Archive for the 'Vitamins and Dietary Supplements' Category
April 6th, 2010 by Nina Thompson, ARNP
Over-the-Counter diet pills may have undeclared pharmaceutical ingredients which can be dangerous and extremely addictive, researchers say. In fact the FDA has recently issued several warnings on diet pills with undeclared ingredients, specifically amphetamine-based ones from Brazil.
Harvard physicians report a recent case of a 29-year-old female patient who became addicted to Brazilian diet pills that contained unlabeled ingredients. She reported taking the Brazilian diet pills for four years and had gone into debt to purchase the pills from an acquaintance, spending $160 per month.
At the time of her first visit with a physician, she had been suffering with a number of symptoms that she attributed to the pills and when she tried to quit, she would experience cravings, tremor, headache, and anxiety.
The diet pills were found to contain an amphetamine, chlordiazepoxide, and fluoxetine, which were illegal, dangerous, and not included on the label. Apparently, all of these components could have contributed to the woman’s depression, anxiety, and hallucinations, as well as her dependence on the pills.
In an article by MedPage Today, “Diet pills with unlabeled ingredients are nothing new… In the 1960s, ‘rainbow pills’ contained amphetamines, diuretics, thyroid hormone, and cardiac glycosides. They were banned after their use was linked to sudden cardiac deaths. In the 1980s, diet pills comprised of amphetamines, benzodiazepines, thyroid hormone, and diuretics appeared in Europe and South America. They’ve long been banned but remain widely available.”
Source: Smith BR, Cohen PA “Dependence on the Brazilian diet pill: a case report” Am J Addict 2010; DOI: 10.1111/j.1521-0391.2010.00034.x.
Source: “Adulterated Diet Pills Could Be Addictive”, MedPage Today, April 5, 2010
March 17th, 2010 by Nina Thompson, ARNP
A recent study from the Intermountain Medical Center Heart Institute in Murray, Utah has found that people who increase their vitamin D blood levels to 43 or higher may lower their risk of diabetes, heart attack, heart failure, high blood pressure and heart disease.
Heralded as “One of the Top 10 Medical Breakthroughs of 2007″, Vitamin D continues to surface in new research as a critical nutrient in maintaining good health and preventing disease, yet almost half of the world’s population has lower than optimal levels of vitamin D.
It is well known that hip fractures and muscle weakness, in people over 50, are linked with a deficiency in Vitamin D. Many recent studies have also found that low Vitamin D levels are associated with a number of serious, chronic diseases, such as diabetes, gum disease, multiple sclerosis and other autoimmune diseases, peripheral neuropathy, osteoporosis, cancer, stroke, mental decline, depression, high blood pressure and heart disease.
A Vitamin D deficiency can be treated with a simple daily supplement and a blood test can measure the circulating Vitamin D levels in your blood. A level of 30 nanograms per milliliter of vitamin D is considered normal, although this may vary from lab to lab.
Many doctors are routinely drawing blood levels of Vitamin D to to make sure patients are getting enough vitamin D to optimize good bone health and prevent chronic disease. Ask your doctor about this.
Important Note: Vitamin D is a fat soluble vitamin, thus toxicity can occur from high intakes of vitamin D. Overdosage can occur from large amounts of supplements or cod liver oil, but it is unlikely to result from sun exposure or diet. Parents should consult with their pediatrician before giving any child vitamin D supplements. Excess vitamin D can reach toxic levels and be harmful.
Source: “Boosting Vitamin D Can Do a Heart Good”, HealthDay News, March 15, 2010
March 6th, 2010 by Nina Thompson, ARNP
Recent attention has been focused on three commonly used, over-the counter supplements and weight loss pills which contain chromium. According to test results by Consumer Labs, a private provider of independent testing of health products, a carcinogenic form of chromium, known as hexavalent chromium, was found in three of these products that are currently on the market. (The three products in question are not listed in this article, because of copyright laws, but a list of these weight-loss supplements, along with others that did pass testing by Consumer Labs, can be obtained at Consumer Labs online).
Hexavalent chromium, or chromium (VI) is a more toxic form of chromium than the nutrient, chromium (III). It should not be found in chromium supplements, but it has occurred as a contaminant in some cases. It is known to be a human carcinogen and can cause other harmful health effects such as kidney and liver damage.
Source: “Carcinogen Found in Several Chromium Supplements (Including Some for Weight Loss)”, Consumer Labs, March 3, 2010
March 5th, 2010 by Nina Thompson, ARNP
More and more products with unidentified and harmful ingredients are finding their way into the booming U.S. “Dietary Supplement” marketplace. They are freely advertised on the radio and TV, and are readily available online as well as on the shelves of local grocery stores, pharmacies, and health food stores across the U.S.
This booming multibillion dollar market falls under the category of “Dietary Supplements” which are vitamins, minerals, herbs and other substances meant to improve your diet or overall health. They are most often advertised as “Natural”, which can often be far from the truth.
“Natural” is an abused word which has become an effective tool of this rapidly growing industry. In fact, many of the so-called “Natural” dietary supplements on the market may not even be what they say they are on the label. Even if they are pure, they still may well have significant adverse effects or interact with commonly prescribed drugs. A good example of their potential danger is that many are well known to interact with anesthesia during surgery.
The “Dietary Supplement” market is essentially unregulated by the FDA. Unlike prescription or over-the-counter drugs, which must be tested and reviewed before they’re sold, federal laws allow the sale of untested, unreviewed, and unregistered Dietary Supplements. So a very dangerous product may be on the store shelves and in your body for quite a while before it’s even reviewed or investigated.
Herbal drugs, claiming to provide miraculous cures for common ailments such as obesity, depression, anxiety, sexual problems, menopausal symptoms, arthritis pain and many others boast safe and natural relief without any side effects. This is absolute nonsense. These supposed remedies may well have dangerous side effects that you will probably discover sooner or later.
These products line many shelves of grocery stores and pharmacies and only the manufacturer itself is responsible for determining that the claims on their labels are accurate and truthful. The products are not even registered with the FDA, and only if the FDA becomes aware of false or misleading claims will the agency take action.
On the other hand, a large number of useful and therapeutic herbal products certainly are on the market, but finding them is a challenge. Do your research before making a purchase. Consumer Labs Online is one reputable source, and your health care provider is another good reference. In fact, it’s important to inform your doctor about any supplements you’re taking. Too many patients make the mistake of assuming that anything purchased over-the-counter is okay, and there’s no point in mentioning it to their doctor.
The law which eliminated the FDA review and testing of dietary supplements was the Dietary Supplements Health and Education Act (DSHEA), which was passed in 1994. Over the years since then, serious health problems have occurred with several different dietary supplements, prompting experts to call for a change in the current law.
Many, including the FDA, are saying this law needs to be changed, but while we’re fixing that law, others are saying that the FDA itself, needs to be reformed. Many people who love their “Natural” products, express their distrust of prescription drugs, and point out that many serious errors have occurred with drugs that have been approved by the FDA. Many experts agree that this is an unfortunate trend, and chronic underfunding of the FDA is said to be a major cause of this problem.
In any event, sticking only to “Natural” products is not the solution. Try to find a health care provider you trust, and make every attempt to be educated, beware and be skeptical of claims that are too good to be true.
Source: “Overview of Dietary Supplements”, FDA
Source: Consumer Labs, “Chromium Supplements (including weight-loss formulas”, March 2010
Source: “What’s in Hydroxycut?”, Kristina Fiore, MedPage Today, May 08, 2009
Source: “Reflections on Hexavalent Chromium: Health Hazards of an Industrial Heavyweight”, Environmental Health Perspectives, National Institute of Environmental Health Sciences, National Institute of Health, September 2000
Source: “New England journal endorses institute’s proposals for FDA”, BMJ. 2006 October 14; 333(7572): 772FDA
January 29th, 2010 by Nina Thompson, ARNP
Low levels of vitamin D are associated with greater asthma severity, report researchers in the American Journal of Respiratory and Critical Care Medicine. In their recent study, low levels of vitamin D correlated with poorer lung function, increased airway reactivity, and reduced response to steroid treatment in adult asthmatics. As a result of these findings, the researchers suggest that vitamin D supplements might improve symptoms in some asthma patients, but this particular study did not specifically prove that vitamin D supplements would reduce asthma symptoms.
The importance of Vitamin D is considered to be one of the top 10 medical breakthroughs of 2007 and researchers are continuing to find evidence of its critical importance in immune function and many other systems in the body.
In recent years, low Vitamin D levels have been linked with a number of serious, chronic diseases such as weak bones and muscles, mental decline in elderly, diabetes, gum disease, multiple sclerosis, peripheral neuropathy, osteoporosis, and possibly cancer, stroke, and heart disease have all been found to be associated with low levels of Vitamin D.
Yet despite the importance of this vitamin, a deficiency of Vitamin D remains widespread.
The National Academy of Sciences’ Institute of Medicine (IOM) has set the Upper Limits (UL) for vitamin D at 2,000 IU for children, adults, pregnant, and lactating women, and 1,000 IU for infants up to 12 months of age. A simple blood test can measure the circulating Vitamin D levels in your blood. Many doctors have recently been drawing blood levels of Vitamin D to to make sure patients are getting enough vitamin D to optimize good bone health and prevent chronic disease. Ask your doctor about this.
Read more about Vitamin D
Source: Sutherland E, et al “Vitamin D levels, lung function and steroid response in adult asthma” Am J Respir Crit Care Med 2010; DOI: 10.1164/rccm.200911-1710OC.
Source: “Low Vitamin D Worsens Asthma”, MedPage Today, January 28, 2010
January 21st, 2010 by Nina Thompson, ARNP
Scientists are getting closer to unraveling the mystery of aging and now a new study points to evidence that omega-3 fatty acids appear to slow the biological aging process. University of California researchers found that omega-3 fatty acids may slow aging by protecting the body’s chromosomes from the usual damage that occurs with aging. In their recent study of patients with heart disease, those who had the highest intake of omega-3 fatty acids had the most slowing of their biological aging process, while those who had the lowest intake of omega-3 fatty acids had evidence of the fastest rate of aging.
To determine the speed of biological aging, the researchers measured the length of telomeres on the patients’ chromosomes. Telomeres are the protective caps at the end of chromosomes and the shortening of telomeres has been linked to not only the aging process, but cancer and a higher risk of dying. Telomeres allow cells to divide while keeping the genetic material intact. Every time a cell divides, telomeres get progressively shorter until the cell ultimately dies. This normal aging process can be sped up by environmental factors such as obesity, poor diet, inactivity and smoking. Scientists theorize that counteracting telomere shortening could allow people to be healthier and live longer.
In the University of California study there was no distinction between meals of fatty fish and fish-oil supplements—leaving open the question of whether it’s better for people to eat more fish, to eat plants such as flaxseed or just to take omega-3 supplements.
Experts point out that the results of this study are preliminary and need to be replicated before physicians should use them in practice, but a number of other studies have found that omega-3 fatty acids are beneficial to heart health, and the American Heart Assn. recommends that patients with known coronary artery disease get at least one gram a day of omega-3 fish oil through intake of oily fish, such as salmon, herring and sardines, or the use of omega-3 fatty acid supplements for the prevention and treatment of heart disease.
Source: MedPage Today January 19, 2010
Video source: JAMA
June 16th, 2009 by Nina Thompson, ARNP
The FDA has reported serious problems with three Zicam Nasal Gel/Nasal Swab products sold over-the-counter as cold remedies.
The Agency has received more than 130 reports of loss of sense of smell associated with the use of these products. In these reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses of the products.
The loss of sense of smell may be long-lasting or permanent, according to the FDA, and can adversely affect a person’s quality of life. The loss of ability to smell can also limit the ability to detect the smell of gas or smoke or other signs of danger in the environment.
Anyone using one of these products should discontinue use immediately. People who have experienced a loss of sense of smell or other problems after use of the affected Zicam products should contact their health care professional.
Source: FDA, MedWatch 2009 Safety Summary for Zicam
January 27th, 2009 by Nina Thompson, ARNP
A growing body of research is revealing that elderly with the lowest levels of Vitamin D in their blood are significantly more likely to have a higher incidence of cognitive impairment. Researchers are discovering mounting evidence for previously unsuspected roles for vitamin D in brain development and neuroprotection.
In a recent study from the University of Cambridge, British researchers recently examined the association between serum vitamin D levels and cognitive impairment in persons 65 and older. Those with the lowest levels of Vitamin D were more than twice as likely to have cognitive impairment.
A simple blood test can measure the circulating Vitamin D levels in your blood. Many doctors are now drawing blood levels of Vitamin D to to make sure patients are getting enough of this important vitamin to optimize good health. Ask your doctor about this.
Most often calcium supplements with Vitamin D are recommended by health care professionals. If calcium supplements are not needed, Vitamin D 1,000 IU is available over-the-counter, and may be recommended. Vitamin D is included in most multivitamins, but in very low strengths from 50 IU to 1,000 IU.
via Llewellyn DJ, et al “Serum 25-hydroxyvitamin D concentration and cognitive impairment” J Geriatr Psych Neurol 2009
January 20th, 2009 by Nina Thompson, ARNP
About the dietary supplements
GAIT is the first large-scale study in the United States to test the effects of the dietary supplements glucosamine and chondroitin sulfate for the treatment of knee osteoarthritis. This clinical trial tested whether glucosamine and chondroitin, used separately or in combination, reduced pain in people with knee osteoarthritis.
Glucosamine and chondroitin sulfate are substances found naturally in the body. Glucosamine is believed to play a role in cartilage formation and repair, while Chondroitin Sulfate is thought to give cartilage its elasticity. Both supplements also have some anti-inflammatory effects that may account for the pain relief.
Both glucosamine and chondroitin sulfate are sold over-the-counter as dietary or nutritional supplements. They are extracted from animal tissue: glucosamine from crab, lobster or shrimp shells; and chondroitin sulfate from animal cartilage, such as tracheas or shark cartilage.
In the GAIT study, participants who took glucosamine and chondroitin and had moderate-to-severe pain, experienced significant pain relief–about 79 percent had a 20 percent or greater reduction in pain versus about 54 percent for placebo. However, the participants in the mild pain subset who took glucosamine and chondroitin sulfate, did not experience statistically significant pain relief. These findings are consistent with the results physicians report in their actual office practice where some people get pain relief, and some don’t.
While it has been speculated that glucosamine supplements may be able to help the body repair damaged cartilage, this has yet to be proven, and in the GAIT study there was in fact no slowing of loss of cartilage in patients who took glucosamine and chondroitin, together or alone. This was determined after assessing the x-ray data on 581 knees of participants in this study. More research needs to be done, but at this point, there appears to be no benefit from taking these dietary supplements, other than for pain relief in those experiencing moderate-to-severe pain.
How to take glucosamine and chondroitin
Because dietary supplements are unregulated, the quality and content of products on the store shelves may vary widely. Identical products of glucosamine and chondroitin used in the GAIT study may not be commercially available. A well-respected private laboratory, Consumer Lab.com performs independent tests on dietary supplements which it publishes online. However, these results are only available for an annual subscription fee. The National Arthritis Foundation recommends simply choosing only products sold by large, well-established companies.
If you decide to take these supplements:
- Always consult your doctor before deciding to try these supplements, and make sure that osteoarthritis is the cause of your pain.
- Consult your doctor about the proper dosage. The amount used in studies of glucosamine was 1,500 mg per day and in studies of chondroitin sulfate, 1,200 mg per day was used. Divide the daily total into three doses per day.
- You can try the supplements along with your current medications for three months. If you don’t experience any difference in your symptoms within this time, you probably will not get any relief from using the supplements. If the supplements are having a beneficial effect, continue on the supplement, but it may be possible to reduce the dose after the first few months:
- First two months: 1500 mg glucosamine and 1,200 mg chondroitin per day in three divided doses
- Next month: try reducing the dose to 1,000 mg of glucosamine and 800 mg of chondroitin, in two divided doses.
- Next month: try reducing to 500 mg glucosamine and 400 mg of chondroitin in one dose
- If symptoms return, increase to the full dosage.
- Do not stop or reduce your current prescribed medications without talking with your doctor.
- Choose products sold by large, well-established companies that can be held accountable.
- Read the product labels carefully to make sure the ingredient lists make sense to you. If you have trouble, ask your pharmacists for help.
- Recommended doses should cost about $1 to $3 per day, but most insurance companies do not cover this cost.
Both glucosamine and chondroitin sulfate have been used in Europe for several years, with few reported side effects and in most human studies, glucosamine sulfate has been well tolerated for 30 to 90 days. But these supplements are not appropriate for all forms of arthritis or for all people.
Pregnant women should not take this or anything else without asking their obstetrician. Diabetics should be especially cautious–It remains unclear if glucosamine alters blood sugar levels. Since glucosamine can be made from the shells of shrimp, crab, and other shellfish, people with shellfish allergy or iodine hypersensitivity may theoretically have an allergic reaction to glucosamine products. There are reported cases suggesting a link between glucosamine/chondroitin products and asthma exacerbations. In theory glucosamine may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding.
Side effects may include upset stomach, drowsiness, insomnia, headache, skin reactions, sun sensitivity, and nail toughening. There are rare reports of abdominal pain, loss of appetite, vomiting, nausea, flatulence (gas), constipation, heartburn, and diarrhea.
Image of the knee courtesy of the National Institute of Musculoskeletal and Skin Diseases
via “Questions and Answers: NIH Glucosamine/chondroitin Arthritis Intervention Trial Primary Study (GAIT)”, (The University of Utah, School of Medicine coordinated this study, which was conducted at 16 rheumatology research centers across the United States.) National Center for Complementary and Alternative Medicine (NCCAM), January 09, 2009
via “Glucosamine and Chondroitin Sulfate”, Arthritis Foundation
via “Glucosamine and Chondroitin Sulfate“, American Academy of Orthopedic Surgeons
January 12th, 2009 by Nina Thompson, ARNP
More and more products with unidentified and harmful ingredients are finding their way into the U.S. marketplace, and the FDA is quickly taking action to file criminal charges and help ensure that these products are removed from the store shelves. It is an extensive process, however, and dangerous products are still advertised on the TV and radio and readily available online as well as on the shelves of local grocery stores, pharmacies, and health food stores in the U.S.
Most of the dangerous and illegal products are for weight loss, but there are also many for erectile dysfunction, diabetes and hair loss. Usually they are labeled as dietary supplements or supplements. Often the manufacturer is not listed on the label or in the advertisements. However, the FDA has discovered that most of the products with illegal and undeclared ingredients have been manufactured in China.
Some of these ingredients are known to be carcinogenic and cause damage or mutations to DNA. Other known side effects include increased blood pressure, stroke, tachycardia, seizure, depression, anxiety, insomnia, aggressiveness, and suicidal thoughts.
The FDA urges all consumers to be aware of the following signs of health fraud:
- Promises of an “easy” fix for problems like excess weight, hair loss, or impotency.
- Claims that the product is safe because it is “natural.”
- Claims such as “scientific breakthrough,” “miraculous cure,” “secret ingredient,” and “ancient remedy.”
- Impressive-sounding terms, such as “hunger stimulation point” and “thermogenesis” for a weight loss product.
- Undocumented case histories or personal testimonials by consumers or doctors claiming amazing results.
- Promises of no-risk, money-back guarantees.
In other words, if it’s too good to be true, it is. The only OTC drug approved for weight loss in the United States is Ally. Orlistat is the active ingredient in Ally which helps produce weight loss by decreasing the intestinal absorption of fat. Some people have lost weight with Ally, but there are a number of people who shouldn’t take Ally. Click on the link below for more about Ally.