Is Hydroxycut really dangerously toxic?

The FDA announced today the recall of a dietary supplement touted for fat loss called Hydroxycut. This is a heavily advertised and popular supplement among bodybuilders and others. I received two e-mails shortly after the FDA announcement about the Hydroxycut recall. Here was my response:

In the most recent study, a case study is presented about a 28-year-old man who showed symptoms indicative of severe liver toxicity. He had ingested Hydroxycut according to product directions, ingesting 2 tablets, 2-3 times daily for 3 months prior to the onset of his symptoms. He also ingested Tylenol and aspirin to treat his “sore muscles.” The man also admitted to drinking an average of 2-3 beers a week, which was described by the study authors as “heavy drinking.”  The man showed a high copper level in his urine, which could be indicative of a genetic disease called Wilson’s disease that is characterized by high copper levels. But this was ruled out by the finding of normal serum copper and ceruloplasmin (the protein carrier of copper in the blood) levels. So why did Hydroxycut cause his liver problem? The UCLA physicians who submitted this case study suggest that it may be related to some of the ingredients in the product. This was the third case of liver toxicity linked to Hydroxycut reported in the medical literature. As with this case, the other “victims” also ingested the recommended dose. Three of the ingredients of Hydroxycut, namely Garcinia cambogia, Gymnema sylvestre, and green tea, have all been associated with severe liver toxicity. In one case reported last year, a man used two fat-loss products containing these ingredients (one was Hydroxycut) for only a week, then died of fulminent liver failure. Complicating the case was the fact that he was also ingesting a type of drug called a leukotriene antagonist (used to treat asthma, I take one myself). The theory is that the combination of the drug and the supplement ingredients resulted in rapid liver failure. Green tea extract has been shown to cause liver problems, but it’s difficult to explain why, since the active polypheonols in green tea aren’t absorbed too well, and you would have to ingest far more than is contained in any type of fat-loss supplement. There is the possibility, however, of an idiosyncratic reaction limited to only certain people. The fact that the man was also ingesting Tylenol may have played a role, since the primary ingredient of Tylenol (acetaminophen) is extremely toxic to the liver. Just ingesting 12 tablets at once could alone cause liver failure, and consuming it with alcohol makes it toxic even at lower doses. Since this man admitted a fondness for beer, I suspect that his case of liver failure wasn’t related to the Hydroxycut, but rather to the likelihood that he ingested a large dose of Tylenol with alcohol, which would definitely cause his symptoms. I view this report as alarming, since it reminds me of the previous Ephedrine scare, which was just a conspiracy involving the FDA in collusion with pharmaceutical companies to remove an effective weight-loss product,i.e., ephedrine, that was proven superior in several published studies to existing drugs prescribed to treat obesity. I  don’t think the existing medical literature (which I am quite familiar with) justifies pointing an accusatory finger at Hydroxycut or any other existing fat-loss supplement

Studies examining how green tea may be toxic to liver function found the the effect emanates from a parodoxical action of green tea that also exists for other nutrient antioxidants. This involves the fact that large amounts of green tea can act like a pro-oxidant, instead of imparting its usual antioxidant activity. In the liver, the oxidation activity of green tea depletes the primary antioxidant/detoxifyer in the liver, namely glutathione. This suggests that if a person who uses supplements that contain green tea also ingests other nutrients known to increase the liver production of glutathione, such as N-acetylcysteine and milk thistle, the side effects linked to green tea could be blocked.

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