Articles Posted in Health Alerts

The coming issue of Clinical Cancer Research will publish two case reports concerning the progression of prostate cancer believed to have been caused by a dietary supplement “spiked” with pharmaceutical compounds. “Spiking” is, unfortunately, an all too common practice in that industry. While claiming to sell “all natural” products, and taking advantage of the regulatory limitations imposed on the FDA under the Dietary Supplement Heath and Education Act (DSHEA), , diet supplement manufacturers put consumers at risk by “spiking” their products with pharmaceutical compounds they know to work, when the herbal compounds do not. Unlike prescription and over-the-counter drugs, current law does not require nutritional supplements to undergo pre-market testing or approval for safety and efficacy.

This was a key issue in the first jury verdict in the nation against an ephedra manufacturer, a case the Alaska Personal Injury Group brought: Talbert v. E’ola Products, Inc., . There, the manufacturer, whose product has since been confiscated by the FDA, “spiked” its ephedra product with the pharmaceutical drug, ephedrine hydrochloride. . In that instance, it caused a healthy young woman to suffer a cerebellar stroke.

The product analyzed by the researchers at University of Texas Southwestern Medical Center has led to an equally horrific outcome–virulent prostate cancer. The researchers report in the journal that the diet supplement, which they have declined to identify by name, contained the sex hormones testosterone and estradiol. Laboratory tests of the product on human prostate cancer cells found it to be a more potent stimulator of cancer cell growth than testosterone alone. Such compounds cannot be sold except by prescription. The spiked hormones are believed to have caused the two men to develop rapidly advancing prostate cancer within months of using the dietary supplement. Both men, before using the product, had low levels of prostate-specific antigen (PSA), a signal for prostate cancer and then presented with widespread cancer within six months, which is unusual. One of the men has died; the other is in the final stages of the disease and is expected to die within months. Notified of these findings, the FDA sent a warning letter to the manufacturer, and the supplement has now been removed from the market.

In addition to failing to list all the steroid hormones contained in the product, the researchers also found that the product’s label stated ingredients that were not present, and it also misrepresented the concentrations of the ingredients present. These kinds of failings are very common in this industry, and arise because of the lack of regulation over the industry’s manufacturing processes. This type of misrepresentation and mislabeling is not just blatant consumer fraud, it can be dangerous when the concentration of an ingredient is too high.
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A common problem an attorney has is how to be certain their client is receiving proper medical care. The attorney can collaborate with the client to be sure that the proper diagnostic steps are being taken. This not only helps further a client’s case, but it also helps the client return to function. It is often the case that a better diagnosis can be obtained depending on what type of films are taken. A current debate is whether the MRI or arthroscophy is preferable in diagnosing a knee injury. Both have shown good diagnostic performance in detecting lesions of the menisci and cruciate ligaments. Nonetheless, arthroscopy has remained the “gold standard”.

The British Medical Bulletin recently published an article examining this question. As might be expected, the answer was, “well, it depends”. The results of the study were that MRI was deemed “highly accurate ” in diagnosing meniscal and anterior cruciate ligament (ACL) tears. Because its use avoids the risk of surgery, it is “the most appropriate screening tool” before arthroscophy is performed. The results differed, however, depending on whether the medial and lateral meniscus and ACL were being examined.

British Medical Bulletin 2007 84(1):5-23.

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