1 Product identity
Ingredient risk
Contains a high-risk ingredient
Nutritional Management Pack
BrandDouglas Laboratories→Other Combinations Other (e.g. tea bag) 75 ingredients 1 high-risk 7 caution DSLD #8864Net contents: 30 Pack(s)
Target: Adults and Children 4 years and above
DSLD entry: 2013-01-25
2 Ingredients (75)
IngredientGroupSafety
PABAPABA—
RutinRutin—
Citrus Bioflavonoid ComplexFlavonoid (mixture)—
BetaineBetaine—
Glutamic AcidGlutamic Acid—
MethionineMETHIONINE—
Hesperidin ComplexBlend (non-nutrient/non-botanical)—
Raw Pancreas ConcentratePancreas—
Lecithinlecithin—
Proprietary BlendProprietary Blend (Combination)—
PancreatinBlend (non-nutrient/non-botanical)—
PepsinPepsin—
Aspergillus OryzaAspergillus oryzae—
LipaseLipase—
Ox Bile extractBile—
RenninChymosin—
DiastaseDiastase (unspecified)—
Beet root powderBeet—
Citrus PectinPectin—
Lactalbumin, HydrolysateLactalbumin—
LysineLysine—
AlanineAlanine—
ValineValine—
LeucineLeucine—
IsoleucineIsoleucine—
SerineSerine—
ThreonineTHREONINE—
ArginineArginine—
Aspartic AcidAspartic Acid—
ProlineProline—
HistidineHistidine—
TryptophanTryptophan—
PhenylalaninePhenylalanine—
TyrosineTyrosine—
CystineCystine—
CelluloseCellulose—
Gelatin Capsulecapsule—
AlfalfaAlfalfa—
Ingredient amounts require the full DSLD label. View full label at NIH DSLD →
⛔ High-risk ingredient — documented serious harm
Inositol — GDM prevention — 4 g/day from first trimester in high-risk women [2]
⚠️ Use with caution — restricted in some markets
Vitamin D — Granulomatous diseases (sarcoidosis, TB) — unregulated extra-renal CYP27B1 can cause life-threatening hypercalcemia even at standard doses [2][21]
Thiamin — Wernicke encephalopathy: classic triad (confusion, ophthalmoplegia, ataxia) is present in only 16% of cases — any ONE element in an at-risk patie…
Vitamin B6 — Sensory neuropathy from chronic high-dose B6 (>200 mg/day) — presents as numbness, ataxia. Can be irreversible. Often self-prescribed by patients…
Vitamin B12 — Nitrous oxide anesthesia in subclinically B12-deficient patients can precipitate acute combined degeneration — always check B12 before elective p…
Iron — Iron supplementation in iron-replete patients may increase cardiovascular and cancer risk — always document deficiency before prescribing [1].
Magnesium — Severe deficiency (<0.50 mmol/L) causes secondary hypocalcemia and hypokalemia that will not correct until magnesium is repleted first [1].
Zinc — Chronic zinc >40 mg/day without copper causes copper deficiency: anemia, neutropenia, myeloneuropathy [1].
3 Safety cross-reference
Vitamin A — Conditionally Safe
⚠ Teratogenic at high doses
⚠ Hepatotoxic with chronic excess
Vitamin C — Generally Safe
⚠ GI distress at high doses
⚠ Kidney stones risk >1g/day
Vitamin D — Use with Caution
⚠ Hypercalcemia at >10,000 IU/day
⚠ Vascular calcification risk
Vitamin E — Conditionally Safe
⚠ Increased bleeding risk
⚠ All-cause mortality at >400 IU/day
Thiamin — Use with Caution
⚠ Very low toxicity
Riboflavin — Generally Safe
⚠ Harmless yellow urine
Niacin — Conditionally Safe
⚠ Flushing at >50 mg
⚠ Hepatotoxicity at high doses
Vitamin B6 — Use with Caution
Folate — Conditionally Safe
⚠ May mask B12 deficiency
⚠ Colorectal cancer risk debated
Vitamin B12 — Use with Caution
Pantothenic Acid — Generally Safe
⚠ Diarrhea at very high doses
Biotin — Generally Safe
⚠ Interferes with troponin and thyroid lab assays
Calcium — Conditionally Safe
⚠ Cardiovascular risk debated >1,000 mg/day
⚠ Kidney stones
Phosphorus — Generally Safe
⚠ Excess impairs calcium absorption
Iron — Use with Caution
⚠ GI upset, constipation
⚠ Fatal toxicity in children
Iodine — Conditionally Safe
⚠ Thyroid dysfunction at excess
⚠ Kelp: variable content
Magnesium — Use with Caution
⚠ Diarrhea (especially oxide)
⚠ Accumulates in renal impairment
Zinc — Use with Caution
⚠ Copper deficiency at >40 mg/day
⚠ Nausea, metallic taste
Selenium — Conditionally Safe
⚠ Selenosis >400 mcg
⚠ Diabetes risk at high doses
Copper — Conditionally Safe
⚠ Hepatotoxicity at high doses
Manganese — Conditionally Safe
⚠ Neurotoxicity with chronic excess
Chromium — Conditionally Safe
⚠ Hypoglycemia with diabetes meds
⚠ Rare renal/hepatic toxicity
Molybdenum — Generally Safe
⚠ Very low toxicity
Potassium — Conditionally Safe
⚠ Hyperkalemia risk
⚠ Dangerous with ACE inhibitors
Choline — Generally Safe
⚠ Fishy odor at high doses
Inositol — High risk
⚠ GI disturbance at high doses (>12 g)
⚠ May lower blood glucose
Betaine HCl — Limited Evidence
⚠ Heartburn, GI burning if used without protein meals
⚠ Not for those on H. pylori treatment
Silicon — Generally Safe
⚠ Very low toxicity
Vanadium — Limited Evidence
⚠ GI toxicity: nausea, vomiting, diarrhea
⚠ Green tongue
Boron — Conditionally Safe
⚠ Reproductive toxicity in animals
GLA — Limited Evidence
⚠ May lower seizure threshold
⚠ Borage oil: hepatotoxic unless PA-free
Papain — Conditionally Safe
⚠ Allergic reactions
⚠ Increased bleeding risk
Glycine — Generally Safe
⚠ Well tolerated
Myrrh — Conditionally Safe
⚠ May lower blood glucose
⚠ Uterine stimulant
4 Label claims
• All Other
5 Data source
DSLD ID8864
Full labelView at NIH DSLD →
SourceOffice of Dietary Supplements, NIH
Market statusOn market
Entry date2013-01-25
6 More from Douglas Laboratories
View Douglas Laboratories Safety Scorecard → 788 products
A-Potene 10A-Potene 25A-Retic Natural Herbal FormulaA-Retic Natural Herbal FormulaA.R. FormulaA.R.M.D. Eye Support7 Cite this page
Vancouver
Pkhakadze G. Nutritional Management Pack — product analysis [Internet]. Tbilisi: Public Health Institute of Georgia; 2026 [cited 2026 Jun 24]. Available from: https://supplement.ge/products/nutritional-management-pack-8864/
CC BY 4.0. Product data from NIH DSLD; safety analysis by SupplementIndex.
GP
Analyzed by SupplementIndex
PHIG · Editor-in-Chief: Prof. Giorgi Pkhakadze, MD, MPH, PhD
Product data sourced from the NIH Dietary Supplement Label Database (DSLD). Safety cross-referencing by SupplementIndex. This analysis is for informational purposes only. For corrections: info@accreditation.ge.
Publisher: PHIG
Publisher: PHIG