Archive for the ‘nutraceuticals’ Category

The Wonderfully Spun Wizardry of Dr. Oz

June 6, 2012

As a pharmacist, I die a little bit inside every time I hear the question “Do you have (insert Product X here)? I saw it on Dr. Oz…” As I work and have a social life, and also a fair amount of love and respect for myself, I don’t watch Dr. Oz, and therefore have usually not heard of said wonder product. The herbal, nutraceutical, aruvedic and homeopathic market is growing quickly and it is virtually impossible to keep up with every product being marketed. Not to mention that most of these alternative health care products are not well studied, and have unknown actions, side effects and drug interactions. Products that claim to have “science” and “clinical studies” proving their effectiveness may have small scale experiments or very small, often biased studies paid for by the marketing company in their favor. That being said, if a product is considered a “nutraceutical” it does not need to go through the rigorous clinical trial process that drugs do in order to be marketed. A lot of people don’t consider the possible harm these products can cause, assuming that because a product is “natural” it must be “safe”. Has nobody told you not to eat wild berries in the woods because they are poisonous and can kill you? Some wild mushrooms can also be fatal if ingested, while some are used as illicit drugs for their hallucinogenic properties. The list goes on. In fact, many of the western medicines we have today are derived from “natural” or plant medicines. Asprin or ASA is derived from Willow Bark, and in large amounts can cause gastric ulceration, metabolic acidosis and death. A commonly used class of chemotherapy agents, the taxanes, are also derived from plant structures. These agents are extremely toxic. Digoxin, a powerful medication for heart failure, from the digitalis leaf. This is not to say that it is never appropriate to recommend herbal products to patients. Many are well studied and useful in certain situations. However it is important to consider each individual’s medical conditions, medications, and what they are treating, weighing the benefits and risks for each person based on their particular situation. Health care professionals have an ethical responsibility to put patients first above all else. This is why it angers me that the good Dr. Oz is touting the benefits of these “safe” natural products to millions of impressionable and trusting people watching his show every day. And it really pisses me off that I have to clean up his mess.

First of all, who the hell is Dr. Oz? Even the name sounds fake. In fact, he is a real doctor. The problem is, he is a cardiothoracic surgeon. Meaning, his expertise lies in the operating room. He is not an expert in nutrition, herbal remedies, exercise, microbiology, dermatology, homeopathy, diabetes, obesity etc. However, if you watch his show you would believe he knows everything there is to know about health. He gives tips on everything from vaccinations to weight loss and nutrition to diabetes.Of course, he always has a panel of experts on board to back him up. These “experts” often have something to gain from advocating the point of the day. For example, a recent show discussing the fad HCG diet featured the doctor responsible for the recent resurgence of the diet’s popularity and who has published numerous recent studies supporting the diet. Advocating this diet which consists of starving by eating a mere 600 calories a day (the average is about 2000) and receiving expensive daily shots of the hormone HCG (the pregnancy hormone) will of course gain her patients, notoriety, and money. This does not change the fact that the data supporting the diet is very weak and the diet is dangerous.

For the good of the public and the clarity of my conscience I would like to draw attention to a few of the good doctor’s most recent and most dangerous claims:

1) Raspberry Ketone:
Claim: Raspberry Ketone is great for weight loss and has no side effects

Fact: Raspberry ketone is structurally related to synephrine (a stimulant) and capsaicin. As a stimulant, it has been associated with heart palpitations and shakiness. Syneophrine and norepinephrine, as well as ephedrine, similar stimulants, have been associated with increased blood pressure, heart rate, heart palpitations, chest pain, and cardiac arrest. Ephedrine has been restricted in Canada to use as a nasal decongestant.
There is some evidence that it helps rats lose weight. There is not enough evidence in humans yet.
This medication can significantly decrease INR and require a larger dose of warfarin and require much more frequent monitoring of levels. However there is an unpredictable effect.

2)African Mango
Claim: It’s a wonder pill that will make you lose tons of weight without changing a thing in your life.
Fact:Yes, the African Mango group loss some weigh over the placebo group in a small study. However, they also consumed fewer calories Quite a lot fewer calories. Hmm. I wonder why they lost weight. Apparently the African Mango acts like a fiber making you feel full. Eat more fiber. This has been in every nutritional guideline for years. Take heed people!!

Claim:A natural byproduct of the DHEA hormone we naturally produce that helps keep us young and regulates our metabolic rate. After the age of 30 this drops, slowing metabolism and causing weight gain. 7-Keto stimulates the thyroid to increase your resting metabolic rate causing weight loss, less fat, more muscle and a smaller belly, especially with diet and exercise.
Fact: Some preliminary evidence of a decrease in body weight and fat in obese females but more evidence is needed. Decreased hemoglobin in some patients. Also has been associated with an increase in T3 hormone in some patients. Could be a concern for people with overactive thyroid, heart disease or uncontrolled blood pressure.

Claim: Helps promote breakdown of stored fats in fat cells. May also release fatty acids from fat tissue. Results in loss of body fat and theoretically increased lean body mass.
Fact: This is a potentially dangerous herb for many people. There is some evidence for its use in asthma and congestive cardiomyopathy, but no statistically significant clinical evidence of efficacy for weight loss. It can cause decreased blood pressure and flushing. There are many significant drug interactions. It can also interact with many other herbs such as anise, arnica, capsicum, chamomile, clove, fenugreek, garlic, ginger, ginkgo, ginseng, horseradish, licorice, red clover, tumeric, causing risk of bleeding or serious decrease in blood pressure. Any patients on anticoagulant or antiplatelet drugs, calcium channel blockers or nitrates should not take this herb. For patients on warfarin, INR may be increased if forskolin is used. Anyone with a bleeding disorder should not take this herb. Anyone with a heart condition should not use this herb. It should be stopped 2 weeks before any surgery to prevent serious bleeding.
This sounds really scary? Is it really worth it to lose a couple of pounds?


We live in a society that has been taught that everything can be cured with a pill. This is the combined fault of doctors, drug companies through marketing and advertising, retailers, and probably even pharmacist. But it is also the fault of patients. It is each person’s own responsibility to take ownership of their own health. There has been a big push towards an empowerment model of health care, that is one where the patient is a partner in their own health, and is an active voice in the decision making process with respect to how they are going to prevent and treat their medical conditions. In order to make informed decisions, people need to have knowledge. Shows like Dr. Oz give the facade that people are making healthy lifestyle choices for themselves, but really they are being manipulated by someone who is often spewing misinformation under the guise of health promotion. What needs to happen is that people need to look into what is right for them, consult other sources, and not assume that everything they hear on TV is gospel. If something sounds too miraculous to be true, it likely is. Weight loss is still only possible with diet and/or exercise. You won’t get abs without sit-ups. This is why I will never have any. And Dr. Oz will only go away if everyone stops watching him.