Friday, September 11, 2009

The Damaging Effects of Ephedra

Ephedra, better known as Ma Huang in China, is an herbal plant that has been used for over 4,000 years by the Chinese to treat respiratory infections (Fast Facts: Ephedra). Ephedra typically grows in desert conditions (Health Canada Notice: Information Ephedra/Ephedrine). Early US settlers used ephedra in the form of “Mormon tea” or “Squaw tea” for medicinal purposes (Fast Facts: Ephedra). Ephedrine, the harmful chemical found in Ephedra sinica, is now being coupled with caffeine to act as a quick weight loss supplement (Health Canada Notice: Information Ephedra/Ephedrine). Ephedrine has only been synthesized and regulated under the Federal Food, Drug and Cosmetic Act of 1938, making the herb a regulated supplement for less than 100 years (Consumer Alert). Ephedrine, until 2003, could be found in over 200 over the counter dietary supplements (Fast Facts: Ephedra). As a result of major studies and many complaints and deaths, the US Food and Drug Administration outlawed the use of ephedrine in December 2003 (Consumer Alert).
Many people would take ephedrine to lose weight, increase energy, sculpt their bodies, and to induce a euphoric high without being aware of the health risks (Health Canada Notice: Information Ephedra/Ephedrine). The short term effects of ephedrine could make people feel ecstatic, alert, and full of energy, but it could also make people feel dizzy, sweaty, anxious, and flush (Health Canada Notice: Information Ephedra/Ephedrine). Adverse effects of ephedrine can also leave a person with a headache, a decreased appetite, gastrointestinal distress, tachycardia, irregular heartbeat, hypertension, seizures, and psychosis (Health Canada Notice: Information Ephedra/Ephedrine). Ephedrine can significantly increase a person’s blood pressure leaving a person with heart problems, strokes, or death (Consumer Alert). Ephedrine aggravates the following conditions: heart disease, hypertension, diabetes, anxiety and restlessness, glaucoma, pheochromocytoma, thyroid disease, and enlarged prostate (Health Canada Notice: Information Ephedra/Ephedrine). A study that was based on data from the American Association of Poison Control Centers found that ephedrine was the cause of 64 percent of all adverse effects involving herbs; ephedrine can only be found in less than 1 percent of all herbal products (Ephedra). There are over 1,000 reports of serious health issues due to ephedrine and over 100 deaths (Fast Facts: Ephedra). One of the more famous deaths due to ephedra was the death of the Baltimore Orioles pitcher who died at only 23 years old (Fast Facts: Ephedra).
The herbal weight loss supplements containing ephedra had been banned in Europe and Canada before the recent ban in the US (US Government to Expand Ephedra Research). In 1997, the US Food and Drug Administration proposed to require all supplements containing ephedra to carry a warning label on the bottles stating that the drug should not be used longer than seven days (Consumer Alert). In 2000 the US Food and Drug Administration modified the proposal (Consumer Alert). The International Olympic Committee was one of the very first to ban ephedra use (Ephedra). During the 2000 Olympics a Romanian gymnast was stripped of his gold medal when he tested positive for ephedra (Ephedra). In September of 2001, the NCAA banned the use of ephedra (Ephedra). Soon the NFL also began treating ephedra use the same as cocaine and marijuana (Ephedra). Today, most sporting groups ban ephedra or at least discourage its use (Fast Facts: Ephedra). In 2002 Canada banned ephedra (Health Canada Notice: Information Ephedra/Ephedrine). Finally in December 2003 the US announced it too would ban ephedrine use (Consumer Alert). Although the US Food and Drug Administration warned everyone to stop ephedra use immediately, the ban on ephedra was to become effective 60 days after the consumer alert (Consumer Alert).
The US was not always open to deterring ephedra use. In 1997 the US Food and Drug Administration wanted to put warning labels on ephedrine products, similar to those on cigarettes (Consumer Alert). Although the agency had received numerous reports of adverse effects, they insisted that the reports could not provide a scientific basis in which to accurately assess the safety of ephedrine (US Government to Expand Ephedra Research). Without a “scientific basis” the US could not ban ephedra (US Government to Expand Ephedra Research). As a result, the HHS funded the RAND Corporation to peruse the existing information regarding ephedrine (US Government to Expand Ephedra Research). Just because the US Food and Drug Administration was not willing to ban the herb instantly does not mean they ignored the calls for action. The administration strengthened its monitoring system and placed all the information it received from reports of complaints into a single system to monitor safety issues (US Government to Expand Ephedra Research). The administration also reviewed information regarding ephedra’s pharmacology, clinical studies regarding ephedra’s effectiveness, and the reports regarding adverse effects in order to be able to ban the herb (Consumer Alert). A year before ephedra was banned in the US, the HHS had planned to “clamp down” on the illegal synthetic ephedra market (US Government to Expand Ephedra Research). In 2002, the US Food and Drug Administration had sent six letters to firms selling illegal synthetic ephedra (US Government to Expand Ephedra Research). These letters were warnings for the firms to inform the administration of their plans to correct the illegal activity or else the Food and Drug Administration would act (US Government to Expand Ephedra Research). One well known company, Biogenics, signed an agreement in April 2002 stating that it would cease the sale of synthetic ephedra (US Government to Expand Ephedra Research). One of the largest US manufacturers of ephedra, Metabolife International, faces numerous lawsuits from those claiming they were not warned of the potential side effects (US Government to Expand Ephedra Research). This company supported the HHS’ decision on investigating ephedra as opposed to banning it immediately (US Government to Expand Ephedra Research). In February 2003, the Food and Drug Administration announced measures that would include enforcements against ephedra selling firms making unsubstantiated claims about their products (Consumer Alert). In October 2001, the US Marshals successfully removed $2.8 million worth of synthetic ephedra products from the market (US Government to Expand Ephedra Research).
The result of further studies indicated that ephedrine is dangerous even in recommended dosages (Ephedra). The makers of ephedra products were not required to report the effects of the herb because it is a supplement and not a drug (Ephedra). The data suggested that there is little evidence of ephedra’s effectiveness except for short-term weight loss (Consumer Alert). The research also confirmed that ephedra raises blood pressure and stresses the circulatory system causing a myriad of potential problems (Consumer Alert). The herb now met the requirements for banning a supplement based on the Dietary Supplement Health and Education Act of 1994, the Food and Drug Administration was able to ban all ephedra use. Officials say that other herbs are currently being watched as “possible health hazards” including chaparral, comfrey, willow bark, and wormwood (Fast Facts: Ephedra). No immediate action is expected to be taken against these herbs until more information can be found (Fast Facts: Ephedra).

"Consumer Alert." US Food and Drug Administration. 30 Dec. 2003. 24 Nov. 2007 .
"Ephedra." CBS News. 19 Nov. 2007 .
"Fast Facts: Ephedra." Fox News. 30 Dec. 2003. 21 Nov. 2007 .
"Health Canada Notice: Information Ephedra/Ephedrine." National Association of Pharmacy Regulatory Authorities. Jan. 2002. 24 Nov. 2007 .
"US Government to Expand Ephedra Research." Nutra Ingredients. 17 June 2002. 19 Nov. 2007 .

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