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Battle Rages Over Bitter Orange

Some People Turn To Bitter Orange After Ephedra Banned

May 18, 2004 |

If you're trying to lose weight and taking a diet supplement, chances are it contains bitter orange an ingredient similar to ephedra.

The Food and Drug Administration banned ephedra earlier this year because of deadly side effects and is now concerned about bitter orange.

Bitter orange has the botanical name citrus aurantium and is derived from the seville orange. Bitter orange is in many foods, including some orange marmalades, but in supplements, its active ingredient synephrine is much more concentrated.

Synephrine is in the same family as ephedrine and other stimulants.

"They stimulate your cardiovascular system, raise your heart rate, raise your blood pressure, stimulate your central nervous system," said Nancy Metcalf, senior editor of Consumer Reports.

For people trying to lose weight, bitter orange has become a popular replacement for ephedra, which the FDA pulled from the market in April after being linked to heart attacks and strokes and 155 deaths. It also was linked to the death of Orioles pitcher Steve Bechler in February 2003.

Consumer Reports placed bitter orange on its hit list of dangerous supplements still at large.

"Here's the problem with synephrine it's almost never been studied in people," said Metcalf. "There are animal studies. People who go on it lose weight, but with bad cardiovascular results."

Mark Blumenthal is the founder of the American Botanical Council, a nonprofit organization that tries to educate doctors, the media and the public about herbs. When it comes to bitter orange, he said it's been unfairly judged.

"Because something is chemically similar doesn't mean that it has the same pharmacological or biological action in the human body," said Blumenthal.

Blumenthal points to the fact that bitter orange has been judged by the FDA to be generally recognized as safe as a food additive.

"Bitter orange has been used in Chinese medicine for hundreds, maybe thousands of years," he said. "It does have an effect when taken orally. The question is how much."

There have been some reports of adverse effects in people taking bitter orange, but companies who use it don't have to report those negative reactions to the FDA it's all voluntary.

Blumenthal is waiting for the results of a scientific review of all available research on bitter orange. In the meantime, he said the warnings on bitter orange labels should be sufficient.

"If people heed the warnings and use the products in a responsible manner, by and large, most of these products are very safe," said Blumenthal.

But Metcalf thinks weight-loss supplements should be avoided altogether.

"Either they're ineffective in which case you're wasting your money or if they work, it's a stimulant and a stimulant is endangering your health," said Metcalf.

There is a bill now before the Senate which would give the FDA the authority to make supplement companies report bitter orange adverse events. The bill would also put stimulants in a different category, so they'd have a pass some sort of safety screen before they're brought to the market.

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