State Orders Halt in Sale of L-Tryptophan : Health: Food supplement may be the cause of 154 cases of a rare blood disorder, 19 in California. Study of the substance is planned.

State Health Director Kenneth W. Kizer on Wednesday ordered retail merchants to discontinue the sale of L-Tryptophan, an over-the-counter food supplement used for sleeping problems and premenstrual syndrome, which he said may be to blame for 154 cases of a rare blood disorder 22 states.

Kizer said more study is needed to determine if there is a direct link between L-Tryptophan and eosinophilia-myalgia syndrome (EMS), a blood disorder marked by a higher-than-normal number of a certain type of white blood cell and severe muscle pain. Other symptoms may include weakness, swelling of the arms and legs, fever and skin rash.

Thus far, Kizer said, 19 cases of the disorder have been reported in California.

Most victims reported taking the food supplement before becoming ill, he told a Capitol press conference. Some of the patients had to be hospitalized.

“We believe there are hundreds of thousands of people in California who use this product and are potentially at risk,” Kizer said.

Asked if there have been any deaths from the blood disorder, the state health official said there have been “no substantiated reports of deaths” but that investigation of some cases is continuing.

As for for the possible link between L-Tryptophan and the blood disorder, Kizer said, “While there is not an obvious physiologic link, the statistical data are very strong. This seems to be a new condition.

“There does not appear to be any clear-cut treatment for the condition at this time,” he added. “Likewise, the long-term force of the illness is not known.”

Kizer said a study will be jointly conducted by the state Department of Health Services, the federal Food and Drug Administration and the national Centers for Disease Control to determine if the food supplement does cause the syndrome. Kizer said the study will take “a minimum of weeks and quite possibly longer.”

He asked that people who have been taking L-Tryptophan and believe that they are experiencing abnormal symptoms to consult their physicians, who should report cases to city or county health departments.

On Monday, the state health official requested California consumers taking the food supplement to temporarily discontinue its use. He also asked retailers to discontinue its sale until further notice.

“But some retailers have not complied with this request,” Kizer said, adding that the state Department of Health Services will now send food and drug investigators into retail stores to insure that all retailers pull the food supplement from their shelves.

L-Tryptophan is manufactured in Japan, according to Kizer, and distributed in California by numerous suppliers. At the press conference, he displayed a bottle from the Vita-Fresh Vitamin Co. of Garden Grove.

Asked for comment, Michael Leiner, chairman of the board of Vita-Fresh’s parent company, P-Leiner Nutritional Products, said, “Yesterday we advised all of our retailer customers to temporarily take all L-Tryptophan products off their shelves until this mystery is solved.

“We are working closely with the FDA to see if we can assist them in determining whether there is any link between eosinophilia and L-Tryptophan products. At this stage, the connection is purely circumstantial.”

Kizer said L-Tryptophan’s popularity has risen dramatically during the past few years. It is also touted as a relaxant or stress reducer, “but its efficacy is unproven,” he said.

Because it is sold as a food supplement instead of a drug, it is not subject to the same stringent testing process, he said.

Times medical writer Robert Steinbrook contributed to this story.