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Because They're Legal Doesn't Mean Supplements Are Safe

Feb 19, 2003 | San Diego Union Tribune

It's perfectly legal. Perhaps lethal, too.

Already too familiar with the link between "supplements" and the deaths of athletes, the sports world was hardly shocked by yesterday's determination that the herbal stimulant ephedrine probably contributed to the death of Baltimore Orioles pitcher Steve Bechler, a 23-year-old who died of heatstroke after a spring-training workout in Florida.

Nor was it the least bit unusual that Bechler kept a bottle of a dietary supplement that contained ephedrine in his locker, ostensibly to help him shed his winter weight. You'll find pills and powders of all sorts in players' stalls throughout major league baseball, which permits the use of ephedrine, even though it has been banned by the NFL, NCAA and International Olympic Committee.

Available over the counter in most grocery and drug stores, ephedrine hasn't been declared a controlled substance by the Food and Drug Administration. Still, as Bechler's life was slipping away in an ambulance, somebody with the Orioles reportedly threw the bottle in the trash, where it had to be retrieved.

"I would hope this tragic death would lead Major League Baseball to ban ephedra," said Dr. Josh Perper, the Broward County medical examiner. Perper said he intends to "send a letter to the league and the players association. The players should recognize the fact that this is dangerous."

Also known as ma huang, ephedra is a herbal source of the chemical ephedrine, the effects of which as a stimulant are compared to those of amphetamines. In addition to providing jolts of energy, it speeds up the heart rate and central nervous system.

At the same time, ephedrine diminishes the body's ability to release heat. Perper wanted to wait for the full toxicology report to draw any further conclusions, but Bechler was reported to have had a body temperature of 108 degrees in the hospital after an Orioles workout that was described as not exceedingly strenuous, coming in the first week of camp.

The NFL forbade its players from using ephedrine after offensive lineman Korey Stringer, who reportedly used the same weight-loss supplement as Bechler, collapsed and died in the heat of the Minnesota Vikings' training camp in 2001.

In an ongoing lawsuit, Northwestern University contends that Wildcats strong safety Rashidi Wheeler used ephedrine-containing supplements before his similar death on a practice field in 2001. Three of Wheeler's teammates were identified as having a product with ephedrine in their lockers on the day Wheeler died.

"I don't think people know what they're getting when you take (the supplements in question)," said Gary Johnson, head athletic trainer at San Diego State, which has implemented the NCAA's first year of testing for ephedrine. "The FDA has not done a great job in the past of regulating supplements."

Because they're not categorized as drugs, the ephedrine-containing supplements aren't subject to FDA approval. Millions of Americans consume them, primarily for the purpose of losing weight, and claims of problems with their use far outweigh those associated with other types of supplements.

A recent story in the Union-Tribune disclosed allegations of questionable research practices by various manufacturers of supplements. Included were charges of omitting or destroying negative research data, deception, fraud and sloppy research practices by an industry besieged with personal-injury lawsuits.

"We believe that people who take ephedra are conducting what amounts to a vast, uncontrolled clinical experiment on themselves with untested, largely unregulated medications," said Elisa Odabashian, a senior policy analyst for Consumers Union in Sacramento. "Given the health concerns that have been raised about this product, we recommend that it be avoided by consumers, especially adolescents."

In a letter to the secretary of health and human services in September, Rep. Henry Waxman of Southern California noted that the FDA has received "approximately 15,000 adverse-event reports regarding ephedrine-containing supplements, including reports of heart attack, stroke, seizure and death." Ultimately, Waxman urged the FDA to ban supplements with ephedrine altogether.

Said SDSU's Johnson: "There are so many things you don't know. You get somebody taking something with ephedra. He might be taking that on top of diet pills of some sort. On top of that, he may be using caffeine in some form. On top of that, he could have an underlying heart condition. Right there, you've got the combination for a catastrophic outcome."

Then there is the competitor's fundamental nature.

"Athletes are always looking for the quick fix," Johnson said, "always looking for the edge."

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