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Severe liver damage from certain dietary aid supplements in news again

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Anyone can use the word 'natural' on any supplement that in some way began as an atom in nature. Be careful of which green tea extract diet products you use, if you use any because at high doses, there can be problems with your liver. Patients with liver injuries who frequently used certain types of green tea extract, which contains catechins, need to know about the danger of high doses.

There's a problem in the news again, the rising number of patients coming into emergency rooms with severe liver or other organ damage after taking a variety of certain supplements covered in the news stories, dietary aids or body building goals as a recent NY Times article, "Spike in Harm to Liver Is Tied to Dietary Aids" notes.

You also can check out the December 20, 2013 FDA site, "FDA Proposes New Food Defense Rule to Tackle Intentional Adulteration." Catechins include a group of potent antioxidants that reputedly increase metabolism. The extracts are often marketed as fat burners, and catechins are often added to weight-loss products and energy boosters, according to the December 21, 2013 NYTimes.com article by Anahad O’Connor, "Spike in Harm to Liver Is Tied to Dietary Aids." Most green tea pills are highly concentrated, containing many times the amount of catechins found in a single cup of green tea, according to that NY Times article. In high doses, catechins can be toxic to the liver.

A small percentage of people appear to be particularly susceptible

That article contains interviews with physicians and patients who had severe liver injuries due to taking certain types of supplements. You need to know what dose of green tea catechins you're taking if you take green tea supplements, what else is in the supplements, and how it affects your liver.

Also, you can check out articles such as "Acute liver injury induced by weight-loss herbal supplements " and "Liver Damage Cases In Hawaii Linked To Dietary Supplements." One teenage patient interviewed in the NY Times article had severe liver injury, including suddenly yellow eyes, face, and chest. He had purchased and used a concentrated green tea extract from a nutrition store that had been labeled as a fat-burning supplement. Doctors put him on a waiting list for a liver transplant due to the severity of his liver damage.

Dietary supplements account for almost 20 percent of drug-related liver injuries in the USA

You can read in a wide variety of news reports about numerous cases of liver damage from various supplements. Mostly, though, you hear about liver damage from prescription drugs, but dietary supplements account for almost 20 percent of drug-related liver injuries in the USA. The problem is on the rise, up 7 percent from ten years ago. You can check out the statistics from a network of liver specialists or check out the coverage of the problem in the NY Times article, "Spike in Harm to Liver Is Tied to Dietary Aids."

Some people do end up requiring liver transplants or they die of liver failure while waiting for a liver. Consumers are at risk because they don't know or aren't told by supplement companies what safe levels of green tea catechins won't harm their livers. And with the few people extra susceptible and sensitive to liver damage from too-high doses of green tea catechins or other ingredients in the various nutritional supplements, you don't know what you're getting or whether you're more susceptible to what's in the supplement than the next person. See, "CRN and ETA Publish Best Practices Guide for Enzyme Dietary Supplement Products," December 17, 2013.

If you're taking a supplement that promises fat-burning or speeding up weight loss, know what's in the container and how it affects you and your liver or other organs

Americans spend an estimated $32 billion on dietary supplements every year. Approximately half of people in the USA use dietary supplements, and most of them take more than one product at a time. Although most supplements are safe, there are still cases of liver injuries from supplements seen by physicians. Even more liver injuries tracked by a network of medical officials are caused by prescription drugs used to treat serious illnesses such as heart disease, cancer, or diabetes, to name just a few conditions.

If you're taking an unregulated supplement, how would you know whether it's safe unless you checked out whether there have been cases of injuries to people's livers or other organs. Do you know where you can check such statistics on ingredients such as green tea extract catechins? Do you know where you can find information on what doses are safe for most people and who the exceptions might be? And were there other ingredients also added to the supplements that added to the issue?

The 1994 federal Dietary Supplement Health and Education Act prevents the FDA from evaluating many supplements before they go on the market

That means the FDA has to wait until someone is seriously harmed before any official can act to remove or recall the products from stores. But consumers can buy such products online, sometimes from overseas sources. Consumers need to know that the supplement industry operates on the honor system. But does any given company have the money, resources, and staff to make sure what's on the label is what's in the container, including the dosage amounts?

Is that given company putting the money into safety and research? When consumers ask about a product, too often they're told they've contacted the distributor not the manufacturer. And when they write to or call the manufacturer, they may not get the answer they want about data, research, or ingredients. An example might be where the ingredients originate and who regulates that place somewhere overseas? Many companies don't reveal the origin of ingredients to customers.

It's important that you check the results of consumer laboratory independent studies to find out whether any type of supplement contains in the box what it says on the label. Most important is that the consumer needs to know the, dosage of the supplements ingredients and whether that dosage level has been studied to see whether it's safe.

Which sources do you use to check out results of independent lab tests on any ingredient and its dosage and safety reports in various supplements?

You need a source to go to quickly to find out whether people are complaining of liver injuries from any ingredient or whether the dosage of any ingredient in any given supplement is too high for safety, or even whether the supplement contains excess levels of lead. If you check out the research on bodybuilding supplements spiked with steroids, you'll see data about liver injuries in some of there type of products, including herbal pills and powders.

If the product says it will build energy or help you lose weight faster, find out what's in the supplement. You don't want unlisted steroids and high doses of green tea catechins mixed together, for example.

Watch out for spiked products listed as dietary supplements. Check out the facts on sites such as the Council for Responsible Nutrition-The Science Behind the Supplements, a supplement industry trade group. Check out the article posted there, "New Economic Report: Smart Prevention – Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements."

You also can check out the site, "CRN Responds to Studies in Annals of Internal Medicine," December, 2013. The Council for Responsible Nutrition (CRN), founded in 1973 and based in Washington, D.C., is the leading trade association representing dietary supplement manufacturers and ingredient suppliers. CRN companies produce a large portion of the dietary supplements marketed in the United States and globally. See, "CRN Updates Vitamin and Mineral Safety Book," Septemeber 12, 2013.

Its member companies manufacture popular national brands as well as the store brands marketed by major supermarkets, drug stores and discount chains. These products also include those marketed through natural food stores and mainstream direct selling companies. CRN represents more than 100 companies that manufacture dietary ingredients and/or dietary supplements, or supply services to those suppliers and manufacturers. See, "CRN Opposes the Dietary Supplement Labeling Act of 2013," August 2, 2013.

Its member companies are expected to comply with a host of federal and state regulations governing dietary supplements in the areas of manufacturing, marketing, quality control and safety. Our supplier and manufacturer member companies also agree to adhere to additional voluntary guidelines as well as to CRN’s Code of Ethics. Click here to download a fact sheet on The Council for Responsible Nutrition (PDF).

Dietary supplements are regulated by the Food and Drug Administration (FDA) and are defined in the Dietary Supplement Health and Education Act of 1994 (DSHEA) as any products which contain one or more dietary ingredients such as vitamins, minerals, herbs or other botanicals, amino acids or other ingredients used to supplement the diet. Dietary Supplements: Safe, Beneficial and Regulated—Click here for Q&A

There are companies that spike products and pass them off as dietary supplements

Sure, it's on the fringe of the industry, but patients come into emergency rooms with real issues such as the teenager with the liver damage. But the majority of the popular supplements such as vitamins, minerals, fish oil, and probiotics are not linked to adverse effects. The trouble comes when some fringe company takes products like those and adds its own ingredients, that is spikes them with other ingredients that may cause trouble to susceptible people.

Interestingly, the NY Times article notes that the F.D.A. estimates that 70 percent of dietary supplement companies are not following basic quality control standards that would help prevent adulteration of their products. Of about 55,000 supplements that are sold in the United States, only 170 — about 0.3 percent — have been studied closely enough to determine their common side effects. You can read more about this and the interview in the NY Times article, "Spike in Harm to Liver Is Tied to Dietary Aids."

The big issue for consumers is what's regulated and what's slipping by and getting into the hands of vulnerable consumers who believe what they're told without researching the ingredients, dosages, and facts on how each ingredient and dose may affect the body or what complaints have been filed about the product. Read the reviews of any supplement you want, especially reviews from independent consumer lab tests that inform you of what's in the supplement and how its affecting people.

If any product isn't regulated, you can't make an informed decision

You also can't make a decision because you don't know whether or not you'll have an adverse reaction or allergy to anything you eat until you take it. But you don't want to take it to find out if it will damage your liver or other organ. This is what's on the mind of many consumers. Other consumers believe what they hear about a product without fact-checking. You have the vigilant consumer and the vulnerable consumer. What you need to solve the problem is access to easy-to-understand efficacy data on any given supplement. You want safety data.

For more information, check out the site of the Center for Food Safety and Applied Nutrition - Food and Drug Administration. Or see, "News for Center for Food Safety and Applied Nutrition." As required by the bipartisan Food Safety Modernization Act (FSMA), the U.S. Food and Drug Administration (FDA) on December 20, 2013 proposed a rule that would require the largest food businesses in the U.S. and abroad to take steps to prevent facilities from being the target of intentional attempts to contaminate the food supply.

The FDA will hold a public meeting on the proposed rule on Feb. 20, 2014, in College Park, Maryland. For more information on the public meeting, or to voice your say in the matter, please check out the December 20, 2013 FDA article, "FDA Proposes New Food Defense Rule to Tackle Intentional Adulteration."

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