Supplements are in the spotlight right now, partly thanks to new offerings from established brands and the promotion of various compounds by social media influencers. But not all of these products are created equal: Some can be downright dangerous, as unsettling news about the popular supplement kratom shows.

An herbal supplement with origins in Southeast Asia, kratom has gained fans with its claims of promoting energy and feelings of euphoria. On Tuesday, the Centers for Disease Control and Prevention (CDC) announced the discovery of 28 reported cases of salmonella — including 11 reported hospitalizations — across 20 states. The cases were associated with symptoms including fever, abdominal pain, and diarrhea. The CDC interviewed 11 affected people so far, and eight of them said they took kratom not long before becoming ill. The CDC hasn't yet identified a common source of kratom that's been contaminated and is recommending against its use entirely. The Food and Drug Administration (FDA) also sent out a press release on Tuesday about the supplement, reiterating its concerns on risks associated with kratom and noting that the agency is looking at "peer-reviewed research and a growing number of adverse event reports associated with kratom use, including 44 reported deaths."

The FDA noted that it is aware that users may rely on kratom to treat conditions including pain, anxiety, and depression. Amid reports of dependence and abuse, the FDA's commissioner issued a statement earlier this month citing evidence on the presence of opioid compounds in kratom. "We have been especially concerned about the use of kratom to treat opioid withdrawal symptoms, as there is no reliable evidence to support the use of kratom as a treatment for opioid use disorder and significant safety issues exist," the statement reads. "The FDA stands ready to evaluate evidence that could demonstrate a medicinal purpose for kratom. However, to date, we have received no such submissions and are not aware of any evidence that would meet the agency’s standard for approval."

Public health investigators at the CDC are continuing to investigate the illnesses, and they are recommending that no one consume kratom at this time in any form. According to Mayo Clinic, the complications of salmonella infections for some people — especially pregnant women, those with weakened immune systems, the elderly, and children — can be dangerous. This common bacterial disease often has no symptoms, but in at-risk individuals, it can cause severe dehydration and potentially life-threatening complications.

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