Dietary supplements and poisons

Angry Critic: I'm losing weight with your dietary supplements

Alexey Vodovozov, XX2 century

Once again, spam brings advertising of miracle weight loss products. It looks about the same, promises an immediate and, importantly, extremely lasting effect. At the same time, there are no contraindications, no side effects – after all, we will lose weight with the help of biologically active food additives.

Almost always, such advertising focuses on a certain scientific component. At least – on the evidence of effectiveness. Something like that:

But as a toxicologist, I am always primarily concerned with another question: is safety proven? And these doubts did not appear from scratch at all.

I will not retell for the hundredth time the already textbook story with kirkazon aka Aristolochia, about her back in 2013, Chemistry and Life wrote in detail. There are many other equally interesting facts. Let's start with meta-analysis, may they forgive me Ioannidis and Belkov for such an inappropriate expression.

Center for Health Research in Portland analyzed 89 randomized clinical trials with almost 122 thousand participants and came to a disappointing conclusion: people rarely listen to advice from doctors about not only healthy eating, but also about the need for a high level of physical activity, it is difficult to persuade adults, especially those who do not yet have cardiorisks, such interventions give, according to the expression The authors have "very modest benefits in the short term" on health indicators such as blood pressure, the level of total and "bad" cholesterol, as well as BMI. Although the effect was still dose-dependent, in other words, a person needs to thoroughly take out the brain so that it starts to move. At the same time, reliable data on the long-term benefits of medical consultations on healthy lifestyle (at least in the interval of 6-12 months) simply could not be found.

At the same time, the simplest and most effective (although very long–lasting) method of losing weight is to spend more calories than to get, while eating in a balanced way. The whole industry does not agree with this, parasitizing on a completely natural, but not always feasible desire to quickly get into a swimsuit for a vacation. Well, or at least in the economy class seat of a low-cost airline. Only three packages of miracle dietary supplements for the price of two!!!!!kilograms of caviar!!!!!!!!!! they will allow you to find the desired forms – the advertisement helpfully suggests. Dietary supplements are just a form of registration of a food product, skeptics sarcastically remark from their reservation, therefore, to lose weight, they need to be eaten less, like all the rest of the food.

"But these funds are working!" – the supporters of augmented reality put the main trump card on the table. And here skeptics can take a deep breath and tell their story about why dietary supplements "work".

The idea, strictly speaking, lies on the surface: additives cannot and have no right under the law to have a pronounced effect on the body. Otherwise, they need to be registered as medicines, and these are completely different terms, money and problems. But buyers should feel some effects on themselves, so that they can buy a couple more packages themselves, and advise their friends. What needs to be done? Add something that really works. For example, some pharmaceutical substance with a pronounced effect. Quietly, of course, because there should be nothing like that in dietary supplements.

This idea is international – drugs are added to supplements and in China, and in The European Union, and in In Russia, and in the USA. Systematized information is available only by State, because such cases there are tightly tied to lawsuits. Therefore, on the website of the "chief for tablets" – the Food and Drug Administration (FDA) – since 2007, the list of those who have been fined has been kept on an increasing basis. As in other countries, in the USA additives are released to the market conditionally, before the first "flight".

Meanwhile, the list inspires. For example, in slimming dietary supplements, sibutramine is frighteningly often found, which the FDA scolds with the last words. The main complaint is that the already low efficiency is accompanied by too much risk of complications from the cardiovascular system. Well, yes, initially the drug was developed as an appetite regulator, to enhance the feeling of satiety. But then he was followed by such a train of strokes and heart attacks that at least in Australia, Canada, China, the European Union, Hong Kong, India, Mexico, New Zealand, Great Britain, the USA, Thailand and the Philippines, they all said "whatever, whatever" and put him off the market. In Russia, it is still legal, but strictly prescription. It can be taken only as prescribed by an endocrinologist and only under his control, and weight-loss dietary supplements are mainly self-prescribed based on the results of self-diagnosis in the mirror and are drunk until full enlightenment, sometimes for months.

Another great substance from the table is phenolphthalein. Older readers remember him under the legendary name "Purgen" or from school chemistry lessons, where he acted as an indicator (the one that gradually discolors as the pH of the medium decreases). Laxative. A carcinogen from group 2B according to the IARC classification is not exactly a horror, of course, but it has been removed from production all over the world for this. You can relax in safer ways.

We continue to study the composition of miracle dietary supplements. Fluoxetine. An antidepressant. Selective serotonin reuptake inhibitor. A prescription drug, has a bunch of side effects, is able to provoke serotonin syndrome, which can occur in a whole bunch of variants, for example, as delirium with diarrhea. Very suitable for weight loss condition.

Let's move on. Diuretics, for example, in the form of furosemide. This diuretic refers to potassium-sparing, that is, it leads to a massive loss of potassium. A couple dozen items in the instructions section "Contraindications", another dozen in the section "With caution". Three dozen side effects and sweets – what happens with an overdose (and dietary supplements are drunk for months, I remind you): collapse, shock, arrhythmias (including AV block and ventricular fibrillation), acute renal failure with anuria, thrombosis, thromboembolism, confusion, lethargic paralysis.

The most interesting thing is that sometimes all this beauty is poured into one dietary supplement. Apparently, to be sure.

But that's not all. Fellow toxicologists from different countries regularly throw up information for reflection. For example, the Iranians. We rolled out eight of the most popular plant products in our country in the analytical laboratory (this is not chemistry for you!) dietary supplements. We found the already familiar sibutramine and phenolphthalein, as well as the non-selective diuretic bumetanide, anticonvulsant phenytoin, the adrenomimetic pseudoephedrine, as well as the psychotropic drug amphepramone.

And the Australians who pulled the same trick with 26 dietary supplements from the arsenal of traditional Chinese medicine, which are also used for weight loss, found out that only two of them can be called relatively pure. And in the rest, strychnine, arsenic, cadmium, lead, steroids, paracetamol, antibiotics, repotenters, warfarin (anticoagulant) were found on a completely industrial scale. DNA of goats, cats, dogs, rats, snakes and frogs were also found. Guaranteed weight loss until the end of life – mainly due to the displacement of the end to the left.

And with all this, all the listed ingredients are added to the dietary supplement secretly, without an announcement on the label, in unpredictable and unknown dosages for the buyer. It is not surprising that, according to researchers, about 23 thousand Americans go to the emergency departments of hospitals every year with side effects from taking dietary supplements. Moreover, in the first place – not allergic reactions at all, as one might assume, and what would be logical for food, but very serious conditions: heart failure, loss of consciousness, tachycardia, convulsions, headache and dizziness. Moreover, all of the above suspiciously looks like side effects or symptoms of overdose by the very pharmaceutical substances that are found in dietary supplements by toxicologists bribed by the world "BigPharma".

It is a pity that effective and safe miracle remedies for weight loss exist only in advertising. Otherwise, I would look like twenty kilograms differently…

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