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.