Sidney Wolfe, a physician and a public health advocate, has pleaded with federal health officials to ban over-the-counter diet products that contain ephedra, warning that with each delay, “more people are dying.”
Tuesday, another death was linked to the controversial supplement.
Steve Bechler, the 23-year-old Baltimore Orioles prospect from Medford who died of heatstroke Monday, was using Xenadrine. The over-the-counter weight loss supplement contains ephedrine (a chemical in ephedra), the medical examiner who conducted his autopsy said.
The supplement is banned by the U.S. and the international Olympic committees, the NCAA and most major sports leagues but not Major League Baseball.
Although toxicology results will take several weeks, Dr. Joshua Perper, chief medical examiner for Broward County, Fla., said Bechler had been taking the supplement and had eaten almost nothing in the two days before his collapse Sunday during conditioning exercises in Fort Lauderdale, Fla. Bechler also had high blood pressure and liver abnormalities, Perper said.
Linked to heatstroke among a host of ailments, ephedrine acts as an accelerant to the body’s efforts to control overheating.
“What we have is enough to make this preliminary determination,” Perper said at a news conference.
The death of Bechler recently married and soon to be a father turned the spotlight again on ephedra, a supplement that Wolfe, director of the Public Citizen’s Health Research Group, has lobbied hard to ban.
The nonprofit organization, founded by activist Ralph Nader, submitted a petition to the U.S. Department of Health and Human Services in 2001 to ban ephedra. Health and Human Services officials say they are awaiting a survey of deaths and damage attributed to the diet supplements, which are available at many health food stores and health clubs.
“It’s a dangerous delay because more people are dying,” Wolfe said.
Ephedrine is derived from ephedra, or ma huang, which has been used in Chinese herbal medicine for centuries. Its proponents say it increases metabolism burning fat and boosts energy.
Critics say the fact that ephedrine “works” is its danger.
“Any time you cheat, any time you try to get quick gains, there’s a price,” said Dr. Kerry Kuehl, director of the Oregon Human Performance Lab at Oregon Health & Science University and an internist in sports medicine who has focused on supplements in recent years. “It is a drug of abuse, a huge drug of abuse.”
In addition to the bans by sports organizations, the U.S. Army, Air Force and Marines have pulled ephedra products from military commissary shelves. Last year, the Canadian government warned its citizens against using ephedra products.
Major League Baseball does not prohibit ephedra, but Orioles physician William Goldiner told the Washington Times that he discourages players from using it.
“We don’t have it. We don’t supply it. We don’t prescribe it,” Goldiner said. “I see no reason to have it in the marketplace. I think it should be off the shelves.”
Ephedra is not controlled by the Food and Drug Administration except for its use in some medications for asthma, colds, hay fever and hemorrhoids.
The supplement is sold in some health clubs, promising leaner bodies and more explosive workouts.
“A lot of people think, number one, ‘It can’t happen to me,’ and it’s going to give them an edge they don’t have,” said Colin Hoobler, owner of C.H. Physical Therapy and Personal Training and a critic of supplements and the gyms that sell them. “Ephedra is like caffeine on steroids.”
Ephedra raises one’s heart rate and blood pressure. It is blamed for heart attacks, strokes, seizures and hallucinations. It inhibits the body’s ability to regulate heat a potentially deadly side effect for someone exercising in heat.
“It’s like taking a hot tub with alcohol,” Kuehl said. “It decreases thermal regulation.”
Team coaches said the 6-foot-2, 239-pound Bechler, a third-round draft pick by the Orioles in 1998, reported to training camp overweight. He participated in drills Saturday but complained of feeling ill, Perper said. He had not been eating in an effort to lose weight.
“He wanted to change his work ethic; he just wanted to change the way he was,” reliever Matt Riley said. “He realized that he had a great opportunity here to make this club and do something with the big team.”
Bechler collapsed during drills Sunday and died Monday morning of multiple organ failure after his temperature peaked at 108 degrees almost 10 degrees above normal. The lack of food, the ephedra and the warm temperatures contributed to Bechler’s death, Perper said.
“At this time, I don’t have a complete or sufficient degree of toxicology results that I can say precisely what was in the blood and at what levels,” he said. “But it’s very difficult to believe, in view of all the circumstances, that anything else was really of importance.”