Daily Archives: January 5, 2011

Less Than 25% of Valerian Herbal Sleep Supplements Pass Tests For Quality

Long-time readers of this blog know of my admiration for ConsumerLab.com, a leading provider of consumer information and independent evaluations of natural medications (herbs, vitamins and supplements). In fact, I use their findings almost daily in my practice to recommend natural medications to my patients.

In its most recent evaluation of a natural medication, valerian, ConsumerLab found that MOST of the valerian herbal supplements tested contained less of the herb than expected and/or were contaminated with lead.

Valerian is a popular herbal sleep aid used by approximately 6% of the U.S. population. Valerian accounted for $68 million in sales in the U.S. in 2009, up 10% from the prior year, according to Nutrition Business Journal.

Among nine leading and best-selling products selected by ConsumerLab.com for review, only TWO passed testing.

Of the seven that failed, one contained no detectable key valerian compounds and four others had only 26.7% to 82.5% of amounts expected from ingredient listings.

One of these products was found to be contaminated with lead, as were two other products. These results were confirmed in independent laboratories. Lead is a heavy metal that can impair mental functioning and may affect blood pressure. The amounts of lead found in the products (which ranged up to 3.5 mcg of lead per daily serving) are not likely to cause toxicity alone, but it is best to avoid unnecessary lead exposure.

Lead contamination was found to be an issue in products consisting primarily of valerian root powder as opposed to valerian root extract. The extraction process removes heavy metals.

“Valerian may help some people with sleep problems, although the evidence is mixed,” said Tod Cooperman, M.D., President of ConsumerLab.com. “Unfortunately, it appears that many people may not be giving valerian a fair try because the brand they buy lacks the expected ingredient. And some brands unnecessarily increase one’s exposure to lead.”

ConsumerLab.com found similar problems in earlier reviews of valerian supplements in 2001, 2004, and 2006. Dr. Cooperman added, “If you use valerian, it would seem prudent to choose a product that passed ConsumerLab.com’s testing.”

The complete report is available here. The report includes results for ten products. ConsumerLab.com selected nine. One other product was tested at the request of its manufacturer through CL’s Voluntary Certification Program and is included for having passed testing.

Brands included are:

  • A. Vogel (Bioforce),
  • Bluebonnet,
  • CVS,
  • Douglas Laboratories,
  • Genestra (Seroyal),
  • Mason,
  • Nature’s Answer,
  • Shaklee,
  • Solaray, and
  • Solgar.

Another of my favorite Internet-based sites for information on natural medications, the Natural Medicines Comprehensive Database, rates valerian as POSSIBLY EFFECTIVE for insomnia. The Database says:

Most research shows that taking valerian orally reduces the time to sleep onset (sleep latency), and improves subjective sleep quality. The greatest benefit is usually seen in patients using 400-900 mg valerian extract up to 2 hours before bedtime.

Valerian does not relieve insomnia as fast as benzodiazepines. Continuous nightly use for several days to four weeks might be needed for significant effect.

Some research suggests that valerian is not as effective as temazepam (Restoril) or diphenhydramine (Benadryl) for causing sedation in elderly people.

Valerian is often used in combination with other sedative herbs. Taking a combination product containing valerian extract 187 mg plus hops extract 41.9 mg per tablet, two tablets at bedtime, seems to modestly improve subjective sleep measures including subjective sleep latency compared to placebo after 28 days of treatment; however it was not significantly better than placebo after only 14 days of treatment (15018). A combination of valerian with lemon balm might also improve the quality and quantity of sleep in healthy people.

Valerian also seems to improve the sleep quality of insomniacs who have recently withdrawn from benzodiazepines. After tapering the benzodiazepine over two weeks, 300 mg valerian extract in three divided daily doses might subjectively improve sleep quality.

There is also preliminary clinical research that suggests valerian also might help improve sleep in intellectually impaired children.

Not all evidence is positive. Some evidence suggests that valerian does not significantly improve insomnia compared to placebo.

Valerian does not relieve insomnia as fast as benzodiazepines (6480). Continuous nightly use for several days to four weeks might be needed for significant effect (6249,10209).
Some research suggests that valerian is not as effective as temazepam (Restoril) or diphenhydramine (Benadryl) for causing sedation in elderly people (10424).
Valerian is often used in combination with other sedative herbs. Taking a combination product containing valerian extract 187 mg plus hops extract 41.9 mg per tablet, two tablets at bedtime, seems to modestly improve subjective sleep measures including subjective sleep latency compared to placebo after 28 days of treatment; however it was not significantly better than placebo after only 14 days of treatment (15018). A combination of valerian with lemon balm might also improve the quality and quantity of sleep in healthy people (10423).
Valerian also seems to improve the sleep quality of insomniacs who have recently withdrawn from benzodiazepines. After tapering the benzodiazepine over two weeks, 300 mg valerian extract in three divided daily doses might subjectively improve sleep quality (8006).
There is also preliminary clinical research that suggests valerian also might help improve sleep in intellectually impaired children (10207).
Not all evidence is positive. Some evidence suggests that valerian does not significantly improve insomnia compared to placebo (15046).

The Natural Medicines Database also rates valerian as POSSIBLY SAFE “when used orally and appropriately, short-term. Clinical studies have reported safe use of valerian for medicinal purposes in over 12,000 patients in trials lasting up to 28 day.” However, “the safety of long-term use is unknown.”

So, for my patients with occasional insomnia, I simply print off the ConsumerLab.com list of valerian products that have passed quality testing and say, “Buy the least expensive one and don’t use it more than a month at a time.”

The three products on the current “approved” list include:

  • Bluebonnet Herbals Valerian Extract (1 vegetable capsule, 1 per day)
  • Shaklee® Gentle Sleep Complex (3 tablets, 3 per day)
  • Solgar® Standardized Valerian Root Extract (1 vegetable capsule, up to 3 per day)

9 Food Additives That May Affect ADHD

In my book on ADHD, Why ADHD Doesn’t Mean Disaster …

ADHD

On sale now in both softcover and hardcover

… I say this about the association between food additives and ADHD:

Dr. Ben Feingold first popularized the idea in his 1985 book, Why Your Child Is Hyperactive, that food additives caused ADHD. However, multiple medical studies since then indicate that the likelihood of these substances playing a role in ADHD is very, very low. Although food dyes or preservatives may affect some children, it is at most a very small percentage and a very small effect.

Nevertheless, I also wrote this:

While it is highly unlikely that ADHD is either caused or worsened by junk foods, there are plenty of other health reasons to restrict these foods at least on normal days.

And, I might add, there’s certainly no harm in trying a diet eliminating or restricting food additives and see how your child does. If you want to give this a try, here are nine additives you may want to first eliminate according to an article at Health.com:

1) Blue No. 1

  • Also known as: Brilliant blue
  • What it is: A food coloring
  • Where you can find it: Frito-Lay Sun Chips French Onion and other Frito-Lay products; some Yoplait products; some JELL-O dessert products; Fruity Cheerios; Trix; Froot-Loops; Apple Jacks; Quaker Cap’N Crunch’s Crunch Berries; some Pop-Tarts products; some Oscar Mayer Lunchables; Duncan Hines Whipped Frosting Chocolate; Edy’s ice cream products; Skittles candies; Jolly Ranchers Screaming Sours Soft & Chew Candy; Eclipse gum; Fanta Grape

2) Blue No. 2

  • Also known as: Indigotine
  • What it is: A food coloring
  • Where you can find it: Froot-Loops; Post Fruity Pebbles; Pop-Tarts products; Duncan Hines Moist Deluxe Strawberry Supreme Premium Cake Mix; Betty Crocker Frosting Rich & Creamy Cherry; M&M’s Milk Chocolate Candies; M&M’s Milk Chocolate Peanut Candies; Wonka Nerds Grape/Strawberry; pet foods

3) Green No. 3

  • What it is: A food coloring, though rarely used these days
  • Where you can find it: Candy, beverages, ice cream, puddings

4) Orange B

  • What it is: A food coloring, but no longer used
  • Where you used to find it: Sausage casings

5) Red No. 3

  • Also known as: Carmoisine
  • What it is: A food coloring found only in a few types of food products
  • Where you can find it: Candy, cake icing, chewing gum

6) Sodium benzoate

  • What it is: A food preservative
  • Where you can find it: Fruit juice, carbonated beverages, and pickles
  • You’ll find sodium benzoate in abundance in acidic foods. It is used to stymie the growth of microorganisms, according to the Center for Science in the Public Interest (CSPI).

7) Red No. 40

  • Also known as: Allura red
  • What it is: A food coloring and the most widely used food dye in the U.S., trumping both Yellow No. 5 and Yellow No. 6.
  • Where you can find it: Some Frito-Lay products; some Yoplait products; JELL-O Gelatin desserts; Quaker Instant Oatmeal; Trix; Froot-Loops; Apple Jacks; some Pop-Tart products; Kid Cuisine Kung Fu Panda products; Oscar Mayer Lunchables products; Hostess Twinkies; some Pillsbury rolls and frostings; some Betty Crocker and Duncan Hines frostings; and more

8) Yellow No. 5

  • Also known as: Tartrazine
  • What it is: Yellow No. 5 is the only food dye that has been tested alone and not simply as part of a mix. Those studies did link it to hyperactivity. It is the second most commonly used dye in the U.S.
  • Where you can find it: Nabisco Cheese Nips Four Cheese; Frito-Lay Sun Chips Harvest Cheddar and other Frito-Lay products; some Hunt’s Snack Pack Pudding products; Lucky Charms; Eggo waffles and other waffle products; some Pop-Tarts products; various Kraft macaroni and cheese products; Betty Crocker Hamburger Helper and other products

9) Yellow No. 6

  • Also known as: Sunset yellow
  • What it is: The third most widely used food dye in the U.S.
  • Where you can find it: Frito-Lay Cheetos Flamin’ Hot Crunchy and other Frito-Lay products; Betty Crocker Fruit Roll-ups; some JELL-O gelatin deserts and instant puddings; Fruity Cheerios; Trix; some Eggo waffle products; some Kid Cuisine Kung Fu Panda products; some Kraft macaroni and cheese dinners; some Betty Crocker frostings; some M&M’s and Skittles candies; Sunkist Orange Soda; Fanta Orange

Celebrities With Attention Deficit Hyperactivity Disorder

Writing the book Why ADHD Doesn’t Mean Disaster brought me much joy. In the book I emphasize that people with ADHD are usually quite gifted, but as kids need to be parented in a special way. Kids with ADHD are very valuable but fragile gifts that must be unwrapped and cared for with special skills. (BTW, the book is now on clearance sale here for the softcover [$1.99] and here for the hardcover [$3.99]).

ADHD

I’ve found as I care for kids with ADHD, it’s helpful for them to learn of celebrities who have ADHD. Here is a nice article of celebrities with ADHD from Health.com:

Up to 10 million American adults have attention deficit hyperactivity disorder (ADHD)—also commonly referred to as ADD—so it’s no surprise that some of America’s most acclaimed athletes, actors, and musicians make up part of that mix. Left untreated, the disorder is characterized by poor concentration and disorganization, and can lead to emotional and social problems.

About 60% of children diagnosed with ADHD will continue to experience these symptoms well into adulthood. And some people with the disorder don’t receive an official diagnosis until middle age.

See which celebs have suffered with an ADHD diagnosis since childhood, and which have learned to manage their disorder as adults.

Michael Phelps

The 25-year-old Olympic swimming sensation is famous for his incredible focus in the pool, so it’s hard to believe he has struggled with ADHD since childhood. His teachers complained about his inability to sit still until, in fifth grade, the Phelps’ family physician formally diagnosed him with ADHD. At age 9, Phelps went on Ritalin; his mother, Debbie, later recalled in the New York Times that it seemed to help his hyperactivity. After two years on medication, however, Phelps said he felt stigmatized (each day at lunchtime he had to visit the school nurse to get his medicine) and asked to be taken off the drug. After consulting with his doctor, Debbie agreed to let him be med free.

Instead, Phelps used swimming to help him find focus. In fact, many children with ADHD benefit from competitive sports. “I’m just different in the water,” Phelps told Sports Illustrated. “I just feel at home in it.”

Solange Knowles

The soulful songstress says she’s always been full of energy, and claims that sometimes her sporadic speech and effervescence led people to believe she was on drugs. The real culprit? ADHD.

Knowles, whose older sister is the popular singer and actress Beyoncé, said she was diagnosed with the disorder twice before she believed it. “I didn’t believe the first doctor who told me,” she has said. “I guess I was in denial.”

Traditionally, ADHD was thought to be a male-oriented disease, and men were once believed to account for the vast majority of cases. But recent research has begun to focus on how the disorder affects females, so that ADHD may be identified earlier in women’s lives.

Ty Pennington

The energetic and upbeat star of ABC’s Extreme Makeover: Home Edition said he was “uncontrollable” as a child unless he had a crayon and piece of paper in hand. Pennington, 44, earned poor marks throughout high school and college, until he was diagnosed with ADHD as an undergrad. He’s now a spokesperson for Shire, a pharmaceutical company that manufactures adult ADHD drugs.

“I’m about as ADHD as you can get,” Pennington told InStyle magazine. He went on medication following his diagnosis and saw an instant improvement in his schoolwork. “I immediately stared getting straight A’s. It changed my life!”

Howie Mandel

The Deal or No Deal host is calm and collected during his super-hyped game show, but ADHD made him impulsive and unfocused well into adulthood, when he finally got a formal diagnosis.

A penchant for pranks got Mandel expelled from high school, and he continued to struggle with his attention span for the next 20 years before his doctor finally gave him an ADHD diagnosis. “I found it difficult to sit down and read a script for work, or even have a conversation,” says Mandel, 55.

Mandel is now the celebrity spokesperson for the Adult ADHD Is Real PSA campaign, encouraging treatment for the disease.

James Carville

The political pundit and consultant is widely credited with helping Bill Clinton win the 1992 presidential election, but he wasn’t always so focused. In fact, Carville, 66, initially flunked out of college.

He later went back to earn his bachelor’s degree before going on to graduate from law school. Carville has said that he found his razor-sharp focus for politics because of its fast-paced and ever-changing nature. In 2007, Carville was a featured guest at the CHADD (Children and Adults With Attention Deficit/Hyperactivity Disorder) 20th Anniversary Hall of Fame Conference.

Christopher Knight

Playing pint-size Peter on the original Brady Bunch television series, Knight, 52, had a hard time learning his lines. Finally, in 1997, he was diagnosed with ADHD. He sought treatment to help manage his condition and served as a spokesperson for the National Consumer League’s AD/HD campaign.

Cammi Granato

She helped lead her team to gold as the captain of the U.S. women’s ice hockey team at the 1998 Olympics in Nagano, Japan—and she credits her ADHD with helping her get that far. Granato, 39, claims that constantly feeling restless contributed to her drive on ice.

ADHD makes everyday tasks such as paying bills more difficult for Granato, but the energy and creativity associated with the disorder have helped in her sport. “It’s affected me in positive and negative ways,” Granato told the St. Louis Post-Dispatch in 2005. “It’s really my worst and best qualities wrapped in one.”