Authorities have identified a second death that may have been caused by Diamond Shruumz microdosing candies, which are under investigation for causing a nationwide rash of severe illnesses involving seizures, and the need for intubation and intensive care.

In an update on Tuesday, the Food and Drug Administration reported that the total number of illnesses linked to the brand's candies has risen to 74 across 28 states. Of the 74 people sickened, 62 sought medical care, and 38 were admitted to a hospital. There are two potentially associated deaths that are now under investigation. The counts are up from 69 cases and 36 hospitalizations, with one potentially linked death reported in an update last week.

The FDA announced its investigation into Diamond Shruumz products on June 7, when there had been just eight cases reported from four states. The federal investigation—led by the FDA and the Centers for Disease Control and Prevention, with help from America’s Poison Centers and state and local partners—followed warnings from Arizona poison control officials.

There is "clearly something toxic occurring," with Diamond Shruumz's products, Steve Dudley, director of the Arizona Poison and Drug Information Center, said in a June 3 warning. "We’ve seen the same phenomenon of people eating the chocolate bar then seizing, losing consciousness, and having to be intubated."

On June 27, Diamond Shruumz's parent company, Prophet Premium Blends, announced a recall of all flavors and batches of its products, including chocolate bars, gummies, and candy cones.

But, even with the ongoing investigation and analyses, it remains unclear which ingredient in the candies is causing the severe illnesses. The products are sold as "microdosing" candies, suggesting they contain psychedelic drugs of some kind. However, the company has not disclosed the full ingredient list. It only markets the candies as containing a "primo proprietary blend of nootropic and functional mushrooms," which are thought to include the non-hallucinogenic Lion's mane, Reishi, and Chaga mushrooms.

Psychoactive suspects

FDA testing results released on June 25 indicated that samples of two Diamond Shruumz's chocolate bars contained 4-AcO-DMT (aka 4- acetoxy-N,N-dimethyltryptamine, O-acetylpsilocin, or psilacetin). This is a synthetic, gray-market psychedelic drug similar to psilocybin, the hallucinogenic component of magic mushrooms that is categorized as a Schedule I controlled substance by the Drug Enforcement Administration. However, independent testing of Diamond Shruumz gummy products purchased in 2023 by researchers at the University of Virginia found that those candies contained psilocin. This is another psilocybin-related drug but one that is itself listed as a Schedule I drug.

While these findings are troubling and highlight the common dangers of gray-market microdosing candies, the compounds do not necessarily explain the illnesses. Neither Psilocin, 4-AcO-DMT, nor the related psilocybin is associated with seizures and the severe outcomes noted in the cases linked to Diamond Shruumz-brand candies.

Perhaps the most plausible possible cause identified so far is yet another compound identified by Diamond Shruumz itself. In its recall notice, the company reported that third-party lab testing of some of its candies identified higher than normal amounts of muscimol, a psychoactive compound found in hallucinogenic Amanita mushrooms, including the iconic toadstool A. muscaria. These mushrooms contain a combination of muscimol and the related ibotenic acid, both of which resemble neurotransmitters. Together, they could cause the symptoms seen in the cases so far, including seizures, central nervous system depression (loss of consciousness, confusion, sleepiness), agitation, abnormal heart rates, hyper/hypotension, nausea, and vomiting.

But questions still abound. Particularly, it remains unclear what levels of muscimol were found, what candies contained the compound, and whether ibotenic acid was also present. Neither Diamond Shruumz nor its parent company Prophet Premium Blends has responded to inquiries from Ars.