Endo: Supplements

Question 1

What demographic is most likely to use a supplement?

Answer 1

Older American women with higher education and income

Question 2

What is the role of the FDA in regulating supplements?

Answer 2

FDA only takes supplements off the market after proven to be unsafe (no pre-market evaluation)

Question 3

Do manufacturers of supplements need FDA approval?

Answer 3

NO

Question 4

What is the disclaimer required on all supplements?

Answer 4

This statements has not been evaluated by the FDA.

The product is not intended to diagnose, treat, cure, or prevent disease.

Question 5

What is a structure-function claim?

Is it required?

Answer 5

Structure-function claim indicates the intended purpose of a particular substance.

It is not required.

Question 6

Fish oil: Use, Safety, Evidence

Answer 6

• Use: Lower TG’s (secondary prevention)
• Generally recognized as safe
• Little evidence for decreasing mortality

Question 7

Fish Oil ADR (2)

Answer 7

Increases bleeding risk

Fishy taste

Question 8

Whole grains reduce the risk of __________

Answer 8

Whole grains reduce the risk of heart disease

Question 9

Niacin: Use, ADR (4)

Answer 9

• Use: Treat dyslipidemia (lowers LDL and TG, raises HDL)
• Flushing, hyperglycemia, hyperuricemia, hepatotoxic

Question 10

Plant Sterols/Stanols: Use, ADR (1), DDI (1)

Answer 10

• Use: Reduce total cholesterol and LDL
• ADR: GI upset
• DDI: Ezetimibe

Question 11

What dyslipidemia supplement requires 2-3 weeks to work?

Answer 11

Plant sterols

Question 12

Red Yeast Rice: Use, MOA, ADR (3)

Answer 12

• Use: lower LDL
• MOA: HMG-CoA reductase inhibitor (like statin)
• ADR: Renal failure, liver damage, GI upset

Question 13

Ephedra: Use, MOA, Safety

Answer 13

• Use: weight loss
• MOA: contains pseudoephedrine and ephedrine (alpha, beta agonists)
• Safety: RISK >> BENEFIT

Question 14

Bitter orange: Use, safety

Answer 14

• Use: Weight loss
• Similar to ephedra in MOA and safety (no safer than ephedra)

Question 15

Calcium: Use, evidence

Answer 15

• Used for weight loss
• Although dietary calcium increases fat loss, calcium supplements do not

Question 16

Alli/Orlistat: Use, MOA

Answer 16

• Use: weight loss
• MOA: Lipase inhibitor (prevents fat digestion & absorption)

Question 17

Alli/Orlistat: Safety, ADR

Answer 17

• Safe for long-term weight loss
• ADR: Steatorrhea, fecal urgency

Question 18

Chromium: Use, evidence, caution in these patients (2)

Answer 18

• Use: Diabetes
• Evidence: mixed data about efficacy
• Extra caution in patients with renal or hepatic problems

Question 19

Vanadium: Use, MOA, ADR (2)

Answer 19

• Use: treat T2D
• MOA: activates insulin receptor, promotes glucose oxidation
• ADR: GI upset, kidney toxicity

Question 20

Which supplement is effective in treating T2D?

Answer 20

Vanadium

Question 21

Garlic: Use, safety, active ingredient

Answer 21

• Use: treats HTN
• Generally recognized as safe
• Active ingredient: allicin

Question 22

How should dietary garlic be prepared as a supplement?

Answer 22

Garlic must sit out for 10 minutes chopped up before ingesting

Question 23

Co-enzymeQ: Use, evidence, ADR (2)

Answer 23

• Use: CHF, counter statin-induced myopathy
• Evidence only as adjunct with normal CHF medications
• ADR: lowers Prostate-Specific Antigen, increased bleeding risk

Question 24

How should CoenzymeQ be ingested?

Answer 24

Take with a fatty meal to increase absorption