Friday, December 12, 2014

The Dangers of Off The Shelf Supplements

The following is an article posted in Yahoo! Health, written by Jenna Birch with the title "Death By Raspberry Ketones And Caffeine Powder: The Dangers Of OTC Supplements". It highlights the dangers of taking off the shelf (aka Over The Counter) supplements which cannot be guaranteed for purity, lack of toxins, efficacy, nor can you be assured that what is in the label is in the bottle.

Cara Reynolds, 24, took her first dose of Forza raspberry ketone supplements in February 2013 to help with a new weight-loss regimen. She went to her dad soon after with complaints about heart palpitations.

“She’d only taken the recommended amount of pills but was scared because her heart was going 10 to the dozen,” her father told The Daily Mail. “That’s when she said she wasn’t going to take them for weight loss any more — it had really worried her.”

However, after a split from her fiancé the following month, the British healthcare worker took a lethal dose of the supplements she had bought off Amazon for under $40.

Doctors tried 44 times to resuscitate Reynolds, but were unable bring her back.

Raspberry ketones are the chemical compound that give the fruit its scent, and have been touted by the media and personalities like Dr. Oz and Kim Kardashian as weight-loss wonders. Although a few preliminary studies have shown ketones may help with weight loss, the evidence of its effectiveness is mixed at best. Outside a few animal and test-tube studies, there’s little science that proves ketones really work for slimming down.

Along with raspberry ketones, Forza supplements combine resveratrol and caffeine. These tablets contain up to 250 milligrams of caffeine per pill, or roughly the same amount you’d get from four cans of Red Bull or seven cans of Coke. The dose Reynolds consumed was likely the equivalent of 2.5 cans of Red Bull.

Through a representative, Forza issued a statement regarding Reynolds, saying, “This is a tragic and understandably upsetting situation for her family and friends, but it could have been effected through the misuse of any supplement. Forza products meet vigorous health and safety standards and have clear labeling and directions for safe usage.” The representative also said that it is “regrettable” that the overdose of a supplement “potentially contributed to Miss Reynolds’ suicide,” but that our client entirely rejects any implication that an inherent safety issue with its products is responsible.”

A report just submitted to the British Medical Journal cited Reynolds’ case as an example of the dangerous side effects associated with untested supplements. The FDA placed raspberry ketones on their “generally recognized as safe” list all the way back in the 1960s, but only for use in very small amounts in food as an additive, not as a weight-loss aid.

That you can get supplements with a potent dose of additives like caffeine over the counter and online is disconcerting, highlighting the need for better regulation of these types of substances.

There’s been a recent boom in advocacy about the dangers posed by unexpected, unregulated substances. Reynolds’ parents are telling their daughter’s story in hopes that the untested ketone supplements will be taken off the market. And the parents of Logan Stiner — the 18- year-old who died last May after suffering from a caffeine overdose — were on Capitol Hill yesterday, pushing lawmakers to ban the sale of caffeine powder.

Stiner ingested 23 times the amount of the stimulant that you’d find in a standard coffee drink. While not a supplement, the powder is often marketed as a weight-loss helper. It is also legally and easily obtained, even though just a teaspoon can deliver a deadly punch of caffeine. The FDA’s investigation into the powder is ongoing.

Part of the problem with supplements in particular is that they’re regulated much differently than drugs. “They’re regulated more like foods,” says Eliseo Guallar, MD, DrPH, a professor of epidemiology and medicine at Johns Hopkins Bloomberg School of Public Health. “They don’t have as tough a standard, and some of the claims reflect that.” Think: miracle weight loss.

This is unsupported, however. “Very often they don’t have the studies to back up their claims, and then they start moving the target to fix that — like the study was on the wrong population,” Guallar explains.

In general, distinct populations are all supplements should be used for — and not the ones that claim big slim-downs and the fountain of youth.

Guallar, who has studied the widespread effects of supplements like daily vitamins, says even these common mineral forms have no clear evidence that they work to prevent disease or provide substantial health benefits for the general population. “They might work for a certain population, perhaps for overcoming a deficiency, but I can’t say any of these compounds work to reduce general risk of chronic diseases like obesity and cardiovascular disease,” he explains. “And half of adults in the adults in the United States take a daily vitamin.”

Big results are unlikely. In fact, a 2012 study published in the International Journal of Sport Nutrition and Exercise Metabolism did not find that any specific supplement promoted significant weight loss, only that some like green tea, fiber, and calcium supplements could “complement a healthy lifestyle.” But in particular, author Melinda Manore, PhD, RD, called out products containing substances like caffeine, ephedra and synephrine as “likely to produce adverse side effects,” saying that they “should be avoided.” This would include Forza supplements.

However, some are still under the impression that, because they’re “supplements,” they can’t possibly hurt — which underscores the need for more regulation in the U.S. — but in the meantime, we should heed the warnings.

Like Guallar says, there are many different kinds of supplements, and even “natural” substances can be harmful. The biggest danger might ultimately be in the idea that they’re not dangerous. “I think people have the idea that these supplements are safe, because you can buy them at the supermarket,” Guallar says. “And then they think, ‘If one is good, then why not take two?’”

So, beware and be smart: Over-the-counter supplements are not without dangers, and they can be just potent as the drugs prescribed by your doc.

Perhaps more so.

Correction Notice: A previous version of this article incorrectly compared the amount of caffeine in Red Bull with the amount of caffeine consumed by Reynolds through the Forza supplements. The piece has been updated to reflect that she consumed the equivalent amount of caffeine in 2.5 cans of Red Bull.

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