The truth about Herbal Weight Loss Supplements
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directly to Diet and Herbal Supplements Pro Review
Many over-the-counter
diet supplements are herbal and are sold in health food stores. The
most well known herbal supplements include ephedrine or ephedra, guarana,
St. John’s Wart, and Senna. They generally act as fat burners
by boosting your metabolism. They may be successful weight loss supplements
in the short term.
Con: Herbal supplements are generally
not advised by the established medical community, including stark warnings
from the FDA. Widespread lack of ingredient labeling and knowledgable
health store salespeople exemplify the concept of caveat emptor,
let the buyer beware. The real problem with herbal supplements is not
their effectiveness, but their side effects, which often include drastic
increases in blood pressure and heart problems. If you ever have questions
about herbal supplements, write down the primary ingredients and look
them up at webmd.com. And ask yourself, if there really was some miracle
herb, would not pharmaceutical companies research and bring them to
the mainstream market as soon as possible.
The following review article appears at
webmd.com: It is an excellent review.
Weight-Loss Warning
Shoppers searching for dietary supplements
in health food stores may get useless, even deadly, advice. The industry
says it is improving and policing itself.
WebMD Medical News. Reviewed by Dominique S. Walton, MD, MBA
Dec. 11, 2000 -- The herb ephedra can cause some serious side effects,
from high blood pressure to strokes and seizures. But the clerk at the
health food store didn’t mention any of that when I asked her for a
product that would help me lose 10 pounds.
Instead, she suggested some products that
might do the trick: meal replacement shakes, pyruvate (a substance said
to increase metabolism) and L-carnitine (a so-called fat burner).
On I went to four other health food stores,
asking the same question. The list of recommendations got longer, with
clerks suggesting other types of fat burners, chitosan (promoted
as a fat absorber), ciwuja (a relative of ginseng promoted as a fat
metabolism booster), and green tea extract.
Each clerk sounded convinced that the product
he or she was recommending was the best for weight loss. Never mind
that I didn’t see a single piece of literature confirming that the products
worked (even though I often asked). And although some of the suggested
products contained ephedra (sometimes called ma huang), no one mentioned
what I already knew: that two San Francisco researchers recently found
an alarming number of ill effects, including high blood pressure and
stroke, associated with that supplement.
In wake of Congress deregulating the health
food industry with the Dietary Supplement Health and Education Act of
1994 (DSHEA), the business of handing out unproven remedies has mushroomed
to a $15 billion industry. Doctors and herbalists alike are becoming
concerned that many people are spending their money for substances that
will not help and may even hurt them.
So when it comes to getting advice at the
health food store, the quality of the advice being dispensed is anyone’s
guess, and the environment is definitely caveat emptor, or let
the buyer beware. That point was brought home not only by my personal
experiences, but also by at least three recent medical journal reports:
The San Francisco doctors reviewed 140
reports of ill effects related to the use of dietary supplements containing
ephedra and concluded that almost two-thirds either were definitely,
probably, or possibly associated with use of the supplement. High blood
pressure was the single most frequent adverse effect, followed by heart
palpitations, rapid heart rate, stroke, and seizures. Due to potential
public health implications, the findings were released early by The
New England Journal of Medicine, which plans to publish the final version
of the report Dec. 21.
A University of Hawaii researcher who posed
as the daughter of a breast cancer patient and visited 40 health food
stores in Hawaii asking for advice was frequently told her mother should
take shark cartilage, an unproven remedy that has been associated with
liver toxicity, nausea, fever, and other ill effects in cancer patients.
Her study appears in the August 2000 issue of the Archives of Family
Medicine.
Doctors from Belgium and Germany discovered
that the Chinese herb Aristolochia fangchi may cause not only kidney
failure but urinary tract cancer, according to a report published June
8 in The New England Journal of Medicine. The researchers followed 105
patients treated with the herb at a Belgium weight loss clinic. End-stage
renal (or kidney) failure developed in 43. And nearly half of the 39
who agreed to preventive removal of the kidneys were found to have urinary
tract cancer. The FDA issued an import alert on the herb to ban its
entry into the country.
This information doesn’t seem to have filtered
down to those who sell supplements. When I recently called the same
five health food stores I had visited, asking if they carried aristolochia,
four said no and one clerk asked me to call back when her boss returned.
No one mentioned the import ban, and one suggested he might be able
to order the herb for me.
So what should health food store clerks
tell you and what can you do to protect yourself while supplement-shopping?
How can consumers decide if they are being given potentially dangerous
medical advice?
The fine line
The fine line between selling and giving medical advice is of concern
to the health food industry, too, insiders say. Those who sell supplements
should know their product, says Gayle Engels, a spokeswoman for the
American Botanical Council, an education and research organization in
Austin, Texas. But they should not dispense any medical advice. All
the information we put out says, ’This information is not intended to
replace the information provided by a health care professional.’
To be on the safe side, retailers
should not go much beyond label statements, says Diane McEnroe,
an attorney for Sidley & Austin, the general counsel for the National
Nutritional Foods Association, an industry group based in Newport Beach,
Calif., representing health food stores and manufacturers and suppliers.
The best response to someone like me who asks for help in losing weight,
McEnroe says, is to tell the customer there are a variety of products
that help with weight loss and that they work different ways: some affect
metabolism, others help with the absorption of fat, for instance.
A clerk would cross the line, McEnroe adds,
if he or she talked about obesity, a disease, or miracle solutions designed
to be taken at night so you lose weight as you sleep. Under DSHEA, claims
about how a dietary supplement may help prevent or treat a particular
disease condition are not permitted. A consumer interested in weight
loss supplements should also expect to hear about the importance of
a good diet and exercise program, McEnroe says.
Health food stores can also distribute
promotional literature from the manufacturer if the claims are limited
to what’s known as structure and function claims (this supplement helps
preserve joint maintenance) and not disease claims (it can’t cure arthritis).
Consumers should also expect to see more third party literature
-- reports about supplements authored by independent experts that don’t
mention supplements by brand name, which are also permitted under DSHEA.
There’s no standardized training for health
food store employees, but large chains insist they invest heavily in
employee training. We have invested millions of dollars in a state-of-the-art
interactive training programs to ensure that employees are educated
on GNC brand products and their benefits, says Roberta Gaffga,
a company spokeswoman.
More on my shopping trip
When I visited the five health food stores
-- four chains, one mom-and-pop -- no one promised me miracle weight
loss and no one talked about obesity. One clerk, at a GNC near Los Angeles,
quizzed me before suggesting anything. She asked how old I was, whether
I had high blood pressure or heart disease, whether I worked out, and
how nutritious my diet is.
Her questioning, however, was the exception.
No other clerk asked a thing about my health habits or medical history.
Consumer, educate yourself
In the current deregulated climate, consumers
should educate themselves before even setting foot in a health food
store, suggests Varro Tyler, PhD, professor emeritus of pharmacognosy
at Purdue University, West Lafayette, Ind., and an herbal expert. Most
health food employees, he says, are business people. And many
[stores} hire young people, high school students, as clerks, and probably
they repeat what they heard the boss tell them about products.
And what does Tyler think of the recommendations
I got? Meal replacements will help if you don’t also eat a meal, he
says, but pyruvate, L-carnitine, chitosan, and ciwuja are all unproven
for weight loss. Green tea extract, if it includes caffeine, will help
burn more calories, he says, but the weight loss effect is negligible.
Ephedra with caffeine formulas work best for weight loss, he adds, but
many people’s health histories make those products risky to take.
Tyler proposes that the industry set up
some sort of standardized educational program. But, he adds, I
don’t think it will ever happen.
Meanwhile, consumers should read up on
supplements before going to the store, Tyler says. Among the bibles
in the field: Tyler’s Honest Herbal, by Tyler and Steven Foster, now
in its fourth edition; and Herbal Medicine: Expanded Commission E Monographs,
edited by Mark Blumenthal, founder of the American Botanical Council.
Get information from someone who
is not selling the product, Tyler urges. Trust authors who
do not have an herb company.
It can’t hurt, as well, to keep an ear
out for medical journal reports publicized in the press, such as the
recent ephedra supplement study.
Kathleen Doheny is a Los Angeles-based
health journalist whose work has also appeared in the Los Angeles Times,
Shape, Fit Pregnancy, Modern Maturity, CNN.com/HEALTH, and other publications.
Always consult your doctor or physician
before taking herbal supplements.
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