Methylsulfonylmethane for treatment of low back pain: A safety analysis of a randomized, controlled trial.

OBJECTIVE: To ensure that 16 weeks of methylsulfonylmethane (MSM) does not cause adverse effects in patients with the musculoskeletal disorders of osteoarthritis and back pain. DESIGN: We carried out a subgroup analysis on data from a randomized, double-blind, placebo-controlled trial, "The use of Methylsulfonylmethane (MSM) in the treatment of low back pain," to determine the safety of taking 6 g daily of MSM (OptiMSM®, Bergstrom Nutrition). We monitored metabolic parameters to determine whether MSM altered hematologic, liver or kidney function. We also monitored physiologic parameters of blood pressure and weight. SETTING: Family Medicine Residency, Mike O'Callaghan Military Medical Center. MAIN OUTCOME MEASURES: Metabolic parameters as measured by hematologic function - white blood cells (WBC), platelets, hemoglobin (Hb), glucose; liver function as measured by - total bilirubin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Physiologic parameters as measured by weight, diastolic (DBP) and systolic blood pressure (SBP); kidney function as measured by creatinine. RESULTS: Analysis of outcome measures showed no significant difference between MSM and placebo (p < 0.05) safety values. CONCLUSION: MSM has no effects on WBC, platelets, Hb, total bilirubin, AST, ALT, creatinine weight, DBP, or SBP in this study.

Caffeine Toxicity Due to Supplement Use in Caffeine--Naïve Individual: A Cautionary Tale.

Thousands of military members self-medicate with dietary supplements containing unknown quantities of pharmacologically active compounds. These poorly regulated substances can cause real harm to the military population, especially when they contain stimulants such as caffeine. When taken regularly, caffeine has several performance-enhancing benefits. However, when used excessively or in vulnerable populations, caffeine can cause several unwanted side effects such as nervousness, sensory disturbances, insomnia, arrhythmia, excitability, inattentiveness, restlessness, mood changes, gastrointestinal disturbances, and even psychosis. Vulnerable patients include the caffeine-naïve, physiologically stressed, young, and mentally ill patients. One such case describes a caffeine-naïve service member who suffered an adverse reaction after taking an allegedly moderate dose of caffeine from a pill he obtained from a teammate. This case highlights the importance of supplement awareness among service members, increased provider vigilance, third party verification, and enhanced regulation on the approval and marketing of dietary supplements.