A 38 year old Californian rose early, downed his usual 2 capsules of the herbal supplement ephedra with his normal cup of coffee, then left for his morning jog. Later that same morning he lay dead from a heart attack.
A 35 year old woman, an apparently healthy ephedra user collapsed during her aerobics session - she'd had a stroke.
Medical experts agree that these and many other similar examples disclose a clear risk existent to users of the herbal stimulant. Still, with millions of Americans taking supplements and reports of severe side effects only in the hundreds, who is truly at risk is a valid question.
What is really called to question? Does a person need to see a physician for a full physical examination before taking ephedra? Does the combination of the herb and caffeine represent a greater risk than ephedra alone? Perhaps the combination with the addition of strenuous exercise is the culprit. Maybe the dose is at fault.
Today, the Food and Drug Administration (FDA) is involved in discovering the truth behind the questions. Unfortunately, the FDA had retreated before an onslaught of industry protests and drastically scaled back its attempts to regulate ephedra containing dietary supplements. Now, however, the agency is buoyed by a list of 273 new reports of untoward effects and is considering the possibility of adding warnings to the labeling.
"It is a federal dilemma," said Dr. Neal Benowitz of the University of California, San Francisco. (He studied the issue representing the government). "Ephedra poses serious risks to subsets of the population," he said. "Until doctors spell it out more specifically, the consumers should know that this herb is not totally benign."
To complicate matters, independent testing laboratories have revealed that half of the products containing ephedra tested either had more or less of the strength stated on the label. The range was extreme, from virtually no ephedra to 150% of labeled strength. One of the testing facilities, the University of Arkansas, confirmed work of other independent labs.
Ephedra, also known by its Chinese name ma-huang, is a herbal form of ephedrine, an amphetamine-like stimulant. Ephedrine, in very small doses, is sold in a few over-the-counter asthma preparations. These preparations are closely monitored by the FDA. Herbal ephedra, on the other hand, is sold in 200 unregulated dietary supplements used for muscle growth, creating energy, and often in huge dosages for an herbal high.
Manufacturers of the ephedra preparations insist their products are safe. After all, they reason, millions take the product without severe side effects. In contrast, Rezulin and Propulsid were recently removed from the marketplace when less than half the number of reports showing side effects were revealed.
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