In part 4 of this Exclusive Interview, Laura Shane-McWhorter talks with Diabetes in Control Publisher Steve Freed during the AACE 2018 convention in Boston, MA about the regulation of supplements and the potential dangers of some products.
Laura Shane-McWhorter, PharmD, BCPS, BC-ADM, CDE, FASCP, FAADE is a professor at the University of Utah.
Transcript of this video segment:
Freed: Why isn’t the government sponsoring studies for nutritional products when the drug companies do it all the time? They take tree bark and they do studies with it. Obviously being able to patent something has a big role to play but when it comes to things like cinnamon and Gymnema Sylvestre, the products are out there, it’s just that there is nobody who stands behind them as far as government officials (FDA and so forth).
Shane-McWhorter: Exactly and I think that there are a lot of entities that are really pushing to appropriately regulate the supplements. The Obesity Society is one of those trying to do that. That is really to be able to ensure patients’ safety and health. I think also that many, many patients see the allure of all of these products and because they are natural, they feel that they are going to be safer, better, or somehow, more desirable to take than what they perceive as other chemical entities when in fact, supplements are drugs – supplements do contain active pharmacologic ingredients that have theorized mechanisms of action as well as side effects and potential interactions with either other supplements or drugs or disease states.
Freed: Are there any weight loss nutritional products that could be dangerous that we should stay away from?
Shane-McWhorter: I think there are a few that could be dangerous. For instance, HCG as an OTC being sold as supplement over the counter without the supervision of a physician. I think that, that could be very dangerous. There are case reports, for instance, when patients have had some sort of a thromboembolic event, possibly because of some sort of a hypercoagulable state that existed that could be dangerous. I think that there are certain ingredients in some of the supplements that, again, have been banned but we don’t know whether or not they’re in the supplement itself. Also, for instance, stimulants like DMAA. Some supplements have also been found to be contaminated with substances, for instance, with drugs that have been banned such as Sibutramine. Also, some of them have other ingredients, for instance, diuretics or laxatives to actually help people lose weight. Sometimes the products may have something like a beta blocker to offset the cardiovascular side effects that a supplement may produce. So, I think that there can be a lot of substances that in and of themselves are not dangerous such as the beta blockers but, again, the intent to try and hide or mask adverse effects I think would be something that is not appropriate.
Freed: So, let me ask you, there’s been recently, within the last month or so, a couple of studies coming out basically saying fish oil is a lot of bunk. And yet, there must be a thousand different brands and there are doctors recommending them all the time. What do we really know about the fish oils?
Shane-McWhorter: Well and again, I think that fish oil is somewhat of a difficult compound. Once again, I think I would go with ones that either are prescription products that are being prescribed by a physician so that appropriate monitoring is taking place or supplements that have that USP verification label may be something else that is appropriate. I think as far as the efficacy of fish oil, some of the studies that were done that really showed its [fish oil] tremendous benefit were in the days before things like statins or ACE inhibitors were used. So, now it seems that the benefit of fish oil is not as great as was once thought. But I think it still has a tremendous merit and it’s something that may help, especially to lower triglycerides.