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Testing finds lead in vitamins, other problems


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#1 doug123

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Posted 23 January 2007 - 09:53 PM


News Source: Reuters

Posted Image

Testing finds lead in vitamins, other problems
Tue Jan 23, 2007 12:17 PM ET

By Megan Rauscher

NEW YORK (Reuters Health) - Among 21 multivitamin products for adults and children independently selected and tested by ConsumerLab.com, problems were found with more than half -- including unacceptably high levels of lead, and too much or too little of a particular ingredient.

Only 10 of the 21 products tested met their claims and other quality standards, according to ConsumerLab.com.

The company, based in White Plains, New York, is privately held and provides consumer information and independent evaluations of products that affect health and nutrition. According to the company, it is neither owned by nor has a financial interest in any companies that make, distribute or sell consumer products.

In a telephone interview with Reuters Health, Dr. Tod Cooperman, president of ConsumerLab.com, said one of the most serious problems was a women's multivitamin that contained 15.3 micrograms of lead per daily dose. This is more than 10 times the amount of lead allowed without a warning label in the state of California, the only state to regulate lead in supplements.

"There is lead in small amounts in many foods and drink," Cooperman said, "but the amount of lead in this multivitamin was more than you'd be exposed to from all the lead you are exposed to every day for about 5 days, and you'd be getting that every day from just the daily dose of this multivitamin."

Another "disturbing finding," Cooperman said, was a children's vitamin that contained 216 percent of its labeled amount of vitamin A -- an amount far in excess of the "upper tolerable intake level for kids under the age of 9," Cooperman said. "Young kids should definitely be avoiding that amount of vitamin A in the retinol form," he said.

Another multivitamin product -- a strip that dissolves on the tongue -- contained none of its claimed vitamin A; four other products, including a liquid product, came up short by 15 percent to 46 percent in amounts of vitamin A or folic acid.

"Several products had trouble breaking apart; they wouldn't release their ingredients," Cooperman said. These products may pass through the body without being fully utilized.

The report is available at www.consumerlab.com/results/multivit.asp.

"Multivitamin and multimineral supplements are often touted as insurance against nutritional deficiencies, but problems with multivitamins appear to be common," Cooperman said. "Compounding any problem is the fact that a multivitamin may be taken for years."

The bottom line, according to Cooperman: "If you don't feel like you have a balanced diet, a multivitamin can be helpful, but choose carefully and also choose products that have the right amount for you."

Multivitamins are the most popular supplement in the United States, with sales of more than $4 billion in 2005 according to the Nutrition Business Journal.

--------------------------------------------------------------------------------

© Reuters 2007. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

#2 doug123

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Posted 23 January 2007 - 09:58 PM

Posted Image

Click here to join Consumerlab.com and view independent testing results.

Fees to join are $27 last I checked.

sponsored ad

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Click HERE to rent this advertising spot for SUPPLEMENTS (in thread) to support LongeCity (this will replace the google ad above).

#3 Athanasios

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Posted 23 January 2007 - 11:16 PM

and I am sure they come out with an article every once in a while when their numbers of people joining are slipping. Sprinkle a few decent companies with some bulk cheapos and you are guaranteed a good headline. Woohoo!

#4 ajnast4r

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Posted 23 January 2007 - 11:52 PM

someone post the results

#5

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Posted 24 January 2007 - 03:04 AM

What's a little lead? No biggy, I mean mercury that we shoot into infants children and adults is harmless so hey what is a little lead, Right?! [huh]

#6 doug123

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Posted 24 January 2007 - 03:21 AM

What's a little lead? No biggy, I mean mercury that we shoot into infants children and adults is harmless so hey what is a little lead, Right?!  [huh]


You might want to click here

...and this might help...I found this lying on the floor at my school Fall, 2004.

Posted Image

#7 doug123

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Posted 27 April 2007 - 11:00 PM

It looks like lead is beginning to be found in some cosmetic products....

News Source: ABC Inc

Posted Image

New Yorkers warned against eye makeup with lead

(New York - WABC, April 25, 2007) - The New York City Department of Health issued a warning to New Yorkers Thursday that certain imported eye cosmetics contain high levels of lead and should not be used.

The cosmetics, called kohl, kajal, and surma, are imported from Asia, Africa and the Middle East and can be purchased at neighborhood stores throughout New York City.
In recent months, the health department has investigated five lead poisoning cases among children and pregnant women who used these products. They can cause lead poisoning when accidentally ingested.

Children are at special risk because they may put hands in their mouths after touching these cosmetics on their faces. Lead is a toxic metal that damages the brain, nervous system, kidneys and reproductive system.


Lead poisoning can also cause problems in pregnancy and can lead to learning and behavior problems in young children.

Health department officials recently tested different kohl, kajal, and surma products purchased from stores in New York City. Most of the sampled products had lead concentrations exceeding the federal recommended limit of 10 parts per million (ppm) for lead in certain cosmetic additives.

The following products were found to contain excessive levels of lead:

o Hashmi Surma Special: Made in Pakistan, 47 percent lead (468,708 ppm)
o Pure Kohl from the Waters of ZamZam: Manufacturer information not listed, 36 percent lead (362,419 ppm)
o Hashmi Kohl Aswad: Made in Pakistan, contains 27 percent lead (272,353 ppm)
o Hashmi Kajal: Made in Pakistan, contains 4 percent lead (41,298 ppm)
o These products come in many varieties, any of which may contain lead. It is not possible to tell the difference between safe and dangerous brands because lead is not listed as an ingredient on the label.
o These products are banned by the FDA and have been imported illegally. They should all be considered unsafe.


"We urge New Yorkers not to use any products that contain lead," Health Commissioner Dr. Thomas Frieden said. "Lead is poisonous and can cause serious health problems, especially for children and pregnant women. If you are using these products, stop using them immediately and call a doctor to request a blood lead test."

The sale of toxic personal products is prohibited under New York City Health Code. The Health Department is working with distributors and storeowners to remove these products from their shelves.

The health department has ordered distributors and storeowners selling kohl, kajal, or surma products to:

o Immediately stop selling the products
o Remove them from shelves and inventory stockrooms
o Package and return the products to the distributors
o Dispose of products as required by law
o Post a warning sign advising customers to stop using these products.
o The health department advises people who may have obtained and used these products to:

o Immediately stop using these products
o Call a physician to request a blood-lead test
o Keep products away from children.
Call 212-POISONS (212-764-7667)

for additional information on imported eye cosmetics that contain lead or to report locations where these products are sold. More information is also available at NYC.gov

http://www.nyc.gov/h...rt-eyecos.shtml

(Copyright 2007 WABC-TV)


Take care.

#8 neogenic

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Posted 28 April 2007 - 05:34 PM

Anyone have a membership at consumerlab.com? I'd love to hear which products and more specifics.

#9 tedsez

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Posted 28 April 2007 - 09:14 PM

Consumerlab's business model really bothers me. They're basically saying, "Tens of thousands of people are taking something that's giving them lead poisoning. We'll tell you if you're one of them, but only if you pay us."

It's also ridiculous that the news-service reports don't give the brand names because they're afraid of infringing on a copyright. This is important news, isn't it?

What if it had been Consumerlab that discovered the pet-food contamination problem a few weeks ago? They would say, "If you want to know if your dog's eating poison, subscribe to our service."

#10 OutOfThyme

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Posted 29 April 2007 - 12:46 AM

CL's multivitamin findings were not life threatening. Had they been, I would expect immediate government intervention.

The amount of lead found in a daily dose of the Vitamin Shoppe Multivitamins for
Women product - 15.3 micrograms - represents a potentially dangerous level. This amount
might not be immediately toxic, but it could cause serious harm over time, particularly for a
woman who is pregnant or breastfeeding or who may become pregnant. If accidentally taken by
a child, this amount could be even more dangerous.

http://oversight.hou...70409120002.pdf

As a for-profit entity, how long would CL be around if they made a habit of divulging subscriber level info with every other news release revealing a contaminated or quality control affected product?

Maybe the FDA should regulate the industry after all, so we're not at the mercy of these greedy enterprises. ;)

I’m elated someone's out there scrutinizing these supplements--having said that, no doubt their services could use some improvement.

http://www.consumerl...ultivitamin.asp

Edited by thymeless, 29 April 2007 - 03:53 AM.


#11 doug123

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Posted 17 May 2007 - 11:25 PM

Here's an example of the damage chromium (another deadly heavy metal) can cause. I think it's better to stay safe rather than be sorry.

Reuters UK: News Source

Posted Image

Chromium in drinking water causes cancer: U.S. agency
Thu May 17, 2007 1:11AM BST
By Jill Serjeant

LOS ANGELES (Reuters) - A type of chromium highlighted in the film "Erin Brockovich" causes cancer in lab animals when they drink it in water, and it could be harmful to people, the U.S. National Institutes of Health said on Wednesday.

Hexavalent chromium, also called chromium 6, already has been shown to cause lung cancer when inhaled and is controlled by the Environmental Protection Agency as well as by states.

It is best known as the contaminant exposed by campaigner Erin Brockovich, whose battle against a polluter was dramatized in the May 2000 movie of the same name.

"I am relieved and pleased and sorry because there are a lot of people who have ingested chromium 6," said Brockovich, who still works in Los Angeles as a legal consultant on environmental issues.

"It is high time but it is no surprise to me," she told Reuters. "This is a chemical that there have been ongoing arguments about, and now a third party has concluded that it can cause cancer by ingestion."


Environmentalists, who have been fighting for decades for tighter limits on how much chromium can be present in drinking water, said the findings offered a basis for such restrictions.

High doses of chromium 6 given to rats and mice in drinking water caused malignant tumors, the two-year study by the NIH's National Toxicology Program or NTP found.

"In the rats we saw oral cavity tumors," said Michelle Hooth, who worked on the report. "In the mice we saw tumors in the small intestine."

Hooth said the animals were given much higher doses of chromium than people would ever encounter in drinking water, which is the usual practice in testing chemicals for cancer-causing potential.

INDUSTRIAL USES


Hexavalent chromium compounds are often used in electroplating, leather tanning and textile manufacturing and have been found in some drinking water sources, the NTP said.

Brockovich started investigations in 1991 into exposure to chromium 6 in drinking water in the town of Hinkley, California. In 1996, she and lawyer Ed Masry won a landmark $333 million settlement with Pacific Gas and Electricity over claims of toxic exposure.

Brockovich said on Wednesday she had settled another lawsuit with PG&E involving the contaminant last year. But she said there were potentially dozens more toxic sites around the country.

The lowest doses given to rats and mice in the study were 10 times higher than what humans could consume from the most highly contaminated water sources identified at Hinkley, the researchers said.

From 1987 to 1993, according to the Toxics Release Inventory, chromium compound releases to land and water in various U.S. states totaled nearly 200 million pounds.

"The chromium industry has been trying to convince regulators for years that hexavalent chromium is actually quite safe when consumed via drinking water, even though it has long been known to be carcinogenic when inhaled," said Renee Sharp, a senior analyst at the Environmental Working Group.

"NTP's findings will finally allow state and federal regulators to set drinking water standards based on up-to-date sound science, rather than having to rely on old, inadequate, and/or biased studies often funded by chromium polluters," added Sharp, whose group has lobbied for tighter regulation of chromium and other chemicals.

(Additional reporting by Maggie Fox in Washington)

© Reuters 2006. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
Reuters journalists are subject to the Reuters Editorial Handbook which requires fair presentation and disclosure of relevant interests.


Take care.

#12 krillin

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Posted 18 May 2007 - 05:04 PM

Here's an example of the damage chromium (another deadly heavy metal) can cause.  I think it's better to stay safe rather than be sorry.


Is there anyone selling a product with Cr(VI)?

#13 doug123

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Posted 29 June 2007 - 12:07 AM

It looks like lead is beginning to be found in some cosmetic products....

News Source: ABC Inc

Posted Image
New Yorkers warned against eye makeup with lead

(New York - WABC, April 25, 2007) - The New York City Department of Health issued a warning to New Yorkers Thursday that certain imported eye cosmetics contain high levels of lead and should not be used.

The cosmetics, called kohl, kajal, and surma, are imported from Asia, Africa and the Middle East and can be purchased at neighborhood stores throughout New York City.
In recent months, the health department has investigated five lead poisoning cases among children and pregnant women who used these products. They can cause lead poisoning when accidentally ingested.

Children are at special risk because they may put hands in their mouths after touching these cosmetics on their faces. Lead is a toxic metal that damages the brain, nervous system, kidneys and reproductive system.


Lead poisoning can also cause problems in pregnancy and can lead to learning and behavior problems in young children.

The health department has ordered distributors and storeowners selling kohl, kajal, or surma products to:

o Immediately stop selling the products
o Remove them from shelves and inventory stockrooms
o Package and return the products to the distributors
o Dispose of products as required by law
o Post a warning sign advising customers to stop using these products.
o The health department advises people who may have obtained and used these products to:

o Immediately stop using these products
o Call a physician to request a blood-lead test
o Keep products away from children.
Call 212-POISONS (212-764-7667)

for additional information on imported eye cosmetics that contain lead or to report locations where these products are sold. More information is also available at NYC.gov

http://www.nyc.gov/h...rt-eyecos.shtml

(Copyright 2007 WABC-TV)


Take care.


It now appears that the The New England Journal of Medicine has reported that adverse reactions may be caused by what are considered: "Permanent-Makeup Procedures." I am not sure in exactly what context this all comes up in (i.e. I am not a Doctor or a health care professional of any kind, so some of the terminology used in Medical Literature is incomprehensible -- to me at least -- so I'd always suggest consulting with your Doctor or other licensed health care practitioner before acting on anything you may read in something I may post -- or -- for that matter, anything you read online -- who knows who is whom online anyways?).

First, here is the "mainstream" news report on this matter:

Posted Image

Women beware, permanent makeup can cause permanent disfigurement

Women's Health News
Published: Wednesday, 27-Jun-2007 

Researchers in the United States are warning consumers that "permanent makeup" can leave some people permanently disfigured.

Permanent makeup ink is injected into recipients to enhance eyebrows, eyelids and lips and is a form of tattoo.

More than 8 million women in the U.S. alone undergo such procedures to supposedly enhance their appearance.

The researchers from the Cosmetics and Colors branch of the Food and Drug Administration (FDA) say the process can cause long term disfigurement for patients who suffer allergic reactions.


That allergic reactions can occur with such ink injections, is well documented and in 2004, the American Institute of Intradermal Cosmetics in Arlington, Texas, recalled and replaced inks in its Premier Pigments brand after they were implicated in many of the problems reported to the FDA.

In order to assess the extent of the problem and how long the disfigurement lasted, Masja Straetemans of the Centers for Disease Control and Prevention (CDC) and her colleagues interviewed 92 women who had problems following the procedure.

More than 9 out of 10 had swelling and tenderness and almost as many complained of itching with more than 4 out of 5 experiencing bumps.

They found that in 68 per cent of 63 cases the reactions had not healed at the time of the telephone interview, and the allergic reaction lasted anywhere from five months to more than three years.

According to the FDA reports of allergic reactions to tattoo pigments have been rare and from 1988 to 2003 they received only five reports of adverse reactions after permanent makeup procedures; however since 2003, more than 150 reports were made.

The FDA says when things do go wrong they may be particularly bad because the pigments can be hard to remove and occasionally people develop an allergic reaction to tattoos they have had for years.

Side-effects reported include tenderness, swelling, itching and bumps and the FDA says the application of permanent makeup can result in serious, long-term disfiguring reactions.

They have called on consumers and medical professionals to report adverse reactions to permanent makeup procedures to the FDA.

The report from the CDC appears in Thursday's New England Journal of Medicine.


I have access the Full Text of the NEJM study...and I'll share some excerpts here now...I hope this doesn't get me into too much trouble... [mellow]

This release doesn't even have an abstract: Click here to view the first 100 words of the full text and any section headings.

Let me please provide some introductory information for my fellow laymen and women regarding the New England Journal of Medicine -- this information is provided by Answers.com:

Posted Image

The New England Journal of Medicine (N Engl J Med or NEJM) is a peer-reviewed medical journal published by the Massachusetts Medical Society. It is one of the most popular and widely-read peer-reviewed general medical journals in the world. It is also the oldest continuously published medical journal in the world.

It was founded by Dr. John Collins Warren in 1812 as a quarterly called The New England Journal of Medicine and Surgery. In 1828, it became a weekly, and was renamed The Boston Medical and Surgical Journal; one hundred years later, it took on its present name.

It publishes editorials, papers on original research, widely-cited review articles, correspondences, case reports, and has a special section called "Images in Clinical Medicine".
Authors have included Oliver Wendell Holmes, Sr., Hans Zinsser, and Lewis Thomas. One of its early editors, Jerome V. C. Smith, resigned in 1857 to assume his duties as mayor of the City of Boston.

The website for the George Polk Awards noted that its 1977 award to the New England Journal of Medicine "provided the first significant mainstream visibility for a publication that would achieve enormous attention and prestige in the ensuing decades"[1]

The journal usually has the highest impact factor of the journals of clinical medicine (including the Journal of the American Medical Association, and The Lancet); in 2005, the impact factor was 44.016, according to Journal Citation Reports.

Open access policy

NEJM provides delayed free online access to its research articles (it does so six months after publication, and maintains that access dating back to 1993). This delay does not apply to readers from the least developed countries, for whom the content is available at no charge for personal use.

NEJM also has two podcast features, one with interviews of doctors and researchers that are publishing in the journal, and another summarizing the content of each issue.

Editors


o Walter Prentice Bowers, 1921–1937
o Robert Nason Nye, 1937–1947
o Joseph Garland, 1947–1967
o Franz J. Ingelfinger, 1967–1977
o Arnold S. Relman, 1977–1991
o Jerome P. Kassirer, 1991–1999
o Marcia Angell, 1999–2000
o Jeffrey M. Drazen, 2000-

Other leading medical journals

o JAMA http://www.answers.c...cal-association
o Nature Medicine http://www.answers.c...nature-medicine
o The Lancet http://www.answers.c...opic/the-lancet
o British Medical Journal http://www.answers.c...medical-journal
o Annals of Internal Medicine http://www.answers.c...ternal-medicine
o Archives of Internal Medicine http://www.answers.c...ternal-medicine
o Canadian Medical Association Journal http://www.answers.c...ciation-journal
o Journal Watch, sibling publication to NEJM http://www.answers.c...c/journal-watch
o The Medical Letter on Drugs and Therapeutics http://www.answers.c...nd-therapeutics

External links

o NEJM Online http://www.nejm.org/
o NEJM's Audio interview RSS feed, in XML format http://podcast.nejm....o_interview.xml

References
1.  http://www.brooklyn....lk/history.html


Here is an extract from the full text...

Posted Image

Volume 356:2753  June 28, 2007  Number 26
Adverse Reactions after Permanent-Makeup Procedures

To the Editor: Permanent makeup, used to enhance facial appearance (most commonly the eyebrows, eyelids, and lips), is administered by intradermally injecting inks containing various pigments and suspending agents. The number of people receiving permanent makeup is unknown.

...

Our findings show that application of permanent makeup can result in serious, long-term disfiguring reactions. The product line of ink associated with most of the reactions was recalled in September 27, 2004. Consumers and medical professionals should report adverse reactions to permanent-makeup procedures to the FDA.5


5. Tattoos and permanent makeup. Rockville, MD: Food and Drug Administration, 2006. (Accessed June 7, 2007, at http://www.cfsan.fda.../cos-204.html.)


Take care, and be safe.

#14 doug123

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Posted 29 June 2007 - 06:27 AM

Dear krillin,

Let me please apologize for overlooking your question.

Here's an example of the damage chromium (another deadly heavy metal) can cause.  I think it's better to stay safe rather than be sorry.


Is there anyone selling a product with Cr(VI)?


I am unaware of anyone knowingly selling products contaminated with Cr(VI).

Did you read the story posted above: "Chromium in drinking water causes cancer: U.S. agency?"

A news report published on the FDA Final Rule on GMP Requirements for Dietary Supplements is posted below:

Posted Image

FDAnews Marketing and Sales Bulletin
June 28, 2007  | Vol. 2 No. 26

FDA Publishes Final Rule on GMP Requirements for Dietary Supplements


The FDA issued the long-anticipated final rule on current good manufacturing practices (cGMP) for dietary supplements, as well as a companion interim final rule for exemptions to aspects of the new regulation.

Last year Congress revised the Dietary Supplement Health and Education Act, sponsored by Sens. Orrin Hatch (R-Utah) and Tom Harkin (D-Iowa). It requires manufacturers of dietary supplements to collect consumer product complaints and submit all serious adverse events in patients taking supplements to the FDA.

The new regulation calls for manufacturers to evaluate the identity, purity, strength and composition of their products and gives the FDA the authority to declare nonconforming supplements as adulterated or misbranded, the agency said.

“The aim of the final rule is to prevent inclusion of the wrong ingredients, too much or too little of a dietary ingredient, contamination by substances such as natural toxins, bacteria, pesticides, glass, lead and other heavy metals, as well as improper packaging and labeling,” the FDA said.


In a companion interim final rule, the agency outlines a petition process whereby manufacturers may be exempted from the 100 percent identity testing cGMP requirements for ingredients used in the processing of supplements, the FDA said.

If a manufacturer can demonstrate with sufficient documentation that less frequent testing would still ensure product identity, then an exemption may be obtained.

The final cGMP and interim final rule take effect Aug. 24. The FDA is adopting a three-year phased implementation of the regulation. Manufacturers with more than 500 employees must comply by June 2008 while those with fewer than 500 employees have until June 2009.  Companies with fewer than 20 employees have until 2010 to implement the cGMP requirements.


It seems (and I quote from above): "the new regulation calls for manufacturers to evaluate the identity, purity, strength and composition of their products and gives the FDA the authority to declare nonconforming supplements as adulterated or misbranded..."

It appears that the possibility of contamination still remains likely in dietary supplements, so I'd still err on the side of caution and stick to brands that consistently pass independent testing (especially since some supplement organizations may have until 2010 to comply with these newly issued cGMP requirements).

At this time, ConsumerLab.com seems to be the only credible US independent testing organization.

Click here to visit the ConsumerLab.com website

Take care.

Edited by adam_kamil, 29 June 2007 - 08:59 PM.


#15 oregon

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Posted 01 July 2007 - 03:37 AM

It is not surprising to me. Considering that many vitamins are not actually made in US, but are imported from China.

Somebody please share the results!
Somebody please share the results!
Somebody please share the results!
Somebody please share the results!

#16 tintinet

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Posted 01 July 2007 - 01:10 PM

Which results?

#17 doug123

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Posted 30 July 2007 - 11:23 PM

An update on the lead issue -- it seems lead may have less of an effect on certain groups.

Here's some information regarding the primary source of evidence: The American Academy of Neurology - AAN -- from the U.S. Department of Health and Human Services:

Posted Image
Posted Image

American Academy of Neurology - AAN

Organization URL(s)

memberservices@aan.com
www.aan.com


Other Contact Information

1080 Montreal Avenue
St. Paul, MN 55116

800-879-1960 (Voice - Toll-free)
651-695-2717 (Voice)
651-695-2791 (FAX)

Description

The American Academy of Neurology (AAN) is a professional society composed of neurologists and professionals in related fields who share a common goal of continued growth and development of the neurological sciences.


Online Resources

Find a Neurologist
http://www.aan.com/membersearch/

Print Resources

The Academy publishes several brochures on neurology which are used by members for patient information. The Patient Information Guide for Neurology lists organizations which can supply information and materials on specific diseases. The publication, Neurologist, describes what a neurologist is and does. Serial publications: Neurology (journal), monthly; AANews (newsletter), monthly.


Here is some info from wikipedia on AAN:

The American Academy of Neurology (AAN) is a professional society for neurologists and neuroscientists. As a medical specialty society it was established in 1949 to advance the art and science of neurology, and thereby promote the best possible care for patients with neurological disorders.

Annual Meeting The annual meeting of the AAN is attended by more than 15,000 neurologists and neuroscientists from the US and abroad. The 2007 meeting will be in Boston featuring scientific presentations and educational courses. Plenary presentations on three days will highlight cutting edge clinical, translational and basic research. The annual "Future of Neuroscience" conference is titled "Therapies of Genetic Disorders" and will feature talks on enzyme replacement, gene therapy, siRNA, and stem cells ([1]).


Here is the study abstract:

Posted Image

Impact of cognitive reserve on the relationship of lead exposure and neurobehavioral performance.

Bleecker, M, MD, PhD, Ford, D, MD, MPH, Celio, M, Vaughan, C, Lindgren, K

Background: Cognitive reserve (CR)-a construct studied in many neurologic disorders-refers to the maintenance of cognitive performance in spite of ongoing underlying brain pathology.Objective: We hypothesized that a dose-effect relationship would exist between chronic occupational lead exposure and cognitive effects in workers with low CR but not in workers with high CR and identical lead exposure, and that level of CR would not influence the relationship between lead exposure and motor performance.Methods: We stratified currently employed lead smelter workers by Wide Range Achievement Test-R for reading (WRAT), a recognized measure of CR, into loCR and hiCR groups. From these two groups we matched 56 pairs on working lifetime weighted blood lead (TWA). We performed a factor analysis on 14 neuropsychological outcome variables. Within each CR group regression analyses after adjusting for age, alcohol use, and depression scale score tested for dose-effect relationships between TWA and outcome variables.Results: Both CR groups had comparable age, years employed, alcohol use, and current blood lead levels. Factor analysis provided three factors and five tests used in the regression analyses. Significant dose-effect relationships between TWA and cognitive tests present only in the loCR group included Attention Factor and Digit Symbol. Both CR groups demonstrated significant dose-effect relationships on the Motor Factor. Conclusion: This study found that cognitive reserve protects against the effect of chronic lead exposure on select measures of cognitive performance but not on motor performance.

©2007AAN Enterprises, Inc.


For a "mainstream" take on this story, click here to read Health Day News: "Lead Less Toxic to the Well-Read: High literacy somehow shields the brain from the toxin's effects, study finds."

Thoughts or comments?

Take care.

#18 doug123

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Posted 18 August 2007 - 07:21 PM

An update on the lead issue -- it seems lead may have less of an effect on certain groups.

Here's some information regarding the primary source of evidence: The American Academy of Neurology - AAN -- from the U.S. Department of Health and Human Services:

Posted Image
Posted Image

American Academy of Neurology - AAN

Organization URL(s)

memberservices@aan.com
www.aan.com


Other Contact Information

1080 Montreal Avenue
St. Paul, MN 55116

800-879-1960 (Voice - Toll-free)
651-695-2717 (Voice)
651-695-2791 (FAX)

Description

The American Academy of Neurology (AAN) is a professional society composed of neurologists and professionals in related fields who share a common goal of continued growth and development of the neurological sciences.


Online Resources

Find a Neurologist
http://www.aan.com/membersearch/

Print Resources

The Academy publishes several brochures on neurology which are used by members for patient information. The Patient Information Guide for Neurology lists organizations which can supply information and materials on specific diseases. The publication, Neurologist, describes what a neurologist is and does. Serial publications: Neurology (journal), monthly; AANews (newsletter), monthly.


Here is some info from wikipedia on AAN:

The American Academy of Neurology (AAN) is a professional society for neurologists and neuroscientists. As a medical specialty society it was established in 1949 to advance the art and science of neurology, and thereby promote the best possible care for patients with neurological disorders.

Annual Meeting The annual meeting of the AAN is attended by more than 15,000 neurologists and neuroscientists from the US and abroad. The 2007 meeting will be in Boston featuring scientific presentations and educational courses. Plenary presentations on three days will highlight cutting edge clinical, translational and basic research. The annual "Future of Neuroscience" conference is titled "Therapies of Genetic Disorders" and will feature talks on enzyme replacement, gene therapy, siRNA, and stem cells ([1]).


Here is the study abstract:

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Impact of cognitive reserve on the relationship of lead exposure and neurobehavioral performance.

Bleecker, M, MD, PhD, Ford, D, MD, MPH, Celio, M, Vaughan, C, Lindgren, K

Background: Cognitive reserve (CR)-a construct studied in many neurologic disorders-refers to the maintenance of cognitive performance in spite of ongoing underlying brain pathology.Objective: We hypothesized that a dose-effect relationship would exist between chronic occupational lead exposure and cognitive effects in workers with low CR but not in workers with high CR and identical lead exposure, and that level of CR would not influence the relationship between lead exposure and motor performance.Methods: We stratified currently employed lead smelter workers by Wide Range Achievement Test-R for reading (WRAT), a recognized measure of CR, into loCR and hiCR groups. From these two groups we matched 56 pairs on working lifetime weighted blood lead (TWA). We performed a factor analysis on 14 neuropsychological outcome variables. Within each CR group regression analyses after adjusting for age, alcohol use, and depression scale score tested for dose-effect relationships between TWA and outcome variables.Results: Both CR groups had comparable age, years employed, alcohol use, and current blood lead levels. Factor analysis provided three factors and five tests used in the regression analyses. Significant dose-effect relationships between TWA and cognitive tests present only in the loCR group included Attention Factor and Digit Symbol. Both CR groups demonstrated significant dose-effect relationships on the Motor Factor. Conclusion: This study found that cognitive reserve protects against the effect of chronic lead exposure on select measures of cognitive performance but not on motor performance.

©2007AAN Enterprises, Inc.


For a "mainstream" take on this story, click here to read Health Day News: "Lead Less Toxic to the Well-Read: High literacy somehow shields the brain from the toxin's effects, study finds."

Thoughts or comments?

Take care.


Please evaluate: Lead Hazards in California's Public Elementary Schools and Child Care Facilities.

Anyways, there has been a recent scare because many toys that are imported may have high lead content. I think it's a big deal because it appears some children may have a tendency to eat their toys.

First, however, a study from NEJM on lead poisoning in children -- and it's effects on children's IQ:

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Volume 348:1517-1526  April 17, 2003  Number 16

Intellectual Impairment in Children with Blood Lead Concentrations below 10 µg per Deciliter


Richard L. Canfield, Ph.D., Charles R. Henderson, Jr., M.A., Deborah A. Cory-Slechta, Ph.D., Christopher Cox, Ph.D., Todd A. Jusko, B.S., and Bruce P. Lanphear, M.D., M.P.H.


ABSTRACT

Background Despite dramatic declines in children's blood lead concentrations and a lowering of the Centers for Disease Control and Prevention's level of concern to 10 µg per deciliter (0.483 µmol per liter), little is known about children's neurobehavioral functioning at lead concentrations below this level.

Methods We measured blood lead concentrations in 172 children at 6, 12, 18, 24, 36, 48, and 60 months of age and administered the Stanford–Binet Intelligence Scale at the ages of 3 and 5 years. The relation between IQ and blood lead concentration was estimated with the use of linear and nonlinear mixed models, with adjustment for maternal IQ, quality of the home environment, and other potential confounders.

Results The blood lead concentration was inversely and significantly associated with IQ. In the linear model, each increase of 10 µg per deciliter in the lifetime average blood lead concentration was associated with a 4.6-point decrease in IQ (P=0.004), whereas for the subsample of 101 children whose maximal lead concentrations remained below 10 µg per deciliter, the change in IQ associated with a given change in lead concentration was greater. When estimated in a nonlinear model with the full sample, IQ declined by 7.4 points as lifetime average blood lead concentrations increased from 1 to 10 µg per deciliter.

Conclusions
Blood lead concentrations, even those below 10 µg per deciliter, are inversely associated with children's IQ scores at three and five years of age, and associated declines in IQ are greater at these concentrations than at higher concentrations. These findings suggest that more U.S. children may be adversely affected by environmental lead than previously estimated.

Source Information

From the Division of Nutritional Sciences (R.L.C.) and the Department of Human Development (C.R.H.), College of Human Ecology, Cornell University, Ithaca, N.Y.; the Departments of Environmental Medicine (D.A.C.-S.) and Biostatistics and Computational Biology (C.C.), University of Rochester School of Medicine, Rochester, N.Y.; the Division of Epidemiology, Statistics, and Prevention, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Md. (C.C.); the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle (T.A.J.); and Cincinnati Children's Environmental Health Center, Children's Hospital Medical Center, Cincinnati (B.P.L.).

Address reprint requests to Dr. Canfield at the Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY 14853, or at rlc5@cornell.edu.


So here's a story published at WebMD that reflects on the recent lead scare:

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Lead Poisoning and Kids
Lead Poisoning: What It Is, How to Test, What to Do

By Daniel J. DeNoon

WebMD Medical News Reviewed by Louise Chang, MD

Aug. 15, 2007 -- Lead poisoning -- at levels that do not cause immediate symptoms -- can permanently damage kids' brains.

Before their second birthday, children are particularly susceptible to lead poisoning. They are, of course, more likely than older children to put lead-contaminated hands or toys or paint chips in their mouths. Moreover, a child's gastrointestinal tract also absorbs lead more readily than does the adult gut.

Most importantly, a child's rapidly developing brain is highly vulnerable to lead toxicity, says pediatrics professor John Rosen, MD, director of the lead program at the Children's Hospital at Montefiore Medical Center, Bronx, N.Y.

"Lead can be extremely dangerous for young children and can affect their lives forever," Rosen tells WebMD. "It is better to be conservative and safe and not ever sorry about excessive lead exposure."

Lead poisoning is almost never a single event in which a child ingests harmful quantities of lead, gets sick, and must be rushed to the hospital. Instead, lead poisoning is an insidious, month-by-month accumulation of lead in a child's body.

"I have supervised 30,000 cases of child lead poisoning, and I have not seen a case of symptomatic lead poisoning for many years," Rosen says.

That's why lead-painted toys can be such a problem, says John Benitez, MD, director of the Lawrence Poison and Drug Information Center and associate professor of pediatric and environmental medicine at the University of Rochester, N.Y.

"Parents need to know it is not an acute problem," Benitez tells WebMD. "If a kid just touches and plays with a lead painted toy, it is not a problem. But if that child sits and chews on it for weeks and months and absorbs lead -- that becomes a risk."

What, exactly, is lead poisoning? How do you know if your child is at risk? What should you do if your child has a worrisome level of lead exposure? WebMD consulted experts for answers to these and other questions.

What Is Lead Poisoning?

The risks of lead have been known for decades. But there is surprisingly little agreement on exactly when a child has accumulated a toxic amount of lead.

Everybody agrees that there is no "safe" level of lead exposure. However, the CDC doesn't recommend taking action unless a child's blood-lead level exceeds 10 micrograms/dL -- a threshold set in 1991. Rosen says that's far too high.

"There are now seven peer-reviewed articles in the medical literature that indicate the major loss of IQ occurs in children at blood-lead levels of less than 7.5 micrograms/dL," Rosen says. "A threshold of 10 is no longer protective of children. ... I would very strongly suggest lowering the threshold to 5, based on abundant data in the last five years."

The CDC says about 310,000 American kids (1 to 5 years old) have blood-lead levels over 10 micrograms/dL.

A U.S. child's main risk of lead poisoning comes from the lead-based house paints in near-universal use before 1950. The paints were banned for housing use in 1978. An estimated 24 million U.S. housing units -- which some 4 million young children call home -- have deteriorated lead paint contributing to lead-contaminated house dust.

"Very small particles of paint get into household dust you cannot see," Rosen says. "That gets on hair, fingers, toys, and skin. Through normal hand-mouth activity, that paint is absorbed."

How long it takes a child to absorb toxic levels of lead depends on the concentration of lead in the dust. Rosen says that in a typical lead-contaminated housing unit, it takes one to six months for a small child's blood-lead levels to rise to a level of concern.

"If the amount of hand-to-mouth activity is robust, and the concentrations of lead in that housing unit are substantial, it does not take long," he warns.

What about the recently discovered lead paint on children's toys?

"In terms of pervasiveness and widespread distribution of those toys, only time will tell how many children will be identified who develop lead poisoning. At the present time that is unknown, although the risk is definite," Rosen says.

Lead Poisoning: What It Is, How to Test, What to Do

What Are the Risks of Lead Poisoning?

Rosen says the ultimate effects of lead on children include:

o Loss of IQ points
o Impairments in language fluency or communication
o Memory problems
o Trouble paying attention
o Lack of concentration
o Poor fine-motor skills
o Difficulty with planning and organization
o Difficulty forming abstract concepts
o Poor cognitive flexibility (trying something else if the first thing you try doesn't solve a problem)

"To fully test children to see if there are any adverse outcomes from lead poisoning cannot be done until they reach their sixth birthday," Rosen says. "Many of these symptoms don't manifest until age 6 or 7 years. What a parent might know before that might well be some common complaints such as speech delay, hyperactivity, not being able to sit/listen/learn in school, and not being able to focus. Those observations may be the result of earlier childhood lead poisoning."

Is Your Child at Risk of Lead Poisoning?

Except in those rare cases in which a child ingests a huge amount of lead, lead poisoning has no obvious, immediate symptoms.

"Over time, you may notice tiredness, nonspecific belly complaints, or a child may become anemic," Benitez says. "Unless you are eating blocks of lead, there are no acute or sudden symptoms that would appear in minutes. That is the problem with lead -- the subtle, slow dose over time."

There is a sure way to know whether your child has accumulated dangerous amounts of lead: a simple blood test. Such tests cost about $15 or $20. Results come back in two days, says Emory University pediatrician Robert J. Geller, MD, medical director of the Georgia Poison Center and chief of pediatrics at Grady Health System, Atlanta. Rosen says, "To be cautious, if a child has been playing with a leaded toy for about one month or more, it is suggested that a child should be tested for lead."

"The average American blood level is 2 to 3 micrograms/dL," Geller tells WebMD. "Your body does get rid of lead very slowly. So a small amount that gets in will be excreted. It is not a permanent blood level."

A recent U.S. Preventive Services (USPS) Task Force panel noted in a 2006 report that children's blood-lead levels usually peak at about age 2 and go down after that.

Rosen says all children's blood lead levels should be tested at age 12 months and again at age 24 months -- with additional testing every six months if the child is at high risk of lead exposure.

"If a child has never been tested for lead, it should be done regardless of the child's age," Rosen says. "The prime question for a pediatrician to ask is what is the status of the apartment or home where the child lives: Is there peeling paint? Is it an old building, or new construction?"

The USPS panel reached a different conclusion. It found no evidence that universal lead-exposure screening leads to better clinical outcomes than targeted screening of at-risk children.

What to Do for Children With Lead Poisoning
Unfortunately, once a child has absorbed a dangerous amount of lead, there's no quick way to make the lead go away.

Children with dangerously high blood lead levels -- 45 micrograms/dL or more -- can be treated by chelation (pronounced key-LAY-shun). Chelation involves giving a child one of two drugs that quickly remove lead from the blood.


Chelation can save the life of a child with acute lead poisoning. But it does not remove all lead from the body. Most ingested lead is stored in the bones and leaches back into the bloodstream -- and brain -- over time.

"Chelation stops lead poisoning from being life-threatening," Rosen says. "Has damage already been done to the brain? Yes. Chelation does not reverse the adverse effects of lead on the brain. What it does do is save lives. Chelation is of no value -- and may actually harm -- children with lead levels under 45 micrograms/dL."

The USPS panel notes that repeated chelation may temporarily lower blood lead levels, but these reductions are not sustained. The panel found no evidence that these temporary reductions improve health or behavioral outcomes.

What does work? Rosen says the first thing to do is to have the child's pediatrician work with local health authorities to find and remove the source of lead poisoning.

Second, Rosen recommends making sure children with high lead levels get a diet rich in calcium and iron. This, he says, helps prevent intestinal absorption of lead and speeds elimination of lead from the body.

"We are recommending a diet replete in calcium-rich foods such as milk and cheese and iron-rich foods such as fresh green vegetables and some red meat," he says. "If a child is iron deficient, yes, we recommend supplements, but unless lab tests show this, we do not put these children on iron supplements."

This does not mean forcing a child to drink gallons of milk and to eat pounds of spinach.

"In essence, I am really saying a child with high lead levels should be on a well-balanced, healthy diet," Rosen says.

Rosen admits that frustrated parents may want to do more. But he says that if lead has been removed from the child's environment and the child gets a healthy diet, lead levels will naturally decrease over time.

Rosen also suggests that children who have had high blood lead levels should be assessed by a neuropsychologist at age 6 years to evaluate the need for educational interventions.

SOURCES: John Rosen, MD, professor of pediatrics; director, lead program, and director, division of environmental sciences, Children's Hospital at Montefiore Medical Center, Bronx, N.Y. John Benitez, MD, associate professor of emergency medicine, pediatrics, and environmental medicine, and director, Lawrence Poison and Drug Information Center, University of Rochester, N.Y. Robert J. Geller, MD, associate professor of pediatrics, Emory University School of Medicine; medical director, Georgia Poison Center; chief of pediatrics, Grady Health System, Atlanta. Rischitelli, G. Pediatrics, December 2006; vol 118: pp e1867-e1895. U.S. Preventive Services Task Force web site. CDC web site. Environmental Protection Agency web site.

© 2007 WebMD, Inc. All rights reserved.


Take care.

#19 ageless

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Posted 20 August 2007 - 07:13 PM

This is scary stuff... anyone from custom capsule able to ensure no lead is present in custom formulation? What do people think?

#20 Athanasios

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Posted 20 August 2007 - 07:17 PM

Consumerlab's business model really bothers me. They're basically saying, "Tens of thousands of people are taking something that's giving them lead poisoning. We'll tell you if you're one of them, but only if you pay us."

It's also ridiculous that the news-service reports don't give the brand names because they're afraid of infringing on a copyright. This is important news, isn't it?

What if it had been Consumerlab that discovered the pet-food contamination problem a few weeks ago? They would say, "If you want to know if your dog's eating poison, subscribe to our service."

Agreed.

#21 doug123

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Posted 20 August 2007 - 10:41 PM

What do people think?


I don't think my opinion is really of any value, since I have no clinical expertise in medicine or pharmacy. When it comes to matters of health, I try to seek the strongest sources of evidence where it may correspond to the opinions of licensed health care professionals. I think anecdotal evidence provided by myself and others in online forums may be useful, but only as they may correspond with the evidence. Expert opinion can be valuable as well, but I recall not too long ago it seemed several individuals in this forum were convinced a particular individual was a licensed physician, when it turned out that was quite far from the truth. I learned from example that -- emotions aside -- all it takes to determine the truth is a simple call for evidence.

An article of interest was published in U.S. Pharmacist that may be of interest here.

Here ya go:

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Vol. No: 30:06 Posted: 6/15/2005
The USP Dietary Supplement Verification Program: Helping Pharmacists and Consumers Select Dietary Supplements 

John Atwater, PhD
Jennifer Montgomery-Salguero, BS
David B. Roll, PhD
United States Pharmacopeia
Rockville, Maryland

US Pharm.2005;6:61-64.

In the fall of 1994, the U.S. Congress passed the Dietary Supplement Health and Education Act (DSHEA). This law treats dietary supplements as foods and defines them as "vitamins, minerals, amino acids, botanicals, and 'other' dietary ingredients." The law contains a number of unusual provisions, not the least of which is that the Food and Drug Administration was given the burden of proving a supplement is harmful rather than requiring that the manufacturer prove that it is safe.

At the time of passage of DSHEA, the FDA estimated that there were about 4,000 dietary supplement products on the market. Since this controversial law was passed, the number of products has increased to more than 29,000, with more than 1,000 products being added each year. The plethora of products makes it extremely difficult for pharmacists, other health care professionals, and consumers to make informed decisions about which brands and products to select. The selection process becomes even more confusing due to widespread reports of adulterated, subpotent or superpotent, and even dangerous dietary supplements. It is apparent that those using and recommending dietary supplements need guidance in the selection process.

In October 2001, the United States Pharmacopeial Convention, Inc. (USP) launched a verification program for dietary supplements designed to provide assurance to consumers that the products they purchase contain the ingredients listed on the label at the stated level(s). In addition, the program evaluates and verifies supplements according to stringent standards for product purity, accuracy of ingredient labeling, and proper manufacturing practices.

Why USP?
USP, founded in 1820, is a nongovernmental, nonprofit organization whose mission is to promote public health. Scientific experts from pharmacy and numerous other fields, including the dietary supplement industry, volunteer their efforts to support USP's work.

Federal law recognizes USP as the official body that sets standards for prescription drugs and dietary supplements. USP has set FDA-recognized standards for more than 4,000 prescription and over-the-counter drugs that pharmaceutical manufacturers are required by federal regulation to meet or exceed. USP has brought that experience to the dietary supplement industry and has developed standards for hundreds of dietary supplement ingredients and products. These standards are compiled in a separate dietary supplements section in the United States Pharmacopeia (USP28). Although supplement manufacturers are not required to comply with USP monographs, according to DSHEA, a dietary supplement represented as meeting USP­NF standards is deemed misbranded if it fails to conform to those standards.

Thus, verification of dietary supplements is a natural progression of USP's long-established history of standards setting and promotion of public health.

A Compelling Need

It is estimated that in 2002, Americans spent nearly $19 billion on dietary supplements; nearly half of this was spent on vitamins and minerals, and about one fourth on herbal products. There are numerous reports in the literature of supplements that were found to be inferior in one or more aspects. Clearly, not all supplements are created equal, as is illustrated in FIGURE 1. The calcium supplements taken by this individual over a three-day period are obvious in the x-ray image. It is readily apparent that the tablets have not dissolved and thus are not having their intended effect.

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ConsumerLab.com has analyzed 27 multivitamin/mineral supplements for labeled content, disintegration, and lead content. In this study they found that nine of the products failed one or more of the USP requirements. The most common problems related to vitamin A. For example, one children's product contained more than 150% of the labeled content, exceeding the established upper limit for an adult. One of the multiproducts failed the USP disintegration test. Another, a prenatal product, contained only 75% of the amount of folic acid claimed on the label, while one of the multiproducts had only 50% of the claimed amount of this important vitamin. Given what we know about the importance of folic acid in prevention of spina bifida and other neural tube defects, these inferior products should concern all health care professionals.

In a separate study of 32 coenzyme Q10 (CoQ10) supplements tested by ConsumerLab.com, the content ranged from no detectable quantity in one product to 175% of the claimed amount in another. Thus, simply by changing brands, a consumer could go from 0% to 175% of the labeled amount of CoQ10.

Similarly, it is easy to find reports of botanical products that do not meet label specifications. In a recent study published in the Canadian Journal of Clinical Pharmacology, 54 commercial St. John's wort products were tested for the marker compound hypericin. Only two products tested within 10% of the stated label amount, and on average, most products contained only half of the labeled amount of hypericin.

In addition to concerns about the quality of botanical products, a daunting task facing pharmacists and consumers is choosing a product from among the vast number of brands in the marketplace. A recent paper describes a survey of 20 retail stores in a large metropolitan area for products containing the herbs Echinacea, St. John's wort, Ginkgo biloba, garlic, saw palmetto, ginseng, goldenseal, aloe, "Siberian ginseng" (eleuthero), and valerian. For these 10 herbs, consumers had a choice of 880 products and could select from 241 different brands. For example, there were 143 garlic products (33 brands), 138 Ginkgo biloba products (34 brands), and 130 St. John's wort products (34 brands). This survey did not analyze the products for labeled amount but did find that a substantial number of products were not labeled properly and showed a wide variation in label information in regard to plant part ingredients and recommended serving size. In some cases, experienced pharmacists on the survey team were not able to discern ingredient information from the labels. The authors posed the rhetorical question, "If pharmacists trained to interpret pharmaceutical product descriptions are unable to understand the labels for some of these products, how can a layperson make sense of them, much less compare products with a benchmark or with one another or convey this information to their physician?"

The USP verification program for dietary supplements is an attempt to help pharmacists and consumers answer this and other questions regarding dietary supplement quality.

How the Verification Program Works

USP will not accept a product into its verification program if the product contains an ingredient with known safety concerns. However, USP does not comprehensively address the issue of safety. No single program or organization could be expected to completely address this issue because it has broad implications, including drug­nutrient interactions, contraindications, and side effects. To thoroughly tackle these issues would require the combined resources of government, industry, and educational institutions. Despite these obstacles, USP has developed a process by which its Dietary Supplement Information Expert Committee evaluates the safety of ingredients so as to prevent those with known safety concerns from entering the verification program. Examples of dietary supplements that have been excluded from the verification program include ephedra, kava, comfrey, chaparral, and the Chinese herb aristolochia.

In the complex, technical world of dietary supplement manufacturing, finished product testing is not enough to ensure the overall quality of dietary supplements. The verification program's principal distinguishing element is the premise that good manufacturing practices (GMPs) are the most essential elements needed to produce a quality product. The program verifies that GMPs are being used by thoroughly examining the manufacturer's quality systems, conducting an on-site audit of compliance with USP's General Chapter <2750> Manufacturing Practices for Dietary Supplements, reviewing quality control and manufacturing product documentation, and performing extensive laboratory testing of products prior to verification.

Once the dietary supplement is granted use of the USP verification mark, USP periodically conducts random off-the-shelf tests on verified products to ensure that they continue to meet the strict program standards, and the organization performs periodic manufacturing site audits to ensure continued compliance with <GMPs>.

Impact of the Verification Program

The verification program has had a significant impact on the quality systems and manufacturing practices of participating companies. Examples include:
• Additional testing for undesirable contaminants.
• Reformulation of products that fail to dissolve.
• Reformulation to ensure the formulation provides 100% of label claim throughout the shelf life of the product.
• Characterization and quantification of botanical marker compounds.
• Implementation of stability study protocols to establish appropriate expiration dating.
• Labeling changes to ensure an accurate list and appropriate quantitative claims for ingredients.

Significance of the USP Verification Mark

The USP verification mark can be used only by manufacturers that are participating in the program, whose manufacturing and quality control facilities have been audited and checked, whose manufacturing documentation has been reviewed, and whose products have been tested by USP for conformance to USP­NF standards.

If a product submitted to USP for verification meets the standards of the program, it will be awarded the USP verification mark. FIGURE 2 shows the trademark symbol used to indicate that a product has been verified by USP. The USP mark helps assure consumers, health care professionals, and supplement retailers that the product:
• Has labeling that is accurate.
• Contains the ingredients stated on the label, in the designated amount or strength.
• Meets stringent standards for product purity and passes federal requirements for limits on contaminants, such as heavy metals, pesticides, and microbes.
• Has been manufactured properly and complies with USP and proposed FDA standards for good manufacturing practices, by using safe, sanitary, well-controlled procedures.

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Products bearing the USP Verified mark have been available since the beginning of 2003 and can be found in most major drug, food, and discount retailer stores and selected health food stores. It is estimated that by the end of 2004, 20% to 25% of the mass-marketed vitamin and mineral supplements displayed the USP Verified mark.

More information about the program, including participating companies and verified products, can be found at www.uspverified.org.

USP also has a continuing education program which can be presented to pharmacy state associations and other organizations whose members would benefit from learning more about the USP verification process as well as how USP standards can be used to select dietary supplements. More information about this program can be found at the Web site above.

References to cited research can be obtained by contacting the authors at jxs@usp.org.

To comment on this article, contact editor@uspharmacist.com.
 
Vol. No: 30:06 Posted: 6/15/2005

December 2006 


Consumer Reports (expert, independent, non profit) also published a story that may be of interest here as well:

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Here is the Consumer Reports article from 2004:

May 2004 
Dangerous supplements: Still at large


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If you can buy it at a clean, well-lighted store, if it's “all natural,” it's not going to do you serious harm, right? That's what many Americans assume about dietary supplements. But while most supplements are probably fairly benign, Consumer Reports has identified a dozen that according to government warnings, adverse-event reports, and top experts are too dangerous to be on the market. Yet they are. We easily purchased all 12 in February 2004 in a few days of shopping online and in retail stores.

These unsafe supplements include Aristolochia, an herb conclusively linked to kidney failure and cancer in China, Europe, Japan, and the U.S.; yohimbe, a sexual stimulant linked to heart and respiratory problems; bitter orange, whose ingredients have effects similar to those of the banned weight-loss stimulant ephedra; and chaparral, comfrey, germander, and kava, all known or likely causes of liver failure. (For a complete list of the “dirty dozen,” see
12 supplements to avoid.)

CR Quick Take:

A CR investigation found that many dangerous supplements can easily be purchased in stores and online. Many of these supplements have been banned in other countries. Why can't the U.S. Food and Drug Administration ban these products now?

We found that regulatory barriers created by Congress, supplement-industry pressure, and a lack of resources at the FDA have resulted in major risks for consumers.

• These widely available dietary supplements (see 12 supplements to avoid) may cause cancer, severe kidney or liver damage, heart problems, or even death. They should be avoided by consumers.

• These supplements are sold under a profusion of names, making it difficult for consumers to know what they're purchasing.

• Most also appear in combination products marketed for a broad array of uses, such as aphrodisiacs, athletic-performance boosters, and treatments for anxiety, arthritis, menstrual problems, ulcers, and weight loss.


U.S. consumers shelled out some $76 million in 2002 for just three of these supplements: androstenedione, kava, and yohimbe, the only ones for which sales figures were available, according to the Nutrition Business Journal, which tracks the supplement industry.

The potentially dangerous effects of most of these products have been known for more than a decade, and at least five of them are banned in Asia, Europe, or Canada. Yet until very recently, the U.S. Food and Drug Administration had not managed to remove a single dietary supplement from the market for safety reasons.

After seven years of trying, the agency announced a ban on the weight-loss aid ephedra in December 2003. And in March 2004 it warned 23 companies to stop marketing the body-building supplement androstenedione (andro).

Despite these actions against high-profile supplements, whose dangers were so well known that even industry trade groups had stopped defending them, the agency continues to be hamstrung by the 1994 Dietary Supplement Health and Education Act (DSHEA, pronounced de-shay). While drug manufacturers are required to prove that their products are safe before being marketed, DSHEA makes the FDA prove that supplements on the market are unsafe and denies the agency all but the sketchiest information about the safety record of most of them.

“The standards for demonstrating a supplement is hazardous are so high that it can take the FDA years to build a case,” said Bruce Silverglade, legal director of the Center for Science in the Public Interest, a Washington, D.C., consumer-advocacy group.

At the same time, the FDA’s supplement division is understaffed and underfunded, with about 60 people and a budget of only $10 million to police a $19.4 billion-a-year industry. To regulate drugs, annual sales of which are 12 times the amount of supplement sales, the FDA has almost 43 times as much money and almost 48 times as many people.

“The law has never been fully funded,” said William Hubbard, FDA associate commissioner for policy and planning. “There's never been the resources to do all the things the law would command us to do.”

The agency has learned that it must tread carefully when regulating supplements. The first time it tried to regulate the dangerous stimulant ephedra, in 1997, overwhelming opposition from Congress and industry forced it to back down.

As a result, the FDA is sometimes left practicing what Silverglade calls “regulation by press release”--issuing warnings about dangerous supplements and hoping that consumers and health practitioners
read them.

There are signs of hope. The FDA has said that if the ban on ephedra holds up against likely legal challenges, it plans to go after other harmful supplements. Legislation has been introduced to strengthen the FDA's authority under DSHEA and give the agency more money to enforce the act.

But the supplement marketplace still holds hidden hazards for consumers, especially among products that aren't in the headlines. “Consumers are provided with more information about the composition and nutritional value of a loaf of bread than about the ingredients and potential hazards of botanical medicines,” said Arthur Grollman, M.D., professor of pharmacological sciences at the State University of New York, Stony Brook, and a critic of DSHEA.

A question of safety

Supplement-industry advocates say the ephedra ban demonstrates that DSHEA gives the FDA enough power to protect consumers from unsafe products. “I don't think there's anything wrong except that FDA has only recently begun vigorous and active enforcement of the law,” said Annette Dickinson, Ph.D., president of the Council for Responsible Nutrition, a major trade association for the supplement industry.

But critics of DSHEA think the ban illustrates the extremes to which the FDA must go to outlaw a hazardous product.

When the agency initially tried to rein in ephedra use in 1997, after receiving hundreds of reports of adverse events, it sought not an outright ban but dosage restrictions and sterner warning labels. The industry mounted a furious counter-attack, including the creation of a public-relations group called the Ephedra Education Council and a scientific review from a private consulting firm, commissioned by Dickinson's trade group, that concluded ephedra was safe. After the U.S. General Accounting Office said the FDA “did not establish a causal link” between taking ephedra and deaths or injuries, the agency was forced to drop its proposal.

SUFFERED seizure
Gretchen Fitzgerald, age 21, Fort Collins, Colo.
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PROBLEM She took Xenadrine EFX “thermogenic” diet pills to boost her energy while studying for final exams, believing they were safe because they were labeled ephedra-free. After three weeks of taking the product she had a seizure. The neurologist consulted told her the bitter orange in the Xenadrine was the probable cause. Xenadrine’s manufacturer did not return our phone calls. Since going off the Xenadrine, Fitzgerald has had no further problems.
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The industry continued to vigorously market and defend ephedra. Metabolife International, a leading ephedra manufacturer, did not let the FDA know that it had received 14,684 complaints of adverse events associated with its ephedra product, Metabolife 356, in the previous five years, including 18 heart attacks, 26 strokes, 43 seizures, and 5 deaths. It took the pressure of congressional and Justice Department investigations to get the company to turn over the complaints in 2002. Then Steve Bechler, a pitcher for the Baltimore Orioles, died unexpectedly in 2003 while taking another ephedra supplement, Xenadrine RFA-1. With sales suffering from the bad publicity, manufacturers began to replace ephedra with other stimulants such as bitter orange, which mimics ephedra in chemical composition and function.

“All of a sudden Congress dropped objections to an ephedra ban andstarted demanding the FDA act,” said Silverglade.

To amass the necessary scientific evidence that it hoped would satisfy the demanding standard set by DSHEA, the FDA took aggressive action: It commissioned an outside review from the RAND Corporation, analyzed adverse-event reports, and pored over every available shred of scientific evidence.

“We’ve gone the whole nine yards to collect and evaluate all the possible evidence,” Mark McClellan, commissioner of the FDA, said in announcing the ban. “We will be doing our best to defend this in court, and if that’s not sufficient, it may be time to re-examine the act.”

Drugs vs. supplements


In an October 2002 nationwide Harris Poll of 1,010 adults, 59 percent of respondents said they believed that supplements must be approved by a government agency before they can be sold to the public. Sixty-eight percent said the government requires warning labels on supplements’ potential side effects or dangers. Fifty-five percent said supplement manufacturers can’t make safety claims without solid scientific support.

They were wrong. None of those protections exist for supplements--only for prescription and over-the-counter medicines. Here are the major differences in the safety regulations:

Testing for hazards. Before approval, drugs must be proved effective, with an acceptable safety profile, by means of lab research and rigorous human clinical trials involving a minimum of several thousand people, many millions of dollars, and several years.

In contrast, supplement manufacturers can introduce new products without any testing for safety and efficacy. The maker’s only obligation is to send the FDA a copy of the language on the label (see
Supplement labels).

“Products regulated by DSHEA were presumed to be safe because of their long history of use, often in other countries,” said Jane E. Henney, M.D., commissioner of the FDA from 1998 to 2001. “As their use dramatically increased in this country after the passage of DSHEA, the presumption of safety may have been misplaced, particularly for products other than traditional vitamins and minerals. Some, like ephedra, act like drugs and thus have similar risks.”

The only exceptions to this “presumption of safety” are supplement ingredients that weren’t being sold in the U.S. when DSHEA took effect. Makers of such “new dietary ingredients” must show the FDA evidence of the products’ safety before marketing them. The FDA invoked that rarely used provision in its action against androstenedione. After years of allowing andro to be marketed without restriction, the agency declared that it was “not aware” that the supplement was used before DSHEA, so it couldn’t be sold without evidence of safety.

Disclosing the risks. Drug labels and package inserts must mention all possible adverse effects and interactions. But supplement makers don’t have to put safety warnings on the labels, even for products with known serious hazards.

We bought a product called Relaxit whose label had no warning about the kava it contained, even though the American Herbal Products Association, an industry trade group, recommends a detailed, though voluntary warning label about potential liver toxicity on all kava products.

Ensuring product quality. Drugs must conform to “good manufacturing practices” that guarantee that their contents are pure and in the quantities stated on the label. While DSHEA gave the FDA authority to impose similar standards on supplements, it took until 2003 for the agency to propose regulations--as yet not final--to implement that part of the law.

Contaminants, too, regularly turn up in supplements. In 1998 Richard Ko, Ph.D., of the California Department of Health Services reported that 32 percent of the Asian patent medicines he tested contained pharmaceuticals or heavy metals that weren’t on the label. In 2002, the FDA oversaw a voluntary manufacturer recall of a "prostate health" supplement called PC SPES that, according to tests by the California department, contained a powerful prescription blood thinner, warfarin.

Reporting the problems. By law, drug companies are required to tell the FDA about any reports of product-related adverse events that they receive from any source. Almost every year, drugs are removed from the market based on safety risks that first surfaced in those reports.

In contrast, supplement makers don’t have to report adverse events. Indeed, in the five years after DSHEA took effect, 1994 to 1999, fewer than 10 of the more than 2,500 reports that the FDA received came from manufacturers, according to a 2001 estimate from the inspector general of the U.S. Department of Health and Human Services. (Other sources of reports included consumers, health practitioners, and poison-control centers.) Overall, the FDA estimates that it learns of less than 1 percent of adverse events involving dietary supplements.

THE ‘NATURAL’ MYSTIQUE

Many makers market their supplements as “natural,” exploiting assumptions that such products can’t harm you. That’s a dangerous assumption, said Lois Swirsky Gold, Ph.D., director of the Carcinogenic Potency Project at the University of California, Berkeley, and an expert on chemical carcinogens. “Natural is hemlock, natural is arsenic, natural is poisonous mushrooms,” she said.

A cautionary example is aristolochic acid, which occurs naturally in species of Aristolochia vines that grow wild in many parts of the world. In addition to being a powerful kidney toxin, it is on the World Health Organization’s list of human carcinogens. “It’s one of the most potent chemicals of 1,400 in my Carcinogenic Potency Database,” Gold said. “People have taken high doses similar to the doses that animals are given in tests, and they both get tumors very quickly.”

KIDNEYS FAILED
Beverly Hames, age 59, Beaverton, Ore.
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PROBLEM Hames went to an acupuncturist in 1992 seeking a “safe, natural” treatment for an aching back. She got a selection of Chinese herbal products, at least five of which were later found to contain aristolochic acid. By mid-1994, she had symptoms of kidney failure, and in 1996 she underwent a kidney transplant. She must take anti-rejection drugs (below) for life. The herbs’ distributor said his Chinese suppliers had substituted Aristolochia for another herb without his knowledge.
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The dangers of aristolochic acid have been known since at least 1993, when medical-journal articles began appearing about 105 patrons of a Belgian weight-loss clinic who had suffered kidney failure after consuming Chinese herbs adulterated with Aristolochia. At least 18 of the women also subsequently developed cancer near
the kidney.

These findings prompted the FDA to issue a nationwide warning against Aristolochia in 2001 and to impose a ban on further imports of the herb. But in early 2004, more than two years after the import ban went into effect, Consumer Reports was able to purchase products online that were labeled as containing Aristolochia.
In 2003, Gold identified more than 100 products for sale online with botanical ingredients listed by the FDA as known or suspected to contain aristolochic acid.

Donna Andrade-Wheaton, a former aerobics instructor in Rhode Island, learned those facts too late to save her kidneys. After taking Chinese herbs containing Aristolochia for more than two years, she suffered severe kidney damage; her kidney tissues were found to contain aristolochic acid. In late 2002, at age 39, she underwent a kidney transplant.

Andrade-Wheaton is suing both the acupuncturist who gave her the herbs and several companies that manufactured them. The acupuncturist declined to discuss the case on the record, and the manufacturer did not return our phone calls.

There’s another widespread and false assumption about natural supplements: that they’re always pure, unprocessed products of the earth. Because DSHEA permits the marketing of concentrates and extracts, supplement makers can and do manipulate ingredients to increase the concentrations of pharmacologically active compounds.

That’s especially true of the many weight-loss supplements designed for “thermogenic” stimulant effects--boosting calorie expenditure by revving the metabolic rate.

On one Internet shopping tour, for instance, we bought a product called Thermorexin--”the Hottest new Thermogenic on the market!” Its label says it contains, among its 22 ingredients, 30 milligrams of theophylline derived from a black tea extract and the stimulant bitter orange. Sold as Theo-Dur and other brands, theophylline is a prescription drug and an effective asthma treatment, but most doctors seldom prescribe it because it can cause seizures and irregular heartbeats at relatively low doses.

Larry Berube, president of Anafit, Thermorexin’s manufacturer, based in Orlando, Fla., described how the product’s combination of ingredients was developed: “Once we find out that the FDA says it’s OK, we put them together in the lab, run our tests, and do our trials, and if it comes up good, we capsulate it, put it online and in the stores and sell it,” he said.

Those tests involved asking fitness professionals to use the supplement, and measuring their heart rate and blood pressure, Berube said. The company doesn’t use a control group, he said. Then “we go to the fitness discussion boards and let trainers and people know we have a new product and do they want to try it,” he said. “And then they try it, and they report back.” Berube said he has not heard of any bad reactions to Thermorexin.

KIDNEYS FAILED
Donna Andrade-Wheaton, age 40, Cranston, R.I.
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PROBLEM Andrade-Wheaton’s acupuncturist prescribed more than a half dozen Chinese herbal supplements to treat health conditions, including endometriosis. At least one of the products listed Aristolochia as an ingredient, even after the FDA issued a nationwide Aristolochia safety warning in 2001. She underwent a kidney transplant in September 2002 and must take anti-rejection drugs (below) for life.
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Copyright © 2000-2006 Consumers Union of U.S., Inc. No reproduction, in whole or in part, without written permission.


So I guess the prerequisites for safely taking supplements are:

1) Start by asking your Doctor for advice
2) Choosing supplements with the USP mark

-- All else is gambling with your health.

Take care, and be safe.

#22 dannov

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Posted 21 August 2007 - 01:49 PM

15.3 MICROgrams a day people. Come on...that's nothing.

#23 Anthony_Loera

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Posted 21 August 2007 - 02:26 PM

Consumerlab's business model really bothers me. They're basically saying, "Tens of thousands of people are taking something that's giving them lead poisoning. We'll tell you if you're one of them, but only if you pay us."

It's also ridiculous that the news-service reports don't give the brand names because they're afraid of infringing on a copyright. This is important news, isn't it?

What if it had been Consumerlab that discovered the pet-food contamination problem a few weeks ago? They would say, "If you want to know if your dog's eating poison, subscribe to our service."

Agreed.



It's a business,

Make no mistake, it is not "Consumer Reports" which is a very popular and helpful product review site/publication that has been around for a while, is non-profit, and independent.

ConsumerLabs is a test lab that tests and produces reports, but it is for-profit. I believe their testing is quite good, but I am not sure how else they would make a profit without doing the 'headlines' and scary reports. It's a marketing tactic in my view, although if they do have info that may detrimentally effect hundreds of thousands of folks, I think it is their duty to the American people to make these issues known as part of their 'Press Release' and not shield them behind a subscription or pay structure. I am not sure if many other 'consumer' advocates would use this kind of marketing to gain subscribers. I think the press release of such detrimental findings would give them the national attention in news outlets they are looking for to acquire new subscribers, but that is just simply my opinion of course.

I have inquired about there pricing for tests (when we were looking for labs) and found them to be very expensive compared to the cost of a normal lab. This deterred us from using them at the time.

#24 doug123

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Posted 22 August 2007 - 06:17 AM

It seems the problems aren't only with impurities, but also with inaccuracies in dosing. I think it would be silly to assume this only happens occasionally, and not only with supplements, it's also with medicines; you may find the following compelling:

o Seattle Times: China corners vitamin market

o NEJM: Safer Drugs for the American People

o Canada.com: Counterfeit pills killed B.C. woman: coroner

o New York Times: F.D.A. Tracked Tainted Drugs..., ...but Trail Went Cold in China

o Reuters: Panama's death toll from Chinese toxins rises to 83

o MyFox: FDA Issues Online Counterfeit Drug Warning

o WHO seeks smart technology to stop fake medicines

o A growing epidemic of fake medications in Asia

And finally, here's a really solid example of overdosing of vitamin D in NEJM. If you're unfamiliar with the New England Journal of Medicine, it's the most cited journal in all of medicine (yes, this data is from Wikipedia, but it's accurate):

The New England Journal of Medicine (New Engl J Med or NEJM) is a peer-reviewed medical journal published by the Massachusetts Medical Society. It is one of the most popular and widely-read peer-reviewed general medical journals in the world. It is also the oldest continuously published medical journal in the world.

It was founded by Dr. John Collins Warren in 1812 as a quarterly called The New England Journal of Medicine and Surgery. In 1828, it became a weekly, and was renamed The Boston Medical and Surgical Journal; one hundred years later, it took on its present name.

It publishes editorials, papers on original research, widely-cited review articles, correspondences, case reports, and has a special section called "Images in Clinical Medicine".

Authors have included Oliver Wendell Holmes, Sr., Hans Zinsser, and Lewis Thomas. One of its early editors, Jerome V. C. Smith, resigned in 1857 to assume his duties as mayor of the City of Boston.

The website for the George Polk Awards noted that its 1977 award to the New England Journal of Medicine "provided the first significant mainstream visibility for a publication that would achieve enormous attention and prestige in the ensuing decades"[1]

The journal usually has the highest impact factor of the journals of clinical medicine (including the Journal of the American Medical Association, and The Lancet); in 2006, the impact factor was 51, according to Journal Citation Reports, the first research journal to break 50.

Open access policy


NEJM provides delayed free online access to its research articles (it does so six months after publication, and maintains that access dating back to 1993). This delay does not apply to readers from the least developed countries, for whom the content is available at no charge for personal use.

NEJM also has two podcast features, one with interviews of doctors and researchers that are publishing in the journal, and another summarizing the content of each issue. Other offerings include Continuing Medical Education, Videos in Clinical Medicine (showing videos of medical procedures), and the weekly Image Challenge.


I found this to be rather startling:

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Volume 357:308-309  July 19, 2007  Number 3

Dietary Supplement–Induced Vitamin D Intoxication


To the Editor: Vitamin D intoxication that is associated with the consumption of dietary supplements is reported rarely.1 In 2004, the Food and Drug Administration (FDA) learned of the following case.

A 58-year-old woman with diabetes mellitus and rheumatoid arthritis began taking a dietary supplement called Solutions IE Ageless Formula II on January 12, 2004. Fatigue, constipation, back pain, forgetfulness, nausea, and vomiting soon developed. On March 15, 2004, she was hospitalized because her speech was slurred, and a blood glucose reading taken at home was 30 mg per deciliter. On admission, her serum levels were as follows: calcium, more than 3.75 mmol per liter; 25-hydroxyvitamin D, 1171 nmol per liter (normal range, 22 to 135); 1,25-dihydroxyvitamin D, 305 pmol per liter (normal range, 36 to 144); parathyroid hormone, 12 ng per liter (normal range, 10 to 65); calcitonin, 4.5 ng per liter (normal range, 0 to 4.6); albumin, 31 g per liter; phosphorus, 0.81 mmol per liter; blood urea nitrogen, 18.6 mmol per liter; and creatinine, 265 µmol per liter.

The patient was treated with intravenous normal saline, furosemide, and pamidronate disodium. On March 19, 2004, while still hospitalized, she was informed by the product distributor of an error in product formulation such that 188,640 IU of vitamin D3 had been added to the daily serving size of six capsules instead of the intended 400 IU. At discharge on March 24, the patient's serum levels were as follows: calcium, 2.60 mmol per liter; blood urea nitrogen, 10.0 mmol per liter; and creatinine, 221 µmol per liter. The patient died from a cause unknown to us on January 8, 2005.

Laboratory analysis of the product by the FDA, obtained from one of two lots reportedly overfortified with vitamin D3, revealed 186,906 IU of vitamin D3 in each serving size of six capsules, indicating that the patient had consumed roughly 90 times the recommended safe upper limit of 2000 IU per day. Long-term daily vitamin D consumption of more than 40,000 IU (1000 µg) is needed to cause hypercalcemia in healthy persons.2 In March 2004, the product distributor announced that during the previous month it had received three complaints from customers who had been hospitalized for hypercalcemia and vitamin D toxicity. The same month, the product manufacturer recalled 1600 bottles of the product. The case described here underscores the need for the manufacturers of dietary supplements to rigorously monitor levels of ingredients in products and for physicians to be aware of supplements their patients may be taking.


Karl C. Klontz, M.D.
David W. Acheson, M.D.
Food and Drug Administration
College Park, MD 20740

References

Koutkia P, Chen TC, Holick MF. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med 2001;345:66-67. http://content.nejm....esid=345/1/66-a
Veith R. Do we really need 100 µg vitamin D/d, and is it safe for all of us? Am J Clin Nutr 2001;74:862-864 http://content.nejm....&resid=74/6/862


I am now working with a body of well respected licensed doctors. I think I will propose to them soon the possibility that we may conduct our own independent testing and provide the results to the public. Thus far, we haven't allowed any advertising from supplement firms; and we may not ever; and if we do our own testing, that might make that virtually impossible due to conflict of interest.

I also plan to propose a discounted health plan for individuals without insurance. I'll keep you all up to date.

Take care.

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#25 doug123

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Posted 07 November 2007 - 12:01 AM

Everyone's favorite topic I am sure.

In November's Journal of the American Academy of Pediatrics -- but first, some introductory background information regarding the American Academy of Pediatrics, provided by Wikipedia November 6, 2007:

The American Academy of Pediatrics ("AAP") is an organization of pediatricians, physicians trained to deal with the medical care of infants, children, and adolescents. Its motto is: "Dedicated to the Health of All Children." Most American and Canadian pediatricians are members of this physician-focused organization.

History
In 1930, 60 physicians who specialized in child health founded the American Academy of Pediatrics (AAP). The name of the non-profit organization reflected the physician's commitment to children and the specialty of pediatrics. It also formally acknowledged the difference between adult and child health care. In 1948, the first issue of their journal Pediatrics was published.

In the last 75 years, the AAP has grown to a membership of 60,000 board-certified primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists. Through advocacy efforts, physician education, research, and the continual creation of pediatric care and practice policies, AAP members and staff work tirelessly to affect broad social and medical changes benefiting all children and the future of pediatrics.

A Board of Directors, consisting of district chairs elected by AAP members in 10 geographic districts, oversees the governance of the AAP. AAP chapters are organized groups of pediatricians and other health care professionals working to achieve AAP goals in their communities. There are 59 chapters in the US and 7 chapters in Canada.

The AAP is located in Elk Grove Village, Illinois.

Mission statement
"The mission of the American Academy of Pediatrics is to attain optimal physical, mental and social health and well-being for all infants, children, adolescents and young adults."
Fellows
A Fellow of the American Academy of Pediatrics (FAAP) must be certified in pediatrics by the American Board of Pediatrics, American Osteopathic Board of Pediatrics, the Royal College of Physicians and Surgeons of Canada, or La Corporation Professionelle de Medicins du Quebec. A Specialty Fellow must be certified in a specialty of pediatrics. A Corresponding Fellow is a fellow who resides and practices in a country other than the United States of America, its territories, or Canada, and must have been certified by the appropriate boards.

Controversy
The AAP has recently faced criticism over its campaign for stricter gun controls and its support for gay adoption.

Campaign for Children's Health Care
AAP is a partner in the Campaign for Children's Health Care, a multi-year campaign to raise awareness about the problem of uninsured children in America.


Here is the study abstract:

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Published online November 1, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. e1285-e1298 (doi:10.1542/peds.2005-1770)

SPECIAL ARTICLE

Interpreting and Managing Blood Lead Levels of Less Than 10 µg/dL in Children and Reducing Childhood Exposure to Lead: Recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention

Helen J. Binns, MDa, Carla Campbell, MDb, Mary Jean Brown, ScD, RNc for the Advisory Committee on Childhood Lead Poisoning Prevention


a Feinberg School of Medicine, Northwestern University, Chicago, Illinois
b Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
c Division of Environmental and Emergency Health Services, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Center for Disease Control and Prevention, Atlanta, Georgia

Lead is a common environmental contaminant. Lead exposure is a preventable risk that exists in all areas of the United States. In children, lead is associated with impaired cognitive, motor, behavioral, and physical abilities. In 1991, the Centers for Disease Control and Prevention defined the blood lead level that should prompt public health actions as 10 µg/dL. Concurrently, the Centers for Disease Control and Prevention also recognized that a blood lead level of 10 µg/dL did not define a threshold for the harmful effects of lead. Research conducted since 1991 has strengthened the evidence that children's physical and mental development can be affected at blood lead levels of <10 µg/dL. In this report we provide information to help clinicians understand blood lead levels < 10 µg/dL, identify gaps in knowledge concerning lead levels in this range, and outline strategies to reduce childhood exposures to lead.
We also summarize scientific data relevant to counseling, blood lead screening, and lead-exposure risk assessment. To aid in the interpretation of blood lead levels, clinicians should understand the laboratory error range for blood lead values and, if possible, select a laboratory that achieves routine performance within ±2 µg/dL. Clinicians should obtain an environmental history on all children they examine, provide families with lead-prevention counseling, and follow blood lead screening recommendations established for their areas. As circumstances permit, clinicians should consider referral to developmental programs for children at high risk for exposure to lead and more frequent rescreening of children with blood lead levels approaching 10 µg/dL. In addition, clinicians should direct parents to agencies and sources of information that will help them establish a lead-safe environment for their children. For these preventive strategies to succeed, partnerships between health care providers, families, and local public health and housing programs should be strengthened.


So it seems lead in any amount can affect intelligence. Lead is bad.

Take care.




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