Over-the-Counter Adrenal Supplements: More Than Meets the Eye

[helvella]

A short paper reflecting on OTC Adrenal Supplements.

I very much agree that proper labelling and, in so far as practicable, accurate description and assay, are highly desirable.

Over-the-Counter Adrenal Supplements: More Than Meets the Eye

Ryan T. Hurt, MD, PhD

Division of General Internal Medicine, Mayo Clinic, Rochester, MN

Manpreet S. Mundi, MD

Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN

DOI: doi.org/10.1016/j.mayocp.20...

A large number of patients (some estimates are as high as 115 million people) are currently consuming over-the-counter (OTC) dietary supplements to relieve symptoms of chronic disease and illness. Sales of OTC supplements have exceeded $20 billion per year. Despite this widespread use, OTC supplements remain largely unregulated. The Dietary Supplement Health and Education Act of 1994 classified dietary supplements as being exempt from having to prove safety or efficacy as long as the product does not claim to prevent, treat, or cure a specific disease. Product labels can still make general claims such as “This supplement is an important part of a healthy immune system.” In addition to lack of efficacy data, a number of additional concerns have also been raised about OTC supplements, including the presence of potentially harmful contaminants or whether the amount of intended supplement is accurate or declared on the label.

Another primary concern about these products is potential the inclusion of a “mimic drug” rather than a dietary supplement. Mimic drugs typically have a chemical structure very similar to pure crystallized pharmacological-grade drugs. A well-known example is red yeast rice (RYR), which has been consumed in Asia for centuries and has been associated with potential cardiovascular benefits. Some RYR supplements may contain monacolin K, a mimic drug of the prescription statin drug lovastatin. A recent study of 28 commercial brands of RYR demonstrated a 60-fold variation in the quantity of monacolin K per 1200 mg. We often see patients with dyslipidemia who prefer RYR to statins because it is “natural,” when in reality the active drug that provides benefit (monacolin K) is essentially a statin.

Rest of paper available here on web and as PDF:

mayoclinicproceedings.org/a...

[LindaC]

Dr S used to be really suspicious of these - I still take - thank, helvella, your for posting.

[helvella Administrator in reply to LindaC]

If someone is taking them, and they are helping, that is great.

I worry about things like consistency, and possibility of swapping makes should it be necessary, and so on.

We should not have to take the word of the makers and sellers as to what they really are.

[LindaC in reply to helvella]

Yes, agree - but I've never really been comfortable about taking them - ridiculous because I used Armour for a good while. Always trying to lower and lower and only take x1 per day now.

Endo tried to scare me, among other things, saying if I ever needed an op. to tell any doctor because I'd need steroids before proceeding but called it 'rubbish'. Who can tell, eh?

[SilverAvocado]

To some extent we're stuck between a rock and a hard place with this, aren't we?

Any new regulation would be the equivalent of the British Thyroid Association or NICE guidelines. And possibly even more influenced by pharmaceutical companies who will be free to lobby and produce their own research.