MELVILLE, N.Y. - At least 29 people were sickened and one hospitalized in what has grown into a nationwide federal alert involving vitamin tablets laced with potentially dangerous anabolic steroids. The product is manufactured by a Long Island company.

The unfolding medical drama could result in more cases, federal experts say, should other consumers link their symptoms to the product.

The tainted vitamins are marketed as Healthy Life Chemistry By Purity First B-50. The U.S. Food and Drug Administration has asked the manufacturer - Mira Health Products Ltd. - to voluntarily recall the product, but the company has refused. The vitamins are sold in retail outlets and over the Internet.

The refusal, FDA officials said Wednesday, could result in seizure and sanctions against the company.

A man who answered the phone at Mira Health Products would not identify himself and refused to answer questions.

An FDA lab analysis revealed the vitamins contain dimethazine and methasterone, a controlled substance. Methasterone is highly potent and a so-called designer anabolic steroid first synthesized in the 1950s. Bodybuilders illegally use anabolic steroids to increase muscle mass.

"Products marketed as a vitamin but which contain undisclosed steroids pose a real danger to consumers and are illegal," Howard Sklamberg, director of the FDA's Office of Compliance, said in a statement.

Discovery of the contaminated vitamins began as a medical mystery in February when patients began trickling into North Shore University Hospital in Manhasset, N.Y. Doctors initially suspected possible environmental contamination, and patients were referred to Dr. Ken Spaeth, director of occupational and environmental medicine. But Spaeth said after questioning patients it was clear they had come from throughout the tri-state area, with a few from as far away as Florida. The widespread geography dashed the environmental theory.

Spaeth said women who had taken the vitamins reported facial hair growth and missed menstrual periods. Men reported impotence.