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�The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.�

Weight Loss Supplements: What the Labels Don't Say

by Sarah Albert

"I�ve tried everything to lose weight," says Bob, a project coordinator residing in New York City. "I�ve decided to try nutritional supplements, but I have no idea which work."


Bob is not unlike many in the LGBT communities who want to find dietary supplements that work, without spending -- or losing -- a lot of money.

Whether you are trying to lose weight or build muscle, finding a supplement that will go the distance -- and make a long-term difference -- is no easy feat. A lot of supplements make promises they just can�t keep.

"Unlike drugs, the U.S. Food and Drug Administration (FDA) does not regulate herbal and dietary supplements. For this reason, manufacturers of supplements are able to make claims about their products that aren't necessarily supported by scientific research and may be misleading," says Holly Vance, Pharm.D., manager of pharmacy services,

While supplements can help you reach your goals, it is crucial to keep abreast of the latest news and studies. Vance shares her knowledge about some popular supplements including ephedra, chromium and more.

Ma huang and guarana are herbal supplements that are frequently promoted to help with weight loss. Both herbs are stimulants used as an ingredient in diet pills. Ma huang -- also known as ephedra -- is also taken for some respiratory conditions including asthma, bronchitis and cough.

The Food and Drug Administration (FDA) issued warnings about side effects associated with these herbs. The FDA does not, however, regulate ephedra because it is a dietary supplement protected under the Dietary Supplement Health and Education Act of 1994 (DSHEA, link in the sidebar). Unless proven unsafe, ephedra will remain on the market.

Are these herbs safe?

Ma huang may cause fast and irregular heartbeats, high blood pressure, chest pain, nervousness, tremor, and trouble sleeping. Serious side effects including heart attack, stroke, and seizures have also been linked to the herb.

"Products containing ma huang or guarana may worsen high blood pressure, kidney disease, or a thyroid condition," says Vance. "People who have one of these conditions should avoid using ma huang or guarana, or only use them as directed by a physician." You should also avoid these supplements if you have prostate cancer.

As with all supplements, there can be drug interactions when ephedra is combined with certain antidepressants, heart drugs, blood pressure medications and certain MAO inhibitors. Combining ephedra with certain migraine treatments can result in high blood pressure.

Bottom Line:

To avoid drug interactions and dangerous side effects, discuss ma huang or guarana with your physician or healthcare provider prior to taking them.

Chromium picolinate is found in many supplements for weight loss and muscle building.

Chromium picolinate is a form of synthetic chromium. Chromium is an essential mineral found in many foods including fish, beef, milk, fresh fruit, eggs, whole grains and brewer�s yeast. "The body uses chromium to help handle sugar and fat. It does this by improving insulin�s function in the body. Insulin helps the body use sugars, carbohydrates (starches), proteins and fat," says Vance. There has been some evidence that chromium supplements may help people with diabetes.

Yet many experts are skeptical about the use of chromium picolinate for weight loss or body building. The Federal Trade Commission has warned of false advertising and unsubstantiated claims in these areas by the manufacturers.

What are the side effects of chromium picolinate?

Serious side effects have been reported among people taking high doses of chromium picolinate -- between 1200 and 2400 mcg. per day, according to Vance. Anemia and liver problems are among reported complications.

An article published in the April 28, 1999 issue of the Journal of the American Medical Association(JAMA) discussed research presented at the 1999 meeting of the American Chemical Society in Anaheim, California. Researchers from the University of Alabama in Tuscaloosa reported that chromium picolinate may be associated with cancer risk. "When chromium picolinate interacts with such common biochemicals as vitamin C, the Alabama researchers reported, the by-products react with oxygen to generate potent, DNA-damaging hydroxyl radicals," according to the article.

"Careful investigation into the effects of long-term diet supplementation with chromium picolinate are needed to evaluate its mutagenic and carcinogen potentials," said Alabama chemist John B. Vincent, PhD.

Does it work?

There has been conflicting evidence as to whether or not chromium picolinate actually works in weight loss or muscle gain.

"Chromium picolinate does not make you thinner, more muscular, stronger, or give you more energy," according to an article on the web site for Georgia Council Against Health Fraud�s Health Care Reality Check (link in the sidebar).

Bottom Line:

The manufacturers' claims about supplements containing chromium picolinate aren't necessarily supported by scientific research and may be misleading, warns Vance. "If a claim about a product seems too good to be true, it probably is," she says.

You should talk to your doctor, pharmacist or trained herbalist prior to starting any dietary supplement to avoid complications or side effects.

Androstenedione is a dietary supplement promoted to increase levels of the hormone testosterone. It is marketed for both muscle building and the treatment of sexual dysfunction in men.

Does this supplement work?

Recent studies show that the drug's actions don't support manufacturer's claims, says Vance. While a few individuals have shown increased levels of testosterone, most failed to achieve increases in blood testosterone levels.

Safety First: Advice from Holly Vance, Pharm.D.

  Carefully read the labels on all herbs and supplements before trying them.

  Be aware that supplements can interact with over-the-counter and prescription drugs as well as other supplements. Check with your doctor and pharmacist before taking anything new to make sure that it doesn't interact with your medical conditions or any medications you may be taking.

  Arm yourself with information about possible side effects. Ask your doctor, pharmacist or herbalist about side effects that may be caused by the supplements that you are considering. Just because herbs are "natural" does not necessarily mean they are harmless.

Androstenedione -- legally sold in the United States -- is banned from use at most amateur and professional athletic events. Why? "It is thought that androstenedione may give an unfair advantage in sports by increasing athletic performance due to its effects on testosterone levels," says Vance.

What are the side effects?

Information about possible side effects and risks is very limited. "Androstenedione has been reported to cause hair loss, blurred vision, acne, enlarged breasts, mood swings, shrunken testicles, and infrequently, liver cancer," says Vance.

A small study -- published in JAMA in June of 1999 -- found no difference between the muscle strength of 10 men given androstenedione and 20 men given placebo. Researchers also found that androstenedione raised levels of the female hormone estrogen in the men, which may increase risk of heart and pancreas problems.

In addition, the levels of HDL cholesterol dropped in men who took the supplement for eight weeks. "Since HDL is the 'good' form of cholesterol that protects against heart problems, lowering HDL can increase people's risk of heart disease," says Vance. "The safety of androstenedione for longer-term use is not known."

Bottom Line:

Information about the side effects of androstenedione is very limited, and the safety of it for long-term use is not known. Recent studies indicate that there are several risks associated with the use of androstenedione.

While you may still be hoping for a magic bullet, losing weight and building muscle requires more than magic. "A low-calorie diet, along with more exercise and changes in eating habits, is the best way to lose weight and keep it off long-term," says Vance.

Keep it slow and steady. If you try to change your body overnight, you�ll burn out, and it will likely not last. "Experts recommend that overweight and obese individuals focus on modest weight loss of about 5 to 10 percent of their baseline weight," says Vance.

With all this in mind, you may ask: are supplements for weight loss, increasing muscle and energy all useless? While there has been some evidence to support the use of certain supplements, research is still very limited for a lot of the products.

In recent news, calcium, Conjugated Linoleic Acid (CLA), and other supplements have shown promise in these areas. Stay tuned for Part II of the Supplement Series which will focus on these and other supplements.

Updated: Wednesday, March 21st 2001