Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
BD, BDO, blue nitro, blue nitro vitality, busulfan, Busulfex®, but-2-yne-1,4-diol, butane, butane-1,4-diol, butanediol fermentation, butylene glycol, butylene glycol fermentation, caps, cherry fX bombs, cherry meth, circles, easy lay, enliven, euphorigenic, Everclear®, fantasy, firewater, forget-me pill, G, GABA-active agent, gamma-butyrolactone, gamma-G, gamma-hydrate, γ-hydroxybutyrate, gamma-hydroxybutyrate (GHB), gamma-hydroxybutyric acid, gamma-hydroxybutyrate sodium, gamma-OH, GBL, Georgia home boy, GHB, GH revitalizer, G.H. revitalizer, GHRE, gib, goop, goops, great hormones at bedtime, grievous bodily harm, g-riffick, growth hormone booster, insom-X, invigorate, la rocha, lemon fX drops, liquid E, liquid ecstasy, liquid X, longevity, Mexican valium, Myleran®, natural sleep-500, nature's Quaalude, nitro, NRG3, one-comma-four, one-four-B-D-O, one-four-bee, orange fX rush, organic Quaalude, oxy-sleep, pine needle oil, poor man's heroin, precursor product, R2, remforce, renewtrient, revitalize plus, revivarant, revivarant G, roche, roofies, rope, rophies, salty water, scoop, serenity, soap, sodium oxybate, sodium oxybutyrate, somatomax, somatomax PM, somatoPro, somsanit, tetramethylene-1,4-diol, tetramethylene glycol, thunder nectar, vita-G, water, weight belt cleaner, wolfies, zonked.
1,4-Butanediol is a colorless, thick liquid that is converted into gamma-hydroxybutyrate (GHB) after ingestion. GHB is a strong sedative that is often used as a date-rape drug because it is easily concealed in water due to a lack of smell and taste.
GHB is a metabolite of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, and has been linked to cases of dependence, coma, and death. GBL (gamma-butyrolactone), a solvent commonly used as a paint stripper, is another precursor for GHB. 1,4-Butanediol itself is used as an industrial chemical to make some plastics and fibers.
GHB, GBL, and 1,4-butanediol are prevalent drugs of abuse in the United States. While available as a prescription drug for sleep disorders in some other countries, GHB was banned in the United States by the U.S. Food and Drug Administration (FDA) in 1990 because of the dangers associated with its use. It has since been approved only for the treatment of a rare form of narcolepsy (a sleep disorder that result in excessive daytime sleepiness). In Europe, GHB has been used as an anesthetic and experimentally to treat alcohol withdrawal.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
No available studies qualify for inclusion in the evidence table.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Aging, alcohol withdrawal, athletic performance, bone marrow transplant, central nervous system disorders (depressant), depression, growth hormone stimulation, increased muscle mass, laxative, leukemia, libido, narcolepsy (a sleep disorder that result in excessive daytime sleepiness), sedative, sleep aid, weight loss.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
There is no proven safe or effective dose for butanediol or gamma-hydroxybutyrate (GHB). Traditionally, doses of 0.25-1 grams of butanediol have been used for stimulating the release of growth hormone, for muscle growth, and for treating insomnia. For narcolepsy, 3 grams of GHB has been taken twice nightly, four hours apart.
Children (under 18 years old)
There is no proven safe or effective dose for butanediol or GHB in children.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
There is a lack of information about allergies to butanediol or gamma-hydroxybutyrate (GHB).
Side Effects and Warnings
Taking 1,4-butanediol (present in various nutritional supplements) by mouth has been linked to numerous deaths from pulmonary edema (abnormal build up of fluid in the air sacs of the lungs, leading to shortness of breath). Closely related products, gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL), are also likely unsafe due to their ability to produce similar effects.
1,4-Butanediol and GHB may cause severe sedative effects as well as slow heart rate (bradycardia), involuntary eye movements (nystagmus), dizziness (vertigo), lack of muscle coordination (ataxia), sedation or drowsiness, confusion, short-term amnesia, coma, tonic-clonic seizure-like activity, insomnia, and respiratory depression that may require intubation.
Butanediol may cause aggression, agitation, flailing episodes, treatment-resistant psychoses, hallucinations, anxiety, delusions, and combativeness.
Use cautiously with alcohol, narcotic pain relievers, antipsychotic drugs, sedatives, drugs used to treat seizures, stimulants, and skeletal muscle relaxants.
Pregnancy and Breastfeeding
Butanediol is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Butanediol may enhance the effects of alcohol, leading to further intoxication.
Butanediol and/or gamma-hydroxybutyrate (GHB) may enhance the effects of narcotic pain relievers, such as morphine, anesthetics, antipsychotic drugs, antianxiety drugs, and sedatives.
Butanediol and/or GHB may interfere with the effects of drugs used to treat/prevent seizures and stimulants.
Antiretroviral drugs may inhibit the metabolism of GHB. Therefore, if taken together, a serious reaction may occur.
Butanediol may have serious adverse effects when taken together with skeletal muscle relaxants.
Interactions with Herbs and Dietary Supplements
Butanediol may enhance the effects of alcohol, leading to further intoxication.
Butanediol and/or gamma-hydroxybutyrate (GHB) may enhance the effects of anesthetics, antipsychotic herbs, antianxiety herbs, and sedatives.
Butanediol and/or GHB may interfere with the effects of herbs used to treat/prevent seizures and stimulants.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Caputo, F., Addolorato, G., Stoppo, M., Francini, S., Vignoli, T., Lorenzini, F., Del Re, A., Comaschi, C., Andreone, P., Trevisani, F., Bernardi, M., and Alcohol Treatment Study Group. Comparing and combining gamma-hydroxybutyric acid (GHB) and naltrexone in maintaining abstinence from alcohol: an open randomised comparative study. Eur.Neuropsychopharmacol. 2007;17(12):781-789. View Abstract
Caputo, F., Vignoli, T., Lorenzini, F., Ciuffoli, E., Del Re, A., Stefanini, G. F., Addolorato, G., Trevisani, F., and Bernardi, M. Suppression of craving for gamma-hydroxybutyric acid by naltrexone administration: three case reports. Clin.Neuropharmacol. 2005;28(2):87-89. View Abstract
Dyer, JE. Evolving abuse of GHB in California: bodybuilding drug to date-rape drug. J Toxicol Clin Toxicol 2000;38:184.
Gervasi, N., Monnier, Z., Vincent, P., Paupardin-Tritsch, D., Hughes, S. W., Crunelli, V., and Leresche, N. Pathway-specific action of gamma-hydroxybutyric acid in sensory thalamus and its relevance to absence seizures. J Neurosci. 12-10-2003;23(36):11469-11478. View Abstract
Gunja, N., Doyle, E., Carpenter, K., Chan, O. T., Gilmore, S., Browne, G., and Graudins, A. Gamma-hydroxybutyrate poisoning from toy beads. Med J Aust. 1-7-2008;188(1):54-55. View Abstract
Harrington, R. D., Woodward, J. A., Hooton, T. M., and Horn, J. R. Life-threatening interactions between HIV-1 protease inhibitors and the illicit drugs MDMA and gamma-hydroxybutyrate. Arch Intern.Med 10-11-1999;159(18):2221-2224. View Abstract
Irwin, R. D. A review of evidence leading to the prediction that 1,4-butanediol is not a carcinogen. J Appl.Toxicol. 2006;26(1):72-80. View Abstract
Maldonado, C., Rodriiuez-Arias, M., Aguilar, M. A., and Minarro, J. GHB differentially affects morphine actions on motor activity and social behaviours in male mice. Pharmacol Biochem.Behav. 2003;76(2):259-265. View Abstract
Navarro, J. F., Davila, G., Pedraza, C., and Arias, J. L. Anxiogenic-like effects of gamma-hydroxybutyric acid (GHB) in mice tested in the light-dark box. Psicothema. 2008;20(3):460-464. View Abstract
Ricaurte, G. A. and McCann, U. D. Recognition and management of complications of new recreational drug use. Lancet 6-18-2005;365(9477):2137-2145. View Abstract
Shannon, M. and Quang, L. S. Gamma-hydroxybutyrate, gamma-butyrolactone, and 1,4-butanediol: a case report and review of the literature. Pediatr.Emerg.Care 2000;16(6):435-440. View Abstract
Tarabar, A. F. and Nelson, L. S. The gamma-hydroxybutyrate withdrawal syndrome. Toxicol.Rev. 2004;23(1):45-49. View Abstract
Thai, D., Dyer, J. E., Jacob, P., and Haller, C. A. Clinical pharmacology of 1,4-butanediol and gamma-hydroxybutyrate after oral 1,4-butanediol administration to healthy volunteers. Clin.Pharmacol Ther. 2007;81(2):178-184. View Abstract
van Nieuwenhuijzen, P. S. and McGregor, I. S. Sedative and hypothermic effects of gamma-hydroxybutyrate (GHB) in rats alone and in combination with other drugs: assessment using biotelemetry. Drug Alcohol Depend. 8-1-2009;103(3):137-147. View Abstract
Zvosec, D. L., Smith, S. W., McCutcheon, J. R., Spillane, J., Hall, B. J., and Peacock, E. A. Adverse events, including death, associated with the use of 1,4-butanediol. N.Engl.J.Med. 1-11-2001;344(2):87-94. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017