Brazilian Diet Pill

My colleagues over at the Psychiatric Resource Forum just got this FDA warning and asked me what I thought. I am reproducing in its entirety:

“MedWatch – The FDA Safety Information and Adverse Event Reporting Program The FDA warned consumers not to use two unapproved drug products that are being marketed as dietary supplements for weight loss. Emagrece Sim Dietary Supplement, also known as the Brazilian Diet Pill, and Herbathin Dietary Supplement may contain several active ingredients, including controlled substances, found in prescription drugs that could lead to serious side effects or injury. They contain chlordiazepoxide HCl (the active ingredient in Librium), and fluoxetine HCl (the active ingredient in Prozac). Emagrece Sim and Herbathin were also found to contain Fenproporex, a stimulant that is not approved for marketing in the United States. Consumers are advised not to use the Emagrece Sim and Herbathin products and to return them to the suppliers. There may be other manufacturers or suppliers of imported Emagrece Sim and Herbathin, and consumers should exercise caution in using any of these imported products.

Read the complete MedWatch 2006 Safety summary, by using the following link: FDA news release

My Comments: Sadly this sort of thing is not uncommon. An unknown but clinically significant proportion of the Ayurvedic and Chinese herbs that are imported into the United States and Europe contain steroids and other drugs. I once diagnosed two cases of Cushing’s syndrome that were the result of people taking imported Indian herbs. One of them was an Indian man who was referred for weakness of his proximal muscles, which prevented him from walking up the stairs. He also add other classic symptoms of Cushing’s syndrome: he had gained weight, particularly in the face and around the abdomen, he had high blood pressure and diabetes mellitus. The other had a less florid presentation. There have been quite a number of publications on the subject of adulteration of herbal remedies.

Several years ago I became involved in an investigation of some apparently miraculous cures of eczema with Chinese herbal remedies, and sadly some of these had also been adulterated with corticosteroids. This was a real shame, because some of the herbal remedies actually helped eczema even if they did not contain steroids. These cases are all the more sad, because there are also large numbers of companies that make Indian and Chinese herbs to the highest possible standards, yet the bad apples have put even these under scrutiny.

The message must be that just because something is natural does not guarantee that it is safe. I have said before, but it bears repeating that arsenic, deadly nightshade and hurricanes are all natural. It is essential to obtain any herbals from a reputable source and to ensure that your health care provider knows exactly what you are taking: apart form the topic of adulteration, there are hundreds of potential interactions between herbal and prescription medicines.

Within the last three months, I have written an educational program for professionals that explores these issues in considerable detail, and makes recommendations about reliable suppliers of herbs.

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