Plexus Slim

 Also known as: Pink Drink

Safety Rating:

(For explanations of what these safety ratings mean, click here) 

Overview:

Side Effects: 

Agitation/Irritability
Anxiety/Nervousness
Belching
Bitter taste
Bleeding
Bloating
Confusion
Constipation
Diarrhea
Dizziness
Gas
Headache
Heartburn/GERD
Liver damage
High blood pressure
High liver enzyme levels
Hypoglycemia (low blood sugar)
Increased eye pressure
Increased urination
Insomnia
Loss of appetite
Mania in patients with Bipolar disorder
Nausea/vomiting
Serotonin Syndrome
Spikes in blood pressure
Stomach pain
Tremors
Urine color change
Weight gain

Interactions with health conditions:

ADHD: Green coffee bean extract may cause or increase side effects from ADHD medications

Alcoholism:

• Heavy regular consumption of alcohol causes liver damage over time. Adding Garcinia may speed up the development of liver damage.
• Alcoholism can cause Thiamine (Vitamin B-1) deficiency. Based on animal studies, people with low levels of Thiamine may be at a higher risk of ALA poisoning

Aneurism/Bleed risk: Caffeine can increase bleeds in patients with higher bleed risks.

Anxiety: May cause or worsen anxiety

Bone density/Osteoporosis: Green coffee bean extract can reduce the effectiveness of some medications meant to treat or prevent osteoporosis.

Diabetes: ALA, Chromium and White Mulberry may increase the risk of Hypoglycemia (low blood sugar) when combined with medications meant to control blood sugar. 

Glaucoma: Green coffee bean extract could raise the pressure inside the eye due to tightened blood vessels.

Heart problems: Temporarily increased blood pressure and/or heart rate is usually seen 30 minutes after ingesting caffeine, and can last up to 4 hours after drinking.

Insomnia: Green coffee bean extract could worsen insomnia symptoms

Liver problems: Garcinia can cause liver damage. For people with liver problems like cirrhosis or hepatitis, this can be especially dangerous.

Mental Health: Garcinia may worsen existing mental health symptoms or cause new ones. Garcinia may increase the risk of mania in people with bipolar disorder, working against their medications.

Purposely weakened immune system: XOS may strengthen the immune system, which could be extremely dangerous for patients depending on immunosuppression (weakened immune system) to survive. There are 2 main conditions that are controlled by immunosuppressant medications:

• Autoimmune disorders: People with autoimmune disorders are suffering from an over-active or misguided immune system that attacks their own body. Many patients with audoimmucondition need to keep their immune system weakened to control their disorder.
• Transplant: The immune system will usually attack anything that is not originally part of the body, including donated organs. Patients who have received an organ transplant need to keep their immune system weakened so that it does not reject (attack) the donated tissue. 

Surgery: ALA may impact blood sugar levels during and after surgery, which may complicate the procedures. Because the effect is unpredictable, it is recommended that ALA be stopped 2 weeks before surgery.

Thyroid: Chromium may impact some thyroid medications

Drug Interactions:

ADHD medications: Combining Caffeine with ADHD medications may:

• increase blood pressure
• worsen other medication side effects such as insomnia and loss of appetite

Anxiety medications: Caffeine may increase anxiety, requiring higher or more frequent doses of anti-anxiety medications

Blood Thinners: Caffeine may increase risk of bleeding when taken with blood thinners.

Blood Pressure medications: Caffeine may raise blood pressure for up to 4 hours, working against the effects of blood pressure medications.

Bone density/Osteoporosis: Taking Alendronate (Fosamax) with coffee has been shown to decrease the amount of Alendronate available to the body by 60%. This may be avoided by taking them 2 hours apart.

Cancer: Not much is known about the safety of combining antioxidants with chemotherapy. Patients should speak to their oncologist (cancer doctor) before adding any supplements, especially if they are on chemotherapy drugs.

CYP1A2 inhibitors: Combining caffeine with CYP1A2 inhibitors may increase the amount of caffeine in the body, resulting in increased caffeine side effects. Examples: Cimetidine, Ciprofloxacin, Ethinyl Estradiol, Fluvoxamine

Diabetes/blood sugar control: ALA, Chromium and White Mulberry may increase the risk of Hypoglycemia (low blood sugar) when combined with Diabetes drugs. Examples include:

• Metformin
• Glipizide (Glucotrol)
• Insulin
• Pioglitazone (Actos)
• Liraglutide (Victoza)
• Canagliflozin (Invokana)
• Sitagliptin (Januvia)
  

For more examples of diabetes drugs, click here.

Heart Rate Control medications: Caffeine may increase heart rate for up to 4 hours, countering the action of medications meant to lower heart rate. These medications include Beta Blockers, some CCBs like Diltiazem and Verapamil, and Digoxin.

Hepatotoxic (may cause liver damage): Taking Garcinia with medications linked to liver damage could cause or worsen the damage. Examples of hepatotoxic drugs include:

• Acetaminophen (Tylenol)
• Amiodarone (Cordarone)
• Isoniazid (INH)
• Methotrexate (Theumatrex)
• Click here for a complete list of drugs that can cause liver damage.

Immunosuppressants: Some people need to take medications that weaken their immune systems. These are known as immunosuppressant drugs.Examples include:

• Adalimumab (Humira)
• Azathioprine (Imuran)
• Cyclosporine (Neoral, Sandimmune)
• Tacrolimus (Prograf)
  

XOS may these drugs less effective, which could have serious consequences for the patient. For more information on immunosuppressant drugs, click here.

Mental Health medications:

• Bipolar Disorder: Garcinia could worsen or trigger mania in people with bipolar disorder, effectively making their medications less effective and requiring changes to their medications. Click here for a list of medications used to treat Bipolar Disorder, and click here for an overview of those medications by type.
• Depression/Anxiety: Interactions with some depression or anxiety medications, which could lead to serious reactions like Serotonin Syndrome. Examples include:
  • Sertraline (Zoloft)
  • Fluoxetine (Prozac)
  • Escitalopram (Lexapro)
  • Venlafaxine (Effexor)
  • Amitriptyline (Elavil)

Pain medications: Interactions with some pain medications could lead to serious reactions like Serotonin Syndrome and Call-Fleming Syndrome.

Sleep medications:  Green coffee bean extract could worsen insomnia, requiring higher doses of sleep medications

Stimulants: Combining caffeine with other stimulants can increase side effects and risk of heart attack, stroke, or seizure. Stimulant drugs are often used for ADHD and weight loss. For stimulant herbs, see "Interactions with herbs/supplements" below. 

Thyroid medication:

• ALA may decrease efficacy of medications to treat low thyroid hormone levels. 

  Examples:

  • Levothyroxine (Synthroid)
  • Armour Thyroid
• Chromium has been shown to decrease the level of Levothyroxine when taken at the same time.  

Interactions with herbs/supplements:

Blood clot prevention: There may be an increased risk of bleeding when caffeine is combined with supplements meant to prevent blood clots.

Blood sugar control: Combining ingredients that may lower blood sugar increases the risk of Hypoglycemia(low blood sugar). There are 3 ingredients in Plexus Slim that could have this interaction with each other:

• Alpha-lipoic acid (ALA)
• Chromium
• White Mulberry

Calcium and Magnesium: High caffeine intake can increase the amount of Calcium and Magnesium removed from the body in urine.

CYP1A2 inhibitors: Taking Green coffee bean extract with CYP1A2 inhibitor ingredients may raise the amount of caffeine in the body, resulting in increased caffeine side effects. Examples of inhibitors include:

• Danshen
• Echinacea
• Kudzu
• Red clover
• St John’s Wort

Hepatotoxic (damaging to the liver): Taking Garcinia with other products linked to liver damage could cause or worsen the damage. Examples include:

• Borage leaf
• Comfrey
• DHEA
• Germander
• Pennyroyal oil
• Red yeast

Stimulants: Combining a stimulant like caffeine with other herbal stimulants could worsen the side effects from both ingredients. Examples include:

• Green tea extract
• Guarana
• Octodrine
• PEA

Interactions with foods: 

Alcohol: Combining Green coffee bean extract and alcohol can raise caffeine levels, resulting in increased caffeine side effects.

Interactions with lab tests: 

Some ingredients in Plexus Slim may impact several lab and test results. Make sure to speak to your health care team about use of this product (how much, how often, and when you last had some) before getting these labs/tests done:

Blood sugar: White Mulberry may temporarily lower blood sugar levels, which can impact some blood sugar tests. 

Cancer screening: One important tool used to help detect certain types of cancer is testing the urine for specific chemicals. Caffeine may temporarily increase the levels of some of these chemicals in the urine, making the tests inaccurate.

Heart function: Caffeine may temporarily increase blood pressure and heart rate, which could change the results of tests measuring heart function.

Kidney function: Creatinine urine tests can show how well (or poorly) your kidneys are working. They can also help identify harmful muscle breakdown. Caffeine may increase the amount of creatinine in urine.

Liver function tests:  Garcinia has been reported to cause increases in the level of enzymes that measure liver damage.

Lung function/breathing: Caffeine may change the results of tests measuring lung function, such as in patients with asthma. 

References:

1. *Natural Medicines. (2019, March 11). Plexus Slim by Plexus [Monograph]. Natural Standard Professional Monograph. Retrieved from: https://naturalmedicines.therapeuticresearch.com/databases/fcommercial-products/commercial-product.aspx?cpid=38883
   

2. A Linares-Pasten, J., Aronsson, A., & Nordberg Karlsson, E. (2018). Structural considerations on the use of endo-xylanases for the production of prebiotic xylooligosaccharides from biomass. Current Protein and Peptide Science, 19(1), 48-67. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738707/  

3. *Ma, R., Bai, Y., Huang, H., Luo, H., Chen, S., Fan, Y., ... & Yao, B. (2017). Utility of thermostable xylanases of Mycothermus thermophilus in generating prebiotic xylooligosaccharides. Journal of agricultural and food chemistry, 65(6), 1139-1145. Retrieved 03/2019: https://pubs.acs.org/doi/pdf/10.1021/acs.jafc.6b05183 

4. *Natural Medicines. (2019, January 29). Fructo-Oligosaccharide [Monograph]. Natural Standard Professional Monograph. Retrieved from: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=450

5. Qualified Health Claims: Letter of Enforcement Discretion -Chromium Picolinate and Insulin Resistance (Docket No. 2004Q-0144).CFSAN/Office of Nutritional Products, Labeling, and Dietary Supplements August 25, 2005. Retrieved 03/2019: http://www.cfsan.fda.gov/~dms/qhccr.html
   
6. Food and Nutrition Board, Institute of Medicine. Prototype monograph on chromium picolinate. Washington, DC: National Academy Press, 2005. Retrieved 03/2019: http://www.iom.edu/CMS/3788/19554.aspx
   
7. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002. Retrieved 03/2019: https://www.nap.edu/read/10026/chapter/8   
   
8. *Natural Medicines. (2019, March 11). Chromium [Monograph]. Natural Standard Professional Monograph. Retrieved from: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=932
9. *Natural Medicines. (2019, March 21). Coffee [Monograph]. Natural Standard Professional Monograph. Retrieved from: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=980 
   
10. *Natural Medicines. (2019, February 21). Green Coffee [Monograph]. Natural Standard Professional Monograph. Retrieved from: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=1264 
11. American Academy of Pediatrics. (2011 Retrieved 03/2019: https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Kids-Should-Not-Consume-Energy-Drinks,-and-Rarely-Need-Sports-Drinks,-Says-AAP.aspx  
12. Mayo Clinic. (2017). "Caffeine: How much is too much?". Retrieved 03/2019: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678  
13. Mayo Clinic. (2017). "Serotonin Syndrome". Retrieved 03/2019: https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758 
    
14. *Natural Medicines. (2019, January 29). White Mulberry [Monograph]. Natural Standard Professional Monograph. Retrieved from: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=1250
15. *Natural Medicines. (2019, January 29). Garcinia [Monograph]. Natural Standard Professional Monograph. Retrieved from: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=818
16. *Corey R, Werner KT, Singer A, Moss A, Smith M, Noelting J, Rakela J. Acute liver failure associated with Garcinia cambogia use. Ann Hepatol. 2016 Jan-Feb;15(1):123-6. Retrieved from: http://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=63816
17. Lunsford KE, Bodzin AS, Reino DC, Wang HL, Busuttil RW. Dangerous dietary supplements: Garcinia cambogia -associated hepatic failure requiring transplantation. World J Gastroenterol. 2016;22(45):10071-10076. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5143754/
18. Huizen, J. (2019). "Bipolar medications: Everything you need to know." Medical News Today. Retrieved: https://www.medicalnewstoday.com/articles/324388.php 
19. Kaswala, D. H., Shah, S., Patel, N., Raisoni, S., & Swaminathan, S. (2014). Case Report: Hydroxycut‑induced Liver Toxicity. Annals of medical and health sciences research, 4(1), 143-145. Retrieved: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952288/ 

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