benzofurans and Weight-Loss

Globally, people are struggling with obesity. Many effective, nonconventional methods of weight reduction, such as herbal and natural dietary supplements, are increasingly being sought. Fat burners are believed to raise metabolism, burn more calories and hasten fat loss. Despite patient perceptions that herbal remedies are free of adverse effects, some supplements are associated with severe hepatotoxicity. The present report describes a young healthy woman who presented with fulminant hepatic failure requiring emergent liver transplantation caused by a dietary supplement and fat burner containing usnic acid, green tea and guggul tree extracts. Thorough investigation, including histopathological examination, revealed no other cause of hepatotoxicity. The present case adds to the increasing number of reports of hepatotoxicity associated with dietary supplements containing usnic acid, and highlights that herbal extracts from green tea or guggul tree may not be free of adverse effects. Until these products are more closely regulated and their advertising better scrutinized, physicians and patients should become more familiar with herbal products that are commonly used as weight loss supplements and recognize those that are potentially harmful.

Topics: Adipose Tissue; Adult; Benzofurans; Camellia sinensis; Commiphora; Dietary Supplements; Hepatic Encephalopathy; Humans; Hypolipidemic Agents; Liver Failure, Acute; Liver Transplantation; Monitoring, Physiologic; Obesity; Phytotherapy; Plant Extracts; Plant Gums; Plant Preparations; Tea; Treatment Outcome; Weight Loss

The objective of this study was to study associations of a wide range of halogenated biphenyls, dibenzo-p-dioxins, dibenzofurans and diphenylethers with body mass index (BMI) and evaluate changes in their concentration following bariatric surgery.. Subcutaneous fat, visceral fat and liver tissue samples were collected from 106 patients undergoing Roux-en-Y gastric bypass surgery for weight loss or patients who were undergoing abdominal surgery for nonbariatric reasons. We measured concentrations of an extensive panel of chlorinated and brominated biphenyls, dioxins, and furans, and brominated diphenylethers in the samples. We conducted linear regression to examine associations with BMI, adjusting for age and gender. Changes in concentration for indicator chemicals were evaluated in samples collected following bariatric surgery in a small subpopulation.. After adjustments for age and gender and correction for multiple testing, seven ortho-chlorinated biphenyls, one nonortho-chlorinated biphenyl, four PCDD/Fs and one ortho-brominated biphenyl were associated with BMI. The strongest associations between BMI and lipid-adjusted concentrations were seen with PCB-105 in subcutaneous fat (beta = 16.838 P-val = 1.45E-06) PCB-126 in visceral fat (beta = 15.067 P-val = 7.72E-06) and PCB-118 (beta = 14.101 P-val = 2.66E-05) in liver. The concentrations of sum PCBs, chlorinated toxic equivalent quantity (TEQ's) and brominated compounds increased significantly with weight loss in subcutaneous fat in a group of ten individuals resampled up to five years after bariatric surgery and substantial weight loss.. We show that selected polychlorinated biphenyls PCBs and structurally related polychlorinated dibenzo-p-dioxins dibenzofurans (PCDD/Fs) were associated with BMI. Concentrations of these lipophilic compounds in subcutaneous fat increased following bariatric surgery.

Topics: Bariatric Surgery; Benzofurans; Body Mass Index; Dibenzofurans; Humans; Polychlorinated Dibenzodioxins; Weight Loss

The variable pathogenesis and progressive nature of type 2 diabetes emphasise the need for new antidiabetic treatments. The long acting glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors have improved the treatment. Novel approaches include inhibitors of sodium glucose co-transporter 2, which increase renal glucose elimination, G-protein-coupled receptor agonists, which potentiate insulin and incretin hormone secretion. Proof of principle has been shown for glucagon receptor agonists, glucokinase activators and treatment with dual intestinal peptides, which all induce weight loss and improve glucose tolerance.

Topics: Benzofurans; Diabetes Mellitus, Type 2; Dipeptidyl-Peptidase IV Inhibitors; Dopamine Agonists; Glucagon-Like Peptide 1; Glucagon-Like Peptide-1 Receptor; Glucokinase; Humans; Hyperglycemia; Hypoglycemic Agents; Insulin, Long-Acting; Peptides, Cyclic; Receptors, G-Protein-Coupled; Receptors, Glucagon; Sodium-Glucose Transporter 2 Inhibitors; Sulfones; Weight Loss

Several studies have found that current levels of 2,3,7,8 tetrachlorodibenzo-p-dioxin in serum lipids are related to age with older persons generally having higher levels. To account for this age pattern, reference ranges based on national samples have been established in order to allow determination of background levels for regional studies. In several studies, body mass index (BMI), has also been associated with current 2,3,7,8 tetrachlorodibenzo-p-dioxin levels with increasing body mass index related to increasing levels. We measured lipid-adjusted serum levels for all 2,3,7,8-substituted dioxins and furans in 62 chemical manufacturing workers with chlorophenol exposures and 36 workers without chlorophenol exposures employed at the same location. We then assessed the impact of age and BMI on the serum levels of all these compounds in the presence of other potential confounders. We found that both factors are important independent determinants of serum levels of 2,3,7,8-substituted dioxins and furans. Specifically, age and BMI are both important factors for assessing background levels of 2,3,7,8 tetrachlorodibenzo-p-dioxin, 1,2,3,7,8 pentachlorodibenzo-p-dioxin and the calculated total toxic equivalency. BMI, but not age, is important for assessing background levels of higher chlorinated dioxins and some hexachlorofurans. We conclude that age and BMI are both important considerations when comparing a potentially exposed group to a referent group, or to national norms. Further, age and BMI may also be important in epidemiology studies where back-extrapolation from current dioxin levels is used to assess historical chlorophenol exposure.

Topics: Age Factors; Aged; Aged, 80 and over; Benzofurans; Body Mass Index; Chemical Industry; Dibenzofurans, Polychlorinated; Humans; Male; Middle Aged; Occupational Exposure; Polychlorinated Dibenzodioxins; Smoking; Weight Loss

Topics: Acute Disease; Adult; Anti-Infective Agents; Benzofurans; Chemical and Drug Induced Liver Injury; Diagnosis, Differential; Female; Humans; Plants, Medicinal; Weight Loss

The use of complementary and alternative medicine (CAM) in developed countries has increased significantly over the years. Among the most popular are the weight loss supplements or "fat burners." Liver failure due to these popular remedies has been widely recognized. Usnic acid has been an ingredient of dietary supplements that cause liver failure. Its hepatotoxicity has not been recognized because it is usually mixed with other ingredients that are presumably hepatotoxic. We describe a case of a 28-yr-old woman who presented with fulminant liver failure requiring orthotopic liver transplantation, after taking pure usnic acid for weight loss. This is the first report on fulminant liver failure associated with the ingestion of pure usnic acid. A discussion about hepatotoxicity of the different compounds of dietary supplements is presented. This is a reminder for the clinicians about the potential side effects of CAM.

Topics: Adult; Benzofurans; Dietary Supplements; Female; Follow-Up Studies; Humans; Liver Failure; Liver Transplantation; Obesity; Risk Assessment; Weight Loss

2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and 2,3,4,7,8-pentachlorodibenzofuran (PCDF) are widespread environmental pollutants. TCDD is well known for its adverse effects on female reproduction when administered acutely to immature or adult rats. It is also known that fetal/neonatal exposure to this compound alters reproductive parameters. It is unknown whether exposure to PCDF causes similar adverse effects in offspring. The objectives of the study were to investigate the effects of in utero and lactational (IUL) exposure to TCDD and PCDF on subsequent growth, estrous cycles, and ovulation. Additionally a gonadotropin-primed immature rat model was used to investigate possible direct effects on the ovary after IUL exposure to TCDD (2.5 microg/kg) by evaluating 1) ovarian morphometrics and 2) serum estradiol concentrations. Body weights were reduced in animals with IUL exposure to TCDD and PCDF relative to those in controls at 10 days of age (P < 0.05 for each), and this difference was maintained until termination of the experiment at 125-165 days of age (P < 0.05). Exposure to TCDD or PCDF also disrupted regular estrous cycles and inhibited ovulation rate. On Day 23 (before eCG stimulation), ovaries from animals exposed to TCDD contained the same number of primordial, primary, secondary, preantral, and antral follicles as ovaries from control animals. On Day 25 (48 h after eCG stimulation), ovaries from TCDD-exposed rats had significantly fewer large preovulatory follicles when compared with ovaries from controls. The numbers of smaller follicles (both antral and small antral) were not different. Serum estradiol was significantly lower in TCDD-exposed animals 48 h after eCG stimulation.

Topics: Animals; Benzofurans; Chorionic Gonadotropin; Environmental Pollutants; Estradiol; Estrous Cycle; Female; Growth; Lactation; Ovarian Follicle; Ovary; Ovulation; Polychlorinated Dibenzodioxins; Pregnancy; Prenatal Exposure Delayed Effects; Rats; Reproduction; Weight Loss