Nature's Way  Bitter Orange
The immature bitter orange ( Citrus aurantium ) has been used for thousands of years in ancient Chinese medicine. Nature's Way Bitter Orange Extract provides high levels (6%) of the key compound, Synephrine, which has been the focus of study for its thermogenic properties. High doses of bitter orange can increase heart rate and increase metabolism. We suggest at first to only use half or one capsule until you find out how this product works with your system. We also suggest you use bitter orange by itself without other supplements or medicines the first couple of times you try it. Do not use bitter orange if you have a heart condition or taking medicines for your heart or blood pressure.

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Bitter Orange Supplement Facts:
Bitter Orange - 450 mg  - Citrus Aurantium dried extract (fruit)

Compounds in Bitter orange
Extracts from Bitter orange contain a rare combination of five adrenergic amines: synephrine, N-methyltyramine, hordenine, octopamine, and tyramine.

Bitter orange mechanism of action
The amines in Bitter orange stimulate beta-3 cell receptors with less of an effect on other alpha and beta receptors. Stimulation of these beta-3 receptors elicits the breakdown of fat. Simultaneously, this stimulation causes an increase in the metabolic rate – thermogenesis – which burns calories. Bitter orange may also act as an appetite suppressant.

Bitter orange side effects
Increased body temperature may occur as the dose is increased. Drink plenty of cold water. Bitter orange may increase risk of heart irregularities and increase blood pressure. Discuss with your physician if you are taking medicines or have a chronic health condition. Long term effects or potential harm from high dose ingestion is still not fully understood.

Bitter orange summary
Bitter orange extract may help one lose weight, but caution is advised. Use the least amount possible and take breaks from use. Do not take Bitter orange daily for many weeks pr months without a break.

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Other Weight Loss options to consider
5-HTP is a nutrient that helps curb appetite in some individuals . 5-HTP, by converting into serotonin, can be used temporarily to improve will power and decrease the urge to eat until more established weight loss habits are in place. You can buy 5-HTP here. .
Hoodia is a cactus plant extract from the Kalahari desert in South Africa that has been getting a lot of attention lately. You can buy Hoodia Extract here.
Green tea extract may be effective in some people as a weight loss pill. You can purchase Green-Tea-Extract here.
Caffeine is often found in weight loss pills but I personally don't like my patients taking extra caffeine since it can cause increased heart rate and anxiety. Most people already consume enough caffeine through coffee, tea, sodas, and chocolate.
Ginger may be helpful in some people but higher doses are required.
Alpha lipoic acid may also reduce appetite but it is primarily used as an antioxidant.
Guarana may work in combination with yerba mate and damiana
Acetyl-l-carnitine is a weight loss pill that may reduce appetite in some individuals. You can buy Acetyl-l-Carnitine here.

Bitter orange study
Possible association of acute lateral-wall myocardial infarction and bitter orange supplement.
Nykamp DL. School of Pharmacy, Mercer University, Atlanta, GA 30341-4155, USA.
Ann Pharmacother. 2004 May;38(5):812-6.
To report a possible incidence of acute lateral-wall myocardial infarction (MI) coinciding with the use of a Citrus aurantium L. (bitter orange)-containing dietary supplement in a patient with undetected coronary vascular disease. A 55-year-old white woman presented to the emergency department with symptoms of dull aching shoulder and chest pain. A review of medications during cardiac rehabilitation revealed the patient had ingested a multicomponent dietary supplement for weight loss containing 300 mg of Bitter orange (Edita's Skinny Pill) for the past year. Although the patient's past medical history did not include hypertension, coronary disease, or hyperlipidemia, an arteriogram revealed a lesion in the left main coronary artery. She did have a smoking history. She was diagnosed with acute lateral-wall MI and hospitalized for 4 days. Consumers generally consider dietary supplements safe. However, some supplements taken for weight loss contain ingredients that have been associated with cardiovascular events. Although consumers are becoming more aware of the serious adverse effects secondary to products containing ingredients such as Ma huang and ephedra, reports involving other ingredients are increasing. Bitter orange or synephrine, found in Bitter orange, has been associated with adverse cardiovascular reactions. Based on the Naranjo probability scale, Bitter orange is possibly associated with this cardiovascular event. CONCLUSIONS: The use of Bitter orange-containing supplements may present as a risk for cardiovascular toxicity; however, additional studies/case reports are needed to validate this conclusion. Bitter orange research

Bitter orange as a thermogenic, weight-reduction replacement for ephedra: an overview.
Preuss HG. Georgetown University Medical Center, Washington, DC 20057, USA.
J Med. 2002;33(1-4):247-64.
Obesity is a serious health problem throughout the world. More than half of U.S. adults are overweight (61%) and more than a quarter (26%) of U.S. adults are obese. The inability of many individuals to keep their weight in check by diet and exercise has created a need for additional therapeutic means to combat obesity. Despite great effort, the pharmaceutical industry has not come up with the solution; because most weight-loss drugs to date have serious adverse effects to health and well-being. The theory that beta agonists, especially beta 3 agonists, can affect body weight and fat mass is well accepted. Ephedrine has proven time and time again that it is an effective weight loss agent through its ability to increase thermogenesis and quench appetite. However, the publicity concerning adverse reactions has led to its withdrawal from use by many despite the perceived consequences of obesity. Many companies are now substituting Bitter orange extract for ephedra in their formulations. Bitter orange, an agent containing beta agonists, has been reported to aid in weight loss in two studies and increase thermogenesis, at least to some extent, in three studies. Colker et al. (1999) reported that in a double-blind, placebo-controlled, randomized study the subjects receiving a combination of Bitter orange, caffeine and St John's Wort, lost significant amounts of total body weight while on a strict diet and exercise. Those in the placebo and control groups who also were on the same restricted diet did not. However, intergroup analysis showed no statistical significance among the weight changes in the three groups. In contrast, the loss of fat mass in the test group was significantly greater compared to the placebo and control groups. Jones describes an open labeled study performed on 9 women. The subjects showed a mean of 0.94 kg lost during the first week when no product was given and 2.40 kg during the second week when a Bitter orange product was taken. Body weight losses were statistically greater during the second week compared to the first week. Since most clinicians would agree that the most weight loss should occur initially coinciding with a greater fluid loss during the first week, these differences are even more remarkable. Three studies reported increased metabolic rates when ingesting Bitter orange products, however, at least two of these studies were acute. At present, Bitter orange may be the best thermogenic substitute for ephedra. However, more studies are needed to establish this definitively.

Bitter orange questions
Q. Can a bitter orange herb supplement be taken together with Alfalfa supplement or Apple-Cider-Vinegar.
   A. If the dosages are low, yes.

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