Weight Control (“Diet”) Pills – Fenfluramine – #14 in series


Part 14 in my series of posts about products which can contribute to nutrient deficiencies -


Weight Control (“Diet”) Pills – Fenfluramine

Banned in the US in September 1997, this little doozy was causing severe heart issues. Here’s a list of the side effects:


Common side effects of fenfluramine Oral:

Chronic Trouble Sleeping Less Severe

Nervous Less Severe

False Sense of Well-Being Less Severe


Rare side effects of fenfluramine Oral:

Depression Severe

Blood Flowing Wrong Way in Mitral and Aortic Heart Valves Severe

High Blood Pressure Severe

Increased Pressure of Pulmonary Circulation Severe

Inflammation of Skin caused by an Allergy Severe

Hives Severe

Rash Severe

Reaction due to an Allergy Severe

Confused Severe

Mental Disorder with Loss of Normal Personality & Reality Severe

Nightmares Less Severe

Blurred Vision Less Severe

Abnormal Heart Rhythm Less Severe

Dry Mouth Less Severe

Incomplete or Infrequent Bowel Movements Less Severe

Inability to have an Erection Less Severe

Drowsiness Less Severe

Dizzy Less Severe

Low Energy Less Severe

Excessive Sweating Less Severe

Taste Problems Less Severe

Voluntary Movement Difficulty Less Severe

Head Pain Less Severe

Slurred Speech Less Severe

Feel Like Throwing Up Less Severe

Throwing Up Less Severe

Diarrhea Less Severe

Difficult or Painful Urination Less Severe

Frequent Urination Less Severe

Stomach Cramps Less Severe

Feeling Weak Less Severe

Altered Interest in Having Sexual Intercourse Less Severe


- Source:


Avoid this one at all costs, folks!

Weight Control (“Diet”) Pills – Fen-Phen – #13 in series


Part 13 in my series of posts about products which can contribute to nutrient deficiencies -

Weight Control (“Diet”) Pills – Fen-Phen

Lasting Damage From Fen-Phen Drug?

Study Shows Lingering Heart Valve Problems in Former Users of Banned Obesity Drugs Fenfluramine and Dexfenfluramine

By Miranda HittiWebMD Health News

Reviewed By Louise Chang, MD

Nov. 5, 2008 — Two banned obesity drugs may have lingering effects on the heart, according to a new study.

The study shows that heart valve problems linked to the banned obesity drugs fenfluramine and/or dexfenfluramine typically last years after stopping those drugs.

The FDA ordered fenfluramine and dexfenfluramine off the market in September 1997 after those drugs were linked to heart valve problems. Fenfluramine was one of the ingredients in “fen-phen,” and dexfenfluramine is closely related to fenfluramine. The “phen” in fen-phen refers to a drug called phentermine, which wasn’t banned.

The new study, published online today in BMC Medicine, shows what happened to the hearts of 5,743 former users of fenfluramine and/or dexfenfluramine.

Heart Valve ProblemsThe patients were seen by doctors including Charles Dahl, MD, of the Central Utah Clinic in Provo, Utah, between July 1997 and February 2004.

During that time, each patient got an echocardiogram and 1,020 patients got two or more echocardiograms 30 months apart, on average.

Dahl’s team searched the echocardiograms for signs of blood leaking back through heart valves (regurgitation), and they noted which patients got surgery to correct heart valve problems.

When the study started, nearly 20% of the women and almost 12% of the men had at least mild regurgitation through the aortic valve or moderate regurgitation through the mitral valve.

Those conditions were more likely in women and people who had used fenfluramine and/or dexfenfluramine for longer periods of time.

Follow-up echocardiograms showed that aortic and mitral regurgitation usually stayed about the same or worsened, but improved in some cases.

Why would some cases worsen and others improve? That’s not clear from the study.

But the researchers note that they saw evidence of “early improvement, followed by relative stabilization with only slightly more individuals showing improvement over the longer term as compared to deterioration.”

Heart Valve Surgery

Thirty-eight patients — less than 1% — got heart valve surgery. Such surgery wasn’t common, but it was more common than in the general public, and in 25 cases, heart valve damage was linked to the drugs, according to Dahl’s team.

Three of the four researchers who worked on the study, including Dahl, have served as expert witnesses for plaintiffs in lawsuits related to fen-phen. Those lawsuits are over and the researchers declare that they don’t have any current financial conflicts of interest.

Second Opinion

WebMD spoke with cardiologist William O’Neill, MD, FACC, FSCAI, about the study.

O’Neill, who didn’t work on the study, is executive dean of clinical affairs and a professor of medicine at the University of Miami’s Miller School of Medicine.

“It’s pretty clear cut that the rare side effect of the fen-phen administration was inflammation and then fibrosis of the valves. The problem is that there’s just so much litigation wrapped around this and anxiety that it’s hard to know what the actual indications for valve surgery were in many of the patients,” O’Neill tells WebMD.

O’Neill notes that regurgitation “can definitely worsen,” but he says it’s “a little hard to believe that the regurgitation improved,” and that “small differences in the echo[cardiogram] could just be chance observations.”

“If it severely worsens, I believe it. If it only mildly worsens or mildly improves, then I would say it’s probably just variations based on the measurement,” O’Neill says.

Asked what he would tell former fen-phen users, O’Neill says that “probably everybody that’s been on fen-phen has probably already had an echocardiogram,” but that people who are concerned should see a cardiologist and get an echocardiogram.

“That’s the first thing,” says O’Neill. “The second thing is that I would really be hesitant to recommend surgery unless the patients became really symptomatic. Just to do surgery because they’ve got these lesions is really not appropriate.”

O’Neill says symptoms of valve problems may include severe bloating or swelling of the legs, or severe shortness of breath during exercise.

SOURCES: Dahl, C. BMC Medicine, Nov. 5, 2008; online edition. News release, FDA. William O’Neill, MD, FACC, FSCAI, executive director of clinical affairs, professor of medicine, cardiovascular division, University of Miami Leonard M. Miller School of Medicine. News release, BMC Medicine.

Weight Control (“Diet”) Pills – Phentermine – #12 in series


Part 12 in my series of posts about products which can contribute to nutrient deficiencies -

Weight Control (“Diet”) Pills – Phentermine

Until recently the consensus in the scientific community was that prescription weight control medications, also called “anorexiants”, had little or no effect on long-term weight management. In addition, some of these medications, such as phentermine and fenfluramine, have negative side effects, including insomnia, nervousness, and irritability in the case of phentermine, and sedation and depression with fenfluramine. Dizziness, increased blood pressure, diarrhea, and irregular heartbeat also have been reported.

Get emergency medical help if you have any of these signs of an allergic reaction while taking phentermine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:feeling short of breath, even with mild exertion;chest pain, feeling like you might pass out;swelling in your ankles or feet;pounding heartbeats or fluttering in your chest;confusion or irritability, unusual thoughts or behavior;feelings of extreme happiness or sadness; ordangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects of phentermine may include:feeling restless or hyperactive;headache, dizziness, tremors;sleep problems (insomnia);dry mouth or an unpleasant taste in your mouth;diarrhea or constipation, upset stomach; orincreased or decreased interest in sex, impotence.This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.


Hormone Replacement Therapy (HRT) – #11 in series


Part 11 in my series of posts about products which can contribute to nutrient deficiencies -

Hormone Replacement Therapy (HRT)

HRT might affect nutritional status. Some women taking HRT retain salt and water and complain of weight gain. HRT also can affect nutrition if you experience abdominal cramping, loss of apetite, diarrhea, or nausea. These side effects can reduce food and nutrient intake. HRT might also increase the risk of several nutrient deficiencies, including folic acid and vitamin B12. Other estrogen-containing drugs, such as birth control pills, lower blood levels of vitamins B1, B2, and B6, and raise blood levels of vitamin A, iron and other minerals. However, it is poorly understood whether HRT also affects these nutrients.

See the rest of the series at

High Blood Pressure Medications – #10 in series


Part 10 in my series of posts about products which can contribute to nutrient deficiencies -

High Blood Pressure Medications 

Diuretic medications used in the treatment of hypertension increase urinary excretion of magnesium and might increase a person’s resistance to medication therapy and the risk of cardiovascular disease. Thus, this medication therapy lowers blood pressure but increases other risk factors for cardiovascular disease. In addition, potassium supplementation, which often accompanies hypertensive medications, increases magnesium loss. Magnesium supplementation in combination with diuretic treatment is associated with reduced medication dosages and improved cardiovascular risk.

Two other hypertensive medications, called captopril and enelapril, might reduce zinc levels. A study from Tel Aviv University reported that these medications, especially captopril, increased urinary loss of zinc and reduced zinc levels in red blood cells. Depletion of zinc from the tissues could compromise the immune function, reduce a woman’s resistance to colds and infections, and delay wound healing. Other studies report diuretic medications such as clopamide, used in the treatment of hypertension, alter tissue levels of copper and zinc.

Coffee, tea and caffeine – #9 in series


Part 9 in my series of posts about products which can contribute to nutrient deficiencies -

Coffee, Tea, and Caffeine

Coffee and caffeine have been accused of contributing to many degenerative disorders, including heart disease and cancer; however, the effects of coffee or caffeine on these disorders remain inconclusive. A study from the University of California, San Diego, reported that it is not coffee but the habits associated with coffee drinking that predispose a woman to heart disease. Coffee drinkers are more likely than nondrinkers to consume more alcohol, dietary saturated fat, and cholesterol; they are more likely to smoke and not exercise regularly. In addition, smoking and exercise are “dose-related” to coffee consumption. That is, the more a woman smokes and the less she exercises, the greater her coffee consumption and her risk of developing heart disease. These associations between coffee consumption and heart disease behaviors hold true for both drinkers of caffeinated and decaffeinated coffee.

Unfortunately, the evidence is not clear-cut. Other studies have reported a significant association between coffee consumption and the risk of heart attack. Again, the more coffee a person consumed, the greater the risk. In addition, the chance of having a fatal heart attack rises steadily in men who drink three or more cups of coffee a day; however, the effects on women have not been adequately studied. Switching from regular to decaffeinated coffee might not be the answer, either, since both caffeinated and decaffeinated coffees have been implicated in heart disease risk.

How does coffee increase a person’s risk of heart disease? Caffeine in doses greater than five cups of coffee a day might increase total blood cholesterol and LDL-cholesterol levels, blood pressure, and heart arrhythmias – all factors that increase a person’s risk of developing heart disease. It is not well substantiated, however, whether this is caused by caffeine, one or more of the three hundred compounds in coffee, or related behaviors associated with coffee consumption. Drip-filtered coffee, the type consumed by 75 percent of Americans, has no effect on cholesterol levels, so coffee may influence heart disease risk by other unknown mechanisms besides raising blood fat levels.

In short, coffee and/or caffeine consumption is associated with an increased risk of heart disease only when a person consumes more than three to five cups a day. Moderate intake appears safe, while tea consumption at at dose has not been linked to heart disease risk. 

The scientific evidence linking coffee with cancer is also confusing. Caffeine might encourage the growth of tumors depending on the person’s exposure to cancer-causing substances in the environment, the type of cell affected, and the stage of cell replication. One study on rats showed that caffeine increased the risk of cancer fivefold when the animals were also deficient in the B vitamin folic acid. The amount of caffeine used in this study approached typical doses consumed by some adults. If coffee does have cancer-promoting effects, it might be a result of other compounds in the brew rather than the caffeine since cola (another caffeine-containing beverage) is not associated with an increased cancer risk. Tea consumption also shows little or no increased risk of cancer. 

Tannins and other compounds in coffee and tea reduce mineral absorption, especially iron, by as much as 90 percent and can rob the body of other minerals, such as calcium. Two cups or less each day apparently pose no health risk, but one study reported that intakes greater than this could cause calcium imbalances and increase the risk of developing osteoporosis. Consequently, women should drink coffee and tea between meals rather than with food to minimize the effects of these beverages on mineral status and the risk of anemia and osteoporosis. Consuming extra vitamin C at a meal helps counteract the effects of coffee on iron absorption.

Cigarettes – #8 in series


Part 8 in my series of posts about products which can contribute to nutrient deficiencies -


Tobacco smoke influences the nutritional status of both smokers and people who inhale other people’s tobacco smoke (also called passive smokers). Inhaling tobacco smoke removes vitamin C from the tissues and blood and increases requirements to more than 200 mg per day for this vitamin (the RDA is 60 mg). Blood levels of vitamin C decreases as cigarette consumption increases and are as much as 30 percent lower in smokers compared to nonsmokers. Smokers tend to consume less, absorb less, and use more vitamin C than do nonsmokers, while requirements are higher not only to counteract these adverse effects of tobacco but also to reduce free radical damage to tissues generated by tobacco smoke. 

Dietary intakes and tissue levels of vitamin A and beta carotene are also low in smokers and passive smokers. In contrast, when tissue levels of vitamin A, beta carotene, and vitamin E are high, the risk of developing lung and oral cancers, and other respiratory disorders is reduced. Since tobacco smoke increases free radical damage to tissues, the reduced cancer risk associated with these vitamins is probably a result of their antioxidant abilities to destroy and deactivate free radicals. 

B vitamins are also affected by smoking. Cigarette use alters vitamin B6 metabolism, and the residual effects might last as long as two years after cessation of smoking. One study found that blood levels of vitamin B6 were significantly lower in smokers than in nonsmokers. Although the long-term effects of this sustained decrease in vitamin B6 metabolism are unknown, increasing dietary intake of this vitamin is harmless and potentially useful. 

Increased intake of folic acid and vitamin B12 also might help prevent some of the damage caused by tobacco use. Researchers at the University of Alabama in Birmingham reported that smokers who supplement their diets with these two B vitamins have significantly fewer precancerous cells than do other smokers. 

The best advice is to stop smoking and avoid all forms of tobacco smoke, including cigarettes, pipes, and cigars. Since women who smoke during pregnancy have low blood zinc levels and are more likely than nonsmokers to give birth to zinc-deficient babies who are a high risk for birth defects and disease, it is even more important that women who are considering pregnancy should avoid cigarette smoke from all sources. In addition, optimal dietary intake of the anti-oxidant nutrients (that is, vitamin C, beta carotene, and vitamin E), the B vitamins, and some minerals might help counteract some of the harmful effects of tobacco smoke.

Birth control pills – #7 in series


Part 7 in my series of posts about products which can contribute to nutrient deficiencies -

Birth Control Pills

The use of birth control pills has been linked to several diseases including heart disease, although this link is controversial. The female hormone progestin is associated with an elevated risk of heart disease, and birth control pills with either low doses or an alternate form of this hormone might help increase hearts disease risk. Suspicion that birth control pills increased the risk of developing breast cancer has not been substantiated, but a potential link to cervical cancer is still being investigated.

Long-term use of birth control pills can affect the absorption and use of several nutrients. The pills are associated with weight gain, increased appetite, reduced absorption of folic acid and other vitamins, and altered distribution of several nutrients within the body’s tissues.

High blood levels of some nutrients, such as vitamin A, copper, and iron, are noted in some women, while low blood levels of vitamins E, C, B1, B2, B6, folic acid, and zinc are noted in others on birth control pills. These fluctuations in nutrient levels are only partially attributed to the medication, with other factors such as dietary habits also influencing the nutritional status. Although increased dietary intake of foods rich in these nutrients or a moderate-dose vitamin and mineral supplement are practical approaches to the prevention of drug-induced deficiencies, there is no evidence that large supplemental doses of those nutrients improve the nutritional status of women taking birth control pills.

Numerous studies report that these pills lower blood and tissue levels and increase the dietary requirements for vitamin B6. This nutrient is particularly interesting since even moderate deficiencies of vitamin B6 produce many of the mood disorders associated with the use of birth control pills, such as depression, irritability, and insomnia.

Vitamin B6 is an essential component in the production of the brain chemical serotonin that regulates pain, mood, some eating behaviors, and sleep. Low vitamin B6 levels reduce serotonin levels, which could produce mild depression and other symptoms mentioned above. Birth control pills affect the status of vitamin B6 only in those who are already consuming a marginal amount of this vitamin. Improvements in mood and sleep are reported when vitamin B6 intake in increased. Often all that is needed to ensure optimal nutrient intake and reduced mood or sleep problems is improved dietary habits and increased dietary intake of vitamin B6-enriched foods.

Aspirin – #6 in series


Part 6 in my series of posts about products which can contribute to nutrient deficiencies -


Aspirin is used for everything from headaches and athletic injuries to the treatment of heart disease. However, this panacealike over-the-counter medication can also increase the risk of developing nutrient deficiencies if taken repetitively and for long periods of time.

Since aspirin can cause bleeding in the digestive tract, long-term use could result in iron deficiency, reduced formation of red blood cells, and anemia, especially if you have preexisting stomach problems. Long-term use of aspirin might also cause deficiencies of folic acid and vitamins B12 and C, which can be prevented by consuming more foods rich in these nutrients or by taking a moderate dose multi-vitamin and mineral supplement at opposite times of the day from aspirin intake.

Arthritis Medications – #5 in series


Part 5 in my series of posts about products which can contribute to nutrient deficiencies -

Arthritis Medications

A common medication used in the treatment of rheumatoid arthritis is d-penicillamine, or Cuprimine. This medication sometimes reduces food intake by producing nausea, mouth sores, stomach pain, and tongue inflammation, and it also reduces the absorption of several nutrients, including zinc, iron, and other minerals. The drug-nutrient interactions are minimized if this medication is taken on an empty stomach one to two hours following a meal. Vitamin B6 requirements also might increase if you take this medication. Any vitamin or mineral supplements should always be taken at least two or more hours before or after the medication and should always be monitored by a physician.