FDA warns dieters: Stop using Hydroxycut immediately

Bill's forum was the first! All subjects are welcome. Participation by all encouraged.

Moderator: Available

User avatar
Bill Glasheen
Posts: 17299
Joined: Thu Mar 11, 1999 6:01 am
Location: Richmond, VA --- Louisville, KY

FDA warns dieters: Stop using Hydroxycut immediately

Post by Bill Glasheen »

This product used to have ephedrine in it until that was banned. It has since gone through some formula transformations, leading apparently to a very bad set of outcomes.

This story is ongoing. Years back, Fen-phen (fenfluramine and phentermine) was a very popular and effective diet drug. Then cases of valvular heart disease and pulmonary hypertension started popping up. And now it is no longer.

It's even more dicey with supplements. They are not regulated by the FDA, and manufacturers don't even need to prove that their products work as advertised. Buyer beware.

- Bill
WASHINGTON (AP) — Government health officials warned dieters and body builders Friday to immediately stop using Hydroxycut, a widely sold supplement linked to cases of serious liver damage and at least one death.

The Food and Drug Administration said the maker of the dietary supplement has agreed to recall 14 Hydroxycut products. Available in grocery stores and pharmacies, Hydroxycut is advertised as made from natural ingredients. At least 9 million packages were sold last year, the FDA said.

Dr. Linda Katz of the FDA's food and nutrition division said the agency has received 23 reports of liver problems, including the death of a 19-year-old boy living in the Southwest. The teenager died in 2007, and the death was reported to the FDA this March.

Other patients experienced symptoms ranging from jaundice, or yellowing of the skin, to liver failure. One received a transplant and another was placed on a list to await a new liver.

There was no immediate comment from the U.S. distributor of the diet pill, Iovate Health Sciences, headquartered near Buffalo Made by a Canadian company, Hydroxycut is used by people trying to shed pounds and by body builders to sharpen their muscles.

Dietary supplements aren't as tightly regulated by the government as medications. Manufacturers don't need to prove to the FDA that their products are safe and effective before they can sell them to consumers. But regulators monitor aftermarket reports for signs of trouble, and in recent years companies have been put under stricter requirements to alert the FDA when they learn of problems.

Katz said it has taken so long to get a handle on the Hydroxycut problem because the cases of liver damage were rare and the FDA has no authority to review supplements before they're marketed. "Part of the problem is that the FDA looks at dietary supplements from a post-market perspective, and an isolated incident is often difficult to follow," she said.

The FDA relies on voluntary reports to detect such problems, and many cases are never reported, officials acknowledge.

Health officials said they have been unable to determine which Hydroxycut ingredients are potentially toxic, partially because the formulation of the products has changed several times. A medical journal report last month raised questions about one ingredient, hydroxycitric acid, derived from a tropical fruit. The article said it could potentially damage the liver.
- USA Today
User avatar
Uechij
Posts: 250
Joined: Sun Feb 03, 2002 6:01 am

Post by Uechij »

Another knee jerk reaction probably based on bunk science. 1 death...we probably had more deaths from high school sports last year but you don't see a ban on those.

Also I would like to know this 19 yr olds health history and the circumstances surrounding this incident, did he have a preexisting liver problem or other health issues? Just not enough information here to assume the worst.

And was he using the product properly?

This was the same problem with ephedrine years ago when people were supposedly dying from it. Turned out they were taking like 30 times the recommended dose.

Even the famous baseball player in Florida (can't remember his name) who died from it was dehydrated from drinking the night before, had a preexisting heart condition, also had a brother who died of a heart condition, was practicing in a hundred plus weather, and ephedrine gets the blame.

Sadly those facts were never reported on the news.
My Shen Is Raised And My Chi Is Strong... I Eat Rice And Train Chi Gung
User avatar
mhosea
Posts: 1141
Joined: Fri Jun 30, 2006 9:52 pm
Location: Massachusetts

Post by mhosea »

If the 23 cases of liver damage are well-researched, then it doesn't sound knee-jerk to me. This is a context where under-reporting is likely to be excessive. Anyway, if it is a knee-jerk reaction, it couldn't happen to a nicer industry. I was more surprised that they took PPA off the market rather than labeling it. I guess that the existence of pseudoephedrine and phenylephrine were taken into account. The latter doesn't seem to work for me at all, though.
Mike
User avatar
Bill Glasheen
Posts: 17299
Joined: Thu Mar 11, 1999 6:01 am
Location: Richmond, VA --- Louisville, KY

Post by Bill Glasheen »

mhosea wrote:
If the 23 cases of liver damage are well-researched, then it doesn't sound knee-jerk to me.
Word. And thank you.

Frankly I was kind of shocked by the reaction to the article. ONLY one DEATH, eh? Oye!

I don't know... I look at medical data all day long. Liver transplants are nothing to sneeze at. Before the transplant, you're talking about someone on death's door, emaciated and jaundiced. Then after the transplant, the individual is doomed to taking anti-rejection drugs for the rest of his/her life. Can you say ca-ching? We're talking about hundreds of thousands of dollars of expenses through the course of these illnesses. That ain't chump change. Then there's all the pain and suffering.

Never mind the other cases where the livers were ONLY damaged and they were ONLY sick or jaundiced.

All because they got a supplement at the health food store to lose some weight, or used it to get "cut" before a bodybuilding competition. Presumably they were doing something that was good for their bodies, or so they thought. And then this.
mhosea wrote:
This is a context where under-reporting is likely to be excessive.
Indeed. In fact the article stressed that. We have 23 DOCUMENTED cases where there is likely an association between Hydroxycut and liver damage. How many cases got treated without the MD doing the "deep dive" into patient history to find out why his/her liver went south? I dare say it's probably the majority. Most MDs don't have time for such an extra effort.

Meanwhile... An article such as this one is likely to bring more such cases from out of the woodwork. Of course the law offices of Dewey, Chetham, and Howe are going to be falling all over themselves to file the class action lawsuit. Sigh... Don't get me started.
mhosea wrote:
I was more surprised that they took PPA off the market rather than labeling it. I guess that the existence of pseudoephedrine and phenylephrine were taken into account. The latter doesn't seem to work for me at all, though.
I agree with you on PPA.

Here we have a cause of an FDA-approved and regulated pharmaceutical - used for a generation - being taken off the market because a FRACTION of such bad outcomes happened. I say fraction because of the massive number of adults and children who took PPA as a decongestant. Heck, I gave it to number 1 son when he was a baby.

But once again... It was the use/abuse of PPA as an appetite suppressant that resulted in the bad outcomes. And you know what? The manufacturer needs to take the potential for abuse in mind when selling a product. If clear warnings aren't given and efforts to prevent abuse aren't taken, then abuse will happen.

If people would just eat right and exercise in the first place, they wouldn't need this stuff. But they don't. And the manufacturers prey on the obese with these products, and make a FORTUNE off of them. Anyone who is anyone in Hollywood writes a diet book when the career begins to wane. It's a way to keep the income coming in. And people buy the stuff.

If you read bodybuilding and health magazines, you've seen the hundreds of before/after picture ads for Hydroxycut.

Image

They did the major hard sell. So they knew what they were getting into.

Maybe they thought nothing bad would happen because the post-ephedrine product had "all natural" ingredients. Sigh... It's worth mentioning that botulin toxin is "all natural."

One more thing... Hydroxycut has not been "banned."
the maker of the dietary supplement has agreed to recall 14 Hydroxycut products.
- Bill
User avatar
Uechij
Posts: 250
Joined: Sun Feb 03, 2002 6:01 am

Post by Uechij »

"Before the transplant, you're talking about someone on death's door, emaciated and jaundiced. Then after the transplant, the individual is doomed to taking anti-rejection drugs for the rest of his/her life."

With all due respect not entirely true and a little exaggerated. I see about 10 -15 pre-op and post-op liver transplant patients a week. Rarely are they emaciated, just the opposite, they are usually bloated from cirrhosis and are generally not on deaths door.

The article you posted only says:
"Dr. Linda Katz of the FDA's food and nutrition division said the agency has received 23 reports of liver problems..."

nowhere does it say "well documented."

It also goes on to say:
"Katz said it has taken so long to get a handle on the Hydroxycut problem because the cases of liver damage were rare... "

and

"Health officials said they have been unable to determine which Hydroxycut ingredients are potentially toxic, partially because the formulation of the products has changed several times. A medical journal report last month raised questions about one ingredient, hydroxycitric acid, derived from a tropical fruit. The article said it could potentially damage the liver."

Which begs the question is it really something in the product or is it something else that these people are taking or doing along with the hydroxycut in attempt to lose weight.

Again, these are more than likely not healthy individuals taking this product due to weight issues, etc. Were there preexsisting problems before or a past medical history?
My Shen Is Raised And My Chi Is Strong... I Eat Rice And Train Chi Gung
User avatar
Bill Glasheen
Posts: 17299
Joined: Thu Mar 11, 1999 6:01 am
Location: Richmond, VA --- Louisville, KY

Post by Bill Glasheen »

It's worth mentioning that these findings are "preliminary" and that no official banning has happened. However evidence appears to be mounting - both from first principles (properties of hydroxycitric acid published in peer-reviewed literature) and anecdotes (the bad outcomes reported to-date) that caution is in order. And it's worth mentioning that a review of the published literature shows more than a few articles documenting negative effects of hydroxycitric acid (or hydroxycitrate) on the liver.

It's also worth mentioning that combinations of ingredients (rather than individual ones) often lead to the bad outcomes. That was indeed the case with phen-fen - one of the most successful diet medications to date. This is why the FDA has had so much trouble fingering the cause. And when the supplement maker keeps changing the recipe, well...

I shared this article because I know people here use supplements. I use supplements. I take a multivitamin, fish oil, supplements for joint health, key minerals (Ca, Mg, Zn, etc.), acai powder (which I mix with a morning shake), etc. Better to have more information than less, right?

If you think this product is fine, well buy it quick (and cheap) while you can. It's your body.

- Bill
User avatar
Bill Glasheen
Posts: 17299
Joined: Thu Mar 11, 1999 6:01 am
Location: Richmond, VA --- Louisville, KY

Post by Bill Glasheen »

Uechij wrote:
these are more than likely not healthy individuals taking this product due to weight issues, etc. Were there preexsisting problems before or a past medical history?
That's medicine, my friend. You don't treat healthy people, do you? Interventions by definition are used on people who don't have optimal health.

The manufacturer advertised to a select market. See picture above. The manufacturer knew what it was getting into. And the manufacturer was setting itself up for problems by selling this OTC rather than going through an FDA approval process and encouraging people to have this administered under the care of a medical professional.

- Bill
User avatar
Uechij
Posts: 250
Joined: Sun Feb 03, 2002 6:01 am

Post by Uechij »

Bill,

It's been awhile since I looked but I think the label on the bottle recommends seeking the advice of a physician before taking the product.

Also they do have thier products tested before they are released to the public. I found this:

What steps do you take to ensure the safety of Hydroxycut-branded products?

We conduct internal analyses of individual ingredients, and undertake extensive medical, scientific and toxicological literature reviews on the safety of the ingredients during the development stage of each product. Additionally, third-party experts from the leading independent scientific firm specializing in ingredient assessment, toxicology and product safety for the nutritional and pharmaceutical industry review the safety of Iovate’s ingredients and formulas before products are introduced in the marketplace. Only after this external review is completed does Iovate release a formula.

The rest is here:

http://www.hydroxycutinformation.com/
My Shen Is Raised And My Chi Is Strong... I Eat Rice And Train Chi Gung
Valkenar
Posts: 1316
Joined: Mon Aug 21, 2000 6:01 am
Location: Somerville, ma.

Post by Valkenar »

Can anyone clue me in on why supplements aren't regulated by the FDA? Correct me if I'm wrong, but if they were to add hydroxycut to Wonderbread, wouldn't it have to go through all sorts of approval? Seems like either the FDA should regulate supplements, or it should stop regulating food.
User avatar
Bill Glasheen
Posts: 17299
Joined: Thu Mar 11, 1999 6:01 am
Location: Richmond, VA --- Louisville, KY

Post by Bill Glasheen »

Valkenar wrote:
Can anyone clue me in on why supplements aren't regulated by the FDA?
This is the unholy agreement between the FDA and the supplement industry, Justin. It's sort of like the "don't ask, don't tell" policy of the military about being gay.

In order for a drug to be approved by the FDA in the United States, it must pass a series of hurdles. First, the product must be what is advertised, and in the stated amount or concentration. Second, it must be shown to be safe under a variety of conditions and across a spectrum of patients. And finally it must be shown to be effective. Furthermore, approval is not likely to happen (or be meaningful) if the product isn't MORE effective than a proven product that's been on the marketplace for some time, and thus has withstood the test of time.

And when I say "shown", it doesn't mean that your hand-picked panel of experts told you that it was fine (per the quoted information above). The evidence must withstand the peer-review process. That means that INDEPENDENT experts in the field - the people who understand and work with the science every day - get to review and poke at it before one is allowed to publish. If it doesn't meet their standard of excellence for proper science, then it never makes it into the literature.

The supplement industry gets to bypass this whole process. In doing so, it must state on the product that every claim they make has not been evaluated by the FDA. And they make them do that because that's the truth.

It is what it is. People who believe in supplements get their supplements. Science and the FDA gets to wash their hands of what's going on. And on the positive side, inexpensive products with little profit margin that might be beneficial don't have to go through a very expensive approval process before consumers get to have access. But as always, buyer beware.

- Bill
User avatar
Bill Glasheen
Posts: 17299
Joined: Thu Mar 11, 1999 6:01 am
Location: Richmond, VA --- Louisville, KY

Post by Bill Glasheen »

It's worth mentioning that attempts have been made to streamline the FDA approval process to get products to market faster and cheaper. And with those efforts came two results: 1) more products than ever being approved, and 2) more products than ever being recalled shortly after being approved.

There is no free lunch here.

- Bill
User avatar
Bill Glasheen
Posts: 17299
Joined: Thu Mar 11, 1999 6:01 am
Location: Richmond, VA --- Louisville, KY

Post by Bill Glasheen »

It took me all of 2 minutes to find a series of articles in the peer-reviewed literature showing negative effects of hydroxycitrate (HCA). Here is just one example.
Nutrition. 2006 Sep;22(9):905-12. Epub 2006 Jul 10.

Beneficial and deleterious effects of hydroxycitrate in rats fed a high-fructose diet.

Brandt K, Langhans W, Geary N, Leonhardt M.

Institute of Animal Sciences, ETH Zurich, Schwerzenbach, Switzerland.

OBJECTIVE: The present study assessed whether long-term supplementation of a high-fructose diet with hydroxycitrate (HCA), an inhibitor of de novo lipogenesis that is widely used as a non-prescription dietary aid, decreases food intake, visceral fat accumulation, hypertriglyceridemia, and hyperinsulinemia in rats.

METHODS: We examined the effects of HCA (1.8% of diet) on food intake, body weight gain, visceral fat accumulation, hypertriglyceridemia, and hyperinsulinemia in rats during a 4-wk period of ad libitum access to a 50% fructose diet after a 3-wk period of food restriction in which they lost about 20% of their body weight.

RESULTS: HCA decreased food intake and weight gain throughout the test and reduced visceral fat accumulation compared with control rats fed ad libitum (CON). Rats that were pair-fed (PF) to the HCA rats showed similar decreases in weight gain and visceral fat. HCA did not ameliorate the hypertriglyceridemia induced by high-fructose feeding. HCA improved insulin sensitivity on day 10 in comparison with CON rats, but by day 27 insulin levels were similarly higher and liver glycogen levels were similarly lower in HCA and CON rats in comparison with PF rats. Liver lipid content was elevated in HCA rats compared with CON and PF rats.

CONCLUSION: These findings indicate that, although HCA attenuates body weight gain and visceral fat accumulation by reducing food intake under these conditions, it has no lasting beneficial effects on hypertriglyceridemia and hyperinsulinemia and leads to the accumulation of liver lipids.
That's not exactly what you call the breakfast of champions.

- Bill
User avatar
Uechij
Posts: 250
Joined: Sun Feb 03, 2002 6:01 am

Post by Uechij »

"And when I say "shown", it doesn't mean that your hand-picked panel of experts told you that it was fine (per the quoted information above). The evidence must withstand the peer-review process. That means that INDEPENDENT experts in the field "

If you are referring to what I posted I believe it does say they were independent:

"Additionally, third-party experts from the leading independent scientific firm..."

Also, are you absolutely sure these experts are hand picked? It sounds to me like there is an independent review board set up to test, monitor and regulate these supplements. Are these experts any less qualified than the FDA experts, are their testing methods any less legitimate than the FDA's? Personally I don't know, I am just asking.

It seems to me the supplement industry would not want to harm the very people they are profiting from. You can only hurt people for so long before they stop buying your products.

And can they be any worse than some of the pharmaceutical companies who have purposely buried studies or evidence pointing to harmful effects of their drugs in an attempt to profit off of someones illness?[/b]
My Shen Is Raised And My Chi Is Strong... I Eat Rice And Train Chi Gung
Gene DeMambro
Posts: 1684
Joined: Sat Dec 12, 1998 6:01 am
Location: Weymouth, MA US of A

Post by Gene DeMambro »

Where can we find the Phase I, II and post marketing trials for Hydroxycut, Uechij? Where can we find the report from these third-party individual review firms Hydroxycut used? Where are the placebo controlled, double blind multifacility trials in target population? And please show us the epidemiological data showing that the incident of liver failure and death in hydroxycut users is no higher than in non-users, while you are at it. Inquiring minds want to know. If the makers of Hydroxycut truly felt they had a safe and effective product, they would have gone with the new drug approval processs and made $$$$. That is what they would have done if they truly cared about their end users. Instead they took the the sleezy way out and got caught.

In short, supplements are not tightly regulated by the FDA because the FDA can only regulate supplements as food additives, not as drugs, as per the Dietary Supplement Health and Education Act of 1994 - a federal law. Therefore, the FDA may take action against supplements only if they are proven to be unsafe. The FDA, as a federal agency, can only do what Congress allows them to do, and the applicable federal laws only allow the FDA to go so far. It has nothing to do with some unholy agreement. If the FDA could, they would hang all these supplement ba$tard$ out to dry....just like they take enforcement action against drug companies who act sleazy.

Gene
User avatar
Uechij
Posts: 250
Joined: Sun Feb 03, 2002 6:01 am

Post by Uechij »

"Where can we find the Phase I, II and post marketing trials for Hydroxycut, Uechij?"

I don't know Gene...that's why I was asking. :)
My Shen Is Raised And My Chi Is Strong... I Eat Rice And Train Chi Gung
Post Reply

Return to “Bill Glasheen's Dojo Roundtable”