What’s Up With Dietary Supplements?

Recently, a dietary supplement known as DMAA has been making headlines.  This supplement used by some gym-goers is not safe, and in fact, according to the FDA, has been associated with at least 86 reports of illnesses and deaths in the U.S. (as of April 2013).  Yet, it is still making an appearance in some supplements sold in common vitamin shops and online stores.  For a list of the products containing DMAA, visit the Human Performance Resource Center.  It may appear on the supplement label under a variety of names (DMAA, methylhexanamine, dimethylamine, 1, 3-dimethylamine).  But what exactly is this stuff and why is it so dangerous?

1, 3-Dimethylamylamine (DMAA) originates from methylamylamine, an organic compound.  It is a vasoconstrictor, meaning that it restricts blood vessels so that blood flow is decreased, resulting in an increase in systemic blood pressure.  Additionally, DMAA is a central nervous stimulant; thus, it may cause symptoms such as headaches and tremors.  It was originally used in the 1940s as a nasal decongestant.  However, the approval for this particular use was removed in 1983.  In 2006, it reappeared as a dietary supplement.  In April of 2013, the FDA made a statement, warning that it is illegal to market this substance as a dietary supplement.  It can lead to major heart problems and even death.

Unfortunately, there is still ample information that we do not know about DMAA, which is why its use has been banned.  At this time, it is not clear what the half-life is of DMAA.  It may or may not possess the ability to build up in tissues.  We also don’t know what long-term effects may come of its use.

So how does something that could possibly be extremely harmful end up on the market?  Aren’t we in America supposed to have strict guidelines that inhibit this danger from occurring?  Well, not really.  The FDA (Food and Drug Administration) does regulate prescription drugs—the testing, manufacturing, labeling, marketing, safety, etc.  Prior to any prescription drug being allowed on the market, it must undergo rigorous testing for safety.  However, when it comes to dietary supplements, this is not the case.  The FDA can ban certain dietary supplements but this occurs only after they are marketed and sold to the general public.  The manufacturer of the product is responsible for ensuring that the product is safe.  The FDA is only responsible for taking action after the product hits shelves and incident reports begin occurring.

The Dietary Supplement Health and Education Act of 1994 (DSHEA) defines dietary supplements under the umbrella of food as opposed to drugs and/or medicine.  Dietary supplements may be a vitamin, mineral, an herb/botanical, amino acid, a supplement used in increasing total dietary intake, or a concentrate, metabolite, constituent, or extract.  DSHEA requires that these products’ labels list the name and quantity of each ingredient.  It also states that manufacturers cannot make unsupported health claims.  Again, the manufacturer of the product is required by law to submit any and all serious events related to the product.  At that point, the FDA must accumulate enough evidence to prove that the product is unsafe before it can be banned.

Why are dietary supplements allowed to be unregulated?  Well, to some degree it protects our right to use substances without the government sticking its nose into everything we produce and sell.  It has its ups and downs, of course.  Sometimes we want more regulation from the government, such as how some groups and individuals would like the government to require labeling on GMOs.  On the other hand, sometimes we want less regulation, such as how many people feel that marijuana should be legalized as it is a natural substance.  So yes, it can be argued that there are pros and cons to this system.  Though, it cannot be denied that there are flaws within the system, and extremely harmful events can and do occur because of lack of regulation regarding dietary supplements.  However, let’s not be fooled—prescriptions are regulated by the FDA and there are plenty of mishaps and even deaths due to those.  Again, this system is not anywhere near perfect.

What can you do to ensure that you are consuming something safe?  You may wish to refer to the FDA’s Tips for Dietary Supplement Users.  Additionally and very importantly, learn what your body needs and in what quantities.  Regarding vitamins and minerals, refer to the DRIs (Dietary Reference Intakes) and the ULs (Tolerable Upper Intake Levels).  The DRIs are used for nutrient recommendations while the ULs let you know the highest daily intake amount of a specific nutrient that is likely to pose no risk of adverse health effects.  They are both specific to age and gender.  For example, the DRI of niacin for a 16 year old female is 14mg while the UL for this same individual is 30mg.  It is recommended that she intake about 14mg of niacin per day, and it is not recommended that she intake over 30mg per day.

Also, do your research, but be sure that the information you are gathering is from a reputable source.  Who is the person(s) providing the advice/information—do they have credentials related to this area of expertise?  Credentials generally mean that the individual holds a license or certification that must be upheld with continuing education based on the latest research.  If you’re visiting a website, check the URL (.gov, .org, and .edu are probably the best ones to read).  Make note of any health/nutritional claims.  Are those claims supported by evidence?  Reliable health information is evidence and science-based.  Don’t rely on testimonials or someone’s personal experience—perhaps 1000 people tried the product and only 3 had positive results…the 3 that have statements on the website.  Meanwhile, perhaps 997 others had very negative and even harmful effects.

If you are planning on beginning a supplement of any kind, your best bet is to speak with your healthcare provider (a physician or a registered dietitian, such as myself).  Your doctor or RD may have access to information that is not available to the general public.

A good site you can visit for information regarding banned dietary supplements is the USADA’s site Supplement 411.  Also, refer to their High Risk Dietary Supplement List, especially if you are considering taking any kind of dietary supplement—even a powder that you bought at a local vitamin store.  It may contain a banned substance.

Until next time, happy, healthy living!  Oh, and please remember to get your nutrients from food as opposed to supplements.  Use supplements sparingly and only when warranted.

 

References

1.)    PubChem.  Methylhexaneamine: Compound Summary.  NCBI. 26 March 2005.  Accessed 16 July 2013.  http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=7753&loc=ec_rcs

2.)    Andrey Pavlov Jr & Igor I. Bussel.  “DMAA: Efficacious but is it safe?”  Science-Based Medicine.org.  June 7, 2013.  Accessed 16 July, 2013.  http://www.sciencebasedmedicine.org/dmaa-efficacious-but-is-it-safe/

3.)    Chaper I: Dietary Supplement Health and Education Act of 1994.  Commission on Dietary Supplements.  www.health.gov/dietsupp/ch1.htm

4.)    FDA: Q&A on Dietary Supplements.  U.S. Department of Health and Human Services.  21 May 2013.  Accessed 16 July 2013.  http://www.fda.gov/food/dietarysupplements/QADietarySupplements/default.html

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s