An Internet/WWW search with key words involving weight loss produces an overwhelming number of products, with a large variety of ingredents, some claiming near miracle results with their use. Omission of specific supplements from this page is not intended as a statement of inefficacy.

Information about other ingredients is available with online resources, for example The Natural Pharmacy (TNP), co-hosted by iHerb.com.

Behavioral Cybernetics/2002, an e-book also available through PJ Clinic, includes a chapter on integrating herbal supplements with behavior management techniques for appetite control and weight loss. Click here for more information about this product, including a free preview edition.

The focus here is on three supplements for which the evidence related to appetite control and/or weight loss seems relatively clear: Chromium Picolinate, 5-HTP (5-Hydroxytryptophan), and Ephedra (ma huang).

Research studies.   Chromium is an essential trace mineral that helps the body maintain normal blood sugar levels. Although not unequivocal, there are data suggesting that the supplement may promote a loss of body fat and an increase in muscle mass. The Natural Pharmacy also includes studies suggesting its possible benefits in improving blood sugar control in people with diabetes (click Herbs & Supplements, then scroll down to chromium picolinate).

Target Symptoms and Dosage.    The target when using chromium for weight loss is loss of body fat. Studies with the substance have used dosage levels from 200 to 1,000 mcg daily. A dosage of 200 mcg is typically recommended.

Side Effects and Contraindications   Side effects of chromium appears to be rare when taken at a dosage of 50 to 200 mcg daily, an outcome consistent with my personal experience with this supplement. Medical supervision is important if the dosage is higher than 200 mcg, particularly during pregnancy. Consultation with your health care provider to rule out possible negative interactions is always advisable if you are taking prescribed medications.

Research studies.   5-HTP, also recommended for use with anxiety symptoms, is an amino acid that appears to increase the cell’s output of serotonin. It is derived from the seeds of a West African medicinal plan, the Griffonia simplicifolia. Dr. Michael Murray describes studies strongly supportive of this supplement which suggest that it leads to earlier perceptions of being satiated during a meal. Additional studies related to 5-HTP and weight loss, also with positive outcome, are provided in Then Natural Pharmacy (TNP) material about this supplement (click Herbs & Supplements, then scroll down to 5-HTP).

Target Symptoms and Dosage.   A particularly comprehensive online review of 5-HTP has been provided by Ray Sahelian, M.D. which includes specific questions/answers related to use of 5-HTP for appetite control. Dr. Sahelian recommends starting on a very low dosage, 10 to 25 mg a couple of times a day before a meal and 25 mg at bedtime. In response to one of the question regarding use of this supplement for appetite control, he recommends taking the supplement for periods of 4 to 6 weeks and then taking a break to avoid developing a tolerance. Dr. Michael Murray also provides a great deal of valuable information about this supplement and suggests starting 5-HTP at a low dosage, 50 mg, three times per day, and increasing to 100 mg if the response is inadequate.

Both Drs. Murray and Sahelian suggest that 5-HTP can be taken in conjunction with St. John's wort. If combined, low dosages of each would be recommended, perhaps 50-100 mg of 5-HTP and 150-300 mg of St. John's wort, three times daily.

Side Effects and Contraindications.    When used at appropriate dosage levels, side effects of 5-HTP appear to be minimal. The side effect most often reported is mild symptoms of nausea during the first few weeks of 5-HTP use. There were no adverse side effects in my trial with this supplement.

A primary caution is to avoid use of 5-HTP with prescribed medications which increase serotonin levels (e.g. Prozac, Zoloft, Paxil, etc.) unless the use is being directly monitored by your physician. There would be risk of serotonin "overload". 5-HTP would probably not be a good choice for persons with bipolar disorder, whether or not other medications are being used, with risk of triggering a manic episode.

You will also want to be especially cautious in selection of your source for 5-HTP. The U.S. Food and Drug Administration found a dangerous contaminant known as "peak X" in some 5-HTP products.

Summary.    The evidence to this point appears strongly supportive of 5-HTP, both for use with anxiety/depression symptoms and as a supplement for appetite control.

A good rule of thumb for this (and probably all supplements) is to be extremely cautious in combining with prescribed medications. The prescribing physician should be involved in any decision about adding or substituting the 5-HTP supplement.

Research studies.   Without question, ephedrine, the extract of ephedra (ma huang), is one of the most controversial of the herbal supplements. Its effect is stimulation of the central nervous system with dilatation of the bronchial tubes, blood pressure elevation, and increased heart rate. Traditionally it was used to relieve symptoms of bronchial asthma, chronic bronchitis, and related conditions. An increased rate of metabolism with use of this supplement has been suggested to make it especially helpful in weight loss.

In 1998 the U.S. Food and Drug Administration included ephedra on a list of dangerous supplements, citing a variety of risks, including high blood pressure, heart attack, stroke, nerve damage, and seizures. The Natural Pharmacy (TNP) (click Herbs & Supplements, then scroll down to Ephedra) does not recommend use of ephedra because of the safety concerns.

However, in December of 2000, the Council for Responsible Nutrition (CRN) reported that a comprehensive risk analysis performed by an independent scientific consulting firm found the supplement to be both safe and beneficial for weight loss at a 90 mg per day dosage. Their review included 19 clinical trials as well as the adverse events reports collected by the Food and Drug Administration. A follow-up study appears to confirm that ephedra is safe if conditions of use are carefully followed.

Target Symptoms and Dosage.   When used to assist in weight loss, the primary target is a reduction in appetite. The CRN report cited above suggested that the supplement is safe at a total daily dosage of 90 mg, divided into smaller doses of up to 30 mg. The report also noted a 150 mg total daily dosage as the lowest level at which moderate adverse effects were first observed in the studies which were reviewed.

Side Effects and Contraindications.   Side effects are the primary source of controversy related to this supplement. Concerns, particulary if using more than the recommended amounts, are amphetamine-like side effects, including elevated blood pressure, rapid heart beat, nervousness, irritability, and headaches. Major contraindications would include persons with high blood pressure, heart conditions, diabetes, glaucoma, hyperthyroidism, anxiety or restlessness, impaired circulation to the brain, and current use of MAO-inhibiting antidepressants. It is also suggested that ephedra-based products should be avoided during pregnancy and lactation.

Summary.  If, despite the warnings, you choose to use a supplement with ma huang, it would seem especially important for you to involve your health care provider in the decision. There seems little doubt that the supplement can be helpful in lowering appetite, and it may result in burning calories faster through increasing the metabolic rate. The question, an important one for you to decide, is whether the risks which accompany the supplement are worth the help it provides.

Fortunately, there are many formulations available for use in appetite control/weight loss which do not include this supplement. Some herbal providers have, in fact, prepared "twin" versions of such products, one with and one without the ma huang supplement.

Many herbal providers have prepared blends of supplements which include several substances associated with weight loss and/or appetite control. Examples of ingredients which may be in the blend include: L-Phenylalanine and L-Tyrosine (amino acids which may help with depression and increase alertness), Kava (associated with anxiety reduction), and Guarana (a caffeine-like substance).

In addition to the convenience of taking just one supplement, it is usually a little less expensive. The "advantage" in getting more ingredients than would be likely with separate purchases is also a potential disadvantage. If you choose a proprietary blend, you will want to carefully review the ingredients on the label to be sure you are not adding some unwanted substance.

A personal trial with three of the blended products for appetite control had positive result with no side effects.