When former NBA star Lamar Odom was found unresponsive in a Las Vegas brothel last week, experts began trying to piece together the puzzle: What had happened that left him fighting for his life?

While the reports have varied—some employees stated the two-time champion was taking cocaine—brothel owner, Dennis Hof has said that Odom was popping ‘herbal Viagra’, more specifically, a supplement said to enhance sexual performance called Reload. And he didn’t just swallow one—he could have taken about 10 pills of 1,875 milligrams (meant to last three days each), some reports say.

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What is herbal Viagra?
The term herbal Viagra doesn’t really refer to the prescription medicine Viagra at all, says Drogo Montague, M.D., a urologist at the Glickman Urological and Kidney Institute at the Cleveland Clinic.

Viagra (sildenafil citrate) is a prescription oral medicine used for erectile dysfunction that works by increasing blood flow to the penis.

‘Herbal Viagra’ refers to a non-prescription drug or herbal or vitamin/mineral preparation that claims to enhance sexual performance or male enhancement, says Montague. Many claim to stimulate your body to make sex hormones, while others boast ingredients like vitamins and minerals that somewhere along the line, someone has reported help sexual performance, says Montague.

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“Some are just expensive mineral preparations that don’t have any effect. In others, testing has found sildenafil citrate (Viagra) in the preparation—probably not enough to be effective, certainly not disclosed, and potentially dangerous,” says Montague.

But wait, why is it dangerous?
For multiple reasons. The first: When you pop an herbal supplement, there’s no way of knowing what just went into your body. That’s because, since the Food and Drug Administration (FDA) doesn’t regulate supplements, manufacturers aren’t required to list all of their ingredients.

“In prescription and manufactured medicines, potency and purity are guaranteed,” says Montague, who adds that purity and potency in supplements is not guaranteed.

Another danger: The actual ingredients in these supplements can prove worrisome.

Consider Reload—the product Odom was supposedly using. The Washington Post reported that the FDA discovered Reload contained sildenafil—which wasn’t disclosed on its ingredient list—and released a statement saying: “Consumers should stop using this product immediately and throw it away.”

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How come? Viagra can have dangerous interactions with other medicines, like nitrates—prescribed for heart conditions, says Montague. While sildenafil citrate dilates arteries and increases blood flow, it also drops your blood pressure a bit, he explains. Nitrates also increase blood flow and drop blood pressure. That’s why if you’re on nitrates, your doc won’t prescribe you Viagra—it could lead to a scary drop in blood pressure. See where we’re going with this? If you don’t know what you’re taking, you could set yourself up for a health scare without even knowing it.

Beyond nitrates, though, “naturally occurring substances can have side effects, too,” says Montague. And interactions of a slew of different (again … undisclosed) ingredients can lead to other health problems like blood clotting, he says.

So are herbal sexual enhancement supplements safe? “No,” says Montague. “Men shouldn’t be using them. Many people assume that herbal means natural and natural means safe.” That’s simply not the case.

The bottom line: “Men who are taking things that are not prescription drugs are, at best, wasting their money—spending on something that has no effect at all—but potentially, they are getting something that might be harmful to their health.”

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