Michelle Trachtenberg, known for her roles in Buffy the Vampire Slayer, Gossip Girl, and Harriet the Spy, died from complications related to diabetes mellitus, the New York City Office of Chief Medical Examiner confirmed Wednesday. The manner of death was ruled as natural following a toxicology review, which the office said can be conducted without an autopsy.
The announcement comes nearly two months after Trachtenberg, 39, was found unconscious and unresponsive in her Manhattan apartment on February 26. Her family had objected to an autopsy, and with no evidence of foul play, the medical examiner initially listed the cause of death as undetermined.
A spokesperson for the medical examiner's office told PEOPLE that the amended determination was based on toxicology results. "The amended determination was made following review of toxicology testing results," the office said in a statement.
The actress had battled multiple health issues in recent years, according to friends. Sources told PEOPLE that she had recently undergone a liver transplant and had expressed emotional struggles to those close to her. One insider said she was "pale, gaunt, very thin, and dealing with health issues," noting that Trachtenberg had been candid with her circle about her deteriorating health.
Despite visible signs of illness, Trachtenberg had addressed speculation about her appearance earlier this year. In a January Instagram post responding to online comments, she wrote: "Fun fact. This is my face. Not malnutrition no problems. Why do you have to hate? Get a calendar."
Trachtenberg's acting career spanned more than three decades. She made her debut at age 8 on Nickelodeon's The Adventures of Pete & Pete, and gained wider fame in the 1996 film Harriet the Spy. In the 2000s, she played Dawn Summers on Buffy the Vampire Slayer and later portrayed Georgina Sparks in Gossip Girl, a role she reprised in the show's 2021 reboot.
Former co-stars paid tribute following her death. Blake Lively, who starred alongside Trachtenberg in Gossip Girl, posted a photo of their first meeting, writing, "She was electricity. You knew when she entered a room because the vibration changed."
Sarah Michelle Gellar, who played Buffy, shared a carousel of photos from their time on set, captioned with a line from the show's season 5 finale: "Michelle, listen to me. Listen. I love you. I will always love you." Gellar added, "I will live... for you. "
Rosie O'Donnell, who co-starred with Trachtenberg in Harriet the Spy, also mourned her passing, telling PEOPLE: "She struggled the last few years. I wish I could have helped."
Trachtenberg's body of work also included appearances on Six Feet Under, Weeds, 17 Again, and EuroTrip. She is remembered by colleagues and fans for her talent, energy, and vulnerability both on and off screen.
