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Scientists red flag popular supplement ephedra

Nov 6, 2000 | CNN A study released Monday warned that popular dietary supplements containing the ingredient ephedra can pose severe health risks and even kill in some cases.

Ephedra is found in many over-the-counter products designed to help people lose weight or increase their energy.

At the U.S. Food and Drug Administration's request, scientists at the University of California, San Francisco, reviewed 140 reports of serious problems with ephedra-containing products. Among the problems they found:

43 cases were definitely or probably related to the supplements
44 cases were possibly related to the supplements
10 deaths
13 people who were left with permanent disabilities

The researchers also found that of the 87 cases that fell under the "definitely, probably or possibly" link to ephedra, 47 percent involved cardiovascular symptoms and 18 percent involved central nervous system woes.

The study caught the eye of editors at the New England Journal of Medicine who had planned to publish it in December, but released the study Monday on the journal's Internet site due to its health implications.

"Because of the severity of the adverse events that we reviewed and, in particular, the occurrence of events that caused permanent disability and death, we conclude that dietary supplements that contain ephedra alkaloids pose a serious health risk to some users," quoted the online version of the study.

The University of California researchers who gathered the data also said ephedra-containing products should be more uniformly and explicitly labeled. They also called for large-scale studies to quantify the dangers of the products and to identify who is vulnerable to the serious side effects -- steps needed to determine a maximum daily safe dose.

Another complicating factor is that most these products also contain caffeine, which constricts blood vessels and may increase blood pressure in someone prone to hypertension. Most of the stimulating supplements are derived from the herbal plant ma huang, and often also contain caffeine derived from guarana.

Experts said some 12 million people in the United States use ephedrine-containing supplements -- listed as stimulants and used for short-term energy boosts to enhance athletic performance or to help people exercise longer, feel more alert, and to dampen appetite.

Industry experts, though, said when taken as directed -- ephedra is safe.

"There really is no correlation between the serious effects -- I'm talking about death and stroke -- that can be attributed solely to the ephedra-containing dietary supplement," said Norbert Page, of the Ephedra Education Council, a Washington-based industry organization.

The NEJM study said that since ephedra-containing supplements are stimulants, the people who should avoid them are those who have kidney disease, those with preexisting heart disease, high blood pressure, overactive thyroid, or psychiatric disorders and those with histories of seizures and diabetes.

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