By: Beth Warren

One morning at a local gym, anxious whispering could be heard between trainers and clients. The peddling gossip was about two women who spent the previous night in a hospital after experiencing seizures and heart palpitations. Rumor had it that controlled substances, like steroids, were found in their bloodstream, and the gym was reported to be the source of the problem.
Allegedly, these women were taking supplements handed out by their trainer, who had since been dismissed from the gym for distributing these products. The supplements promised to give them more energy, increase their metabolism and help them lose weight, fast. But these supplements, the trainer explained, were different. Better. They were “self-made” by his own hands. His clients fell for the weight-loss promise as quickly as the weight promised to disappear. No questions asked.
Plainly speaking, people are desperately trying to find the quickest and easiest way to lose weight.  So desperate, in fact, that these women continued taking the harmful pills even after the trainer was fired for distributing his supplements.
Before writing these women off as drug abusers, consider that they were acting as many would from the desperation of wanting the miracle weight-loss drug. In 2007, 70 percent of the US population was taking dietary supplements, and the weight-loss supplement industry was worth $1.67 billion. Mr. Jeff Burbank, Rph, a pharmacist for over 20 years at Dear Drugs Pharmacy, attests to the fact that weight-loss supplements are increasingly prevalent in community members’ diets. “Unfortunately, weight-loss supplements are a major component in many diets. People are looking for the miracle drug, like snake oil from the 1800’s where one sip cures your ailments, but it doesn’t work like that. Nothing can replace a good diet and exercise for weight-loss.”

 

Unsupervised and Unrestricted

Rule of thumb: if it sounds too good to be true, then it is – especially when a product promises to produce weight-loss of over two pounds per week without diet and exercise.
Consumer Reports noted that the consequences of these supplements can be far worse than just false advertising, and can include: heart attack, heart palpitations, high blood pressure, rapid or irregular heartbeat, seizures, stroke and possible death. Currently, the Food and Drug Administration (FDA) has limited authorization over dietary supplements, since they are not considered drugs. Manufacturers do not need to register their products or get approval from the FDA before placing them on the market. Mr. Burbank explains, “The lack of FDA approval means that 9 out of 10 times weight-loss supplements do not do a thing.”
Because of the lack of FDA oversight, consumers can easily be taking supplements containing controlled substances. Manufacturers may either omit harmful chemicals on their ingredient list or accidentally contaminate the pill during production. As of 2007, if a supplement is later found to contain illegal substances or have serious side effects, the FDA can pull it off the shelves, as in the case of ephedra, an ingredient in herbal weight-loss treatments. Ephedra was removed from the U.S. market in 2004 after it was found to cause strokes and heart problems.

 

The Natural Ingredients Trick

There is growing controversy over whether other ingredients in supplements, including vitamins, have beneficial or harmful effects on one’s health. Certain herbal and weight-loss supplement ingredients, including comfrey, chaparral and kava, were shown to be linked to 9 percent of 300 cases of drug-induced liver problems in a study published in the Journal of Gastroenterology. Dr. Steven Clarke PhD., MS, a laboratory leader in pharmaceutical research and professor in the Brooklyn College nutrition program, explains, “A supplement can claim to be botanically derived, but once purified, it can be harmful. Being botanically derived does not make it safe.” Furthermore, if a person has preexisting health conditions, extra precaution is needed. Mr. Burbank says, “People need to watch out for ephedra or caffeine, the active ingredients behind many weight-loss supplements, especially if they have high blood pressure, coronary heart failure or an erratic heartbeat.”
Since 2004, with the enactment of Dietary Supplement Health and Education Act (DSHEA), the manufacturer is responsible to ensure a dietary supplement’s safety before marketing it to the consumer. The reality is that the supplement industry is too large and growing too quickly, making it difficult for the FDA to keep up. Therefore, it is incumbent upon consumers to educate themselves from reliable sources  before taking a supplement. As Mr. Burbank explains, “Employees at health food stores are there to sell products. They may have some knowledge, but they are not a replacement for a doctor or pharmacist.” And it seems like the community is taking a step in the right direction. Mr. Burbank finds that “In the past 4 to 5 years, people have become exceptionally educated before purchasing supplements. That is mainly due to the internet. Information that used to be available to only doctors and pharmacists is now available to the general public.”

 

Dangerous Combinations

Education should not end with a supplement’s individual effect on the body; it also includes its combination with other vitamins, minerals or prescription drugs. A supplement can contain an active ingredient at a healthy and effective level, but once it is combined with other products, it can become toxic, lose its effect, or increase its absorption to harmful levels. For example, combining iron with vitamin C can help increase the absorption of iron in the body, while large amounts of zincin the diet for extended periods of time can inhibit the body’s ability to absorb iron, copper and vitamin C, which could cause anemia. But knowledge of these effects is lacking among community members. Mr. Burbank explains, “The first question I still have to ask is, ‘What medications are you currently on?’ Everything depends on that.” He cites some examples of interactions between vitamin E, vitamin K and fish oil supplements and the drug Coumadin, a blood thinning agent. These supplements, among other things, have blood thinning characteristics, and when combined with Coumadin, can be life-threatening.

 

Double Check the Dose

Among those supplements which actually are beneficial, the benefits can only be derived by taking the recommended amounts. Therefore, it is important to read and understand what is being consumed and how much of it you need. Dr. Clarke finds that “sometimes supplements contain just a sprinkle of an active ingredient and thus have no effect.”
Having no effect can seem like a blessing when looking at the other side of the spectrum. Taking vitamins in excess can have dire health consequences and is becoming more common than taking too little. Some vitamins, like vitamin C, are water soluble, and so if they are taken in excess, they are simply excreted. However, fat soluble vitamins, like vitamin A, are absorbed by the body, and the line between safe and harmful levels of vitamin A is quite thin. Consuming a multivitamin, eating fortified cereal and drinking fortified milk bring a person close to toxic levels of vitamin A, which can lead to osteoporosis.
After taking a supplement, it is important to stay attuned to any unusual signs or symptoms, such as nausea, weakness or fatigue, fever, abdominal pain, chest pain, shortness of breath, yellow corneas and skin, and discolored urine. These are all warning signs reported by the FDA in products that may contain steroids and can cause liver or heart problems.

 

Do We Need a Multivitamin?

Potential dangers aside, the value of multivitamins and other supplements for generally healthy individuals is a hotly debated topic. Some, like Mr. Burbank, feel that certain vitamins are beneficial regardless of health status. “The most common supplements taken, like calcium, iron and vitamin D, are proven effective for preventing health conditions like osteoporosis.” Fish oil supplements have also gained increasing popularity for the benefits of eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), which have been shown to lower cardiovascular disease risk and triglyceride levels.
However, there is rarely enough reason to introduce weight-loss supplements, with all its risks, whether over – or behind – the counter. Even if weight-loss can be achieved, the effect is often short lived as the body adapts to the supplement. Or, as Mr. Burbank explains, “A weight loss supplement can be placebo and have no chemical effect other than making a person believe they are losing weight from the supplement. It’s all in a person’s mind.”
Before any of this causes you to develop a phobia of vitamin supplements, remember that the right supplements in the right amounts can be beneficial. The key is to exercise caution. As long as consumers are proactive in educating themselves on the safety and benefit of a supplement for their individual situation, dietary supplements can potentially have an important place in the diet.

 

Other Resources:

·         FDA lists products with potentially harmful ingredients at: www.fda.gov/Food/DietarySupplements
·         Office of Dietary Supplements, National Institute of Health provides information on research about safety and efficacy of supplements at: dietary-supplements.info.nih.gov.
·         National Center for Complementary and Alternative Medicine has information on possible interactions between dietary supplements and drugs at www.nccam.nih.gov or the Center for Education and Research on Therapeutics at www.QTdrugs.org.