Consumer group Public Citizen recently asked the U.S. Food and Drug Administration (FDA) about Botox and similar shots. They wanted clearer warnings on these products because they can cause a severe sickness that paralyzes muscles and could be harmful.

These shots, used to remove wrinkles by targeting certain muscles with toxins, already have a warning about the effect spreading to other areas. Public Citizen wants stronger warnings because these bad effects might happen even with recommended doses. They focused on six shots like Botox, Daxxify, Jeuveau, Myobloc, Dysport, and Xeomin. Public Citizen also asked the FDA to remove statements saying there aren’t serious side effects from the toxin spread in these treatments. They asked after studying over 5,400 reports of deaths and severe side effects from these treatments. They checked the FDA’s records to find unusual effects that might need more warnings. They wanted people to know clearly about a dangerous problem called systemic iatrogenic botulism, which causes muscle paralysis if the toxin spreads too much.