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Spotlight on Ephedra: Dangerous to Take, Completely Legal to Buy

separator False advertising has convinced many Americans that diet pills containing the herbal substance ephedra, or ephedrine, can help you lose weight permanently, increase your energy level and improve your athletic performance.

Baltimore Oriole Steve Bechler died of heatstroke in February when he was in Miami for spring training. He had arrived at training camp overweight, and had been taking a product called Xenadrine RFA-1, which contains ephedra, citrus aurantium (bitter orange) and caffeine. He had other health complications—an enlarged heart, abnormal liver function, slight high blood pressure and excess weight. He had also not eaten well in the previous three days.

In mid-March, the Broward County medical examiner issued a report saying, “It’s my personal opinion that the toxicity of ephedrine played a significant role in the death of Mr. Bechler.”

Bechler isn’t the first athlete to die while taking a supplement containing ephedra. Minnesota Vikings star Korey Stringer, Northwestern University football player Rashid Wheeler and Florida state linebacker Devaughn Darling had all taken the supplement before dying.

The 1994 supplement law
Why is it that you can walk into a vitamin store and buy a product, take it according to the instructions on the label and then become seriously ill or die?

In 1994, Congress approved the Dietary Supplement and Health Education Act. Under this law, herbs are declared to be dietary supplements, and dietary supplements are considered to be foods. Herbs are not dietary supplements. But putting them in the supplement category protects them from needing approval by the Food and Drug Administration (FDA). The FDA has a rigorous approval process for medications, but anything that’s called a dietary supplement can be sold legally in this country without proof of safety. To keep any dietary supplement off the shelves, the FDA has to be able to prove that it’s unsafe. But they can’t prove that anything is unsafe until they’ve had time to test it.

Ephedra facts
Practitioners of Traditional Chinese Medicine have been using ephedra for thousands of years as a treatment for asthma and other respiratory diseases. In the 1920s, US practitioners used it as a nasal decongestant, central nervous system stimulant and asthma treatment. It became less popular as safer, more effective medications became available. It’s only recently that ephedra has become a common ingredient in dietary supplements.

The myth is that ephedra will boost athletic performance and help you lose weight. The facts, presented in a report by the Rand Corporation in late February, are these:

  • Ephedra does speed up metabolism and increases the rate at which you burn calories. But it also increases blood pressure and heart rate. It increases the risk of heat stroke because it constricts blood vessels that play an important role in cooling the body.
  • There have been no studies confirming improved athletic ability due to use of ephedra.
  • Of all adverse reactions to herbal supplements reported to American poison control centers, 64 percent were for products containing ephedra. But ephedra products comprised only 0.82 percent of herbal product sales.
  • The side effects of ephedra pose the most danger to people who are dehydrated and out of shape or overweight. To make things even more dangerous, the energy-boosting effects of ephedra mask the signs of fatigue and dehydration.
  • The American Medical Association (AMA) has recommended banning the sale of ephedra. On its Web site, the AMA states, “The AMA is very concerned about the quality, safety and efficacy of all dietary supplements and urges Congress to require that dietary supplements be regulated the same way prescription and over-the-counter drugs are.”
  • The National Football League, the National Collegiate Athletic Association and the International Olympic Committee have all banned ephedra.
  • The FDA is now taking action to determine whether stronger warning labels should be added to products containing ephedra, and whether to issue set of warning letters against the ephedra products that make unproven claims about athletic performance.

Message still not being heard
Professional athletes are under tremendous pressure to perform well, day after day. Apparently, some of them are still not willing to believe that ephedra is a dangerous substance. Even after Bechler’s death, teammate Brook Fordyce was quoted as saying, “Would I still consider using it? Probably…if I was tired, I probably would take one, like if we had a day game after a night game.”

American Medical Association; Annals of Internal Medicine, 18 March 2003; The Sun, 20 February 2003, 14 March 2003; The New York Times, 25 February 2003; The Rand Corporation, 28 February 2003.
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