Losing weight is difficult. Lots of people have tried; many do not succeed. In 2016, 49% of Americans tried a diet, but it is estimated that less than half of the people who tried it succeeded.
According to the NIH, about 15% of Americans have tried weight loss supplements. Dietary supplements are not subject to the same standards of regulatory oversight as medications, which means consumers don’t always get what the label says. Pieter Cohen, MD, Associate Professor of Medicine at the Cambridge Health Alliance in Somerville, Massachusetts, has long had an interest in the contents of the supplements we take. Dr. Cohen has been a vocal critic of dietary supplement regulation.
Check the label – and the contents
In an article published March 23 in Clinical Toxicology, Dr. Cohen and his research team found deterenol, a beta agonist not approved for use in humans. A beta agonist is a class of drugs that relax the muscles in the airways to help you breathe.
Dr. Cohen used Google to find dietary supplements promoting Deterenol and found 17 dietary supplements promoting Deterenol. Dr. Cohen found Deterenol in 13 of the 17 brands he tested. He thinks this is strange because all 17 deterenol are listed as an ingredient. “It is surprising that a banned stimulant is listed on the label but not in the product,” said Dr. Cohen.
Deterenol wasn’t the only compound found in these pills. And that’s part of why they could be so dangerous. “… We found Deterenol mixed with other experimental stimulants. We don’t have a study to predict at what dose a combination of these banned stimulants would have serious health effects, ”said Dr. Cohen. The researchers also found 9 other experimental stimulants and 8 combinations of prohibited stimulants.
Dr. Cohen became aware of Deterenol when his colleague Bastiaan Venhuis was following up 26 cases of Deterenol toxicity that were reported to the Dutch authorities. “When our colleagues in Europe were investigating the cause of several cases of serious adverse events related to dietary supplements, they discovered Deterenol in the dietary supplements in combination with other ingredients,” explained Dr. Cohen. “We wanted to know if Deterenol might also be found in dietary supplements sold in the US. ”
In the Netherlands, the 26 complication cases came from Dexaprine and Dexaprine XR, dietary supplements for athletes and others looking to lose weight. People taking these deterenol-containing supplements had rapid heart rates, sweating, chest pain, and palpitations. One case of cardiac arrest has been reported. During the investigation, the researchers found deterenol in the supplements along with several other compounds. They were only able to test 4 of the pills because the other 22 complainants had discarded their pills.
According to Dr. Cohen, there are no studies that show that deterenol leads to weight loss.
Confiscated for your safety
Blue Ice, made by EPG, was a weight loss supplement that Dr. Cohen analyzed. He found it contained around 15 mg of deterenol per serving.
One consumer who reviewed the pills wrote, “This stuff scared the hell out of me. I started to breathe quickly and became very warm and felt a sudden change in mood! I didn’t know whether to go to the hospital or not. “Even so, this person persisted and claimed to have lost 6 pounds.
Consumers should not confuse these dietary supplements, which range from “fat burners” to pre-exercise drinks to weight loss pills, with prescription weight loss pills. “To be approved as a prescription weight loss drug in the US, you need to conduct large randomized controlled trials to convince the FDA that it is effective and safe for weight loss,” said Dr. Cohen.
While all drugs have side effects, he explained, an FDA-approved drug must list all side effects on the packaging. Supplements do not need to be clinically tested, so the agency does not have any data on side effects before the drugs hit the market.
The FDA regulates the ingredients of the supplement and requires that manufacturers ensure the safety of their products. It also requires that the labeling be correct.
However, supplements are only reviewed after they are launched. The FDA is “… responsible for taking action against adulterated or mislabeled dietary supplements after they hit the market.” Consumers therefore have a time window between buying a falsified or incorrectly labeled product and a recall.
- The FDA, whose records show that it has spent much of its investigative time on supplements containing unlabeled erectile dysfunction drugs over the past two years, has most, if not all of the Cohen study chemicals on its ingredient advisory list Supplements listed.
- In 2013, the FDA issued a statement on dimethylamylamine, DMAA, stating that “all available tools are available” to stop dietary supplements containing DMAA. Two of the nutritional supplements tested in the current study that Dr. Cohen tested contained DMAA. Without testing, the FDA regards products containing DMBA as “adulterated”.
- While BMPEA is not banned or viewed as an adulterer, it is not considered a “dietary ingredient” by the agency. Two of the Cohen supplements contain BMPEA.
- Higenamine, chemically similar to amphetamine, is known by at least 15 other names.
- Oxilofrin, which is found in four dietary supplements, and octodrine, which is found in three dietary supplements, are also not considered dietary supplements. Oxilofrine, a stimulant, “does not meet the legal definition of a food ingredient” and octodrine is considered an adulterant.
- Another chemical found was phenpromethamine. In highly sensitive tests of its molecular weight, it resembles methamphetamine and amphetamine. After the manufacturer was marketed as a nasal inhaler called Vonedrine, it withdrew Vonedrine from the market in 1960 and lost FDA approval in 1971.
If some of these chemicals are known to be dangerous, let alone not tested or approved for use in humans, why are they found in weight loss supplements? Part of this is due to the FDA’s regulatory structure that Dr. Cohen described as flawed.
Medicine against nutritional supplements
FDA-approved prescription drugs and over-the-counter treatments can only contain claims if the claims are supported by research. In order to face a consumer, the manufacturer must have data that prove that the product can do what it claims. For dietary supplements, the FDA will review a dietary supplement if it contains a new ingredient that was not sold in a dietary supplement until October 1994. For this reason several of the compounds were considered to be adulterants. Their manufacturers had not submitted the compounds to the FDA as new ingredients.
Other institutions have banned these stimulants. For example, the World Anti-Doping Agency has banned most of them. The Department of Defense also has; It prevents its staff from taking supplements that contain certain ingredients designed to stimulate weight loss and improve mood.
Medical Daily contacted several companies whose products were included in Dr. Cohen were included. No one replied with a comment.
Take them home
Consumers can always search for ingredients on the FDA website. But remember, supplement manufacturers sometimes lie. According to the NIH, “What it says on the label may not be what is in the product.” Again, consumers can check for recalled or contaminated supplements before making a purchase.
The NIH cautioned that the use of the words standardized, certified, or verified by a manufacturer does not guarantee the quality or consistency of the product.
Dr. Cohen believes consumers are in the dark under current regulations about the ingredients of a dietary supplement. “There is currently no way to know if exercise or weight loss supplements contain banned ingredients,” he said. “Until the laws can be reformed, my advice is to avoid all supplements sold as pre-workout or weight loss supplements.”
Sabrina Emms is a science journalist. She began as an intern on a health and science podcast on Philadelphia public radio. Before that, she worked as a researcher studying the way bones are formed.