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What’s in your energy drink?

Energy drinks are really “stimulant” drinks. Learn how to identify potentially harmful ingredients.

Stimulants can be dangerous to your health, especially in large quantities, but they’re what give energy drinks their “punch.” You may already know caffeine is a major stimulant found in energy drinks. But do you know that energy drinks often contain other stimulants? These can include “hidden sources” of caffeine (such as guarana, green coffee bean, green tea, and yerba mate), yohimbe, and synephrine (bitter orange).

Many energy drinks, however, aren’t labeled with the amounts of caffeine or other stimulants in them. Some or all of these ingredients are often part of “proprietary blends,” so it’s impossible to determine from the label the exact amount of each ingredient you would be taking. Furthermore, energy drinks might be mislabeled or marketed as sports drinks, causing even more confusion.

Remember, stimulants come in many different forms, so Operation Supplement Safety (OPSS) put together a list of stimulants found in dietary supplements to help you identify these potentially harmful ingredients. And to help you understand what’s in your energy drink, check out the OPSS infosheet on energy drink labels, which includes helpful notes about ingredients. 

Nitric oxide supplements for performance?

Nitric oxide supplements are popular pre-workout supplements, but do they deliver on their promises to boost performance?

Nitric oxide (NO) supplements are marketed to maximize your performance by giving you extra energy and enhancing your focus during workouts so you can train longer and harder. But these supplements don’t contain any nitric oxide, which is a gas. So what’s really in them, and do they work? More important, are they safe to use? Find out in our OPSS FAQ on nitric oxide supplements.

Do you still have questions about dietary supplements? Explore our other Operation Supplement Safety FAQs. If you can’t find the answer there, you can use our “Ask the Expert” button.

“Tainted” dietary supplement products

Dietary supplements sometimes contain ingredients that are not listed on the label. Find out which products can put your health and career at risk.

Service members should be careful about taking dietary supplements because many of these products contain hidden active ingredients that can result in harmful effects.

The most common types of dietary supplements found to contain “undeclared” ingredients (that is, substances not listed on the label) are those marketed for weight loss, sexual enhancement, and bodybuilding. The Food and Drug Administration (FDA) has identified over 600 tainted dietary supplements. FDA specifically warns against the use of products that claim to be “alternatives” to FDA-approved drugs or “legal” alternatives to anabolic steroids.

Dietary supplements don’t require approval by FDA before being put on the market, and without laboratory testing there is no way to know the contents of a product. If you’re considering a dietary supplement, be sure to check the label to see if the product has been evaluated by an independent third-party organization.

For more information, please visit Operation Supplement Safety (OPSS), including the OPSS High-Risk Supplement List.

Have you had an adverse event?

Know the signs of an adverse event and how to report this important information.

An “adverse event” can occur as a result of taking some dietary supplements. Learn how to identify an adverse event from the Operation Supplement Safety (OPSS) FAQ, and find out where you can go to report one. And for healthcare providers, HPRC has a helpful video, “How to probe for dietary supplement use and report adverse events.” (Click on the “Video” tab to access the link.) Documenting adverse events is an essential part of how the Food and Drug Administration (FDA) evaluates potentially dangerous dietary supplements, so it’s very important to report potential problems.

The dirt on diatomaceous earth

Diatomaceous earth is promoted as a “cure-all,” but is there any truth behind the claims?

Diatomaceous earth (DE) is a powder composed of fossilized algae called “diatoms.” Diatoms are single-celled organisms found in bodies of water, and DE is used commonly for various reasons: 1) a natural insecticide; 2) an anti-caking agent; and 3) a clarifier for wine and beer. However, some people add food grade DE to their food and beverages because DE is a rich source of silicon dioxide. Silicon is a chemical element that occurs naturally as silicon dioxide in many foods, such as whole grains and vegetables.

Proponents of DE suggest that the high silicon dioxide content helps with weight loss, detoxification/cleansing, energy levels, joint pain, teeth and gums, cholesterol and blood pressure, and food absorption. Consumers and some retailers of DE supplements also claim that its abrasive (scratchy/rough) and absorptive properties improve digestive health by ridding the intestines of bacteria and parasites as well as regulating bowel movements.

There is not enough research to support these claims, and the biological role of silicon in humans is uncertain, so there is no recommended intake or DRI (Dietary Reference Intake). According to Natural Medicines Comprehensive Database, silicon is safe to consume in amounts commonly found in foods, but insufficient scientific evidence is available for its effectiveness and safety as a dietary supplement.

For more answers to common questions we’ve received about dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.

Redotex for weight loss?

Is the weight-loss product Redotex legal?

Redotex is a drug manufactured in Mexico and being sold in the U.S. as a weight-loss product. According to the U.S. Food and Drug Administration (FDA) it is a misbranded drug and is not legal to sell as either a drug or a dietary supplement. It is not permitted for use by DoD personnel or civilians.

According to the FDA Import Alert, “it appears to be a new drug without an approved New Drug Application…” In addition, it contains a combination of thyroid, diuretic, stimulant, and tranquilizer drugs that may cause serious and potentially fatal adverse reactions. In addition to posing a health hazard, the product contains a DEA Controlled Substance that will cause a positive drug test. It is very important to read product labels, and if the label is not in English or contains any of the drug ingredients listed in the FDA Alert, steer clear, as it is an illegal product.

For more answers to questions we’ve received about weight-loss dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.

FDA warns about BMPEA

What is BMPEA and why has FDA issued a warning about it?

BMPEA is an unapproved amphetamine-like substance that has been appearing in some dietary supplement products. BMPEA (also known as β-methylphenylethylamine, R-beta methylphenylethylamine, beta-methylphenethylamine, and others) was first made in the 1930s as a possible replacement to amphetamine (a central nervous system stimulant), although it never became a drug because human studies on safety were not performed.

The Food and Drug Administration (FDA) tested 21 supplement products with the ingredient Acacia rigidula listed on the label and found that 9 of the 21 products were found to contain BMPEA, which is not derived from the plant Acacia rigidula. Some dietary supplement products actually list BMPEA on their labels. FDA recently issued a warning stating, “…BMPEA does not meet the statutory definition of a dietary ingredient.” Therefore, dietary supplement products with BMPEA are misbranded and cannot be sold as dietary supplements.

The World Anti-Doping Agency has banned BMPEA. For more answers to questions we’ve received about ingredients in dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.

Deadly DNP in supplements

You may have read about deaths associated with weight-loss supplements containing DNP. What is it? Is it really all that dangerous?

DNP stands for “2,4-dinitrophenol,” an industrial chemical used in diet pills in the early 20th century that is now resurfacing. Over the past several years, deaths associated with DNP in weight-loss products have been reported.

A century ago DNP was recognized as dangerous and often deadly. In fact, the first Federal Food, Drug, and Cosmetic Act in 1938 made it illegal in oral products, describing it as “extremely dangerous and not fit for human consumption.” However, it is still made for pesticides and other industrial uses.

Virtually anyone can purchase the chemical and put it into a product. It is currently being marketed on the Internet as a weight-loss product. It takes very little for a lethal oral dose (as low as 4.3 mg/kg bodyweight, or about 350mg for a 180 lb person), and even skin or respiratory exposure can be toxic. DNP leads to dehydration from sweating, severely high body temperature, and cell poisoning, resulting in organ failure. There is no specific antidote for DNP poisoning, and treatment is often unsuccessful.

If you see “DNP” or “dinitrophenol” on a product label, steer clear! DNP supplements are marketed almost exclusively online, so be careful what you buy.

For more answers to common questions we’ve received about dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.

Hemp products: Are they allowed?

Find out if service members are allowed to consume products made with some form of hemp.

Hemp, or Cannabis sativa, is the plant that naturally contains the substance tetrahydrocannabinol (THC, the psychoactive ingredient in marijuana) although the chemical can also be produced in a laboratory. Historically, the hemp plant has been used for fiber in clothing, rope, paper, etc., as well as for nutritional, medicinal, and recreational purposes.

According to a 2015 report on hemp prepared for Congress, different varieties (and parts) of the cannabis plant are grown and used for different purposes. “Industrial hemp”—the kind grown for agricultural crops (including in foods, beverages, and dietary supplements)—is typically less than 1% THC. Cannabis grown to produce marijuana usually contains around 10% (but can exceed 30%) THC in the parts of the plant used.

DoD policy as set in DoDI 1010.01 specifically mentions marijuana, “synthetic cannabinoids,” and controlled substances (which include THC), but does not mention hemp per se, and test levels for THC are described in DoDI 1010.16. However, each military service has its own policy on the use of hemp products:

  • Air Force: AFI 90-507, section 1.1.6, states that “the ingestion of products containing or products derived from hemp seed or hemp seed oil is prohibited.”
  • Army: Army Substance Abuse Program, AR600-85, section 4-2p states “this regulation prohibits Soldiers from using Hemp or products containing Hemp oil.”
  • Navy: OPNAVINST 5350.4d, Drug Testing Program, Enclosure (2), states that the “Navy has ‘zero tolerance’ for...the wrongful use, possession, manufacture, or distribution of a controlled substance,” which includes marijuana and THC. The Navy does not have a formal policy on the use of hemp products in food.
  • Coast Guard: ALCOAST 026/99 and COMDTINST M1000.10, section 3.A, state that “ingestion of hemp oil or products made with hemp oil is misconduct that will not be tolerated in the Coast Guard.”

Currently, hemp seeds are being added to a variety of foods (such as yogurt, energy bars, etc.), and based on service policies, such products are prohibited.

For more answers to common questions we’ve received about dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.

What is bitter orange?

Bitter orange, synephrine, and octopamine are three ingredients I’ve seen a lot on Supplement Facts panels and labels. What are they?

Bitter orange is an extract from the immature green fruit of the Citrus aurantium plant, also known as Seville orange. It is sometimes used in small amounts in food as a flavorant and often used in weight-loss supplements. The terms “bitter orange,” “bitter orange extract,” or “Citrus aurantium” are often used interchangeably with the ingredient name “synephrine,” but bitter orange (the extract from Citrus aurantium fruit) is actually a complex mixture of many compounds, including synephrine and octopamine. Although both synephrine and octopamine occur naturally in the Citrus aurantium plant, they also can be made in a laboratory.

Many safety concerns have been raised with regard to synephrine and octopamine, which are both stimulants. The National Collegiate Athletic Association (NCAA) bans both of them, but the World Anti-Doping Agency (WADA) bans only octopamine. Bitter orange is frequently used in "ephedra-free" products since 2004, when the Food and Drug Administration (FDA) banned ephedra for its association with serious adverse cardiovascular effects. Combinations of stimulants—such as bitter orange and caffeine, commonly found together in weight-loss and bodybuilding products—can cause hypertension and increase heart rate in otherwise healthy adults. A major concern with products that list bitter orange (or synephrine, or octopamine) on the label is that the amount of stimulants in the product is sometimes very difficult—if not impossible—to determine. Service members should exercise extreme caution when considering whether to use supplements containing bitter orange.

No conclusive, peer-reviewed, scientific evidence clearly establishes that bitter orange is any safer than ephedra. For more information on bitter orange and ephedra, read the monographs in HPRC’s Dietary Supplement Classification System series.

For more answers to common questions we’ve received about dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.

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