SALT LAKE CITY — Maddy Maxwell is "thriving."
For the past three months, she's been using THRIVE, a dietary supplement that consists of two pills in the morning, followed by a "lifestyle shake" and topped off with a "dermafusion technology patch" that delivers additional vitamins and extracts through the skin throughout the day.
The 25-year-old Glendale mom began using the supplements, which promise to help with weight loss, energy and mood elevation, after the birth of her second child left her feeling weak and with "no energy to do anything other than basically sit on the couch all day," Maxwell said.
But THRIVE started working on day one, she said. Immediately, Maxwell felt like her body was "firing on all cylinders." The dishes got cleaned. The laundry got done. She lost 15 pounds. She had more energy to play with her children.
"I've noticed mental clarity," said Maxwell, who takes online classes through Dixie State University. "I've been able to focus more on my schoolwork. I've noticed my hair and nails have been growing. … I just feel great, and my body is really getting what it needs now. … As a mother, I am doing a better job. And I've loved every bit of it."
It's an alluring promise — a patch that will turn you into a slimmer, sharper supermom — powered by an industry that produces billions of dollars of revenue in Utah each.
But it's also an industry that’s been questioned for its lax regulations and untested claims.
Now, a new study led by health authorities at the Food and Drug Administration and Centers for Disease Control and Prevention estimates that more than 23,000 emergency room visits each year are associated with dietary supplements.
Of those, more than 2,100 result in hospitalizations each year, they calculated.
The study, which draws on data from 63 emergency departments over 10 years, revealed that most people who reported issues were young adults who complained of palpitations, chest pains or rapid heartbeats.
After accounting for cases that involved children or older adults accidentally ingesting or choking on supplements, most cases turned out to involve weight loss or energy-boosting supplements like the ones Maxwell uses.
Barbara Crouch, director of the Utah Poison Control Center, said the numbers aren't surprising.
"I think this follows exactly what we see," she said.
Last year, the poison control center fielded more than 1,000 cases related to dietary supplements, according to Crouch. Many reported palpitations, dizziness and nausea from weight loss or energy supplements.
Of the people who called, 17 percent were treated in a health care facility, she said.
But Loren Israelsen, president of the United Natural Products Alliance, a Salt Lake City-based supplements lobbying group, said that with an estimated 65 percent of Utahns taking a dietary supplement on a regular basis, “the products are really, really safe, just running the math.”
He didn’t want to minimize the fact that people ended up in the ER, Israelsen said, but in the end, “that’s caffeine overconsumptions.”
“Those people who came in tended to be younger women, suggesting that they … had too much caffeine, whether it was a couple of Red Bulls or some sort of an energy supplement or weight loss supplement," Israelsen said.
Nutritional supplements aren’t regulated like drugs. Makers of supplements don't have to prove that they work — or even that they're safe — before they begin marketing.
In the study, the researchers made note of the fact that people who went to the ER reported cardiac symptoms after using weight loss and energy supplements more often than after using prescription stimulants such as Adderall.
The authors pointed out that prescription stimulants have to have label warnings for adverse effects. Dietary supplements don't.
Supplement manufacturers also don't have to say how much of each ingredient is in their products.
In the THRIVE-W product, for example, which is marketed toward women, the company lists extracts from the guarana plant, green tea and green coffee bean — all of which contain caffeine — but doesn't say how much is in each capsule.
"Just because it's natural doesn't mean it's safe," Crouch said, a mantra she repeated multiple times. She pointed out that over-the-counter medications also often come from natural sources.
Crouch recalled one mother who came to the poison control center because she had fed her child so many vitamins to the point that it became toxic to the child.
And she described a dizzying process of trying to keep track of all the supplements out there.
"I have a product on my desk right now that says it has ephedra in it," Crouch said, referring to a once hugely popular weight loss and bodybuilding drug that was banned by the FDA in 2004 after being linked to more than 100 deaths. "I'm thinking, 'That was banned.' But it may be another alkaloid that we may be getting around or bypassing."
In August, Salt Lake City-based supplement company Novacare issued a recall of 13 products with names like "Thin and Slim" and "Xcellerator" after the FDA discovered their products contained undeclared salicylic acid.
On its website, the FDA said salicylic acid is "acutely toxic, not recommended for oral use and … harmful if swallowed."
Although Crouch thinks manufacturing processes have improved in the past 15 years and that most supplement manufacturers have good intentions, she said she still worries about "the safety issue."
"I do wish that we knew about their safety first, as opposed to we're going after the fact," Crouch said.
Israelsen said the supplements industry is discussing improving the design of tablets and being more specific in their labeling, but it’s ultimately the FDA's job to be more aggressive in finding and stopping unscrupulous manufacturers and the consumers' job to educate themselves on what's safe.
"Something with very rapid weight loss — 'lose 20 pounds in three days' — undoubtedly that will have illegal substances in them," Israelsen said. "Consumers have to ultimately take that responsibility to say, 'OK, I have to do my job, which is don't buy (and) don't use these things.'"
As for Maxwell, she said she's not worried about the safety of her supplements. Maxwell used THRIVE while breastfeeding her now 6-month-old son, and “both of us did great on it.” She continues to use THRIVE daily, and her husband, mother, father and mother-in-law are now all also using it.
If Maxwell goes even a day without THRIVE, she can immediately feel a drop in energy. That's when the dishes pile up, the laundry sits undone and she finds herself back on the couch, listless.
“It really helps to feel those nutritional gaps,” Maxwell said. “It’s all-natural, it’s got pro- and pre-biotics in it.
"I don't ever,” she added, “want to be a day without it.”