The number of poisonings connected to Diamond Shruumz-brand microdosing candies has reached 145 cases across 29 states. Since the illnesses first came to light in early June, 59 of those sickened have required hospitalization, and health officials have reported people having seizures, needing intubation, and being admitted to intensive care units. Two deaths are under investigation. Yet, despite tireless efforts to analyze the candies’ components, the cause of the poisonings remains a mystery.

Diamond Shruumz suggestively markets the chocolates—as well as its gummies and candy cones—as containing psychedelic drugs but doesn’t say what’s in them exactly. They’re only said to contain a “primo proprietary blend of nootropic and functional mushrooms,” and the company has identified non-hallucinogenic mushrooms, including Lion’s mane, Reishi, and Chaga.

In its latest investigation update Monday, the Food and Drug Administration laid out the testing results of 22 chocolate bars from Diamond Shruumz—and the list of illicit and troubling drugs found keeps growing. Stunningly, none of the drugs found so far can alone explain the severe illnesses.

According to the FDA, nine of the bars contain a synthetic psychedelic drug called 4-AcO-DMT (aka acetylpsilocin 4-acetoxy-N,N-dimethyltryptamine, 4-acetoxy-DMT, or psilacetin). This is similar to psilocin, the hallucinogenic drug in magic mushrooms that is designated as a Schedule I drug, alongside LSD and heroin, by the Drug Enforcement Administration. Four of the bars contained plain psilocin. Neither is known to cause the severe effects reported in the people affected.

Three bars contain the prescription drug pregabalin (brand name Lyrica), which is used to treat nerve pain and epilepsy. Eighteen of the bars contained a trio of chemicals from the Kava plant (Piper methysticum)—desmethoxyyangonin, dihydrokavain, and kavain. Kava is used in some herbal remedies to treat anxiety, insomnia, stress, and other ailments.

Leading suspects

In Diamond Shruumz’s June 27 recall of all of its products (all types, flavors, and lots), the company blamed the elevated levels of muscimol. This is a chemical found in hallucinogenic Amanita mushrooms that mimics a neurotransmitter and causes sedation. But the FDA found muscimol in only nine of the 22 chocolate bars tested. The agency notes that the chemical can’t explain all of the illnesses and reported symptoms.

The most plausible explanation to date is if the muscimol was accompanied by another Amanita chemical called ibotenic acid. This also resembles a neurotransmitter and leads to stimulation, including fast heart rate, higher blood pressure, agitation, and potentially seizures. Together, muscimol and ibotenic acid could potentially explain the illnesses. But, to date, the FDA has not found ibotenic acid in any of the candies, although it did find the combination in a raw ingredient reportedly used in making Diamond Shruumz’s products.

Of the other combinations of chemicals that have been found in the chocolate bars so far, the FDA notes that there’s little research on what happens when they’re ingested together. The FDA and the Centers for Disease Control and Prevention “are interpreting these test results to understand the health risks of ingesting these chemical substances and to determine the appropriate next steps,” the agency said.

Testing is also ongoing, including on the Diamond Shruumz gummies and cones.

By Holden