In early 2006 a self-styled “naturopathic” doctor, Chad Livdahl, pleaded guilty in Arizona to mail fraud and conspiracy to engage in mail and wire fraud, to misbrand a drug and to defraud the U.S. He was sentenced to nine years in prison. His wife and business partner in Toxin Research International, Inc., in Tucson, Zarah Karim, pleaded guilty to the same charges and received a six-year sentence. Both also paid heavy fines and restitution because, according to prosecutors, the couple had made at least $1.5 million in just more than a year by peddling tiny vials of fake Botox to doctors across the U.S.