Dr. Rohit Satoskar doesn’t know Marcus Joyner or why he needed a liver transplant, but he  knows this: When healthy individuals in their 20s undergo that procedure, it usually means something out of the ordinary has occurred. Something very out of the ordinary.

“Unless there’s some inciting event, it would be very rare for a healthy 20-year-old to require a liver transplant,” said Satoskar, medical director of liver transplantation at the MedStar Georgetown University Transplant Institute.

In Joyner's case, that event appears to be his use of a dietary supplement known as Mass Destruction. Then 28, Joyner used the body-building product for three or four weeks in October 2013. Two months later, he was in an operating room at Duke University Medical Center getting a new liver.

 Wes Houser

Credit: Lois Norder

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Credit: Lois Norder

Now the incident is part of a federal prosecution that asserts that Mass Destruction was spiked with two illegal steroids -- one of which has long been linked to liver toxicity _ and that two Atlanta men, Beny Mesika and Wes Houser, are responsible for making it.

Satoskar, a member of the American Liver Foundation’s medical advisory committee, said the number of cases of acute liver failure linked to dietary supplements is relatively small, but enough are known to suggest there’s a problem.

 Beny Mesika

Credit: Lois Norder

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Credit: Lois Norder

A 2008 study of 300 patients who suffered drug-induced liver injury reported that 9 percent occurred because of dietary supplements. The study, published in the official journal of the American Gastroenterological Association, linked 73 percent to prescription drugs and 18 percent to “multiple agents.”

Noting that supplements can enter the market unchecked for safety or effectiveness, Satoskar said: “As a physician, the danger is you have someone who has taken something and you can’t say for sure what it is. (These products) may contain agents that are potentially harmful to the liver, and the public can unknowingly ingest them.”

Joyner, a shift worker at a manufacturing plant in Wilson, N.C.,  experienced symptoms that included dark urine, abdominal pain, jaundice and dizziness before tests determined that his liver was damaged, according to adverse event reports filed with the U.S. Food and Drug Administration.

Joyner had no personal or family history of liver disease, didn’t smoke and used alcohol on only a limited basis, the reports, prepared in December 2013, said.

A lawsuit Joyner has filed against Mesika, Houser and others states that “testing” at Duke revealed that a “synthetic steroid” damaged his liver but provides no details.

Neither Joyner nor his attorney, Lynwood Evans, would comment.

The federal case against Mesika and Houser doesn't mention Joyner or the circumstances surrounding his illness, but it contends that Mass Destruction  "resulted in serious bodily injury and death." Read more about the case by clicking here: https://www.myajc.com/news/crime--law/fast-track-riches-harm-their-wake/XFqcGH3efOMTx9IDpUl9AN/

Prosecutors assert that the product contained Methasterone, a so-called designer steroid that has been tied to numerous cases of liver failure and has been classified as a Schedule III controlled substance since July 2012, as well as a  "slightly-adjusted" similar compound. Neither was listed on the label.

Designer steroids are chemical substances that have been engineered by chemists to be similar to actual steroids but with slight modifications. They were first developed to help elite athletes beat drug tests and have since become a staple of body-building supplements.

Houser pleaded guilty last month to a conspiracy charge and acknowledged that he and Mesika manufactured Mass Destruction and a similarly illegal product called Mutant Plexx.  In return, the government has dismissed charges of distributing controlled substances, introducing misbranded drugs into interstate commerce and money laundering.

Mesika has pleaded not guilty, and his attorney, Bruce Harvey, asserts that  his client did not participate in any illegal activity.

Prosecutors claim that the pair made millions manufacturing the illegal substances and used the money to purchase a riverfront mansion in Sandy Springs, a 43-acre farm in Coweta County and 11 vehicles, including four Ferraris, two Porsches and a McLaren.