Baseball Pitcher's Death Renews Fears Around Ephedra ProductsFeb 20, 2003 | The Buffalo News Ephedra promises magic.
"World's Strongest Fat Burner!" "Clinically Proven!" scream its neon bottle labels. The herbal supplement is as alluring to a teenage girl struggling with her weight as it is to a professional athlete searching for ways to stay at the top of his game.
But this week, after a medical examiner linked the death of Baltimore Orioles pitcher Steve Bechler to his use of an over-the-counter ephedra product for weight loss, some of the magic melted away.
Bechler's death is just the latest in a series of events that may spell the end of the herbal drug's shelf life.
Within the past year, two major sports organizations, the National Football League and the National Collegiate Athletic Association, started cracking down on athletes using ephedra. Now the Food and Drug Administration wants the power to regulate herbal dietary supplements just as it does with products ranging from aspirin to lipstick.
"No legitimate doctor would condone this stuff," said Dr. John Leddy, a sports medicine physician with University Sports Medicine in Amherst. "It's cheating, and it's dangerous."
Marketers of herbal supplements first tapped the powers of synthetic ephedra which clears air passages in the lungs to treat respiratory problems caused by asthma and allergies. But since it's a stimulant, it has a special appeal to two other populations: athletes and overweight people.
The supplement available in pill, capsule or shake form offers an instant energy boost for people involved in sports that require endurance and speed, like football. Because it speeds metabolism, it's also promoted as a super-quick weight-loss solution.
But beyond the hype lies a shady side, say critics of the supplement. Reported side effects include high blood pressure, dehydration and dangerously high heart rates. When paired with outdoor workouts in hot weather, the compound can be lethal, Leddy said.
Products containing ephedra are heavily marketed in women's magazines, where models in bikinis pose for glitzy, seemingly miraculous before-and-after shots. In drugstores, health food stores and even gas stations, popular ephedra potions are sold under brand names including Nutramerica's Trim Spa and Xenadrine RFA-1, the product Bechler had been using before he died.
Popular weight-loss product
Local athletic trainers estimate that about one in 10 of their clients use ephedra for weight-loss help, and stores that sell dietary supplements report that ephedra products are among their most popular.
But physicians and fitness experts say the people they know who use the supplements are universally cavalier about the potential side effects. To them, it's just another health trend, like Pilates or the Atkins diet. They'll use if it works and stop only when it no longer does.
"People look at it as being very similar to caffeine," said Mark Ludes, a trainer at the Buffalo Athletic Club. "It's legal, and it's sold all over, so they figure it can't be all that bad."
Authors of a study published in the current issue of the Annals of Internal Medicine found that products containing ephedra account for less than 1 percent of all herbal supplement sales in the United States. But the drug is linked to a staggering 64 percent of all reported adverse reactions to herbs, according to poison control centers across the nation.
Negative effects disputed
Officials with Cytodyne Technologies, the New Jersey company that manufactures Xenadrine, dispute the results of that study, calling its methodology "flawed and biased." For comparison, they point to a recent study published in the International Journal of Obesity that found no difference in the cardiac functions of patients taking Xenadrine compared with those taking a placebo.
Ephedra products are never recommended for use by people under age 18, said Shane Freedman, Cytodyne's general counsel.
But as high school proms and bathing suit season approach, girls are particularly susceptible to ads promising get-thin-quick drugs, said Marcy Gerlach, Sweet Home High School's athletic trainer.
And with no age restriction on sales of the products, teens can have them in their hands almost instantly.
The product could be especially dangerous for teens already struggling with eating disorders or taking certain medications, said Dr. Dalinda Condino, chief of adolescent medicine at Women's and Children's Hospital.
Teens prone to misuse
Although savvy consumers would likely test a small amount of the supplement before they stepped up to a higher dosage, teenagers are more prone to experiment and take more pills than the label advises.
"They figure if one is good, five must be better," Condino said. In someone whose body is already weakened by an eating disorder, the drug's stimulant properties could land them in the hospital or worse. The FDA has reports of at least 100 deaths linked to use of the herbal supplement. Freedman said Cytodyne's products are "widely used" by professional athletes. Across the industry, though, there are fewer and fewer legal opportunities for players to do so.
In light of Bechler's death which may have been hastened by high blood pressure and liver problems, Major League Baseball officials may take another look at adding ephedra to its list of banned substances, following the NFL, the NCAA and the Olympics.
"You would hope this would make them deal with it," said Dick Pound, president of the World Anti-Doping Agency. "How many players will have to die before somebody says, "Hey, we have a problem with it?' "
"No magic pill'
For people who move outside the circles of professional athletics, though, experts say the best way to shed extra pounds and feel more alert are old-fashioned: Eat sensibly, move your body, and get plenty of sleep.
"There is no magic pill," said Ludes, the Buffalo Athletic Club trainer. "There's nothing that will work over time without a good diet or exercise."