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Clear The Shelves of Ephedra

Feb 26, 2003 | The Plain Dealer

When Baltimore Orioles pitcher Steve Bechler collapsed of heatstroke last week at the team's Fort Lauderdale training camp, he became the fourth elite athlete in less than two years whose death could be linked to the herbal stimulant ephedra.

Those athletes are not alone. The Food and Drug Administration has tied ephedra, a cousin of methamphetamine, to at least 50 other deaths and to a range of health problems including strokes, heart arrhythmia and hallucinations.

When asked about ephedra in light of Bechler's death, Health and Human Services Secretary Tommy Thompson replied, "I wouldn't use it. Would you?" That's sound advice, but it needs to be backed up by some real clout.

Americans annually buy $3 billion worth of products containing ephedra, which is derived from a Chinese herb. That's less than 1 percent of all diet supplement sales. And yet a new report in The Annals of Internal Medicine finds that 64 percent of all reports of "adverse reactions" to supplements concern ephedra. Makers of ephedra products contend that they are safe when "taken as directed," but the problem is that many users apparently, including Bechler, consume quantities far beyond what is recommended. They seem to believe that anything sold over the counter can't be too harmful.

When it comes to supplements, that is a poor, potentially even deadly, assumption. Thanks to 1994 legislation, supplements are not defined as drugs, which means that they can be sold without restriction or prescription or extensive safety reviews. Yet in ads and displays, many supplements claim to work like drugs. The ephedra product that Bechler was taking, for example, is marketed as a "revolutionary" weight loss aid and energy source. But by speeding up a user's metabolism, it also appears to strain the heart.

The FDA is awaiting a study on ephedra by the RAND Corp. If it reinforces the anecdotal evidence, the government could and should act to get ephedra products off the market. In the meantime, manufacturers should consider voluntary warning labels or even recalls. Consumers should educate themselves before they ingest. And Major League Baseball, the National Basketball Association and the National Hockey League should join the National Football League, the International Olympic Committee and the National Collegiate Athletic Association in banning ephedra.

In the long term, Congress should revisit its exclusion of diet supplements from reasonable regulation. The time to test the safety of a substance is before it appears on shelves, not after its users start dying.

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