoculated groups developed prion disease. This finding demonstrates that antler velvet from CWD infected elk contain infectious material and may represent a risk material to other elk. Technical Abstract: Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy or prion disease of captive and free ranging white tailed deer, mule deer, Rocky Mountain elk and moose in the some parts of the United States and Canada. The presence of the disease has sharply curtailed movement of captive animals and reduced the domestic or international market for some cervid by-products. The disease appears to be transmitted by Rocky Mountain elk relatively late in the disease course, but the sources of the infectious material remain undefined. Brain and lymphoid tissue contain the highest levels of the abnormal prion protein, the marker for disease, and transmission in white tailed deer can be accomplished by blood transfusion from experimentally infected deer to naive deer. In this study, the investigators examined the transmission potential of antler velvet, a highly vascularized and innervated epidermal tissue covering the growing antler. Antler velvet is shed each year and is widely used as a nutritional supplement. Genetically engineered mice susceptible to CWD were inoculated with homogenates of paired brain and antler velvet from 4 elk with CWD. Mice in both groups developed a transmissible spongiform encephalopathy. These findings demonstrate prion infectivity accumulates in antler velvet and may have impact on marketing of this product.
Last Modified: 7/24/2016
Chronic Wasting Disease Prions in Elk Antler Velvet
Rachel C. Angers,1 Tanya S. Seward, Dana Napier, Michael Green, Edward Hoover, Terry Spraker, Katherine O’Rourke, Aru Balachandran, and Glenn C. Telling
Chronic wasting disease (CWD) is a contagious, fatal prion disease of deer and elk that continues to emerge in new locations. To explore the means by which prions are transmitted with high efficiency among cervids, we examined prion infectivity in the apical skin layer covering the growing antler (antler velvet) by using CWD-susceptible transgenic mice and protein misfolding cyclic amplification. Our finding of prions in antler velvet of CWD-affected elk suggests that this tissue may play a role in disease transmission among cervids. Humans who consume antler velvet as a nutritional supplement are at risk for exposure to prions. The fact that CWD prion incubation times in transgenic mice expressing elk prion protein are consistently more rapid raises the possibility that residue 226, the sole primary structural difference between deer and elk prion protein, may be a major determinant of CWD pathogenesis.
snip...
Implications for Horizontal CWD Transmission and Human Exposure
Our studies indicate that antler velvet represents a previously unrecognized source of CWD prions in the environment. Whereas oral transmission of rodent-adapted scrapie prions is known to be ≈5 orders of magnitude less efficient than transmission by intracerebral inoculation (14,15), the relative efficiency of oral CWD prion transmission is unknown. Multiple exposures to low levels of CWD prions in the environment (16,17), as well as increased infectivity when prions are bound to soil minerals (18), are factors that may influence transmission.
The appearance of variant Creutzfeldt-Jakob disease in humans exposed to bovine spongiform encephalopathy (BSE) (19,20) and the demonstration of CWD prions in muscle (3) placed the human species barrier to CWD prions at the forefront of public health concerns. Our studies indicate that antler velvet represents an additional source for human exposure to CWD prions. Widely used in traditional Asian medicine to treat a variety of ailments including impotence, arthritis, and high blood pressure, antler velvet can be readily purchased in caplet form and its usage has increased worldwide.
Fortunately, to date there is no epidemiologic evidence that rates of CJD in the CWD-endemic region (Colorado, USA) have increased (21,22). Also reassuring is the inefficient in vitro conversion of human PrP to protease-resistant PrP by CWD (23). Two studies have shown that CWD prions failed to induce disease in Tg mice expressing human PrP (24,25). However, the failure of BSE to be transmitted to Tg mice expressing human prion protein (HuPrP) was cited as early evidence of a BSE transmission barrier in humans (26); subsequent studies demonstrated a strong effect of the codon 129 polymorphism on transmissibility of BSE prions (27). To date, only mice expressing HuPrP with methionine at 129 have been challenged with CWD. In support of the argument that humans might be susceptible to CWD, intracerebral inoculation of squirrel monkeys produced disease after >30 months (28). Prion strain properties are also critical when considering the potential for interspecies transmission. The existence of multiple CWD strains has been suggested by several studies (4,25,29,30), but strain isolation and host range characterization have not been reported. Finally, it is worth considering that if CWD were to cross the species barrier into humans, this transmission source might not be recognized if the disease profile overlapped with one of the forms of sporadic CJD reported in North America.
snip...end
Volume 15, Number 5—May 2009
Research
Chronic Wasting Disease Prions in Elk Antler Velvet
ABOUT that deer antler spray and CWD TSE PRION...
I have been screaming this since my neighbors mom died from cjd, and she had been taking a supplement that contained bovine brain, bovine eyeball, and other SRMs specified risk materials, the most high risk for mad cow disease.
just saying...
I made a submission to the BSE Inquiry long ago during the BSE Inquiry days, and they seemed pretty interested.
Sender: "Patricia Cantos"
To: "Terry S Singeltary Sr. (E-mail)"
Subject: Your submission to the Inquiry
Date: Fri, 3 Jul 1998 10:10:05 +0100
3 July 1998
Mr Terry S Singeltary Sr.
Ref: E2979
Dear Mr Singeltary,
Thank you for your E-mail message of the 30th of June 1998 providing the Inquiry with your further comments.
Thank you for offering to provide the Inquiry with any test results on the nutritional supplements your mother was taking before she died.
As requested I am sending you our general Information Pack and a copy of the Chairman's letter. Please contact me if your system cannot read the attachments.
Regarding your question, the Inquiry is looking into many aspects of the scientific evidence on BSE and nvCJD. I would refer you to the transcripts of evidence we have already heard which are found on our internet site at ;
Could you please provide the Inquiry with a copy of the press article you refer to in your e-mail? If not an approximate date for the article so that we can locate it?
In the meantime, thank you for you comments. Please do not hesitate to contact me on...
snip...end...tss
everyone I tell this too gets it screwed up...MY MOTHER WAS NOT TAKING THOSE SUPPLEMENTS IPLEX (that I ever knew of). this was my neighbors mother that died exactly one year _previously_ and to the day of sporadic CJD that was diagnosed as Alzheimer’s at first. my mother died exactly a year later from the Heidenhain Variant of Creutzfeldt Jakob Disease hvCJD, and exceedingly rare strains of the ever growing sporadic CJD’s. _both_ cases confirmed. ...kind regards, terry
TSEs i.e. mad cow disease's BSE/BASE and NUTRITIONAL SUPPLEMENTS
IPLEX, mad by standard process;
vacuum dried bovine BRAIN, bone meal, bovine EYE, veal Bone, bovine liver powder, bovine adrenal, vacuum dried bovine kidney, and vacuum dried porcine stomach.
also;
what about potential mad cow candy bars ?
see their potential mad cow candy bar list too...
THESE are just a few of MANY of just this ONE COMPANY...TSS
DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION CENTER FOR BIOLOGICS EVALUATION AND RESEARCH
TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES ADVISORY COMMITTEE
Friday, January 19, 2001 snip...
17 But I think that we could exhibit some quite
18 reasonable concern about blood donors who are taking dietary
19 supplements that contain a certain amount of unspecified-
20 origin brain, brain-related, brain and pituitary material.
21 If they have done this for more than a sniff or something
22 like that, then, perhaps, they should be deferred as blood
23 donors.
24 That is probably worse than spending six months in
25 the U.K.
1/19/01
3681t2.rtf(845) page 501
see full text ;
everyone I tell this too gets it screwed up...MY MOTHER WAS NOT TAKING THOSE SUPPLEMENTS IPLEX (that I ever knew of). this was my neighbors mother that died exactly one year _previously_ and to the day of sporadic CJD that was diagnosed as Alzheimer’s at first. my mother died exactly a year later from the Heidenhain Variant of Creutzfeldt Jakob Disease hvCJD, and exceedingly rare strains of the ever growing sporadic CJD’s. _both_ cases confirmed. ...kind regards, terry
TSEs i.e. mad cow disease's BSE/BASE and NUTRITIONAL SUPPLEMENTS
IPLEX, mad by standard process;
vacuum dried bovine BRAIN, bone meal, bovine EYE, veal Bone, bovine liver powder, bovine adrenal, vacuum dried bovine kidney, and vacuum dried porcine stomach.
also;
what about potential mad cow candy bars ?
see their potential mad cow candy bar list too...
THESE are just a few of MANY of just this ONE COMPANY...TSS
DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION CENTER FOR BIOLOGICS EVALUATION AND RESEARCH
TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES ADVISORY COMMITTEE
Friday, January 19, 2001 snip...
17 But I think that we could exhibit some quite
18 reasonable concern about blood donors who are taking dietary
19 supplements that contain a certain amount of unspecified-
20 origin brain, brain-related, brain and pituitary material.
21 If they have done this for more than a sniff or something
22 like that, then, perhaps, they should be deferred as blood
23 donors.
24 That is probably worse than spending six months in
25 the U.K.
1/19/01
3681t2.rtf(845) page 501
Docket Management Docket: 96N-0417 - Current Good Manufacturing Practice in Manufacturing, Packing, or Holding Dietary Ingredients a Comment Number: EC -2 Accepted - Volume 7
see full text ;
2003 - 2004 Product Catalog
Standard Process Inc.
NATURAL COCOA STANDARDBAR (mad cow candy bar) (i will just list animal organs) bovine adrenal, bovine liver, bovine spleen, ovine spleen, bovine kidney...
NATURAL PEANUT BUTTER STANDARDBAR
bovine adrenal, bovine liver, bovine spleen, ovine spleen, bovine kidney...
USF (MAD COW) OINTMENT (RUB A DUB DUB, KURU ETC) ;
bovine orhic glandular extract
UTROPHIN PMG
bovine uterus PMG
VASCULIN
bovine heart PMG extract, veal bone PMG extract, bovine liever, porcine duodenum, bovine adrenal Cytosol extract, bovine spleen, ovine spleen
IPLEX (neighbors mom died from CJD while taking these pills for years)
bovine eye PMG extract, veal bone PMG, bovine liver, porcine stomach, bovine adrenal, bovine kidney, bovine adrenal Cytosol extract, BOVINE BRAIN, bovine bone, veal bone meal
MYO-PLUS
bovine heart PMG, bovine liver, porcine stomach, bovine orchic extract, bovine spleen, ovine spleen, bovine adrenal Cytosol extract, BOVINE BRAIN
NEUROPLEX
bovine orchic Cytosol extract, bovine spleen, BOVINE BRAIN PMG EXTRACT, BOVINE ANTERIOR PITUITARY, bovine liver, BOVINE PITUITARY PMG EXTRACT, AND MORE BOVINE BRAIN...
NEUROTROPHIN PMG
BOVINE BRAIN PMG
NIACINAMIDE B6 VM
bovine liver, porcine stomach, bovine spleen ovine spleen, BOVINE BRAIN
OCULOTROPHIN PMG BOVINE EYE PMG
ORCHEX
bovine liver, bovine orchic Cytosol extract, porcine stomch, bovine spleen, ovine spleen, BOVINE BRAIN
OSTARPLEX
veal bone PMG extract, veal bone PMG extract, bovine liver, porcine stomach, bovine adrenal, bovine spleen, ovine spleen, BOVINE BRAIN
PARAPLEX
bovine pancreas PMG extract, porcine duodenum, bovine adrenal PMG, BOVINE PITUITARY PMG EXTRACT, bovine thyroid PMG extract
PITUITROPHIN PMG
RUMAPLEX
BOVINE BRAIN, veal bone PMG extract, bovine adrenal, bovine prostate Cytosol extract, veal bone meal, bovine liver PMG extract, bovine spleen, ovine spleen, bovine liver
SENAPLEX
bovine liver PMG extract, bovine adrenal, BOVNE BRAIN, veal bone meal, bovine kidney, bovine orchic extract, bovine spleen, ovine spleen ..........
THESE are just a few of MANY of just this ONE COMPANY.
FOR the following reason, I implore that the FDA take serious action in further protecting the consumer from the TSE agent via nutritional supplements.
Does all that e-mail spam promising sexual vitality actually hide serious risk of contracting MAD COW DISEASE?
Volume 361, Number 9368 03 May 2003
Correspondence
Tighter regulation needed for dietary supplements in USA
Sir--Mary Palmer and colleagues (Jan 11, p 101)1 found that dietary supplements have the potential to cause serious adverse effects. The investigators state that research on the hazards and risks of dietary supplements should be a priority. The safety of individuals who consume these products is important, and organisations such as the US Food and Drug Administration (FDA) need to take initiative by enforcing stricter regulations on supplements. Several commonly used products--for example ginkgo biloba, St John's Wort, and ephedrine--can have serious adverse effects.2 Although the FDA requires multiple studies on the safety and efficacy for pharmaceutical products before placing them on the market, standards are less robust for dietary supplements. In the USA, under the Dietary Supplement Health and Education Act (DSHEA) of 1994, supplements are subject to the same regulatory requirements as food. There are no provisions that require FDA approval for the safety or effectiveness of supplements,3 which leaves consumers and manufacturers essentially responsible for the health effects of these products. The DSHEA of 1994 needs to be revised so that dietary supplements are subject to the same regulations as pharmacological drugs. The FDA needs to review clinical studies on the safety and efficacy of dietary supplements. Organisations such as Public Citizen and the American Medical Association are already taking steps to achieve these changes. However, they face immense opposition from groups such as the National Nutritional Foods Association, the American Herbal Association, and the Council for Responsible Nutrition. To overcome such resistance, consumer organisations, health-care providers, and government agencies need to approach this subject in unison. The public needs to be able to assess the risks and benefits of dietary supplements before consuming them. Health-care providers and the more than 100 million Americans who consume these products4 should encourage the FDA to treat supplements with the stringent regulations it enforces on pharmaceutical products.
Nipa Kinariwala
----------------------------------------------------------
700 Bolinwood Drive, Apartment 12A, Chapel Hill, NC 27514, USA (e-mail nskinari at
aol.com) 1 Palmer ME, Haller C, McKinney PE, et al. Adverse events associated with dietary supplements: an observational study. Lancet 2003; 361: 101-06. [Text ] 2 Cupp MJ. Herbal remedies: adverse effects and drug interactions. Am Fam Physician 1999; 59: 1239-45. [PubMed ] 3 Unites States Food and Drug Administration. Overview of dietary supplements. Jan 3, 2001.
http://www.cfsan.fda.gov/~dms/ds-oview.html (accessed Feb 20, 2002). 4 Pear R. Feds call for tighter control over nutritional supplements. Organic Consumers Association, April 17, 2001.
http://www.organicconsumers.org/Organic/dietsupp.cfm (accessed Feb 20, 2002).
snip...end tss letter to fda.
=================== 2013 ================
my plight with Metabolife, the GAO et al, and my submission to the BSE inquiry, about mad cow in a pill ;
Wednesday, March 20, 2013
GAO-13-244, Mar 18, 2013 Dietary Supplements FDA May Have Opportunities to Expand Its Use of Reported Health Problems to Oversee Product
From: Terry S. Singeltary Sr.
Sent: Tuesday, March 19, 2013 2:46 PM
Monday, February 01, 2010
Import Alert 17-04 BSE CJD HIGH RISK TISSUES, Nutritional Supplements and Cosmetics Import Alert 17-04
Thursday, March 19, 2009
Chronic Wasting Disease Prions in Elk Antler Velvet (Nutritional Supplements and CJD)
10.3201/eid1505.081458 Suggested citation for this article: Angers RC, Seward TS, Napier D, Green M, Hoover E, Spraker T, et al. Chronic wasting disease prions in elk antler velvet. Emerg Infect Dis. 2009 May; [Epub ahead of print]
Docket Management Docket: 96N-0417 - Current Good Manufacturing Practice in Manufacturing, Packing, or Holding Dietary Ingredients a
Comment Number: EC –2
Accepted - Volume 7
Docket Management Docket: 96N-0417 - Current Good Manufacturing Practice in Manufacturing, Packing, or Holding Dietary Ingredients a Comment Number: EC -2 Accepted - Volume 7
snip...
what did Paul Brown say about this previously;
i bring your attention to (page 500) Dr. Paul Brown statements;
253 1 DR. BOLTON: I have an additional question about 2 that. What is the assurance that additional locally sourced 3 tracheas are not added into that manufacturing process, thus 4 boosting the yield, if you will, but being returned to the 5 U.S. as being produced from U.S.-sourced raw material? 6 DR. McCURDY: Are there data to indicate how many 7 grams, or whatever, of infected brain are likely to infect 8 an organism, either animal or man, when taken orally? 9 DR. BROWN: If I am not mistaken, and I can be 10 corrected, I think a half a gram is enough in a cow, orally; [FULL TEXT ABOUT 600 PAGES] 3681t2.rtf
snip...
Unregulated "foods" such as 'nutritional supplements' containing various extracts from ruminants, whether imported or derived from 3 US cattle/sheep/cervids ("antler velvet" extracts!) should be forbidden or at least very seriously regulated.
(neighbors Mom, whom also died from CJD, had been taking bovine based supplement, which contained brain, eye, and many other bovine/ovine tissues for years, 'IPLEX').
my plight with metabolife and there 'bovine complex' about risk factors of TSE in there product ;
Terry S. Singeltary Sr. wrote:
######## Bovine Spongiform Encephalopathy > > #########
1. Dietary Supplements: Review of Health-Related Call Records for
Users of Metabolife 356. GAO-03-494, March 31.
-------- Original Message --------
Subject: METABOLIFE AND TSEs GAO-03-494 ''URGENT DATA''
Date: Thu, 01 May 2003 11:23:01 –0500
From: "Terry S. Singeltary Sr."
The General Accounting Office (GAO) today released the following reports and testimonies: ‘'
REPORTS;
1. Dietary Supplements: Review of Health-Related Call Records for
Users of Metabolife 356. GAO-03-494, March 31.
GREETINGS GAO:
i was suprised that i did not see any listing of bovine tissue in > metabolife on it's label. have they ceased using these desiccated tissues???
i see that the lable on this product METABOLIFE 356, does not state that it has any tissues of desiccated bovine organs? i no > the product use to, so i am curious if they have ceased the use of the tissues of cattle they _use_ to use (see below)???
METABOLIFE 356
BOVINE COMPLEX/GLANDULAR SYSTEM
OVARIES, PROSTATE, SCROTUM AND ADRENAL
USDA SOURCE CATTLE
i tried warning them years ago of this potential threat of CJD/TSEs;
From: Randy Smith
Subject: Metabolife
Date: Mon, 7 Dec 1998 14:21:35 –0800
Dear Sir,
We are looking at reformulation. I agree that slow virus diseases present a problem in some areas of the world.
Our product uses healthy USDA inspected cattle for the glandular extract.
If you have any links to more information on this subject I would like to examine them.
Thank you for your interest and concern,
Dr. Smith
============
From: Randy Smith
Subject: RE: [Fwd: Your submission to the Inquiry]
Date: Wed, 9 Dec 1998 10:37:07 –0800
Terry,
Thank you for your note and the information links you forwarded to me.
I am new to Metabolife International, however hopefully as my role here enlarges I well have a greater impact on formulation and product development.
Metabolife International does believe in placing safety first. And I am going to do my best to see that we continue to do so.
Sincerely,
Dr. Smith
============
-----Original Message-----
Sent: Wednesday, December 09, 1998 5:49 PM
Subject: [Fwd: Your submission to the Inquiry]
Dr. Smith, I am truly impressed with you honesty, THANKS.....I am not just spouting off about the potential dangers, here. THEY ARE REAL.....I have forwarded an e-mail from the BSE Inquiry, in which I made a statement about them........You might want to go to the site and read through it........IT WILL TAKE A WHILE........ THINGS ARE HAPPENING HERE SIR, THAT YOU ARE NOT AWARE OF, AND AS MOST PEOPLE ARE NOT...............I JUST HOPE, THAT THE REFORMULATION YOU SPEAK OF, IS IN FACT GOING TO TAKE PLACE.
The Department of Health, here in the U.S., is also worried about the potential dangers involved hear............Terry/MADSON
==================================================
From: Randy Smith
Subject: RE: [Fwd: MEDICINES "GREATER BSE RISK THAN BEEF"!!!!]
Date: Fri, 18 Dec 1998 09:55:17 –0800
Return-Receipt-To: Randy Smith
Thanks very much for the info. I appreciate all these articles I can get. It does sound very familiar - just follow the green ($) trail.
-----Original Message-----
Sent: Friday, December 18, 1998 5:15 PM
Subject: [Fwd: MEDICINES "GREATER BSE RISK THAN BEEF"!!!!]
Randy, thought you might be interested in > > this...............MADSON!!!!!1
snip...
===============================
-------- Original Message --------
Subject: re: METABOLIFE AND TSEs GAO-03-494 ''URGENT DATA''
Date: Thu, 01 May 2003 16:04:35 –0400
From: "Marcia G Crosse"
To:
CC: "Charles W Davenport" , "Carolyn Feis Korman" > > , "Martin Gahart" >
Mr. Singletary,
We were informed by representatives of Metabolife, Inc. that Metabolife 356 was reformulated to remove bovine complex as an ingredient in the product, approximately September 2001. We did not independently verify the contents of the product.
Sincerely,
Marcia Crosse
Acting Director
Health CarePublic Health and Science Issues
U.S. General Accounting Office
441 G Street, N.W.
Washington, D.C. 20548
===================
-------- Original Message --------
Subject: Re: METABOLIFE AND TSEs GAO-03-494 ''URGENT DATA''
Date: Thu, 01 May 2003 15:48:52 –0500
From: "Terry S. Singeltary Sr."
To: Marcia G Crosse
CC: Charles W Davenport , Carolyn Feis Korman > > , Martin Gahart > References: > >
THANK YOU!
MIRACLES DO HAPPEN! ;-)
now all we need to do is;
snip......
one small step for man, one giant leap for mankind ;-)
however;
''We did not independently verify the contents of the product''
???
TSS
Could you get mad cow from a pill ? Some doctors say a class of pills that promise smarts, energy, and sexual vitality may cause mad-cow disease.
The government isn't worried. Should you be?
June 1, 2001
Health Magazine
by Susan Freinkel
The German Magazine Der Spiegel came out to the house here and interviewed me in 2001 (I think), about that token purina mad cow feed mill blunder, and they were very concerned about these type supplements that carried the SRMs that could very well carry the TSE prion agent. ...please see ;
GERMAN DER SPIEGEL MAGAZINEDie
BSE-Angst erreicht Amerika: Trotz strikter Auflagen gelangte in Texas verbotenes Tiermehl ins Rinderfutter - die Kontrollen der Aufsichtsbehörden sind lax.
DER SPIEGEL (9/2001) - 24.02.2001 (9397 Zeichen) USA: Loch in der Mauer Die BSE-Angst erreicht Amerika: Trotz strikter Auflagen gelangte in Texas verbotenes Tiermehl ins Rinderfutter - die Kontrollen der Aufsichtsbehördensind
lax.Link auf diesen Artikel im Archiv:
"Löcher wie in einem Schweizer Käse" hat auch Terry Singeltary im Regelwerk der FDA ausgemacht. Der Texaner kam auf einem tragischen Umweg zu dem Thema: Nachdem seine Mutter 1997 binnen weniger Wochen an der Creutzfeldt-Jakob-Krankheit gestorben war, versuchte er, die Ursachen der Infektion aufzuspüren. Er klagte auf die Herausgabe von Regierungsdokumenten und arbeitete sich durch Fachliteratur; heute ist er überzeugt, dass seine Mutter durch die stetige Einnahme von angeblich kräftigenden Mitteln erkrankte, in denen - völlig legal - Anteile aus Rinderprodukten enthalten sind.
Von der Fachwelt wurde Singeltary lange als versponnener Außenseiter belächelt. Doch mittlerweile sorgen sich auch Experten, dass ausgerechnet diese verschreibungsfreien Wundercocktails zur Stärkung von Intelligenz, Immunsystem oder Libido von den Importbeschränkungen ausgenommen sind. Dabei enthalten die Pillen und Ampullen, die in Supermärkten verkauft werden, exotische Mixturen aus Rinderaugen; dazu Extrakte von Hypophyse oder Kälberföten, Prostata, Lymphknoten und gefriergetrocknetem Schweinemagen. In die USA hereingelassen werden auch Blut, Fett, Gelatine und Samen. Diese Stoffe tauchen noch immer in US-Produkten auf, inklusive Medizin und Kosmetika. Selbst in Impfstoffen waren möglicherweise gefährliche Rinderprodukte enthalten. Zwar fordert die FDA schon seit acht Jahren die US-Pharmaindustrie auf, keine Stoffe aus Ländern zu benutzen, in denen die Gefahr einer BSE-Infizierung besteht. Aber erst kürzlich verpflichteten sich fünf Unternehmen, darunter Branchenführer wie GlaxoSmithKline, Aventis und American Home Products, ihre Seren nur noch aus unverdächtigem Material herzustellen.
"Its as full of holes as Swiss Cheese" says Terry Singeltary of the FDA regulations. ...
Sunday, November 10, 2013
LARGE CJD TSE PRION POTENTIAL CASE STUDY AMONG HUMANS WHO TAKE DEER ANTLER VELVET WILL BE ONGOING FOR YEARS IF NOT DECADES, but who's cares $