{"id":1704,"date":"2009-05-05T04:45:41","date_gmt":"2009-05-05T02:45:41","guid":{"rendered":"http:\/\/blog.ultimatefatburner.com\/?p=1704"},"modified":"2015-02-15T00:35:12","modified_gmt":"2015-02-15T05:35:12","slug":"clown-car-supplements-ii-hydroxycut-edition","status":"publish","type":"post","link":"https:\/\/www.ultimatefatburner.com\/ufb-blog\/clown-car-supplements-ii-hydroxycut-edition\/","title":{"rendered":"Clown Car Supplements II – Hydroxycut Edition"},"content":{"rendered":"

The FDA warning<\/a> and Hydroxycut recall\u00a0are all over the news now, and the major retailers appear to have pulled the products from their inventories.\u00a0 While the reports of liver injury are limited (23 so far),\u00a0they’re still not easy to dismiss. Nor is it a good idea to do so, especially since there are some “take home” lessons from the current situation.<\/p>\n

One of them\u00a0is\u00a0a point\u00a0that Paul and I have\u00a0stressed in earlier posts: “natural” does NOT mean safe or wholesome<\/a>.\u00a0 The Hydroxycut products are “natural” all right: they\u00a0contain a slew of herbal extracts.\u00a0 For example, “Hydroxycut Max” contains Pausinystalia yohimbe bark extract, Juniper powder, Aralia mandschurica\u00a0 powder, Angelica keiskei powder, Cissus quadrangularis extract and so on.\u00a0 Some of these are undoubtedly harmless – at least taken solo.\u00a0 Likewise, some are\u00a0almost certainly\u00a0“label decoration” – that is, added in amounts too small to be helpful… or harmful, for that matter.<\/p>\n

Trouble is, which is which?\u00a0 While herbs\u00a0are used extensively in traditional medical systems, this does not make them 100% safe.\u00a0\u00a0\u00a0Leaves, roots, seeds, etc. are\u00a0biologically complex and contain a range of bioactive components.\u00a0 Needless to state,\u00a0many\u00a0haven’t even been\u00a0identified, let alone studied.\u00a0 Thus, it’s not surprising, perhaps,\u00a0to see adverse reactions when a lot of them are\u00a0crammed together in\u00a0a single\u00a0supplement.<\/p>\n

And “crammed” is actually a pretty good description – which is why I\u00a0call supps like\u00a0these “clown car supplements<\/a>“.\u00a0 Hydroxycut Hardcore contains 14 separate active ingredients;\u00a0 there are 23 in Hydroxycut Max.\u00a0 That’s ridiculous…and it brings us to the\u00a0next point:\u00a0 There’s\u00a0very little\u00a0genuine science behind these (overlong) lists of ingredients<\/strong>.<\/p>\n

This may seem counter-intuitive to\u00a0certain folks\u00a0who\u00a0conflate “complexity” with “science.”\u00a0\u00a0The confusion is\u00a0understandable, I guess, since…well, science is HARD.\u00a0 Scientists use a lot of specialized technical terminology that sounds like Greek to a lot of people.\u00a0 Unfortunately, while science IS complex, complexity doesn’t\u00a0automatically mean that that\u00a0scientific methods were used to achieve it, even if scientific terminology is used.<\/p>\n

The reality is that – even in science – the K.I.S.S. principle* applies.\u00a0 When conducting an experiment, a researcher looks at ALL of the variables that could influence the outcome, and holds those constant…except for the one that’s being tested.\u00a0 This “test one thing at a time” approach is what makes it\u00a0difficult – if not impossible –\u00a0to\u00a0optimize a complicated supplement formula: there are too many damn variables to manipulate.\u00a0 There’s not only the individual ingredients, but also the potential\u00a0interactions between\u00a0them to consider.\u00a0 Two or more ingredients might\u00a0work synergistically…or they\u00a0might\u00a0be antagonistic.\u00a0 How the hell do you test different amounts and combinations of 15 – 20 ingredients to find the arrangement that’s most effective?<\/p>\n

The answer is that you can’t.\u00a0 The process would be hideously expensive and time consuming.\u00a0 This is why\u00a0prescription and OTC drugs contain very few active ingredients: it makes the science\u00a0a\u00a0heck of a lot\u00a0more manageable.\u00a0 To even have a chance at being “scientific”, a formula should be no more complex than it\u00a0needs to be to get the job done.\u00a0 Weight loss supps are\u00a0no\u00a0exception.\u00a0 For the record, one of the most\u00a0effective weight loss\u00a0“stacks” ever devised has only two ingredients: ephedrine and caffeine (EC).<\/p>\n

But\u00a0we’ve been down this road before – the only difference is the brand. Unfortunately, there are a number of individual case reports of hepatotoxicity associated with a range of dietary supplements, and figuring out\u00a0the reason(s)\u00a0can be like trying to nail Jello to a tree.\u00a0 This is yet another issue with “clown car supplements” – as the greater the complexity, the greater the potential for unanticipated problems…and the harder the task of figuring out which ingredients\/conditions are causing it.<\/p>\n

The\u00a0difficulty of the task is spelled out in this\u00a0overview of\u00a0hepatotoxicity assessments for dietary supplements<\/a>. To summarize, hepatotoxic reactions can be classified as either predictable or unpredictable.\u00a0 The former are “high incidence”\/”dose related”, and are typically caused by the presence of identifiable hepatotoxic agents.\u00a0 A good example of this would be pyrrolizidine alkaloids<\/a>, which are found in a wide variety of plants, including medicinal\u00a0herbs like comfrey<\/a>.<\/p>\n

It’s the unpredictable reactions\u00a0that are difficult to investigate, as individual variables (pre-existing conditions,\u00a0co-ingested medications\/supplements\/dietary factors, immune hypersensitivity; genetic polymorphisms in liver enzymes, etc.) come into play.<\/p>\n

To take one example, one of the issues I discussed earlier with Paul concerns the potential for problems with “Phase I” (cytochrome P-450) drug metabolizing\u00a0enzymes<\/a>.\u00a0 It’s already well-known that certain dietary factors – such as the furanocoumarins in grapefruit <\/a>– can inhibit an enzyme called “CYP3A4”, which, in turn, reduces the clearance of certain drugs from the body and thus, increases their toxicity<\/a>.<\/p>\n

Could\u00a0certain herbal extracts used in Hydroxycut products also affect Phase I enzymes?\u00a0 If so, the metabolism of co-ingested drugs could be affected.\u00a0 For that matter, the metabolism of other components in Hydroxycut products could be affected, too.<\/p>\n

Then there’s the potential for variability within various herbal extracts, not to mention the presence of potentially toxic contaminants.\u00a0 Many herbs and nutraceuticals come from China, and…well, maybe the<\/a> less<\/a> said<\/a> about<\/a> that<\/a>, the better<\/a>.<\/p>\n

It’s a pretty messy situation, overall, and I don’t envy the folks trying to make sense of it all.<\/p>\n

So what\u00a0can we conclude from\u00a0the current recall\/investigation?\u00a0\u00a0While this may surprise you, my answer isn’t “stop taking supplements”.\u00a0 I certainly haven’t, and don’t intend to.\u00a0 Rather, I’m going to reiterate three guidelines\u00a0from a different, but related post<\/a>.<\/p>\n