Supplements in Metabolic Disease

Question 1

___ of patients didn’t report Integrative Health and Medicine (IHM) use to health care provider

Answer 1

72 %

Question 2

_____ % of Adult American population that use IHM

Answer 2

33.2 %

Question 3

Dietary Supplement and Health Education Act (DSHEA) 1994 states that the manufacturers of supplements are responsible for what 3 things?

Answer 3

1) Do not need to register or get FDA approval
2) Responsible to ensure product is safe
3) Ensure product label information is truthful and not misleading

Question 4

what are the responsibilities of the FDA in terms of supplements

Answer 4

1) Takes action if product is unsafe once on the market
2) Monitors safety (ADR MedWatch reporting)
3) Monitors product information

Question 5

what is the most used natural products by adult americans?

Answer 5

fish oil/omega 3

Question 6

what are the adverse effects of fish oil/omega 3 supplements

Answer 6

Fish taste, GI upset, heartburn, and belching

Question 7

what are the herb interactions with fish oil

Answer 7

(4 G’s) Garlic, Ginger, Ginkgo, and Ginseng

Question 8

what is the MOA of fish oil

Answer 8

Decrease in hepatic secretion of VLDL-C, increase VLDL-C clearance, reduces TG transport

ω-3 fatty acids compete with arachidonic acid in the cyclooxygenase & lipoxygenase pathways

Question 9

what should you monitor when a patient is taking Niacin supplements

Answer 9

Monitor: LFT’s due to Hepatotoxic risk

Question 10

what is the mechanism of action of plant sterols

Answer 10

Inhibits about 50% intestinal absorption of cholesterol

Question 11

what is the MOA of Plant Stanols

Answer 11

Inhibits dietary and biliary cholesterol

Question 12

Plant Sterols & Stanols need to be taken for ____ to be effective

Answer 12

2-3 weeks

Question 13

Certain products of red yeast rice contain about 10 mg of _______

Answer 13

HMG-CoA reductase inhibitors

Question 14

name 3 drugs/supplements that can increase HDL-C

Answer 14

1) fibrates
2) Niacin
3) Statins

Question 15

Patients will low _______ intake often gain more weight and have a higher BMI and maybe overweight or obese

Answer 15

calcium

Question 16

_______ mg/daily dietary calcium had been shown to increase weight reduction & body fat loss

Answer 16

800-1200

Question 17

what is the Mechanism of action of orlistat

Answer 17

Reversible inhibitor of pancreatic & gastric lipase

Question 18

what population can benefit form orlistat

Answer 18

Drew B et al. 2007 meta-analysis review: patient with BMI ≥ 27 saw a significant reduction of weight loss ~ 3 % then diet alone

Question 19

what is the MOA of chromium

Answer 19

Might reduce oxidative stress,

Low levels are associated with impaired glucose & insulin

Question 20

______ found in food and supplements, while

_____ is used in welding industries and is carcinogenic

Answer 20

Chromium III,

Chromium VI

Question 21

What is the MOA of Vanadium

Answer 21

Activates insulin receptor proteins, stimulates glucose oxidation & transport
Liver: stimulates glycogen synthesis
Adipose: inhibits lipolysis
Skeletal muscle: promotes glucose uptake

Question 22

What is the MOA of Garlic

Answer 22

Allicin is the active ingredient
Inhibits hepatic cholesterol synthesis
Activates production of endothelium-derived relaxation factor to relax smooth muscle and vasodilation

Question 23

what supplement should be Discontinued 2 - 3 weeks prior to surgery

Answer 23

Garlic

Question 24

what is the indication for garlic supplements

Answer 24

Hypertension

Question 25

what is the indications for coenzyme Q-10 supplements

Answer 25

Congestive heart failure

Preventing statin-induced myopathy

Question 26

what is the Mechanism of action of Coenzyme Q-10

Answer 26

Has antioxidant properties to stop damage and give energy to cells
Cofactor in metabolic pathways

Question 27

what evidence is there for the efficacy of Coenzyme Q-10

Answer 27

No evidence when taken as monotherapy, possibly useful with prescription treatment for HF
No significant benefit for myopathy or statin tolerability

Question 28

which medications can lower Co Q 10 levels

Answer 28

Statins, beta blockers, and diuretics

Question 29

Coenzyme Q-10 should be taken with ________

Answer 29

a fatty meal