Tejocote root: An ineffective weight-loss supplement with toxic effects
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The bottom line
Tejocote root is a supplement marketed for weight loss. It contains pectin, which could reduce appetite by promoting early satiety, although no research has demonstrated this. It also contains compounds that mimic digoxin, an older medicine used to treat irregular heart rates. Side effects include vomiting, diarrhea, arrhythmias, and low serum potassium. Many tejocote products are contaminated with yellow oleander, which poisons the heart and is potentially lethal. Toxicity includes vomiting, serious arrhythmias, lethargy, coma, and seizures.
Prevention tips
Avoid using tejocote root.
If you are taking it, stop using it immediately.
Discard all tejocote supplements.
This really happened
A 23-month-old child ingested a tejocote root product that her mother had bought for weight loss. The child developed nausea and vomiting and was taken to the emergency department. The child's heart rate and blood pressure were low, and an EKG showed a slow, irregular heartbeat. A blood test was positive for digoxin, a heart medicine the child had never taken. That test also picks up similar plant chemicals, including oleander. The child received 2 doses of the digoxin antidote, and the EKG returned to normal (from Berland et al., 2023).
A 40-year-old woman began taking 4 hawthorn root 4 pills a day to lose weight. Two days later she developed myalgias (sore muscles) and dizziness. She presented to the emergency department 3 days later. Her pulse was slow (52 beats/min) and physical exam notable for tender muscles. Bloodwork detected digoxin, which she was not knowingly taking, consistent with hawthorn root toxicity. After 4 hours of observation, her muscle aches improved, pulse increased, and she was no longer dizzy. She was discharged. On follow-up 24 hours and 1 week later, she was well without return of any symptoms and had followed the recommendation to stop using the hawthorn root tablets (from Espinosa et al., 2024).
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What is tejocote root (Crataegus mexicana)?
Tejocote root is a dietary supplement that comes from Crataegus mexicana, also known as the Mexican hawthorn tree. The fruit was used in Hispanic culinary practices and the root as traditional medicine for coughs, as a diuretic, and as a laxative. It is currently marketed as an herbal supplement for weight loss. There is no evidence that it is effective.
Alternate names include its scientific name, Crataegus mexicana, and Mexican hawthorn. It is also called by its Spanish names including raíz de tejocote, manzanita, manzana de Indias, and texocotl. A heavily promoted brand name is Alipotec.
Is tejocote root safe?
No. Side effects of using tejocote root include gastrointestinal distress, cardiac arrhythmias, and low serum potassium. It does not contain the cardiac glycoside digoxin but has side effects like those of digoxin and can cause falsely elevated digoxin levels.
Furthermore, tejocote root supplements are often contaminated with yellow oleander, a potent cardiac glycoside, which may cause neurologic, gastrointestinal, and cardiovascular toxicity. Symptoms can be severe, and deaths have been reported.
What to do if you or your child took a tejocote root supplement
Stop taking tejocote immediately and contact your health care provider for advice. If you or your child has severe symptoms following exposure to tejocote root such as a slow or irregular heartbeat, fainting, or repeated vomiting, call 911 or go to the emergency department right away.
Get expert help
If someone swallows a tejocote root supplement, or if you have a question about using tejocote safely, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
Why has the FDA warned about tejocote root supplements?
In response to a report by the Centers for Disease Control and Prevention in September 2023, the US Food and Drug Administration (FDA) began sampling and testing tejocote root products. They have issued several warnings that products labeled as tejocote may contain yellow oleander (Cascabela thevetia, also known as Thevetia peruviana).
The FDA advises consumers to stop using these products, dispose of them, and contact their health care provider if they have used the product, even if they did not do so recently. If serious side effects are present, seek emergency medical help right away.
What are the symptoms of tejocote or yellow oleander poisoning?
Symptoms of tejocote poisoning include vomiting, diarrhea, drowsiness, slow heart rate, abnormal heart rhythms, and respiratory depression.
Symptoms of acute yellow oleander poisoning include nausea, vomiting, elevated potassium level, and cardiac toxicity. Possible abnormal cardiac rhythms include slow heart rate, rapid heart rate, heart block, and asystole (flatline). Yellow oleander can also cause lethargy, coma, and seizures. It is so potent that even a small dose is potentially fatal.