JAMA Internal Medicine: Consumer Protection/Safety Topic Collection

Caffeine Content of Dietary Supplements Consumed on Military Bases

Cohen PA, Attipoe S, Travis J, et al. — Mon, 08 Apr 2013 00:00:00 GMT

Excessive caffeine consumption, particularly when combined with other stimulants, may increase the risk of hypokalemia, rhabdomyolysis, and other heat-related injuries among athletes and military personnel. Caffeine is consumed in a wide range of popular items including coffee, teas, sodas, energy drinks, energy gels, chocolate, gums, and over-the-counter medications. Dietary supplements, which are commonly consumed by military personnel, are a poorly characterized source of caffeine. Only with accurate information about the quantity of caffeine in dietary supplements can consumers and clinicians be assured of safe use. As part of an ongoing multidisciplinary collaboration to promote dietary supplement safety, we analyzed some of the most popular supplements sold on military bases to determine the accuracy of information available to military personnel and their health care providers regarding caffeine content in dietary supplements.

Over-the-Counter and Compounded Vitamin D: Is Potency What We Expect?

LeBlanc ES, Perrin N, Johnson JD, et al. — Mon, 08 Apr 2013 00:00:00 GMT

Because vitamin D insufficiency can be harmful to health, supplementation is often prescribed. However, the Food and Drug Administration (FDA) does not regulate vitamin D supplements, so potency may not be well evaluated. In a recent trial examining vitamin D in menopausal women, we found that compounded vitamin D₃ (cholecalciferol) supplements varied significantly in potency. Only one-third of our compounded study pills met US Pharmacopeial (USP) Convention standards, which require that compounded pills contain 90% to 110% of the active ingredient. This variability in compounded cholecalciferol pills led us to additionally investigate over-the-counter (OTC) cholecalciferol pills, in which we also found variability.

DMAA as a Dietary Ingredient

Rodricks JV, Lumpkin MH. — Mon, 08 Apr 2013 00:00:00 GMT

DMAA (1,3-dimethylamylamine) is an aliphatic amine added to some dietary supplement (DS) products. We are responding to the Research Letter by Cohen, in which he discussed natural occurrence of DMAA, as well as labeling it a potent “amphetamine derivative” linked in case reports and the news media to adverse cardiovascular toxic effects. We would like to offer the following points in the interest of moving forward the discussion of the health effects of DMAA within the context of sound toxicological and risk assessment principles.

DMAA as a Dietary Ingredient—Reply

Cohen PA. — Mon, 08 Apr 2013 00:00:00 GMT

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