Workout, Weight-Loss and Diet Supplements While Breastfeeding February 11 2015

Part 1

In my post on Breastfeeding and Losing Weight, I mention in the supplements section that many supplements just aren’t safe to take while nursing. I thought I would explore that subject a bit more for those who are interested (including me). This post will cover some of the basics of supplementing for working out and weight loss and will list the main ingredients I have found in supplements.

I want to emphasize that I am not a medical professional, I am not an herbalist, and all of my research comes from the internet and other books, and may not be 100% accurate due to the source (i.e. the internet is not always accurate). I will list my sources with each post so you can do your own research as well. This is meant to be a basic list of ingredients with their uses and safety for breastfeeding moms.

This post will be followed by posts on popular supplement brands. I will list popular products made by those brands and will list only the questionable ingredients and ingredients you should not take as a nursing mother. This will help you to make your decisions on what supplements you should or should not take while nursing. If you should decide to take something, it is always a good idea to speak with your doctor about it first.

Workout Supplement Basics

Pre-Workout- Used to boost your energy and endurance, increase strength, boost muscle growth and burn body fat. It also increases your ‘pump’. Usually includes amino acids, BCAA’s (Branch Chain Amino Acids), and caffeine.

BCAA’s- (Branch Chain Amino Acids) includes 3 amino acids Leucine, Isoleucine and Valine. These aid in muscle growth, increase energy and stop fatigue. BCAA’s go directly into the blood stream. They are burned for energy during exercise. They lower lactate levels after weight training. They aid in muscle growth, decrease muscle damage and improve recovery. BCAA’s are important to take during or after workouts in addition to a carb like Maltodextrin and a protein. Leucine is the most important BCAA with a recommended daily intake of 1-4g per day, but for athletes this could be as much as 12 g per day for optimum muscle growth. All animal protein sources contain a complete and high level of BCAA’s. You can find more info HERE. If you eat a varied diet and plenty of protein then you likely don’t need to supplement with BCAA’s. You can find a good explanation of that here.

Post-Workout Recovery- Usually includes amino acids, BCAA’s , and a carbohydrate like Maltodextrin and possibly protein, but protein can also be taken separately. A post-workout supplement is taken to increase muscle growth and aide in recovery. A carbohydrate drives the BCAA’s into the blood stream to aid in recovery. Both protein and carbohydrates are important after a workout to stimulate protein synthesis and suppress protein breakdown. This should be taken within 30-60 minutes of your workout.

Amino Acids

As you can see, all three of these supplements contain essential amino acids and BCAA’s. Most sites I have come across have not recommended taking BCAA’s while breastfeeding. However, this is stated simply because they have not been studied in pregnant and nursing women. Essential amino acids, non-essential amino acids, conditional amino acids and BCAA’s are all found readily in the proteins that we eat. Since they are a naturally occurring nutrient, it stands to reason that they are safe to consume in reasonable quantities. When pregnant and lactating you have a naturally higher need for amino acids. So, while it might not be a good idea to consume all 3 of these supplements while nursing, consuming one or consuming a protein supplement that includes naturally occurring amino acids and BCAA’s after a workout is not likely to harm you or your baby. Look for a supplement with 5g or less of amino acids and one that includes a wide range of amino acids so that you aren’t throwing off your amino acid balance.

Caffeine

Most breastfeeding mothers can have caffeine in moderation. The upper limit suggestion ranges from 300 mg to 700 mg per day. Premature and very young infants tend to have more problems with mom’s intake of caffeine. According to Kellymom.com milk levels are .06-1.5% of the mother’s dose of caffeine and they peak 1-2 hours after ingestion (Bonyata, 2011). The following chart shows the half-life of caffeine.

 

As you can see, somewhere between 4 and 9 months most babies can more easily process caffeine. My husband’s pre-workout supplement contains 300 mg of caffeine (equivalent to approximately 3 cups of coffee). You can see how taking a pre-workout may cause some problems in babies sensitive to caffeine. However, if your baby is not sensitive to caffeine or you have an older baby, then taking a pre-workout after nursing your baby and before working out may be ok for you.

If you want to know about how much caffeine you are taking in on a daily basis, you can use the following chart.

 

                                               

Vitamins and Minerals

The following chart lists vitamins, minerals and amino acids commonly in supplements. You will see the Recommended Daily Intake as well as the Upper Limit for daily intake. It is a good idea to try to stay around the RDA for your vitamin intake on a daily basis. Continually supplementing with extremely high doses of some vitamins can cause health problems. According to this article on WebMD the vitamins most likely to cause an issue when continually taken at high doses are Vitamin D, Calcium and Folic Acid. While you might not be taking a large dose of a vitamin in any one supplement, it is important to consider that the total dosage in multiple supplements may be too much.

 

Herbs

The Nursing Mother’s Herbal will be used extensively in my references. The safety ratings used by the Nursing Mother’s Herbal are A, B, C, D, and E. They indicate the degree of caution required for each herb.

A- No contraindications, side-effects, drug interactions, or pregnancy-related safety issues have been     identified. Generally considered safe when used appropriately.

B- May not be appropriate for self-use by some individuals or dyads, or may cause adverse effects if misused. Seek reliable safety and dose information.

C- Moderate potential for toxicity, mainly dose related. Seek an expert herbalist as well as a lactation consultation before using. Consider using safer herbs.

D- Use only with supervision of a knowledgeable physician. Consult with a lactation specialist before use. These herbs are used to make prescription medications. The pharmaceutical forms may be safer in most instances, but not always. Do not use these herbs without the guidance of a supervising physician. Consider using safer herbs.

E- Avoid. This is a toxic plant with no justifiable medical use.

(Humphrey, 2003)

There are a significant amount of unknowns when it comes to herb usage during lactation. You should consider limiting your use of herbs, medications, and supplements to situations where the benefit of the family clearly exceeds the risk to your infant. Herbs, although natural, can still be very powerful. Care must be taken when considering taking herbal supplements. Variables to consider include your health, your baby’s health, medication interactions, and baby’s age. Should you have any doubts about a certain supplement, you should seek your doctor’s approval or follow your mommy gut and avoid usage.

 

 

Complete List of Ingredients in Alphabetical Order

Acai Fruit Extract (Euterpe Oleracea)- thought to aid in weight loss.  Lack of scientific evidence on use while breastfeeding (Acai, 2011).

Aloe- Rated C by The Nursing Mother’s Herbal.

Ascorbic Acid- Vitamin C

Ashwagandha (withania)- this herb helps with stress, fatigue, and lack of energy.  It is a galactagogue, but is rated C by The Nursing Mother’s Herbal.  You can read more here and here.

Banaba Leaf- this is said to lower blood glucose and possibly help the body use insulin more efficiently.  Not much is known about using this while nursing (Web MD Banaba, 2015).

Beet-Root Extract- This is used to enhance physical performance.  It also helps with recovery from stress during exercise (Web MD, Beetroot).  No information found on use during lactation.

Beta-Carotene- Beta-carotene is one of a group of red, orange, and yellow pigments called carotenoids. Beta-carotene and other carotenoids provide approximately 50% of the vitamin A needed in the American diet.  Normal doses are likely safe during pregnancy and breastfeeding (Beta-Carotene).

Betaine- A crystalline compound found in many plant juices.  Likely used as a preservative.

Beta-Sitosterol- A substance found in plants and used to make medicine.  Used to reduce pain and swelling after workouts.  Likely safe for most people when taken by mouth.  Dosing ranges from 60mg-800mg 2-6 times a day.  There is not enough known about use during pregnancy and breastfeeding.  (Web MD).  Mommy Meds rates this as L1-Not enough data-Compatible.

Bitter Melon Extract (Momordica Charantia)- Rated C by The Nursing Mother’s Herbal. This is considered a galactagogue.

Blue Green Algae- Plant like organisms found in salt water and some fresh water lakes.  These are used for a variety of different conditions including weight loss, ADD, stress, fatigue, and PMS.  Not enough is known about the use of Blue Green Algae during lactation so you may want to avoid use (Web MD).

Brown Seaweed- There are two types of brown seaweed, Fucus vesiculosus or Bladderwrack and Laminaria japonica.  Bladderwrack is on the list of herbs to avoid during lactation.  This should be avoided if it does not list the species of brown seaweed used.  More information on brown seaweed can be found here.

Capsicum (Capsicum Annuum, Cayenne)- Rated B by The Nursing Mother’s Herbal.  Used to boost metabolism and burn fat.

Carrageenan-A substance extracted from red and purple seaweeds and used as a thickening agent or emulsifier in food products.

Cascara Sagrada- rated B by The Nursing Mother’s Herbal.  This is an herb used for it’s laxative effects.  It is a stimulant laxative and has the potential for being abused and for causing long-term damage.

Cat’s Claw Extract- Rated C by The Nursing Mother’s Herbal.  This is used to boost the immune system, kill cancer and fight viruses. You can read more here.

Cellulose- an insoluble substance that makes up plant cell walls and vegetable fibers such as cotton.

Cellulose Gum- An emulsifier derived from the cell walls of woody plants, usually trees and cotton.

Chitosan- Chitosan is a sugar that is obtained from the hard outer skeleton of shellfish, including crab, lobster, and shrimp.  There is no information about the use of chitosan while breastfeeding. You can read more here and here.

Chondroitin- a compound that is a major constituent of cartilage and connective tissue. The use of chondroitin by a nursing mother is unlikely to cause adverse effects in a nursing infant (Chondroitin, 2015).

Citric Acid (Sodium Citrate)- used as a food additive, usually for flavor or as a preservative.  This can interact with many medications.  You can read more here

Citrus Pectin- this is used in food as a gelling agent, a stabilizer and a source of dietary fiber. You can read more about it here.

Collagen (Type II)- this is thought to decrease the symptoms of arthritis.  It is likely safe while breastfeeding.

Croscarmellose Sodium- a matrix used to deliver drugs to the intestine.

Dandelion Root Extract (Taraxacum Officinalis)- leaf and flower are rated A by The Nursing Mother’s Herbal. Rhizome is rated B by The Nursing Mother’s Herbal. This is considered a galactagogue.

Dicalcium Phosphate- a form of calcium used in supplements.

EGCG (epigallocatechin gallate)- This comes from green tea.  It is used to boost metabolism and help burn fat.  It has many health benefits and is generally considered very good for you.  Green tea is rated B by The Nursing Mother’s Herbal, however it can be a mild stimulant due to the caffeine, and EGCG is a much more concentrated form of green tea.  You may want to use caution with this supplement.

Eleuthero (Siberian Ginseng)- an herb used to improve athletic performance.  This herb is rated B by The Nursing Mother’s Herbal.  You can read more about this herb here.

Epimedium Grandiflorum (Horny Goat Weed)- This is used for mental and physical fatigue.  It contains phytoestrogens, chemicals that act like estrogen that might affect milk production.

Extramel (French Melon Fruit Extract)- this is thought to reduce stress and fatigue.  I couldn’t find any information on using this while nursing.  You can read more about it here.

Fennel- the seed is rated A by The Nursing Mother’s Herbal and it is considered a galactagogue. 

Ferulic Acid- an organic compound that comes from plant cell walls.

Frankincense- rated A by The Nursing Mother’s Herbal.

Fructose- A hexose sugar found especially in honey and fruit.

GABA (Gamma-Amino Butyric Acid)- an amino acid which acts as a neurotransmitter in the central nervous system. It inhibits nerve transmission in the brain, calming nervous activity. It is also touted as increasing Human Growth Hormone levels and is popular among body builders. The published research supporting any of these promotional claims is weak. Current medical opinion says that GABA taken as a supplement does not reach the brain and has no effect or benefit aside from being a benign placebo.  It has not been studied on pregnant or nursing women, however it is non-toxic and generally considered safe.  Studies that have been done used a dosage of 3g-18g per day.  Information found Here.

Gamma-Oryzanol- rice bran oil or rice bran wax. Information on safety during pregnancy and lactation is lacking.

Garcinia Cambogia- Used to prevent fat storage and control appetite.  Garcinia Cambogia has not been studied for use during breastfeeding.  You can read more here and here.

Garlic- garlic has a wide variety of uses.  It is antibacterial, antiviral and anti-fungal.  It can also be used to control blood sugar.  The Nursing Mother’s Herbal rates Garlic as a B.  It is a galactagogue and is allergenic (Humphrey, 2003).

Ginger- an herb, rated B by The Nursing Mother’s Herbal.

Glucosamine Sulfate- a naturally occurring chemical found in the body.  It is in the fluid that is around the joints.  It can also be found in shellfish. It is not likely to adversely affect the infant (Glucosamine, 2015).

Glucuronolactone- is a naturally occurring chemical that is an important structural component of nearly all connective tissues.  Glucuronolactone is metabolized to glucaric acid, xylitol, and L-xylulose, and humans may also be able to use glucuronolactone as a precursor for ascorbic acid synthesis.  The European Food Safety Authority (EFSA) has concluded that exposure to glucuronolactone from regular consumption of energy drinks is not a safety concern.  Additional information can be found here.

Glycine- This is an amino acid.  Not much is known about use during lactation (Web MD, Glycine).

Green Coffee Beans (Green Coffee Extract)-  used for weight loss.  Thought to affect how the body handles blood sugar and metabolism.  This does contain caffeine.   No information found on use of green coffee beans or extract while breastfeeding.  You can read more about this here.

Green Tea Leaf Extract- rated B by The Nursing Mother’s Herbal, listed as a stimulant due to the caffeine content.

Guarana- used for weight loss and to enhance athletic performance.  It is rated B by The Nursing Mother’s Herbal and is listed as a stimulant due to the caffeine content.  It is likely safe when taken in small amounts (no more than 200 mg) (Web MD, Guarana).

Gymnema Leaf Extract (Gemnema Sylvestre)- Rated C by The Nursing Mother’s Herbal. This is considered a galactagogue.

Hydrochloride-A salt resulting from the reaction of hydrochloric acid with an organic acid.

Inositol- also known as Myo-Inositol or d-chiro-inositol.  It is part of the B-vitamin complex.  It is found in lecithin and helps to emulsify fats.  It is taken by women with PCOS to help with insulin resistance.  Many of them take it while pregnant and breastfeeding.  We get about 1g of inositol daily in the food we eat. There is no RDA for it since it is also made in our bodies.  A therapeutic dose starts around 500 mg per day, and I read here that it should also be taken with choline and other B Vitamins.  Here’s a link to an article written by Well-Rounded Mama on PCOS and Insulin Resistance.

Inulin (Chicory)- this is rated A by The Nursing Mother’s Herbal but it can be allergenic.

Jerusalem Artichoke- rated A by The Nursing Mother’s Herbal, and it is a galactagogue.

L-Arganine- An amino acid used to improve athletic performance.  Not much is known about use during lactation (Web MD, L-Arganine).

L-Carnitine- Also known as L-tartrate, Propionyl-L-Carnitine, Acetyl L-Carnitine, acetylcarnitine or ALCAR, is used as a fat burner.  It will enhance energy during workouts and muscle recovery after workouts.  Jim Stoppani, PhD recommends that body builders take 2-3 g per dose with 30-40g carbs and 20-40g protein preferable with a meal (Andrews).  It can be taken before or after workouts. Information found Here.  L-Carnitine is possibly safe for breastfeeding mothers (Web MD, L-Carnitine).

Locust Bean Gum- Also known as carob bean gum is derived from the beans of a carob tree.  This is a food additive used to thicken, stabilize or emulsify.  It is generally considered safe (Kresser).

L-Ornithine- This is an amino acid.  It is made in the body.  It is used for improving athletic performance.  No information found on use of this amino acid during lactation (Web MD, Ornithine).

Leuzea Extract (Rhaponticum Carthamoides)- This is not found in The Nursing Mother’s Herbal.  It is an herb used to increase muscle mass (Luzea Root Review Article). No info found on use while breastfeeding.

Maca- a plant used to enhance energy, stamina, and physical performance.  Not much is known about the use of Maca while breastfeeding, I also could not find it in The Nursing Mother’s Herbal or on infant risk (Web MD, Maca).

Magnesium Stearate- a salt form used for its lubricating properties for capsules and tablets.

Malic Acid- A crystalline acid present in unripe apples and other fruits.  Likely used as a preservative.

Maltodextrine- a sweetener that comes from treated grain starch.  This is basically a corn syrup solid that has been hydrolyzed to contain less than 20% sugar.  It gives fat-like body to food products, increases their shelf life and mixes well with other ingredients.  It has a glycemic index of 130, this means that it goes through the digestive system quickly.  This is good after a workout because it will get energy and proteins to the muscles quickly (Olsen, 2012).

Meadowsweet Herb- an herb used for colds, bronchitis, peptic ulcers, and to increase urine output.  Not much is known about using this herb while breastfeeding (Web MD Meadowsweet, 2015).

Methylsulfonylmethane (MSM)- a chemical found in plants, animals and humans.  It is used for chronic pain and joint inflammation.  Not much is known about its use while breastfeeding (MSM, 2015).

Microcrystalline Cellulose- a term for refined wood pulp and is used as a texturizer, an anti-caking agent, a fat substitute, an emulsifier, an extender, and a bulking agent in food production. The most common form is used in vitamin supplements or tablets.

Milk Thistle- an herb, rated A by The Nursing Mother’s Herbal, and it is a galactagogue.

Naringin Extract (Grapefruit Seed Extract)- Rated A by The Nursing Mother’s Herbal.  Is allergenic.  It is used as a weight-loss supplement.

Ne-Opuntia (Cactus Leaf)- this is a vegetable based fat blocker.  It blocks fat absorption in the intestines.  This is not in The Nursing Mother’s Herbal, but two places on the internet both say not to take while nursing.  You can see those Here and Here.

Oat (Oat Straw)- also known as avena sativa.  This is rated A by The Nursing Mother’s Herbal and it is considered a galactagogue.  This is used to improve circulation, and to help with cramps, swelling and inflammation.

Oolong Tea- comes from the same plant used to make black tea and green tea.  Oolong tea is partially fermented.  It does contain caffeine. It is used to sharpen thinking skills and improve mental alertness.  This is likely safe to take while breastfeeding if you have less than 2 cups per day, which would contain about 200 mg of caffeine (Web MD, Oolong Tea).

Pau D’Arco- this herb is used to treat a variety of infections.  Not much is known about the use of this herb while breastfeeding, but since WebMD says that it is possibly unsafe when used at normal doses and unsafe for pregnancy, I am listing it as contraindicated (Web MD Pau D’Arco, 2015).

Peppermint- the leaf is rated A by The Nursing Mother’s Herbal, peppermint oil is rated B by The Nursing Mother’s Herbal.  It is an anti-galactagogue, which means it may decrease milk supply.

Polydextrose- A synthetic polymer of glucose.  It is classified as a soluble fiber and is used to increase the non-dietary fiber content of food, replace sugar, and to reduce calories and fat content (Wikipedia, 2014).

Pomegranate Extract- While a pomegranate fruit is perfectly safe to eat, extracts can be much more concentrated, therefore it is not known if this is safe during breastfeeding.  It also depends on what the extract is made from.  The stem bark, root, and root bark are rated E by The Nursing Mother’s Herbal and should be avoided (Humphrey, 2003).

Potassium Citrate- Used for preventing kidney stones.  It is an alkalinizing agent.  You can read more here.

Potassium Chloride- A mineral found in many foods.  It is unknown if potassium chloride will pass through breast milk.  You can read more here.

Psyllium Husk Powder- this is a fiber used to aid in bowel movements.  It increases bulk in the stool, making it easier to pass.  This should be safe to take while breastfeeding.  Information found here and here.

Pterostilbene- a protective compound produced by small plants, and similar to resveratrol. I couldn’t find any information on using this while breastfeeding, but you can read a study on it here.

Puncturevine (Tribulus terrestris)- this is an herb used to enhance mood, enhance athletic performance, and possibly to stimulate milk flow.  Other than the mention of stimulating milk flow in the article on WebMD, I could not find any information on the safety of using this while breastfeeding.

Pyroxidine Hydrochloride- Vitamin B6.  This is likely safe for breastfeeding women when taken in amounts less than 2 mg per day (Web MD, Pyroxidine).

Quercetin- a yellow crystalline pigment present in plants, used as a food supplement to reduce allergic responses or boost immunity. This is rated L1-no data-compatible by Mommy Meds.

Raspberry (Rubus Idaeus)- Rated A by The Nursing Mother’s Herbal.  Used to increase metabolism and boost lean body mass.

Rhodiola Rosea- Rated B in The Nursing Mother’s Herbal.  This is a tonic herb said to fight fatigue and prevent infections (Life Script).

Saw Palmetto- an herb used for inflammation.  Rated A by The Nursing Mother’s Herbal

Schisandra Extract (Schisandra chenesis or Wu wei zi)- Rated A in The Nursing Mother’s Herbal.  Used for increasing energy, physical performance and endurance (Web MD).

Silica- a mineral, used as an anti-caking agent.

Silicon Dioxide- A trace mineral necessary for healthy bones, skin, hair and nails.  Often added to processed foods to keep them fresh.

Sodium Chloride- table salt.

Soy- also soy protein isolate, and soy lecithin.  It’s a good idea to avoid large amounts of soy in your diet or eating it on a daily basis. You can read more about why here.

Soy Lecithin- A food additive used as an emulsifier, found in most processed foods.

Stearic Acid- a solid saturated fatty acid obtained from animal or vegetable fat.

Stinging Nettle- may also be called nettle.  It is an herb used for many things.  In diet supplements it is likely used for the diuretic properties.  This is rated A by The Nursing Mother’s Herbal and is a galactagogue.

Sucralose- An artificial sweetener, also known as Splenda.  You can read about the dangers of sucralose here.

Sustamine- (Also known as L-Alanyl, L-Alanine, or L-Glutamine)  This is a combination of the amino acids L-Alanine and L-Glutamine.  It is used to replenish, recover and rehydrate after workouts.  See the section on Amino Acids for more information.

Taurine- an amino acid, used to increase athletic performance.  Not much is known about use during lactation (Web MD, Taurine).

Turmeric- an herb that is rated B by The Nursing Mother’s Herbal.  It is a warming herb and is considered a galactagogue.

Vandium- a mineral used for improving athletic performance in weight lifting.  Web MD recommends less than 1.8 mg per day for adults and limiting to food intake in breastfeeding women (Web MD, Vanadium). 

Velvet Bean Extract- this is rated C by The Nursing Mother’s Herbal and may be an anti-galactagogue because it can lower prolactin and increase testosterone.  You can read more about it here.

Wheat Amylase Inhibitor- Blocks the amylase enzyme, which breaks down carbohydrates, therefore blocking carbohydrate absorption.  There is no information available on the safety of using amylase inhibitors while breastfeeding (Amylase Inhibitors, 2011).

White Kidney Bean Extract- this is used as a starch blocker.  They work by blocking amylase, the enzyme responsible for breaking down carbohydrates.  Carbohydrates that are not broken down, cannot be absorbed through the intestine.  The effects of this are unknown while breastfeeding, you may want to consult your doctor (Busch, 2014).

Wild Yam Root- an herb used for relaxing muscles, soothing nerves and relieving pain.  It is rated B by The Nursing Mother’s Herbal.  You can read more about wild yam here

Xanthan Gum- A substance produced by bacterial fermentation or synthetically, and used in foods as a gelling agent or thickener.

Yucca Root- rated A by The Nursing Mother’s Herbal.

If you have any evidence for or against any of these ingredients, please post in the comments or email me at midlandlactationsupplies@outlook.com.  I will be adding to this list as I look at ingredients in various supplements that I will review in this series, but if you have an ingredient you would like me to look at, you can comment that as well.  Look forward to hearing your feedback!

 Other Posts in This Series:

Workout, Weight-Loss and Diet Supplements While Breastfeeding

Breastfeeding and Losing Weight

Advocare Products and Breastfeeding

It Works Products and Breastfeeding

Looking for a great workout program? Chalene Johnson's Piyo program is a great program to do at home!

References

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Amylase Inhibitors. 2011.  Natural Standard.  http://www.naturalgrocery.com/ns/DisplayMonograph.asp?StoreID=heu5fkaq17s92nd700akhlbd34wud8vb&DocID=bottomline-amylaseinhibitors

Andrews, R. All About BCAA. http://www.precisionnutrition.com/all-about-bcaas

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Busch, S. (2014).  Side Effects of White Bean Extracthttp://www.livestrong.com/article/265644-side-effects-of-white-bean-extract/

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Garcinia Levels and Effects While Breastfeedinghttp://www.drugs.com/breastfeeding/garcinia.html

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Web MD. Blue-Green Algae. http://www.webmd.com/vitamins-supplements/ingredientmono-923-blue-green%20algae.aspx?activeingredientid=923&activeingredientname=blue-green%20algae

Web MD. Cat’s Claw. http://www.webmd.com/vitamins-supplements/ingredientmono-395-cat's%20claw.aspx?activeingredientid=395&activeingredientname=cat's%20claw

Web MD. Chitosanhttp://www.webmd.com/vitamins-supplements/ingredientmono-625-chitosan.aspx?activeingredientid=625&activeingredientname=chitosan

Web MD.  Horny Goat Weed.  2015. Web MD.  http://www.webmd.com/vitamins-supplements/ingredientmono-699-epimedium.aspx?activeingredientid=699&activeingredientname=epimedium

Web MD. Garcinia. http://www.webmd.com/vitamins-supplements/ingredientmono-818-garcinia.aspx?activeingredientid=818&activeingredientname=garcinia

Web MD. Glycinehttp://www.webmd.com/vitamins-supplements/ingredientmono-1072-glycine.aspx?activeingredientid=1072&activeingredientname=glycine

Web MD. Green Coffeehttp://www.webmd.com/vitamins-supplements/ingredientmono-1264-green%20coffee.aspx?activeingredientid=1264&activeingredientname=green%20coffee

Web MD.  Guaranahttp://www.webmd.com/vitamins-supplements/ingredientmono-935-guarana.aspx?activeingredientid=935&activeingredientname=guarana

Web MD.  L-Arganinehttp://www.webmd.com/vitamins-supplements/ingredientmono-875-l-arginine.aspx?activeingredientid=875&activeingredientname=l-arginine

Web MD.  L-Carnitinehttp://www.webmd.com/vitamins-supplements/ingredientmono-1026-l-carnitine.aspx?activeingredientid=1026&activeingredientname=l-carnitine

Web MD.  Macahttp://www.webmd.com/vitamins-supplements/ingredientmono-555-maca.aspx?activeingredientid=555&activeingredientname=maca

Web MD.  Meadowsweet.  2015.  Web MD.  http://www.webmd.com/vitamins-supplements/ingredientmono-108-meadowsweet.aspx?activeingredientid=108&activeingredientname=meadowsweet

Web MD.  MSM (Methylsulfonylmethane). 2015. Web MD.  http://www.webmd.com/vitamins-supplements/ingredientmono-522-msm%20%28methylsulfonylmethane%29.aspx?activeingredientid=522&activeingredientname=msm%20%28methylsulfonylmethane%29

Web MD.  Oolong Teahttp://www.webmd.com/vitamins-supplements/ingredientmono-1099-oolong%20tea.aspx?activeingredientid=1099&activeingredientname=oolong%20tea

Web MD.  Ornithinehttp://www.webmd.com/vitamins-supplements/ingredientmono-200-ornithine.aspx?activeingredientid=200&activeingredientname=ornithine

Web MD.  Pau D’Arco. 2015.  Web MD.  http://www.webmd.com/vitamins-supplements/ingredientmono-647-pau%20d%27arco.aspx?activeingredientid=647&activeingredientname=pau%20d%27arco

Web MD.  Psyllium Husk Fibre. http://www.webmd.com/drugs/2/drug-56088/psyllium-husk-fibre-oral/details#uses

Web MD. Pyroxidine (Vitamin B6).  http://www.webmd.com/vitamins-supplements/ingredientmono-934-pyridoxine%20vitamin%20b6.aspx?activeingredientid=934&activeingredientname=pyridoxine%20vitamin%20b6

Web MD. Schisandra. http://www.webmd.com/vitamins-supplements/ingredientmono-376-schisandra.aspx?activeingredientid=376&activeingredientname=schisandra

Web MD. Taurinehttp://www.webmd.com/vitamins-supplements/ingredientmono-1024-taurine.aspx?activeingredientid=1024&activeingredientname=taurine

Web MD. Tribulus.  2015. Web MD.  http://www.webmd.com/vitamins-supplements/ingredientmono-39-puncture%20vine.aspx?activeingredientid=39&activeingredientname=puncture%20vine

Web MD.  Vanadiumhttp://www.webmd.com/vitamins-supplements/ingredientmono-749-vanadium.aspx?activeingredientid=749&activeingredientname=vanadium

Well Rounded Mama (2013). PCOS Treatment: The Inositols. http://wellroundedmama.blogspot.com/2013/10/pcos-treatment-inositols.html

Wikipedia. (2014).  Glucoronolctone. http://en.wikipedia.org/wiki/Glucuronolactone

Wikipedia.  (2014).  Polydextrosehttp://en.wikipedia.org/wiki/Polydextrose

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