Update 3/9/24. If you have not heard of Zi Xiu Tang Bee Pollen capsules (also called Zi Xiu Tang Beauty Face and Figure Capsules), this is a natural weight loss supplement where some websites actually encourage people to eat what they want! Even the educational pamphlet that accompanies Zi Xiu Tang Bee Pollen say: “No Diet Restrictions” and that people can achieve “excellent results” even while eating “high fat and high-calorie foods”. The power of Zi Xiu Tang is said to be due to bee pollen and the other ingredients in the supplement. But, things are more complicated than that. This is the second review I've written about the Zi Xiu Tang Bee Pollen. For more insights on the ingredients, see the original review of Zi Xiu Tang bee pollen. Also, read almost 1000 comments on this review and hundreds of comments on the other Zi Xiu Tang Reviews.
Read The Updates First
I posted these updates above the rest of the content so you would see them first. As you will see below, I originally felt Zi Xiu Tang was a laxative, that still did not fully explain the crazy amounts of weight people were experiencing with this product. I wondered if there might be something else behind these effects.
Unfortunately, the FDA proved my suspicions correct when they found a drug called sibutramine (also known as Meridia) in Zi Xiu Tang -as well as other bee pollen weight loss supplements. Sibutramine has been linked to heart attacks and strokes, so it was banned in the US many years ago.
Update 4/8/14. The FDA warns people to immediately stop taking Zi Xiu Tang Bee Pollen's weight loss supplements. It tested several Zi Xiu Tang products – including those that were said to be “genuine” and not counterfeit. The FDA found that some products contained not only sibutramine, an illegal weight loss drug but some also contained Phenolphthalein, a chemical that may increase the risk of cancer. See the FDA alert for more information.
Update. 10/24/12. The FDA has alerted the public that Zi Xiu Tang contains the illegal weight loss drug called sibutramine. They advise people to not take Zi Xiu tang. Click the link to see the FDA Public Notification on Zi Xiu Tang. It took the FDA 2 years to prove what I knew from the first day I reviewed Zi Xiu Tang. There was no way this stuff worked the way it did – if it only had the ingredients listed…
Update 6/26/12. I have written a review of ZXT Gold
Update 7/25/12. : ZXT Gold has been found to contain 2 drugs, see the ZXT Gold review for more information.
6/18/13 Update. Here is the review of Slim Trim U for more information.
At first, I could not explain the weight loss people were seeing with this supplement. One person who commented on my first Zi Xiu Tang review said he lost 13 pounds in 1 month!
Now I know why…
How Does Zi Xiu Tang Work?
Thanks to a friend who sent me a bottle of these so-called slimming capsules I can tell you that bee pollen is NOT the active ingredient in Zi Xiu Tang.
If Zi Xiu Tang works, it's because it's a laxative!
I know this is true because several of the ingredients in Zi Xiu Tang have laxative effects. I suspected this because many websites selling Zi Xiu Tang use the word “cleanse.” Cleanse is the alternative medicine term for laxatives.
Probably, the most famous ingredient in Zi Xiu Tang is senna. Senna is not a weight loss supplement; it is a laxative. The FDA also classified it as a non-prescription, over-the-counter laxative drug.
Several other ingredients as you will see also act as laxatives.
The problem with laxatives is the only weight they help us expel feces (poop) and water.
What Does Zi Xiu Tang Mean?
The supplement's name doesn't seem to refer to anything specific. When translated from traditional Chinese to English, the name means “self-show soup.” However, when translated from Literary Chinese, the word means “be.” Could this be a reference to bee pollen, the alleged key ingredient?
Zi Xiu Tang Ingredients Label
Even if you wear eyeglasses, you will find it very difficult to read the ingredients in Zi Xiu Tang. The bottle and box abound with decorative Chinese art and characters, making reading the ingredients very difficult.
The red lettering of the ingredients makes it doubly hard to read. I had trouble even when I held the bottle up to a lamp! So, to save you the trouble, I've listed the ingredients here.
Zi Xiu Tang Full Ingredients List
Here is the entire list of ingredients in Zi Xiu Tang.
- Bee Pollen
- Chinese Yam
- Barbary Wolfberry Fruit
- Lotus Seed
- Dietary Fiber
- Green tea
- Rhubarb
- Aloe
- Cassia
- Astrigillis
- Polygonum multiflorum
- Lotus leaf
- Gynostemme
- Radish seed
- Malt
- Mulberry
- Hawthorn,
- “Vitamins”
Tthe first 4 ingredients are not weight loss herbs. I've already covered these ingredients in my first Zi Xiu Tang review. Let’s now talk about all the other ingredients.
Zi Xiu Tang Ingredients and Side Effects
Senna. Senna is a laxative. Because Zi Xiu Tang contains senna, it’s possible that the same side effects from using too much senna may be seen in those who take Zi Xiu Tang. The side effects can include,
- Diarrhea
- Abdominal cramping gas/bloating
- Flatulence
- Dizziness
Because of diarrhea, products like Zi Xiu Tang that contain senna may in extreme cases cause excessive loss of electrolytes. This can lead to muscle weakness and maybe heart problems. This is because electrolytes are needed for muscle contraction and the heart is a muscle.
People using heart/blood pressure medications should not use senna-containing supplements or products that have similar laxative effects.
To highlight what can happen with senna overdose, there is a case report of a woman who developed liver failure after long-term use of senna tea.
In this report, the woman was drinking a liter of senna tea that contained 70 grams (2.5 oz) of senna fruit. Even with this amount, it took 3 years before liver failure presented itself. This is worth mentioning because everybody is different, and people often think “more is better,” which isn’t always true.
Unlike the laxative effect of fiber, senna is a non-fiber laxative. It works differently to relieve constipation. One of the ingredients in Senna is a class of compounds called anthranoids, which exert laxative effects by damaging the cells of the colon. Because of this, some have speculated that long-term use of senna, may increase the risk of cancer
Because senna supplements have not been studied for long-term use, it is hard to say if this is true or not.
Senna products should be avoided in people who have
- Hemorrhoids
- Heart disease / Blood pressure issues
- Abdominal pain
- Bowel obstructions
- Pregnant or nursing mothers (for obvious reasons)
- Diabetics
In theory, long-term use of senna supplements may make it harder to defecate as the person becomes dependent on the product.
People who take Zi Xiu Tang may notice that the color of their urine looks pink or rust-colored. This is probably due to the senna (and polygonum multiflorum, discussed below) and is not dangerous.
Update: In 2010 Senna was apparently removed from Zi Xiu Tang. Some people report that their bowel movements are less while others report no change. See the comments for more information.
Cassia. Zi Xiu Tang also contains Cassia. While the word cassia is sometimes used to describe the spice, cinnamon, I don’t think this is how they are using the word because cassia can also be another name for senna.
Both of cassia and senna are listed separately on the Zi Xiu Tang label; cassia appears first, followed by senna. Both words are sometimes used together (“cassia senna”). Other names for cassia senna are Cassia acutifola, and Cassia angustifolia.
If cassia on the Zi Xiu Tang label refers to cassia senna, then this, too, is a laxative and likely works synergistically with senna to promote a greater laxative effect.
Green Tea. Zi Xiu Tang also contains green tea. Because green tea contains caffeine, it’s theoretically possible that the caffeine may slightly raise metabolism. This is likely why the Zi Xiu Tang says “increase metabolism” and “increase energy” on the front of the display box. The box does not say how much caffeine is in Zi Xiu Tang.
Rhubarb. Zi Xiu Tang contains Rhubarb which also has laxative effects. It may also have estrogen-like effects. Rhubarb may act synergistically with senna and cassia to cause a greater laxative effect.
Aloe. Zi Xiu Tang contains aloe as well. Aloe juice also has a laxative effect however the bottle does not say if Zi Xiu Tang contains aloe juice or not.
Astragalus. Like all herbs, there are many types of Astragalus. Often used to treat the common cold, this herb does not seem to have any laxative effect. As for astragalus side effects, in large amounts (about 1 ounce, which is likely more than is in Zi Xiu Tang) this herb may increase the immune system which, while good for some can also be bad for others like those with some immune system disorders such as rheumatoid arthritis.
Polygonum multiflorum. This is an herb also known as Fo-Ti and Ho Shu Wu. Some research notes Polygonum multiflorum has a mild laxative effect. At least 7 case reports have noted liver problems including hepatitis resulting from use/misuse of this herb.
Other reports hint that Polygonum multiflorum might alter blood sugar levels (that may be bad for diabetics).
On a side note, Polygonum multiflorum may also be found in supplements designed to lower cholesterol; research suggests that extracts may lower cholesterol and increase HDL. More research is needed to confirm this.
Gynostemma. Some websites say this herb can both cause both weight loss and weight gain. In this respect, Gynostemma might be classified as an adaptogen. An adaptogen is a non-medical term used in some circles to describe how a supplement “adapts” to your needs. Websites also claim that gynostemma has laxative effects.
Radish Seed. I could not locate any weight loss effects of this ingredient.
Malt: I could not locate any weight loss effects of this ingredient.
Mulberry. This contains fiber which acts as a laxative.
Hawthorn. People who take medications for high blood pressure or a heart condition should not use hawthorn or supplements containing Hawthorn. Hawthorn does influence the way the heart pumps. This means hawthorn can interact with your heart or blood pressure medications.
Vitamins. Zi Xiu Tang lists “vitamins” but does not indicate which vitamins it contains.
Ingredients that are Laxatives
To recap, here are the ingredients in Zi Xiu Tang that are laxatives
- Senna
- Cassia
- Rhubarb
- Aloe (if it contains Aloe juice)
- Polygonum multiflorum
- Gynostemma
- Mulberry
For more info see my review of Zi Xiu Tang Side Effects
Who makes Zi Xiu Tang?
The company that makes zi xiu tang is said to be the Guangzhou Zixiutang Biotechnology located in China. The strange thing is that I've never been able to find a picture of what this company looks like. Google searches turn up no pictures of the company. Even the website for the company – cn-zixiutang.com – does not show a picture of the company (the website no longer exists).
For more info on the company, see my review of the bee pollen weight loss supplement Slim Trim U.
Zi Xiu Tang Warning Label
If you read the label of Zi Xiu Tang you see this warning of who should not use the product (I'm quoting them verbatim):
“Not Suitable For:
Women who are pregnant or breastfeeding. People who suffer from either liver, kidney, Heart Disease, or High Blood Pressure. Adolescents, Elderly, Depressed people, or Anyone with bee or pollen allergies.”
Does Zi Xiu Tang Work?
There is little clinical evidence of weight loss effects for most of the ingredients in Zi Xiu Tang. If it really works, it may be due to laxative effects. Some websites that sell Zi Xiu Tang say the product does not contain sibutramine (weight loss drug), or other drugs like Rimonabant (weight loss drug), Phenytoin (anti-seizure drug) or Phenolphthalein (has laxative effects). This is perhaps a response to previous FDA action against bee pollen-containing weight loss supplements. Does it work as well without pharmaceutical enhancement? You tell me.
I began taking this pill on Jan 2 weighing in at 185lbs. As of today’s date I am 180lbs. Last yr I took this product and dropped 30lbs in 3 mths because I also didnt eat any sugary products, no sodas, and only drank water cranberry or grapefruit juice. However, when I stopped taking pills I gained the weight back and now Im back at square one.
I have experienced dry mouth, a nagging cough and insomnia. I am menopausal and the night sweats are horrible. Im just really desperate to lose weight. Joe, am I in danger?
Teece, the fact that you gained all the weight back the last time should be an indication that zi xiu tang is not the answer. That said, I don’t trust this supplement or any other similar product that gives magical weight loss power to bee pollen.
I recommend you stop taking them
I recommend everybody stop taking zi xiu tang
p.s. i did drink water! lots of it i went thru like 3 24 packs
I tried this stupid diet pill because I was so desperate to see results. I decided to give it a try after a few months of eyeing them bc i happen to talk to a good friend of mine who had lost 10 lbs on them.
After purchasing them, i was soooo excited to drop weight but i didn’t expect the consequences. The first day I was fine…It was a Saturday and i was going to the bathroom A LOT and i was at work so i was kind of embarrassed. I had dry mouth like crazy but I knew that it was a “normal” effect.
When I got home all I could do was lay there bc I felt so out of it. Once again, I was giving my body time to adjust. Day two, I took two pills in the morning….felt weird all day. Bathroom all day. And by night my left arm was tingling like crazy. Almost felt as if it were going numb! I thought it was an oncoming heart attack and I woke up the next morning with a dry swollen red eye!
So i decided to stop but for the next three days I felt like a failure and that I couldn’t tough it out so I decided to take it again after I had begun to feel normal. bad idea….i felt weird. then the next day the it wasn’t tingling it was stinging in my left arm as I was at work.
I was so dazed and my heart rate was up. The next day I decided to lower the dosage by one pill…..I ended up in bed the whole day sleeping bc I didn’t know what to do with myself. I felt so miserable. dry mouth, arm pain, and couldn’t focus. I have not taken them at all today but i still don’t feel completely up to par. my arm is tingly but not as bad and my head is bothering me.
I have had loose stools all day. I will never try another diet supplement again. yes i have lost five pounds but it was not worth it. what scares me is that I wasn’t even consistent and lost five pounds….what if i was? i think I would have died or something….my goodness…as hard as it has been for me to lose weight this has made me more dedicated to changing my lifestyle.
there is no easy way out and people need to stop doing this to themselves. I think a lot of people ignore the symptoms out of pure desperation.
Never again thanks for sharing. The feelings of being “dazed” or out of it is something Im starting to hear from others. I don’t remember people saying that 2 years ago. It makes me wonder if there is something else in zi xiu tang now other than sibutramine or in addition to it?
Wake up! There is no fakes or counterfeit!! Chinese manufacturers are tainting products and sending them here! Losing weight is a wonderful accomplishment but….Not when you put your life at risk.
Like I said in my previous post, I was a distributor of Classic Zi Xiu Tang and also the company who conducted this recall. We also distributed the Ultimate formula as well as other products on our website.
We created the Ultimate a few years back after Zi Xiu tang was not working properly and customers began complaining. We chose a different manufacturer hoping they would produce an effective product.
Since many are still confused about the recall and still choose to believe when certain companies claim to have “authentic” Zi Xiu tang. Here is the info on the the recall that was conducted:
Our Classic Zi Xiu Tang was purchased by http://www.zixiutangbeepollen.com and manufactured by Guangzhou Zi Xiu Tang Biotechnology, Co LTD. This product was tested by our company as well as the FDA and results proved to contain sibutramine. Here is the FDA link recall for the Classic Zi Xiu Tang:
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm325537.htm
The Ultimate formula was manufactured by Guangzhou Yan Xiang Biotechnology, Co Ltd. This was also tested by our company as well as the FDA and results proved to contain sibutramine.
In my personal opinion, these companies continuing to sell products under believing that China is being honest are ignorant and are only after making money. They could care less about the customers consuming these harmful products as long as they are being paid.
How much more proof needs to be made… Taking these supplements is not worth your health!!!
The fda letter you’re referencing is speaking about the Bee Pollen ULTIMATE which is not the same thing as the classic…The Official company only makes the classic and has not branch out to make any other types of bee pollen…
What ever company invented the ultimate, used the Bee Poll Tang name to branch off its success and created one adding that drug and calling it ultimate..also if you read it correctly, it was certain batches that went out and were recalled by the company…
Anyone who has ever experienced any side effects is because they are either taking fakes, or have over dosed the pills. The you true homework before trying to expose someone.
Sidney, I don’t trust any company who makes this stuff.
A friend of mine took me to buy these pills. She had used them for 2 months and lost 30 pounds. i was looking to achieve the same goal. We both gave birth to baby boys 15 months ago and she is back to her normal size after taking these pills.
The first day I took these pills I did not feel well at all but did not think about food so I thought that was a good sign. Two days later i started to experience extreme nauseous, excessive sweating, and I was really scared when one morning after taking the pills and lightly eating I start to sweat uncontrollably my heart was racing, I could not stand.
I thought maybe being stressed out was causing me to have a panic attack. Next day some thing, but now my hemorrhoids (from my first pregnancy with twins 4 years ago) had flared up again and have been causing me so much pain that I had to go to the ER (yesterday).
I started to ask myself what changes have i made that could cause this.
I try to eat healthy with lots of veggies and lots of water. My husband calls me the camel of the house because i drink so much water. (The true is I did not want to go through the pain of my hemorrhoids again.)
I have been going to the gym for 2 months now and the results are slow so i thought i could add this to it to get the results faster. I have only been on these Zi Xiu Tang Beauty Face & Figure Capsule for a week and after reading this will not put another pill in my mouth.
thank you, this might have saved my life.
Nika, thanks for writing and Im VERY happy I was able to help you. Congrats on your baby also 🙂
DO NOT TAKE THESE CAPSULES! the FDA issued a warning against them because they contain a hidden drug that can cause severe side effects which I unfortunately experienced first hand.
At first I really liked these capsules because it gave me a lot of energy and really decreased my appetite. BUT then I started to have symptoms like extremely dry mouth and hot flashes.
Then one day I went for a run about 2 hours after taking 2 capsules as directed, and after only running 1 mile, I could barely breath and felt as if I was having a heart attack. I checked my heart rate and it was almost 190 which is extremely dangerous!!
That is what caused me to research the product more and then I found the FDA warning against them. THROW THESE IN THE TRASH!!!!! they are not safe
I am currently on the zxt and I love them. I’ve never felt better. I know that taking anything long term can cause damage which is why I will only take these for cleansing. The information provided is helpful but still I question why alcohol is still legal. This is not to be mistaken as a weight loss pill but a cleanser if used correctly and used with common sense.
Alisha, one problem with your argument is how much – of whatever is in them that causes weight loss – is in them. You are assuming that they have nothing illegal and that whatever might in them that is illegal is low enough that it wont cause harm in the short term. Both assumptions could lead to very bad consequences.
Hello,
I am Co-owner of Zi Xiu Tang Success, LLC. I wanted to clear up any questions regarding the recent voluntary recall by our company. Our company initiated this recall with the FDA after testing on the products proved they contained the ingredient sibutramine. As a company, we refuse to sell products that are unsafe and contain ingredients that have been added by the Chinese manufacturers without our knowledge. Our recall information is listed on our website: http://www.zixiutangsuccess.com and also at:
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm326341.htm
I have also posted public pictures of the product being recalled on our Facebook Zi Xiu Tang Success.
Now to clear up the big question….did we sell counterfeit products….. Here is the answer:
Our Classic Zi Xiu Tang was purchased directly from Zi Xiu Tang Bee Pollen, LLC http://www.zixiutangbeepollen.com. The manufacturer of the Classic Zi Xiu Tang is Guangzhou Zi Xiu Tang Biotechnology Co, LTD. The Ultimate formula was purchased by us directly from China. The manufacturer of the Ultimate is Guangzhou Yan Xiang Biotechnology Co, LTD.
Both the CLASSIC ZI XIU TANG AND ULTIMATE FORMULA were tested and are being recalled not just the Ultimate formula.
As a company, safety is our number one priority and it has become very clear that the Chinese manufacturers can not be trusted. In my personal opinion, it is very disheartening that after bringing this to the public some companies still continue to sell the Classic Zi Xiu Tang.
Personally, I would NOT take any weight loss/dietary supplement product from China! It is not worth the health risk. Hope this helped clear things up regarding Classic Zi Xiu Tang and Ultimate formula.
ZXT from floyd’s is a fake…FDA has NOT found anything in the “original” Zi Xiu Tang product. I have contacted them. They know the Ultimate had the drug in it. If the box has Chinese writing all over it…it’s a fake…there are a lot of fakes out there…even doing research it’s hard to find out everything.
The big problem is if you do take the “Classic” they say do not take it any longer then 4 to 5 months…this is no different then a diet pill you get from your doctor that only lets you be on it for 3 months at a time. (oh we all don’t question that because a doctor gives it to you!) This is like ANY other drug (not the fake kind) be smart and it’s only a helper but don’t live on it!
I lost 20 lbs in two months by taking Ultimate, then Classic. I just ordered ZXT Slim from Floyd’s Nutrition but haven’t opened the box yet – what is the issue with Floyd’s?
Anonymous my boyfriend had the same problem and stopped taking them and everything went back to normal. It might be because bee pollen increases your estrogen? Either way I’d stop taking them before it becomes a bigger problem!
I took these pills for maybe 2-3 weeks, lost a good amount of weight.. One main concern I have an under active thyroid and taking levothyroxine 75 mcg …. Ever since I have had trouble with weak erections and having getting it going and lasting with the manhood… Never had this issue before. Any advice and will it come back?
Anonymous stop taking the zi xiu tang and see if erections return
i took these pills and noticed i dont have normal erections in the morning and i never had this problem i stopped for a few days things went back to normal i went back on the pills and noticed the same thing im done im gonna watch what happens i feel good but i cant mess with my manhood
I was taking Zi Xiu Tang Bee Pollen since May. I ran out about a week ago and have mixed feelings if I should buy more. There is no doubt that it helped me break my weight plateau that I have been working on for a few years.
But, at the same time, I have experienced physical symptoms that I am concerned about and am not sure whether they are related to the bee pollen. I am calling my doctor on Monday for an appointment. Because she knows that I am extremely health conscious and know my body well, she will not hesitate to perform some tests. I will get back to you with the outcome.
Jen I have too researched the ‘counterfeit’ ones as well because they were ‘cheaper’ on all supposed ‘legit’ websites it states that they ‘the counterfeit’ ones are more harmful and can cause extreme side effects. But whose to say zi xiu tang just doesn’t say that so people will pay their price for them? Either way I would stop taking them.
I had posted this question before but I have been taking these pills since September. The first bottle I had gotten at a natural food store containing of 60 pills and had the authentic labels on it & the new anti-counterfeit labels on them,the website was the cn-zixiutang.com.
Not realizing this my boyfriend had ordered me new ones when I ran out from zixiutangbeepollencapsule.com because they were cheaper. I have been on those since but just stopped taking them two days ago after researching online.
I had lost 20lbs since sept but have also been running a mile every day. I have definitely noticed a decrease in hunger as well. I had diarrhea occasionally but nothing terrible. The only other side effect I had was that I got my period a month early even though I am on a pill where I am suppose to get it every 3 months and I’m not due till next month.
Im concerned because I still have it and its been 10 days now. Does anyone know of any correlation because I can not seem to find any. I have to believe its the second counterfeit bottle that caused this because thats when it started.
The second bottle was all in chinese except for the directions on the box. I’m not sure if they are just as bad as the real ones considering they have the illegal drug or could they be worse even? who knows?
hopefully I didn’t do any more damage to my body. Im very upset because I will admit they definitely did work and the weight loss was over a 3 month period so it wasn’t too quick, just wish I knew it was safe.
Anonymous, I’m not sure how it will be handled but should probably report it anyway. The formula I purchased is called Zi Xiu Tang Beauty Face & Figure Capsule. Most of the writing on the box is in Chinese. RED FLAG!
The label says, [Main Ingredients] Bee Pollen, Chinese Yam, Barbary Wolfberry Fruit, Lotus Seed, and Dietary Fiber.
If those are the “Main Ingredients”, what are the rest of the ingredients and why aren’t they disclosed? RED FLAG! I should’ve known! I’m just glad I didn’t suffer a worse consequence.
Will it even matter if you do report them? They know there is a trace in them. They were put on a voluntary recall. Doesn’t that mean they don’t have to recall them? I’m confused. Vicky- what kind are they?
I still have a few of the pills I took left in the bottle. After my experience, I regret not reporting the store that sold them to me. I noticed they have just recently taken downt he big Xi Xiu Tang sign they had infront of their store. Is it too late to report them? I am convinced that if these pills are tested they will find meridia in them!
Vicky. You can send a report to the FDA at this link http://www.fda.gov/food/dietarysupplements/alerts/ucm111110.htm
Thanks for this blog! I actually had a maintenance bottle of zi xiu tang and went to reorder today and the product is “no longer available” through my distributor. . . and my box says “does not contain sibutramine” in a bubble at the top. hmmmm… wonder why the one stating that it “doesn’t contain sibutramine” is no longer available but the other one that doesn’t say this is still available!?
WOW! the makers of supplements are on the honor system – we have to trust that what they say is true. Just because it says no sibutramine (meridia) doesn’t mean it really doesn’t have it. nobody is looking over their shoulder making sure they are telling the truth. Also, just because a brand is still available doesn’t mean it doesnt have sibutramine (meridia) either. Im still trying to get to the bottom as to why the FDA does not seize these products and prevent them from being sold.
Because Zi Xiu Tang and a lot of other similar ZXT etc. products appear to contain sibutramine, I can’t in good conscious allow people who list where they got their pills from anymore. To do so would potentially be putting people at risk of very serious medical issues (like heart attacks).