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In this day and age dietary supplements are everywhere. Mark McGwire made the front page first for his home runs and then for his controversial use of androstenedione. Though there are a plethora of testimonials for all of the herbal products on the market, sufficient study has not been done to prove them safe. The reason for this is the Dietary Supplement Health and Education act of 1994. This act, pressured through congress by a scare campaign funded by the supplement companies, weakened the FDA’s ability to protect the public. Before this the companies would have to prove safety, now the financially limited FDA must prove danger before it can pull a product off the shelf. Congress is now slow to challenge the power of the supplement industry which has grown from $8 billion to $12 billion in the four years since the law was passed. This Issue applies to many different supplements but one that has been in the limelight as of late is the herb Ephedra. The following will inform you about claims, truth, and side effects of this controversial supplement.
Ephedra, also known as Ma Huang, is a popular herbal supplement in today’s world. It is in the Ephedrace family and has been used in China for more than 4000 years. Traditionally it is used to treat the symptoms of asthma and upper respiratory infections. This herb, also grown in Europe, India. Australia, Afghanistan and the southwestern United States, was widely used by the Mormons. Mormon sects not permitted to drink coffee due to their religion used Ephedra as a substitute. This concoction today is known as ‘Mormon Tea’(recipe at end). This tea has more stimulants than coffee as well as more sexually stimulating effects. Due to these effects, Ephedra is also used in tantric rites as a sexual stimulant. Since the early 1920s Ephedra has been widely used for the treatment of asthma as well as being claimed to counteract the symptoms of narcolepsy AND calm hyperactive children. Though there is no statistical information supporting the last claim, Ephedra is found in the majority of over-the-counter cold and allergy medications. Ephedra and pseudoephedra are the two alkaloids contained in Ephedra. Ephedra is a bronchodiolator and is what causes the benefits to those who suffer from asthma. Pseudoephedra, the quantities of which are less, is a nasal decongestant. These alkaloids are used by physicians to treat bronchitis, emphysema, and many other respiratory problems.
Due to the stimulating effect that Ephedra has on its user, it is also found in many popular weight-loss and energy products. It has been proven to suppress the appetite and stimulate the Thyroid gland, in turn stimulating the metabolism. The most recent research into new uses for Ephedra is into helping obesity due to the fat-burning effect.
The most common use of Ephedra is not respiratory or dietary. Ephedra is a commonly used in “energy” products that claim to give athletes extra energy. This herb is also claimed to increase alertness and perception. Everyone from professional athletes to bike racers to college football players to people looking for an extra push with their exercises are using Ephedra to get optimal performance. Some of these thousands upon thousands of people are taking the drug in its suggested dosage but many are following the “if a little is good, more is better” motto in their life and are taking massive doses of this drug. Their bodies adapt to it like it does to coffee . If it is taken for two weeks you will need more to get the same sensation. Many people who take this are not even aware of it. The drug Ephedra is often sold under other names including ma huang, sida cordifolia and others. With these variations, it is very easy for the drug to get lost in exotic lists of ingredients on the back of bottles. Even people who have decided against taking the drug are unknowingly taking it under one of its aliases. On top of this there are many drugs that are often stacked with it that increase the effects such as caffeine, general psychedelics, and magic mushrooms. There are some proven risks that come hand in hand with Ephedra as well as some proven benefits. Both of theses sides will be viewed in this paper.
According to bodybulidling.com “Ephedra is a powerful stimulator that increases metabolism. Ephedra has been used widely to treat many conditions such as the common cold... Research conducted on this herb has shown that it has awesome implications for bodybuilders, weight-trainers, and athletes. Some of the incredible effects are weight loss, metabolizing fat, and muscle maintenance.” It seems that there are claims like this all over the Internet. Athletes have taken Ephedra for a number of years to enhance performance. Bodybuilders can benefit from Ephedra in many ways. It stimulates the biochemistry of muscles, enhances performance, and breakdown fat cells. Athletes are depending on herbal supplements more and more to get the edge on competition. Some bike racers are taking ten times the recommended amount of Ephedra to get ready for the race. These athletes have been recorded to have heart rates of 150 beats per minute before the race has even began. http://www.bodybuilding.com/store/ephedra.html All of these statistics seem to be amazing but one must first look at the source of these claims. The source of this information is the companies themselves. It is made up of testimonials biased studies. To find out the truth about any drug or supplement, nonbiased medical studies are necessary. These types of studies will be found under the “Studies” section of the paper.
The wide-ranging beneficial properties of Ephedra do not stop at athletic performance and respiratory health, but are huge in the dietary scene. According to Daniel B. Mowrey, Ph.D. “America’s foremost author and expert on herbs” has recently shown how to practice safe Ephedra use at the Natural Products Expo. According to him it is possible to control body fat safely and effectively without the use of these herbs. He states that Ephedra is not only a great tool in addressing obesity but it can also be used to replace prescription appetite suppressants that are often more harsh. Mowrey claims that people who are suffering from obesity is because they often suffer from a metabolic deficiency. “ By combining the correct ratios of Ephedra, a caffeine source and aspirin, the body’s natural fat burning process can be reactivated safely and effectively.” said Mowrey, referring to research done at Harvard University and the American Physiotherapy Research Laboratory. Http://ephedra.com/prnewswire.htm
Industry executives have argued for a long time that Ephedra has a good safety record. They base this on the fact that millions of people use it every year and there were only 140 complaints to the FDA from June 1997 and March 1999. Unfortunately this is not totally accurate because the FDA does not require the makers to report consumer complaints and critics believe that there are thousands of side effects each year that are never reported. Several surveys show that people are less likely to connect headaches, dizziness, nausea, or other symptoms to supplements. “Even when people are having some strange reaction or symptoms they don’t think of the supplements. They think the supplements are somehow ‘natural’ and wouldn’t cause problems.” said Bill Gurley, a pharmaceutical researcher at the University of Arkansas. This is just the beginning of the dark side of Ephedra. http://ephedra.com/los_angeles_times.htm
Once again the FDA received 140 complaints about Ephedra-based supplements. The most common problems were heart palpitations, high blood pressure and rapid heartbeat. The cases also included two heart attacks, two strokes, one seizure and three deaths with victims ranging from 18 to 45 years of age. Even more frightening is that most of them only reported taking moderate doses of the extracts. Three football players have died this year that had been taking supplements containing Ephedra. Doctors cannot prove that Ephedra was the cause of death but the facts point towards that conclusion.
Millions of Americans are taking these supplements in varying doses. A large problem is that because supplements are not technically drugs under the law, they aren’t tested for safety by the Food and Drug Administration. Another problem is that the FDA cannot regulate how carefully the companies measure out their supplements so no one really knows how much ephedra they are getting in any one dose. It has been proven that some people react more strongly to Ephedra than others. The FDA found a variety or problems that we due to the supplements including hypertension, palpitations, arrhythmia, cardiac arrest, and stroke. http://ephedra.com/prnewswire.htm
Ephedra quickly activates the “fight or flight”(sympathetic) part of the nervous system. This opens bronchial airways, increases blood pressure and heart rate, releases adrenaline and puts the body into full alert. Athletes often put this sensation hand in had with better performance but researchers are doubtful. “As far as I know, there’s no good data showing the ephedra by itself measurably improves speed, strength or overall performance,” said Rick Kreider, director of the exercise and sports nutrition lab at the University of Memphis. In many studies, people have been given 25 milligrams of Ephedra mixed with 200 milligrams of caffeine. This is about the dose recommended on most of the product labels. “You get heightened awareness, slight increases in heart rate and blood pressure, and that’s about it,” said Conrad Earnest, a supplement specialist at Cooper Institute for Aerobics Research in Dallas.
Doctors also believe that there isn’t any Ephedra dosage that is safe for everyone. The “amphetamine-like punch” hits a small percentage of people harder than others and puts them at risk of stroke and cardiac arrest.
The American Journal of Botany published a study on ephedra in the November 9, 2000 journal. In this study they did very careful research on ephedra from around the world and shared a lot of information that the ephedra producers failed to contain in their sites. When the ingredients of an ephedra containing product are read, all that it says it “ephedra”. In truth there are 50 different varieties of ephedra throughout the world. Many of these differ GREATLY from the others; some Asian varieties are even used to make the street drug methanphedamine. Ephedra seeds are usually spread by the ingestion of the red berries by birds but the strain found in Israel contains high levels of CCGIII and methanoproline and is not edible. A Nevada community of ephedra contains 6-hydroxykynurenic acid levels comparable only to the leaves of Ginkgo Biloba. The list of MAJOR differences between the 27 studied of 50 studied varieties of ephedra goes on and on. Ephedra from different parts of the world can have totally different proportions of chemicals. The conclusion of this journal stated that “The chemical diversity of ephedra may explain why the taxon has been exploited in so many different ways by native peoples... the complex phytochemistry of ephedra needs further analysis before its myriad ethnopharmacological uses can be fully comprehended.” (Coteney,Charlet,Freitag,Stolte,Starratt, 2001)
Last year the American Society of Clinical Nutrition published a journal on the common uses of a number of popular herbs. Along with Ginseng and Ginkgo Biloba, a section was devoted to Mahuang or Chinese ephedra. They found that ephedra supplements have been specifically marketed for young adults. Ephedra is said to produce “a legal high, sexual ecstasy, euphoria, or increased energy” and “has attracted media and legislative scrutiny.”(Bucci, 2000) According to this article, the problem isn’t with the herb itself. The problem lies in the fact that the products are spiked with synthetic ephedraine alkaloids, a substance not mentioned in any of the weight loss or bodybuilding advertisements. When combined with caffeine, as most supplements are, the potency is increased greatly. According to the author of this study, these spiked products are not comparable with the natural herbal extract or supplements that contain the herb in it’s natural form (with<24 mg ephedra per unit dose)(Bucci,2000). Experts suggest doses of no more than 25 mg of ephedra per unit dose with a total of less than 100 mg per day. In this study, complaints of side effects have nearly always been by those taking more than 100 mg a day of ephedra and those that take a lot of caffeine at the same time (150-300mg)(Bucci,2000). The sensible person would take the herb at recommended doses but unfortunately it doesn’t work that way. In 1977 Sidney and Lefcoe administered 24 mg ephedra to 21 males and found that there weren’t any notable differences between the ephedra and the placebo “in muscle strength, endurance or power, lung function, reaction time, hand-eye coordination, anaerobic capacity, speed, cardio respiratory endurance, VO2max, ratings of perceived exertion, or recovery” (Sidney,Lefcoe,1977). This controlled clinical trial discredits all the claims made by the supplement companies. A second clinical trial found no change in heart rate, blood pressure, glucose, or insulin after a dose of 60-120 mg to 6 males. The only effect noted was increased sinus arrhythmias at high doses (Bright, Sadage, Fletcher,1981)
In 1972 another ephedra study was brought about by the Olympic games. Rick Demont gave his gold metal back because of questions about him using an ephedra-based medicine for his asthma. This trial was done in order to see the effect of the drugs on physical performance. This test involved ten subjects and the conclusion was that there wasn’t any difference in physical performance between those taking the normal ephedra dosage and those taking the placebo. There was a difference however between blood pressure at the 1-mg/kg dose. The blood pressure increased by an average 10.6 mm Hg. (DeMeersman,Getty, Schaefer 1987). From all of this presented data it is clear that ephedra taken at “safe” dosages doesn’t benefit physical performance. Ephedra mixed with caffeine did improve physical stamina in other trials but this has also been proven unhealthy. (Bucci,9)
The University of California, San Francisco did a study, funded by the FDA, on ephedra damage claims. They reviewed 140 Reports of adverse events related to the use of ephedra containing supplements. All of these had been complaints issued with the FDA between June 1, 1997, and march 31, 1999. It was found that 31 percent of cases were probably or defiantly related to the use of ephedra and it was decided that another 31 percent were possibly related. 47 percent of these cases involved cardiovascular symptoms. 18 percent involved the nervous system. The most frequent complaint was of hypertension and there were 17 of these reports. Other complaints were palpitations, tachycardia, and insomnia. There were also 10 strokes, 7 seizures, and 10 deaths. 13 of these injuries caused permanent disability (Fleming, 2000)
The supplement industry has been proven to be a very powerful one with a lot of control over the media. It as also been proven to have very life threatening implications. These two things form a dangerous mixture. The facts can be hard to find and must be sifted out from advertisements and bogus testimonials. Ephedra is one of the controversial supplements in question. It has great potential to do good but also the potential to cause death. When choosing whether or not to allow these alien substances into your body, care should be taken and research should be done to ensure a healthy decision.
DeMeersman R, Getty D, Schaefer DC. Sympathomimetics and exercise enhancement: all in the mind? Pharmacol Biochem Behav 1987;28:361–5.
Fleming, G. A. (2000). The FDA, Regulation, and the Risk of Stroke. N Engl J Med 343: 1886-1887
Luke R Bucci(2000). Selected herbals and human exercise performance. American Journal of Clinical Nutrition, 72, 624-626
Sidney KH, Lefcoe NM. The effects of ephedra on the physiological and psychological responses to submaximal and maximal exercise in man. Med Sci Sports 1977;9:95–9.
Stanley Caveney, David A. Charlet, Helmut Freitag, Maria Maier, Alvin Atarratt (2000). New Observations on the secondary chemistry of world Ephedra. American Journal of Botany, 88, 1199-1208.
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