I don’t waste time thinking, “Am I doing it right?” I ask, “Am I doing it?”
—GEORGETTE MOSBACHER
Drugs and supplements can be a help or a hindrance or may do nothing at all for your weight-loss program. In this chapter, we take a brief look at drugs that may contribute to weight gain, then review some of the herbs and supplements that are often mentioned as helpful for weight loss and fat burning.
DRUGS THAT MAY PROMOTE WEIGHT GAIN
There are a number of drugs that can actually cause weight gain. It’s important to read through the complete list of side effects for all drugs prescribed for you. If weight gain is listed as a possible side effect, discuss with your physician whether there are any options that are more diet-friendly. (Don’t, however, go off any prescribed medications. You should always discuss any changes to your medications with your physician or practitioner.)
Some of the drugs that may contribute to weight gain include
SUPPLEMENTS AND HERBS
There are literally hundreds of vitamins, herbs, minerals, enzymes, essential fatty acids, and combination formula supplements that promote themselves as being helpful in
Do they work? That’s a good question, because many of the supplements have never been extensively studied. Some have undergone various studies and trials, and others have been in use for centuries as part of traditional Chinese medicine or Ayurvedic remedies. There are also some that are touted mainly on the basis of anecdotal evidence. And then there is the constant battery of hype, with never-ending infomercials, bus stop advertisements, magazine and newspaper ads, and multilevel marketers trying to sell you the latest miracle diet supplement—the one that will finally melt the pounds off while you sleep, or allow you to eat anything and still lose weight, or rev up your metabolism and burn 50% more fat!
I’ll let you in on a big secret. That miracle diet supplement doesn’t exist. I get a thousand e-mails a week from frustrated thyroid patients who are trying to lose weight, and I guarantee you, if any of these pills worked, I would be hearing from the legions of people who are thrilled with their miracle pills. So far, I haven’t heard from any. And yes, here and there I’ve fallen prey to the marketing claims and tried a bottle or two of miracle pills, and they haven’t solved the problem. No matter what, I’m always back to diet and exercise.
That said, there are some supplements and herbs that may help you in your weight-loss efforts. I emphasize may, because there are no guarantees, and some supplements will do nothing at all for you; some might actually do the opposite (and you’ll be one of the few people who gains weight on something that is supposed to help!). Some of the supplements, however, might actually be a great fit for you and help with your weight-loss efforts.
For each supplement, I’ve provided my recommendation regarding whether it might be worth trying. Keep in mind that many combination supplements for weight loss contain various ingredients, so you may see some products that contain a number of these supplements together in one pill or liquid formula.
5-HTP
5-hydroxytryptophan (5-HTP) is a precursor to the neurotransmitter serotonin. There is some evidence that 5-HTP may be able to reduce appetite and promote weight loss. One trial showed increased weight loss among overweight women who took 600 to 900 mg of 5-HTP daily. Another study found that type 2 diabetics significantly reduced their carbohydrate and fat intake after several weeks of taking 750 mg per day of 5-HTP. Other studies have found that 5-HTP taken at a daily dose of 8 mg per kilogram body weight could reduce overall caloric intake without making any particular effort to cut food intake. It was thought that the 5-HTP was increasing the sense of fullness. In addition to weight loss, 5-HTP is also thought to help with late afternoon and evening cravings.
Recommendation: Worth trying, but check with your practitioner regarding any potential interactions with antidepressants or other drugs.
7-KETO
7-KETO (3-acetyl-7-oxo-dehydroepiandrosterone) is related to DHEA. One study found that when taken alongside a somewhat calorie-restricted diet with exercise, 7-KETO resulted in greater weight loss and body fat reductions than a placebo. It’s thought that 7-KETO may be able to help make T4 to T3 conversion more effective, resulting in higher T3 levels.
Recommendation: May be worth trying, but keep in mind that it’s a hormone precursor, so tread carefully.
Acetyl-L-Carnitine
Acetyl-L-carnitine is thought to have the following functions:
Carnitine links with fat and moves it into the mitochondria—the cell’s furnace, or power plant—for burning, converting fats and carbohydrates into energy. Low carnitine is thought to slow delivery and allow extra fat to accumulate. One study found that people on a diet and exercise program who also took 1,000 mg of acetyl-L-carnitine daily for 3 months lost significantly more weight than those who took a placebo. Some experts recommend taking 3,000 to 5,000 mg just once daily, around an hour before exercise to help burn fat during a workout.
Recommendation: Consider adding this supplement to your program.
Alpha-Lipoic Acid
Alpha-lipoic acid is a powerful antioxidant that plays a role in helping trigger production of adenosine triphosphate (ATP) to produce cellular energy. There is also some evidence that it may help reduce insulin resistance and help control blood sugar.
Recommendation: Consider adding this supplement to your program.
Caffeine
Caffeine, whether in the form of coffee, caffeine pills, or added as an ingredient to diet pills, is a popular weight-loss aid. Unfortunately, caffeine has a variety of side effects, including elevated blood pressure, heart palpitations (particularly in people who have mitral valve prolapse), nervousness, irritability, sleeplessness, and occasionally rapid heartbeat. It also is not particularly effective on its own but appears to have the ability to enhance the thermogenic effect of other supplements. Like all stimulants, too, you lose the effects when you cut back or stop the levels, and you’ll regain weight.
You need to be particularly careful about overuse of caffeine, particularly supplements that contain caffeine in its various forms. One weight-loss formula, Zantrex-3, for example, contains more than 300 mg of caffeine per 2-pill dosage (the same amount of caffeine that’s in 2 to 3 strong cups of coffee) and has, among other ingredients, seven other stimulants—yerba maté, guarana, green tea, Tibetan ginseng, panax ginseng, cocoa nut, and kola nut—most of which contain caffeine. While the recommended maximum daily intake is 450 mg of caffeine per day total, Zantrex suggests taking up to 6 capsules a day, which would provide almost 1,000 mg of caffeine—an amount that could trigger a variety of symptoms in many people. Caffeine is a drug, and you can overdose on it. Symptoms of overdose range from insomnia to thirst, confusion, irregular heartbeat, dizziness, and even convulsions and breathing problems. Particularly when you’re taking supplements that contain caffeine, then adding caffeine from coffee, tea, foods, and other medicines, you can easily get into a danger zone.
Recommendation: Except for a few cups of coffee or green tea, use at your own risk.
Calcium
Calcium appears to have a connection to weight loss, although studies tend to show that this connection is to calcium-rich dairy foods. However, it’s still important to ensure that you get sufficient calcium, and 1,000 to 2,000 mg a day can be particularly helpful. Some experts recommend using calcium citrate-malate and calcium carbonate forms.
Recommendation: Add this supplement to your program.
Capsaicin/Cayenne Pepper
A slight reduction in appetite has been seen with the consumption of approximately 10 grams of cayenne pepper along with meals. Similar amounts are also thought to have the ability to increase metabolism of dietary fats and suppress appetite. Capsaicin is the ingredient in cayenne pepper that is thought to have this effect, and it can be taken in supplement form.
Recommendation: Consider adding this food or supplement to your program.
Chitosan
Chitosan is made from the shells of shellfish. The idea behind chitosan is that it binds to fat and prevents you from absorbing the fat, making it pass through your body. It’s a popular ingredient in many of the so-called fat-blocker supplements. There is not much in the way of evidence that chitosan actually works for fat absorption, but as a fiber supplement it appears to help with reduction of cholesterol levels in some people.
Recommendation: Save your money.
Chromium Picolinate
The mineral chromium in the form called chromium picolinate has had interesting but inconsistent results. Some studies have shown that it has no effect on weight loss but can help maintain muscle during weight loss. There is growing evidence that chromium can help in improving blood sugar control in people with type 2 diabetes or insulin resistance by improving the body’s responsiveness to insulin. There have been some questions regarding whether chromium picolinate may cause DNA damage, however, but this is controversial and as yet undecided. The dosage range for insulin control is as high as 1,000 mcg daily.
Recommendation: Worth trying, but keep track of developments regarding any downsides.
Coenzyme Q-10
Coenzyme Q-10 (CoQ-10) is a soluble antioxidant that helps the cells’ mitochondria—the powerhouse—to generate nearly all of the energy that the cells need to function. It’s thought that sufficient levels of CoQ-10 are needed for optimum energy and functional metabolism. A 200 mg a day dose is considered a minimum.
Recommendation: Good antioxidant, can’t hurt, and might help.
Coleus
Although there are no specific clinical trials, there is clinical support for use of the herb coleus for weight loss. Coleus forskolin supplements in the 50 to 100 mg range can be taken two to three times per day, and the herb is also thought to have thyroid-supportive effects.
Recommendation: Might be worth trying.
Conjugated Linoleic Acid/CLA
One supplement thought to help not with weight loss but with reducing fat storage and increasing muscle mass is conjugated linoleic acid (CLA). Studies published by the American Chemical Society, the Journal of International Medical Research, the Journal of Nutrition, the International Journal of Obesity, and Lipids have found that taking CLA can help with reduction of body fat while increasing lean muscle mass. There is evidence that CLA acts to indirectly spur the metabolism to store less fat, which prevents fat from being deposited into the body, thereby reducing body fat mass. It’s also thought that CLA can help with leptin resistance and can reduce inflammatory signals coming out of fat cells.
Conjugated linoleic acid is the name for a group of fatty acids found in dairy products (except fat-free dairy products) and some meats. CLA has largely been removed from our diets over the last 50 years, due to changes in livestock development and feeding practices.
Studies have shown that 3 to 4 grams (3,000 to 4,000 milligrams) per day of CLA can help with muscle mass, and 6 grams a day can help with insulin levels. One double-blind, randomized, placebo-controlled study found that CLA reduces fat and preserves muscle tissue. An average reduction of 6 pounds of body fat was found in the group that took CLA compared to a placebo group. The study found that approximately 3.4 grams of CLA per day is needed to obtain the beneficial effects.
CLA has been the subject of a variety of research in the past several years, and findings also suggest that some of the other benefits of CLA include the following:
All CLA is not created equal, and it’s not recommended that you get a cut-rate brand. You’re better off using the patented form of CLA known as Tonalin, which is found in a number of brands. Tonalin is the formulation that has been scientifically tested.
Some people report feeling slightly queasy after taking CLA, or have stomach pain or even loose stools. To minimize side effects, CLA should be taken with a protein; milk is often recommended. Side effects usually go away after 2 weeks of taking the supplement.
When I first began taking CLA (the Natrol Tonalin CLA, 4,000 mg a day), there were 2 or 3 days the first week when I felt slightly green, but I began to take it with a bit of milk, which eliminated the problem. After just 1 week, I noticed less abdominal bloating and a slight reduction in appetite, which may be a result of lower blood sugar. After 3 weeks, my abdominal fat pouch shrunk substantially. Other fat areas (such as cheeks, upper arms, rear end) seemed to be slowly reducing as well. I found that CLA worked very well for the first 2 months in terms of spot reducing some areas of fat, especially my abdomen and face. But after a few months, its effects seemed to slow down for me, and some patients have reported a similar slowdown. Others have reported continued success with CLA.
A handful of people have reported to me that CLA had the opposite effect on them and was actually making them feel more bloated and possibly causing weight gain. If this happens to you, you should obviously discontinue it.
Recommendation: Definitely give this a try to see if it helps.
DHEA
There are some clinical trials showing that dehydroepiandrosterone (DHEA) supplementation can lower fat mass without reducing total body weight. DHEA supplementation should typically not be done without testing your DHEA levels beforehand, however, as too much DHEA can cause a variety of symptoms, especially in women, including facial hair and acne.
Recommendation: Can be a tremendous help, but only take if you’re tested and shown to be DHEA deficient.
Ephedra/Ephedrine/Ma Huang
Ephedra sinica, commonly known as ma huang, is a central nervous system stimulant that was a common ingredient in many weight-loss and diet supplements before it was banned by the FDA in 2004. You may still be able to find ephedra in some selected weight-loss formulations, however, as well as in some traditional Chinese medicine remedies. In the past, ephedra was frequently combined with caffeine—a combination that has sometimes been referred to as herbal Phen-Fen—for greater effectiveness.
There is no question that the ephedra/caffeine combination helps promote weight loss in the short term. Unfortunately, these supplements were shown to have particularly dangerous side effects. In just a several-year period, the FDA reportedly had records showing at least 70 deaths and more than 14,000 adverse events linked to ephedra use, including strokes, heart attacks, seizures, psychiatric and psychotic episodes, nausea, vomiting, autonomic hyperactivity, and heart palpitations.
Supporters argue that ephedra has been used safely for centuries, and it’s true. Ma huang has been used in Chinese medicine for centuries but not in combination with caffeine and not at the doses—or overusage—seen with the weight-loss supplements. Ultimately, most people who used ephedra products gained the weight back quickly, because the artificial increase in metabolism enjoyed while taking these drugs did not last.
Recommendation: Since most forms of ephedra have been banned by the FDA, you probably shouldn’t use these products.
Garcinia Cambogia/Hydroxycitric Acid
Garcinia cambogia is a tree whose tropical fruit contains high amounts of the compound hydroxycitric acid (HCA). It’s thought that HCA may be able to help inhibit the conversion of sugar into fat, curb appetite, and reduce sweet cravings. There are also claims that HCA can reduce the amount of excess carbohydrates that get converted to body fat. Research shows, however, that the supplement has little effect. While HCA is a common ingredient in many weight-loss supplements, the evidence is primarily anecdotal, but the supplement is considered safe with no side effects.
Recommendation: Probably ought to save your money.
Glucosol
Glucosol is derived from a crepe myrtle tree native to southern Asia. The main ingredient, corosolic acid, has been shown in a variety of studies to support natural glucose metabolism and to activate cell glucose transporter mechanisms that balance blood glucose levels. Corosolic acid also continues to work for a time after the treatment is stopped. An oil-based corosolic acid formulation in a soft gelatin capsule like Glucosol seems to be the most efficient way to lower blood glucose levels. One 24 mg Glucosol tablet before meals has been shown to lower blood glucose levels, and in one study Glucosol at daily dosages of 48 mg for 2 weeks showed a significant reduction (as much as 30%) in blood glucose levels.
Recommendation: Definitely worth trying, but talk to your doctor first if you’re diabetic or hypoglycemic.
Glutamine/L-Glutamine
Glutamine is an amino acid that is usually abundant in the body and is stored in muscle. There is a theory that sometimes the body’s need for glutamine is greater than its ability to make it, particularly when you are exercising and building muscle; when there is insufficient glutamine, the body will down muscle tissue. Glutamine is thought to help protect muscles and reduce cravings for carbohydrates like sweets, starches, and alcohol.
Recommendation: Consider trying this, especially if you’re doing weight-bearing and muscle-building exercise.
Green Tea Extract
Green tea and its extract are both rich in polyphenols (epigallocate-chin gallate, or EGCG), which may help your weight-loss program by increasing energy expenditure and thermogenesis (the increase in body heat that results from digestion, absorption, and metabolization of food). In one study, healthy young men who took two green tea capsules (containing 50 mg of caffeine and 90 mg of EGCG) three times a day had a significantly greater energy expenditure and fat oxidation than those who took caffeine alone or placebo. There are claims that drinking green tea in liquid form can also be a help in weight loss. Downsides of green tea extract are that it may make you jittery, give you headaches, or even cause insomnia.
Recommendation: Green tea may be a better way to get your caffeine fix, but don’t overdo it, and be careful if you’re caffeine sensitive.
Guarana
The herb guarana contains caffeine, along with theobromine and theophylline, which are all thought to potentially curb appetite and increase weight loss. Guarana has 30% more caffeine than coffee, so you should be particularly careful about supplementing with it, because it can be overstimulating, especially when combined with other sources of caffeine (e.g., gotu kola, or straight caffeine itself) in some weight-loss combination formula supplements.
Recommendation: Too much caffeine, and not a good idea for most.
Gymnema Sylvestre
Gymnema sylvestre is an Ayurvedic herbal remedy that is thought to particularly help with reducing sweet cravings and minimizing sugar absorption in the intestines.
Recommendation: Not enough research to really recommend it at this time.
Hoodia Gordonii
Hoodia Gordonii is a supplement derived from a cactus found in the deserts of the Kalahari in South Africa. Pharmaceutical researchers claim hoodia contains a substance known as P57 that acts like glucose with nerve cells in the brain and tricks the body into thinking it is full. Drug companies are reportedly developing drugs using hoodia that may be released in the future, but the pure form of the herb supposedly has appetite suppressant capabilities. There aren’t any side effects or dangers to hoodia, and while the research is preliminary, it’s promising. You need a pure hoodia supplement, not a weight-loss formula that contains a smaller amount of hoodia as an ingredient.
Recommendation: I’ve been using hoodia regularly and have found it a tremendous help in reducing appetite.
Milk Thistle
Milk thistle is a fat-burning herb that helps support the liver and detoxification. It is a common ingredient in detoxification and weight-loss formulas. Not much research has been done on this herb to establish the validity of claims, but anecdotally and clinically it is popular with many practitioners.
Recommendation: Considered fairly safe, but the jury is out on effectiveness.
Pantethine
Pantethine is a form of vitamin B5—pantothenic acid. It’s been shown to help reduce triglyceride levels and to reduce abdominal and visceral fat and obesity. The optimum dose to help with metabolizing fat appears to be 600 to 900 mg daily.
Recommendation: Definitely worth trying.
Phaseolus Vulgaris/Starch Blockers
Beans can partially interfere with the body’s ability to digest carbohydrates. (This is actually why they cause so much gas!) Based on this knowledge, a variety of products containing the French white bean Phaseolus vulgaris have recently been widely marketed as carbohydrate blockers. However, there is no specific evidence that supplements made from this treatment (or any other bean) actually aid in weight loss.
Recommendation: Save your money.
Pyruvate
Pyruvate is a compound in the body that is also found in particular fruits and vegetables. It’s thought that pyruvate may increase resting metabolism slightly, can help with overall endurance, and can slightly accelerate fat loss. One trial found that pyruvate at 22 to 44 grams per day could enhance weight loss and help reduce body fat for overweight adults eating a low-fat diet. Several trials using lower doses—from 6 to 10 grams per day—along with exercise, showed similar results with weight loss and body fat. Much of the research was done based on 20 to 30 grams per day, but it’s thought that 5 grams per day is enough to produce results.
Recommendation: There’s enough evidence to make this worth trying.
Spirulina
Spirulina, a type of algae, is a source of protein and a variety of other nutrients. In one double-blind trial, overweight people who took 2.8 grams of spirulina three times per day for 4 weeks experienced a very small and insignificant weight loss. Thus, although spirulina had been promoted as a weight-loss aid, the scientific evidence supporting its use for this purpose is weak.
Recommendation: The jury is still out.
Taurine
Taurine is one of the lesser-known amino acids, and has a number of different functions in the body. It aids the liver in forming bile acids, helps with detoxification of toxins and toxic chemicals from the body, and is even thought to help reduce chemical sensitivity. It is also a good diuretic. 500 to 1000 mg daily of taurine is considered a safe and effective dose.
Recommendation: Worth trying.
Vitamin C
Vitamin C may be able to help with weight loss in those who are significantly overweight. The main risks of too much vitamin C—that is, more than 2,000 mg a day—are diarrhea or loose bowels and abdominal cramping.
One research team found that resting metabolism before and after an infusion of vitamin C among people between 60 and 74 years old resulted in resting metabolism increases on average of almost 100 calories per day. So people burned 100 more calories on the days after vitamin C infusion without doing anything else different.
Some experts recommend that you take vitamin C to bowel tolerance. Basically, you start with 500 mg a day and keep adding 500 mg a day until you get to a point where you have diarrhea. Then cut back to the highest level that will not cause stomach problems. Take that daily dose, which for many can be as much as 5,000 mg (or 5 grams).
Recommendation: Always a good supplement.
Zinc
Supplementation with selenium and zinc may be tried with lower-calorie diets to prevent decline of the thyroid hormone T3. You shouldn’t take more than 400 mcg of selenium a day. A daily dose of 15 mg of zinc is helpful.
Recommendation: Worth trying.
MESOTHERAPY
While not really in the category of supplements, I felt it important to mention mesotherapy, which is fairly new in the United States. Mesotherapy involves injecting a patient-specific mixture of natural extracts and chemicals into the mesoderm, the middle layer of the skin where cellulite resides. The technique is used for weight loss and spot fat reduction, as well as for sports injuries, cellulite, hair loss, skin conditions, chronic pain, bone spurs, allergies, arthritis, chronic fatigue, and chronic sinus problems. Dr. Michel Pistor pioneered the technique in France in 1952, where there are roughly 15,000 practitioners. In the United States, there are only 10 to 15. Around the beginning of this century, the therapy was brought to the United States by Dr. Lionel Bissoon, who learned the technique from Dr. Jacques Le Coz, a protégé of Dr. Pistor. Most physicians practicing in the United States have taken courses with Dr. Le Coz in Paris. The procedure is done on an outpatient basis, and after the initial consultation, patients usually visit the doctor as many as 10 more times. Each 20-minute session costs around $300.
The idea behind mesotherapy is that different chemicals, herbs, or drugs are injected to help deal with the particular problem. In the case of cellulite reduction, for example, the practitioner will prepare a mixture that includes vasodilators (which improve blood flow to the area), stimulants for lymph flow, and lipolytic agents (which break down fat tissue). Injections are given 4 to 6 millimeters below the skin surface with a special mesotherapy pistol. The injections increase blood and lymph flow in the cellulite area, and the broken-down fat is carried away and excreted by the body. Cellulite-reduction patients may receive between 20 and 300 shots per session over 10 to 15 weekly visits. The procedure takes only a few minutes each visit.
Mesotherapy injections can be given directly into areas that need spot reduction such as love handles, bra bulge, saddlebags, saggy neck, and so on. Fat-burning mesotherapy can be done in the abdominal area to help reduce abdominal fat. Mesotherapy is not a substitute for weight loss, but it does appear to be a nonsurgical solution for spot fat reduction, and some patients have reported that it greatly helped with weight loss. Singer Robert Flack, herself hypothyroid, has been battling a weight problem for years. She has been seeing New York’s Dr. Bissoon, the practitioner who brought the therapy to the United States, and has lost more than 40 pounds with her mesotherapy treatments so far, along with a diet and exercise program.
Mesotherapy is practiced extensively in France, Belgium, England, Italy, Germany, Switzerland, and South America, and French studies show the treatment is effective for weight loss. Appendix A gives information on how to find a mesotherapy practitioner.