Globally, people are struggling with obesity, leading many to seek effective weight reduction methods, including herbal and natural dietary supplements. Fat burners are often touted as a way to raise metabolism, burn more calories, and hasten fat loss. However, it's crucial to approach these supplements with caution. While many perceive herbal remedies as free of adverse effects, some are associated with severe health risks.
The Allure and Risks of Weight Loss Supplements
In recent years, there has been an alarming increase in obesity worldwide. Growing numbers of obese individuals are struggling to find the best way to lose weight. This has created an enormous industry for weight loss and related health products. Because they are not subject to regulatory testing by the United States Food and Drug Administration (FDA), herbal remedies continue to be a popular choice due to their perceived safety and easy availability. Among the more popular remedies are the ‘fat burners’. These supplements are advertised to work by increasing thermogenesis and the basal metabolic rate, thus, mimicking exercise.
A Case of Herbal Hepatotoxicity
Despite patient perceptions that herbal remedies are free of adverse effects, some supplements are associated with severe hepatotoxicity. The present report describes a young healthy woman who presented with fulminant hepatic failure requiring emergent liver transplantation caused by a dietary supplement and fat burner containing usnic acid, green tea and guggul tree extracts. Thorough investigation, including histopathological examination, revealed no other cause of hepatotoxicity. The present case adds to the increasing number of reports of hepatotoxicity associated with dietary supplements containing usnic acid, and highlights that herbal extracts from green tea or guggul tree may not be free of adverse effects.
A previously healthy 28-year-old female bodybuilder with no risk factors for liver disease presented to her local emergency centre with fatigue, malaise, inability to exercise and new-onset jaundice. The patient was a professional bodybuilder taking a multi-ingredient, nonstimulant health supplement and fat burner (Somalyz and Lipolyz, Species Nutrition, USA). Somalyz contains usnic acid (4 mg), propionyl-L-carnitine (167 mg), phosphatidylcholine/phosphatidylethanolamine (50 mg), gamma-aminobutyric acid (667 mg) and vitamin E (27 IU) per capsule. Lipolyz contains usnic acid (12 mg), propionyl-L-carnitine (500 mg), green tea extract (300 mg), guggulsterone Z and guggulster-one E (10 mg), cyclic adenosine monophosphate (2 mg) and vitamin E (20 IU) per capsule (Table 1). She was taking one to two capsules of Somalyz at bedtime and one capsule of Lipolyz with meals three times a day as recommended for one month before illness. On evaluation at The Mount Sinai Medical Center, there were no stigmata of chronic liver disease. Blood work revealed a total serum bilirubin level of 82.08 mmol/L (normal range 1.71 mmol/L to 20.5 mmol/L), a direct bilirubin level of 47.88 mmol/L (1.71 mmol/L to 13.6 mmol/L), a serum alanine aminotransferase level of 1220 U/L (1 U/L to 53 U/L), a serum aspartate aminotransferase level of 577 U/L (1 U/L to 50 U/L), an alkaline phosphatase level of 111U/L (30 U/L to 110 U/L), a gamma-glutamyl transferase level of 125 U/L (8 U/L to 35 U/L), an international normalized ratio of 2.6 and a serum creatinine level of 53.04 μmol/L (44.2 μmol/L to 106.2 μmol/L). Etiological workup included the following: negative viral serology (hepatitis A virus immunoglobulin M, hepatitis B virus surface antigen and core antibody, hepatitis C virus antibody [polymerase chain reaction assay], cytomegalovirus DNA and Epstein-Barr virus immunoglobulin M); negative syphilis rapid plasma regain; negative autoimmune markers (antinuclear antibody, antiliver kidney muscle antibody, antimitochondrial antibody and antismooth muscle antibody); and normal serum gamma globulins. Extensive toxicology screening was negative, with no features of acetaminophen toxicity (acidosis, high lactate or renal failure). She had normal levels of ferritin, ceruloplasmin and alpha-1 antitrypsin. A pregnancy test was negative. A computed tomography scan of her abdomen revealed a normal size liver with a patent portal vein, hepatic artery, hepatic vein and normal biliary anatomy. The patient’s encephalopathy worsened and she remained unresponsive. A computed tomography scan of her head was normal. An intracranial pressure monitor was placed, which measured an intracranial pressure of 19 mmHg and a cerebral perfusion pressure of 77 mmHg to 82 mmHg. She underwent successful cadaveric orthotopic liver transplantation on hospital day 2. By postoperative day 4, she was awake and alert. Histology of the native explanted liver. A Low-power magnification showing confluent necrosis resulting in parenchymal collapse (hematoxylin and eosin stain, original magnification ×40). B Reticulin stain confirming the extensive parenchymal collapse (original magnification ×40). C High-power magnification showing the formation of ductular hepatocytes in periportal areas (arrow) (hematoxylin and eosin stain, original magnification ×100).
The Danger of Usnic Acid
Usnic acid is a component of nutritional supplements that are promoted for weight loss and have been associated with liver-related adverse events including mild hepatic toxicity, chemical hepatitis and liver failure requiring liver transplantation. Usnic acid is derived from a lichen species of the genus Usnea. It has been investigated for diverse uses as an antimicrobial, an anti-inflammatory, an antioxidant, an analgesic/antipyretic, an antiproliferative and as a natural supplement for weight loss. Several previous reports described liver failure associated with the use of LipoKinetix, a multi-ingredient preparation containing usnic acid (6-8). In 2002, Favreau et al (6) reported on seven patients who developed acute hepatitis after using LipoKinetix. This dietary supplement contains sodium usniate, norephedrine, yohimbine, 3-5-diiodothyronine and caffeine; both usnic acid and ephedra alkaloids have been associated with severe hepatotoxicity. Sanchez et al (8) reported severe hepatotoxicity in a husband and wife (both 38 years of age) who were bodybuilders taking the multi-ingredient health supplement UCP-1 (BDC Nutrition, USA) for three months. UCP-1 contains usnic acid (150 mg), L-carnitine (525 mg) and calcium pyruvate (1050 mg) per capsule. The wife developed fulminant hepatic failure requiring liver transplantation. The husband experienced submassive necrosis but did not require liver transplantation. Another herbal remedy containing usnic acid - well known to be hepatotoxic - is kombucha tea. Usnic acid has been shown to uncouple oxidative phosphorylation in a murine model, with resultant loss of mitochondrial respiratory control and inhibition of ATP synthesis. A direct hepatotoxic effect analogous to carbon tetrachloride-induced liver toxicity has also been described (10). Usnic acid is a weak inhibitor of cytochrome CYP2D6 and a potent inhibitor of cytochrome CYP2C19. Based on potent inhibition of CYP2C enzymes, usnic acid has significant potential to interact with other medications (5).
Read also: Why Choose the Intex Pure Spa Cover?
Green Tea and Guggul Tree Extracts: Not Always Benign
Chinese green tea extracts are derivatives of the leaves of Camellia sinensis, which belongs to the aceae family. Green tea extracts have been marketed as effective weight-loss supplements, and for the prevention and cure of solid tumours. Although there is little scientific evidence supporting the effectiveness of green tea extracts, serious side effects, including acute liver failure, are increasingly being reported (13,14). Similar cases have been reported from France and Spain resulting in the removal of the green tea extract ‘Exolise’ from the market (15). Two cases of fulminant hepatic failure associated with green tea extracts have been reported (16,17). Mitochondrial toxicity and the formation of reactive oxygen species have been demonstrated with epigallocatechin-3-gallate, a key constituent of green tea extracts.
Gum guggul and its constituents are increasingly being used as dietary supplements. Gum guggul is the oleoresin of Commiphora mukul, a plant native to India. Its extracts include compounds known for their hypolipidemic properties - the Z and E isomers of guggulsterone and its regulated guggulsterols. Human exposure to gum guggul most often occurs from ingesting herbal remedies or pharmaceuticals, and from the use of cosmetics. Side effects include skin rashes, irregular menstruation, diarrhea, headache, mild nausea and, with very high doses, liver toxicity.
The Importance of Regulation and Awareness
Based on the temporal relationship between the use of the dietary supplements and onset of liver failure, literature supporting reports of hepatotoxicity associated with dietary supplements and exclusion of other causes, it is fair to assume that the patient developed fulminant hepatic failure due to dietary supplements. In view of the bulk of the literature, of all the ingredients, usnic acid may have been predominantly responsible for the hepatoxicity. According to the Dietary Supplement Health and Education Act of 1994, dietary supplements are regulated as foods and are not subject to regulation as drugs by the FDA; manufacturers are not compelled to provide safety data to the FDA. However, increasing reports of liver failure due to usnic acid have triggered a regulatory warning and one voluntary product withdrawal (LipoKinetix) (20). Usnic acid is still available and advertised on the Internet as an ingredient in various other dietary supplements and fat burners.
Analyzing the Thrive Patch: Ingredients, Claims, and Evidence
The Thrive Patch is a weight loss patch that you apply to your skin. It’s sold as part of an 8-week lifestyle program created by the company Le-Vel. The program claims to aid weight loss, support healthy digestion, promote healthy aging, and improve brain and immune function. The Thrive Patch is a weight loss aid that you apply to your skin like a plaster. It’s sold as part of a lifestyle plan that claims to help you “feed your body more than 100 premium grade vitamins, minerals, plant extracts, digestive enzymes, probiotics, antioxidants, protein, fiber and more” (1). The plan consists of three steps that people are advised to carry out daily. It costs over $300 for a 60-day supply. The product line is advertised as containing vitamins, minerals, plant extracts, antioxidants, enzymes, probiotics and amino acids. These are taken in various forms. Participants take supplement capsules in the morning, a shake at lunch and change their Thrive Patch in the afternoon. The patch stays on for 24 hours and is said to work by delivering its unique formula directly through your skin.
Key Ingredients in the Thrive Patch
The Thrive Patch contains a number of active ingredients, including:
Read also: Ultimate Spa Water Hygiene
- ForsLean - the commercial name for the herb Coleus forskohlii
- Green coffee bean extract
- Garcinia cambogia
- Coenzyme Q10 (CoQ10)
- Cosmoperine - the commercial name for tetrahydropiperine, a compound extracted from black pepper
There are also other patches available - namely the Thrive Ultra Patch and Black Label Patch. These patches include additional ingredients such as:
- Satiereal saffron extract
- Green tea extract
- 5-HTP
- L-theanine
- L-arginine
- Quercetin
- Guarana
- Yerba mate
- Vitamin B12
Customers can choose to upgrade their regular Thrive Patch to either of these options for an extra cost.
Lack of Scientific Evidence for the Thrive Patch
No studies have assessed the effectiveness of the Thrive Patch for weight loss. Three of the patch’s ingredients have been studied in this regard. However, the research is on the oral consumption of these ingredients, and there is currently no evidence of their effectiveness when used topically, as with a patch. The absorption and concentration in topical products are different than oral products, so this research doesn’t transfer over and the effectiveness of a topical format is unknown.
Examining the Evidence Behind Key Ingredients
- ForsLean (Coleus forskohlii): A 2015 study found the herb to be effective in reducing metabolic risk factors and promoting weight loss when combined with a low calorie diet in overweight and obese participants. However, researchers attributed the weight loss to the diet rather than the herb, unable to prove the herb had any additional effect (2).A 2020 review suggested that the use of natural supplements such as Coleus forskohlii may not be entirely safe and is unlikely to lead to significant weight loss (3).
- Green coffee bean extract: Green coffee beans are unroasted. They’re a source of chlorogenic acid, a substance that aids weight loss by blocking the absorption of carbohydrates. A review of randomized controlled trials found that green coffee bean extract was effective in reducing body weight in participants with an overweight BMI, though these results were seen only after more than 4 weeks of supplementation (4).Another review noted that coffee bean extract improved levels of fasting blood glucose, insulin, and total cholesterol (5).One small study in 60 overweight participants also found that green coffee bean extract led to significant reductions in body weight and body fat and increases in lean body mass when compared to a placebo (6).
- Garcinia cambogia: Garcinia cambogia is a popular weight loss supplement. It’s said to aid weight loss by increasing fat burning and reducing appetite. Results of weight loss studies have been mixed, with the positive studies showing only marginal effects (7). What’s more, while many studies have found Garcinia cambogia to be safe, others have reported cases of toxic liver disease and other health issues (7).
Unproven Delivery Technology and Claims
Effectiveness of the patch’s technology. Overall, there is not currently enough research to support the claim that any of the patch’s active ingredients are effective for weight loss. Additionally, it’s unclear how much of each active ingredient the patch contains and whether they’re present in sufficient amounts to have any effect. Dermal fusion technology - the technology used to deliver the ingredients - has also not been studied, and it’s impossible to know how effective it is at delivering the active ingredients from the patch through your skin. This means that in addition to a lack of evidence for the effectiveness of the ingredients within the patch, it’s currently unclear whether the patches are even able to increase your blood levels of these active ingredients.
In addition to promising weight loss, the Thrive Patch claims to increase energy levels and improve brain function, appetite management, and digestive health. As with the weight loss claims, the lack of studies examining these supposed benefits means it’s impossible to assess whether they are accurate. Some of the ingredients in the Thrive products, including the Thrive Patch, have been linked to some possible benefits. For example, the lifestyle capsules contain caffeine, which can offer some health benefits, such has reducing risk factors for cardiovascular disease and other chronic conditions (8). The capsules include the probiotic Lactobacillus acidophilus, which may help improve gut health in people with irritable bowel syndrome. However, this probiotic’s benefits for the general population are unclear, and in some cases it may do more harm than good (9, 10). The Thrive Patch also contains CoQ10, which has been linked to reduced muscle fatigue and a subsequent improvement in exercise performance, though more research is still needed (11). Ultimately, while some of these ingredients may offer some benefits, it’s unclear how much of each ingredient the Thrive Patch contains, whether they’re present in amounts large enough to have any effect, and how well they are absorbed through the skin. Additionally, given the lack of research and the vague nature of some of the claims, it’s probably wise to be skeptical about the effectiveness of the products.
Read also: Is Pure Slim Keto Worth It? A User Perspective
Precautions and Potential Side Effects
Thrive patches are not recommended for anyone under age 18 or anyone who is pregnant or nursing (12). These reports are hard to verify but may be attributable to the products taken by consumers using the plan. This means we don’t know whether this patch is health-promoting or damaging. What’s more, anecdotal evidence suggests that these patches can cause some unpleasant side effects, such as rashes, nausea, and heart palpitations. While there is no concrete evidence that the product causes adverse health effects, there is also no concrete evidence to suggest it’s healthy.
Thrive Patch: Hype or Help?
The manufacturers of the Thrive Patch claim that it can aid weight loss and improve energy, brain function, appetite management, and digestive health. Though some ingredients may provide such benefits, the available research is insufficient, and it’s unclear whether the patch’s dermal fusion technology can deliver these ingredients through your skin. It’s also worth remembering that while the product has received numerous positive reviews, many people who use it also sell it. This makes it very difficult to differentiate between genuine recommendations and sales pitches. The patch may help some people kick-start their healthy lifestyle - or it may be an expensive gimmick. Without evidence from independent studies, it’s impossible to tell.
Keto Gummies and "Nature's Ozempic": Exploring Other Weight Loss Trends
Keto Gummies: A Ketogenic Shortcut?
The ketogenic diet, also known as the keto diet, is a low-carbohydrate, high-fat diet intended to shift the body into a metabolic state called ketosis. Keto gummies are supplements marketed to help support a ketogenic diet and help with weight loss, energy and metabolism, among other things. But what’s actually in them-and do they work? Dietary supplements are not approved for safety or efficacy by the Food and Drug Administration (FDA), and ingredients and their amounts may vary.
In general, the body uses carbohydrates for fuel, but when there aren’t sufficient amounts of carbohydrates, the body enters what’s known as “nutritional ketosis” and starts to break down fat for energy instead. “It typically takes a few days of strict carbohydrate restriction to enter this state,” explains Katie Schwartz, a registered dietitian based in Asheville, North Carolina. But once the body enters a state of ketosis, it begins producing ketones, which are then used for fuel.
Keto gummies are supplements that resemble ordinary chewable vitamins but offer a different purported health benefit. “They’re marketed as a way to help boost ketone levels in the blood,” says Schwartz. Medium-chain triglyceride (MCT) oil may provide a quick source of energy, explains Rancourt. Exogenous ketones are produced outside of the body and consumed orally (as opposed to endogenous ketones that are produced inside the body). Exogenous ketones include ketone salts and ketone esters, which have different chemical structures and potencies, with esters considered more potent.
Research is sparse when it comes to determining whether keto gummies and supplements support losing weight. “There’s no credible evidence that keto gummies can reliably initiate or maintain ketosis,” says Schwartz. Noom's 5-minute quiz unlocks a weight loss program customized for you so you can manage your health and form habits that last. “These products are not evidence-based and often rely on misleading marketing,” says Schwartz. It’s important to note that being in ketosis, however, is generally considered safe. People with underlying health conditions like kidney disease or diabetes, people who are pregnant or nursing, children, or anyone on medications affecting blood sugar shouldn’t use keto gummies, notes Rancourt.
"Nature's Ozempic": A Cheaper Alternative with Uncertain Efficacy
Weight loss with Ozempic or Wegovy can be effective, but expensive. Enter so-called GLP-1 supplements that have taken on the nickname “nature’s Ozempic.” They’re much cheaper than the injectable prescription drugs, and include berberine, gummies and drink mixes infused with oatmeal and tea. One of the latest products on the market - Lemme GLP-1 Daily, from Kourtney Kardashian Barker's wellness brand - is advertised as helping to reduce hunger, decrease weight and increase levels of GLP-1. It's a hormone the body produces when people eat food to signal fullness to the brain. But do these products really work? Doctors are skeptical.
Ozempic, a Type 2 diabetes medication, and its sister drug Wegovy, which is specifically approved for weight loss, both contain semaglutide, which mimics GLP-1. Food and Drug Administration and has been shown to suppress appetite, leading people to lose weight, said Dr. Roshini Raj, a New York gastroenterologist. It’s a different story with the cheaper alternatives.
“What’s very misleading, in my opinion, is a lot of these supplements have the term GLP-1 on the bottle, but they do not contain GLP-1. They do not contain an agonist or a mimicking hormone,” Raj said in a TODAY segment that aired on Thursday, Sept. 19. “They contain extracts, maybe from fruits or vegetables, that purport to boost your body’s natural GLP-1. But to me, that’s a big difference.” So if you pick up a bottle of supplements that says GLP-1 on the label, you’re not getting GLP-1 and you don’t know exactly what’s inside, Raj warned. Companies can get away with that because the supplement industry is not well regulated, and the FDA doesn’t approve the supplements, so little is known about the safety or efficacy of the products, she added, calling it “a bit of a Wild West.”
The emerging supplements claim to promote natural production of the GLP-1 hormone, but they undergo far less testing than drugs, said Dr. Hans Schmidt, a bariatric surgeon in New Jersey. They're not vetted by the FDA and there's no evidence they work, he added. “I don’t think that they’re anywhere near the strength of the injectable,” Schmidt told TODAY. “If you can just go buy a supplement and lose 20 or 30, 40 pounds, you couldn’t hear the end of it. It would be all over the place. But they’re not.”
The Lemme brand said its GLP-1 Daily supplement is "formulated with clinically validated ingredients based on gold-standard human clinical studies that show increased GLP-1 levels, reduced hunger, and visceral fat loss," in a statement to TODAY.com. The supplement is tested by NSF, an independent testing organization, for safety and dosage claims; and is "thoroughly vetted by third party scientific and medical experts for claims and safety," the company added.
The price difference between the prescription drugs and the supplements has some people eager to try the alternative products. Ozempic and Wegovy can cost $1,000 a month without insurance, while some of the supplements cost about $70 a month or less. Doctors advised consumers to be careful. Berberine, for example, is unlikely to reduce appetite and potentially leads to very little, if any, weight loss, Dr. Pieter Cohen, an associate professor at Harvard Medical School who leads the Supplement Research Program at the Cambridge Health Alliance in Massachusetts, previously told TODAY.com.
Raj said there are too many unknowns about the alternative products. “I’m not saying these are actually bad supplements - we just don’t know. We don’t know what they actually do. … There could be a downside,” she said. “Because I don’t really know if they work, I certainly, as a doctor, wouldn’t recommend them.” Schmidt echoed that sentiment, noting it's crucial to prioritize your health and safety. "I wouldn’t recommend people take them because we don’t know what the side effects are. We don’t know what the downsides are. We don’t know how long you need to take them," he said. "We have very effective treatments that are available, and I think most patients should take that route."
The Foundation of Sustainable Weight Loss
Talk to your physician before taking any dietary supplements, the FDA advises. If you’re trying to lose weight, the classic advice still holds: eat a healthy diet, get plenty of exercise, get enough sleep and manage stress, Raj noted. A high-fiber diet, which also stimulates GLP-1 production, would likely be more effective than the supplements, Schmidt said. If that’s not working, you talk to your doctor about getting one of the prescription GLP-1 medications that actually have been proven to work, she said. A. Pawlowski is a TODAY health reporter focusing on health news and features.
tags: #pure #thrive #weight #loss #ingredients