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The sudden death of yet another well-known athlete has again focused the
spotlight on dietary supplements containing ephedra. The U.S. Department
of Health and Human Services now is taking steps to protect the public
from the potential risks of dietary supplements that contain ephedra. The
HHS is cautioning the public that ephedra use poses potentially serious
health risks, especially when consumed with caffeine or other stimulants
or when used during vigorous exercise.
Just what is ephedra? Where is it found? What are its side effects and
risks? And if ephedra is so dangerous, why doesn't the U.S. Food and Drug
Administration prohibit its sale?
What is ephedra? Ephedra (also known as herbal ephedrine alkaloids) is an
amphetamine-like compound found naturally in several species of plants
including Mormon tea and the ancient Chinese herb ma huang. Like an
amphetamine, ephedra acts as a stimulant on the central nervous system,
increasing a person's blood pressure and heart rate while decreasing
appetite and making the person feel more energetic. Also manufactured in
laboratories, ephedra is sold in dietary supplements and drinks throughout
the U.S. that claim to promote weight loss, increase energy and alertness
and enhance athletic performance. Unless labeled as ephedra-free, most
"fat burners," "metabolism boosters" and weight-loss supplements contain
ephedra. In its synthetic form, it is called ephedrine and regulated as a
pharmaceutical to be used as a decongestant for treating asthma,
bronchitis and allergic reactions.
Potential side effects and risks: Despite the fact that dietary
supplements containing ephedra are widely available and used, many serious
reactions have been reported to the FDA. Among the side effects reported
by ephedra users are nausea, vomiting, anxiety, irregular heartbeat,
seizures, heart attack, stroke and, in a few cases, sudden death.
A recent study published in the Annals of Internal Medicine looked at the
number of adverse reactions associated with ephedra compared to the number
associated with other herbal products. Ephedra-containing supplements
accounted for less than 1 percent of all herbal product sales, yet they
were responsible for 64 percent of all adverse reactions to herbal
products in the U.S.
Regulating ephedra: Under current U.S. law, herbs and other "nutritional"
products marketed as dietary supplements can be sold with very little
regulation by the U.S. government. Unlike pharmaceuticals, the burden of
proof is on the FDA to show that a dietary supplement possesses a clear
danger to public health before the FDA can limit or prohibit sales.
Although there have been thousands of reports of adverse effects
associated with ephedra use, the FDA has thus far not been successful in
banning it. However, earlier this year the FDA began taking steps to
require that ephedra-containing supplements carry a warning label listing
death, heart attack and stroke as potential side effects along with a
caution for consumers to consult their doctor before using the herb.
For now, the best advice for consumers is to carefully consider the
mounting evidence showing the seriousness of ephedra's potential side
effects. Children under the age of 18, pregnant or nursing women and
adults with a history of high blood pressure, heart disease, seizures,
diabetes, kidney disease, thyroid disease, depression or glaucoma are
advised to avoid ephedra products. Anyone taking prescription drugs or
using over-the-counter cold or allergy medicines should consult their
physician before taking dietary supplements containing ephedra.
For more information, contact your local
Colorado State University Extension office.
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