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Despite known hazards, many
potentially dangerous dietary supplements are readily available for purchase in
stores and on the Internet, according to a new report from Consumer Reports.
Today, the magazine released its "dirty dozen" list of
dietary supplements that it says are too dangerous to be on the market.
The list includes
yohimbe, bitter orange, chaparral, and
andro. But researchers say the supplements are sold under many names, which
makes it hard for consumers to know what they're getting.
Many of the supplements that made the list have already
been banned in other countries. But researchers say regulatory barriers created
by Congress have prevented the FDA from taking similar actions to protect
consumers in this country.
The announcement coincides with a report on supplement
safety issued today by the Institute of Medicine, which suggests that the FDA
should take action against potentially hazardous dietary supplements and asks
Congress to ease restraints on the agency.
Dirty Dozen of Dietary Supplements
Researchers from the consumer magazine say the
supplements that made its "dirty dozen" list may cause cancer, severe liver or
kidney damage, heart problems, or even death.
For example, they say the herb
aristolochia has been
conclusively linked to kidney failure and cancer in China, Europe, Japan, and
the U.S. Yohimbe, a supplement marketed as a sexual stimulant and herbal Viagra,
has been linked to heart and respiratory problems. The supplement bitter orange,
whose ingredients have effects similar to those of the banned weight-loss
stimulant ephedra, is also on the list of potentially dangerous supplements.
Many of these dietary supplements are sold in both single
and combination products marketed for a wide variety of uses, from building
muscle and losing weight to easing stress and arthritis.
Researchers divided the list into three categories based
on the amount of available evidence about the dietary supplement: definitely
hazardous, very likely hazardous, and likely hazardous.
Since the brand names of the products containing the
dirty dozen supplement ingredients vary widely, researchers say consumers should
read ingredient labels carefully and look for the following:
Definitely Hazardous
Aristolochic acid (Aristolochia, birthwort, snakeroot,
snakeweed, snagree root, sangrel, serpentary, wild ginger).They list this as
having caused documented human cancers, and it is linked to kidney failure.
Very Likely Hazardous -- These are banned in other
countries, have an FDA warning, or show adverse effects in studies:
Comfrey (Symphytum officinale, ass ear, black root,
blackwort, bruisewort, consolidae radix, consound, gum plant, healing herb,
knitback, knitbone, salsify, slippery root, symphytum radix, wallwort). Abnormal
liver function or damage, often irreversible; deaths reported.
Androstenedione (4-androstene-3, 17-dione, andro,
androstene). Increased cancer risks and decreases in "good" HDL cholesterol have
been reported.
Chaparral (Larrea divaricata, creosote bush, greasewood,
hediondilla, jarilla, larreastat). Abnormal liver function has been linked to
use.
Germander (Teucrium chamaedrys, wall germander, wild
germander). Abnormal liver function has been linked to use.
Kava (Piper methysticum, ava, awa, gea, gi, intoxicating
pepper, kao, kavain, kawa-pfeffer, kew, long pepper, malohu, maluk, meruk, milik,
rauschpfeffer, sakau, tonga, wurzelstock, yagona, yangona). Abnormal liver
function has been linked to use.
Likely Hazardous -- These have adverse-event
reports or theoretical risks.
Bitter orange (Citrus aurantium, green orange, kijitsu,
neroli oil, Seville orange, shangzhou zhiqiao, sour orange, zhi oiao, zhi xhi).
High blood pressure; increased risk of heart arrhythmias, heart attack, and
stroke are risks associated with use.
Organ/glandular extracts
(brain/adrenal/pituitary/placenta/other gland "substance" or "concentrate").
Theoretical risk of mad cow disease, particularly from brain extracts.
Lobelia (Lobelia inflata, asthma weed, bladderpod, emetic
herb, gagroot, lobelie, indian tobacco, pukeweed, vomit wort, wild tobacco).
Difficulty breathing and rapid heart rates are thought to be associated with
this.
Pennyroyal oil (Hedeoma pulegioides, lurk-in-the-ditch,
mosquito plant, piliolerial, pudding grass, pulegium, run-by-the-ground, squaw
balm, squawmint, stinking balm, tickweed). Liver and kidney failure, nerve
damage, convulsions, abdominal tenderness, burning of the throat are risks;
deaths have been reported.
Scullcap (Scutellaria lateriflora, blue pimpernel, helmet
flower, hoodwort, mad weed, mad-dog herb, mad-dog weed, quaker bonnet,
scutelluria, skullcap). Abnormal liver damage.
Yohimbe (Pausinystalia yohimbe, johimbi, yohimbehe,
yohimbine) Blood pressure changes, heart beat irregularities and heart attacks
have been reported.
Experts say it's important to tell your doctor about any
dietary supplement you may be taking. Not only do many supplements have
significant side effects, but they may also interfere with the effectiveness of
prescribed medications, such as birth control pills.
SOURCE: Consumer
Reports, May 2004.
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