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The FDA warned against certain that actually contain toxic yellow oleander.

The warning follows a in September on several weight-loss supplements that were supposed to contain tejocote root but instead contained yellow oleander. The researchers' testing of a number of products was sparked by the case of a New Jersey toddler who experienced a serious heart complication after consuming the mother's weight-loss supplement pills.

Subsequently, the FDA launched an investigation to sample and test additional tejocote root products, the agency stated in its warning this week. All nine samples tested to date contained yellow oleander. Additional sample analysis is pending, so more products may be added to the warning, the FDA said.

Yellow oleander is a poisonous plant native to Mexico and Central America. It can cause severe, and potentially fatal, adverse health effects. It contains a cardenolide with clinical effects similar to digoxin.

In addition to adverse cardiovascular effects, ingestion of yellow oleander can cause neurologic and gastrointestinal issues. Symptoms may include nausea, vomiting, dizziness, diarrhea, abdominal pain, cardiac changes, and dysrhythmia.

Products of concern are typically sold online through third-party platforms, the FDA noted. The products it tested had come from Amazon, Etsy, a natural products site, and the website of two weight-loss consultants.

Despite FDA regulations, "misbranded dietary supplements are frequently found to contain potentially dangerous substances," Noah Berland, MD, of the New Jersey Poison Information and Education System and Rutgers New Jersey Medical School in Newark, and colleagues wrote in a September report in .

"For public health officials, this is concerning because these supplements contain a highly toxic substance and are readily available from multiple retailers," they wrote.

Early in the pandemic, public health officials also warned against a botanical extract made from poisonous oleander, emphasizing that it was harmful and not a cure for COVID.

The FDA called for individuals who have taken any of the nine tejocote root dietary supplements that were found to be substituted with yellow oleander to contact their healthcare provider immediately. "Even if these products have not been used recently, consumers should still inform their health care provider about which product they took, so that an appropriate evaluation may be conducted," the agency noted.

Anyone experiencing serious side effects from affected products should seek immediate emergency medical help, the FDA said. Consumers can also contact their state poison control center.

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