After reports that over-the-counter diet supplements contributed to last week’s death of Baltimore Orioles pitcher Steve Bechler, 23, some people are taking a closer look at the widely available substance known as ephedra.
Its uses are many. It is taken for weight loss, the enhancement of athletic performance, to increase energy or stay awake, to treat allergies, asthma, and respiratory conditions as well as for colds and flu.
And, although it has been banned by a number of sports associations, it’s so common and present in so many different products, many people have probably taken it without knowing it. Local health care workers are advising people to stay away.
“It’s one of those supplements you probably shouldn’t be taking,” said Dr. David Avery of Parkersburg. “It’s buried in so many things, so you don’t know when you are getting it.”
Avery said the “nasty drug” is sold under 47 different names, and since it is not regulated by the Food and Drug Administration, it is unreliable and its purity cannot be guaranteed.
“People take it for stimulation, energy, or to lose weight,” Avery said. He has seen patients develop mild side effects like heart irregularities after using it, but there is a long list of potentially life-threatening side effects, including stroke and heart attack.
In a review of 926 cases reported to the Food and Drug Administration of possible adverse effects of ephedra, 37 patients had serious or fatal adverse reactions, including 16 strokes, 10 myocardial infarctions, and 11 sudden deaths in people aged 30 to 56.
Compounding the possible problems with the herbal drug are indications that heavy users do not follow the recommendations for proper use and may take it in combination with other addictive substances or prescription drugs.
“People use stuff like that to stay out drinking and stay alert,” said Ray Strathers of Recovery Alternatives in Washington County. “They like the buzz. They don’t take it as recommended.”
Strathers said cases of people who need help recovering from recreational use of ephedra are not common, but the agency has seen two or three people in the past year or two, usually those who have taken it in combination with other drugs.
Ephedra is also a significant ingredient in the making of bootleg crystal methamphetamine because of its speed inducing qualities, prompting some area stores to keep cold medicine behind the counter and available upon request and only in small quantities.
But, ephedra is an ingredient in a number of supplements sold by the single dose in convenience stores all over the valley for energy or weight loss. As such, it is available to consumers of any age for as little as $1 a dose.
“A lot of widely available over-the-counter medicines that are supposed to be harmless are not necessarily harmless for everyone,” Strathers said.
Marietta College athletes, who abide by National Collegiate Athletic Association Division III rules, are told to steer clear of amphetamines, including ephedra. The National Football League and the International Olympic Committee have also banned the substance.
“Amphetamines, in general, are banned substance,” said Sam Crowther, athletic trainer. “Athletes are made aware of banned substances and can become ineligible if they use them.”
Crowther said stimulants may be attractive for athletes who believe that an extra rush will enhance their performance, but studies have proven that theory is flawed.
“Athletes try to find a magic bullet to help them perform better,” said Crowther, who believes hard work is the best policy for athletic improvement.
David Hawkins, of Mother Earth Foods in Parkersburg, suggests the problem is with the use and dosage, not necessarily the substance itself.
“The Chinese have used it for hundreds of years for lung conditions, asthma, and bronchitis,” Hawkins said. “But it was never used alone. It was used in combination with other herbs that would tone down the effects on the nervous system.”
Hawkins believes the average person would be safe taking the substance if they followed the guidelines, but he admits a lot of people do not.
The National Women’s Health Information Center reports a study of more than 1,000 adults indicated 66 percent read labels on herbal supplements and follow the directions faithfully, 25 percent find labels difficult to understand, 32 percent take more than recommended, and 22 percent use these products for longer than the recommended time.
Even though Hawkins believes the ephedra plant has a wonderful application, Mother Earth Foods quit carrying weight loss products with an ephedra base.
“It’s too much of a risk,” Hawkins said. “I don’t want to see people have a problem.”
Hawkins believes a more comprehensive approach to weight loss management is preferable to diet drugs, but recommends various herbal supplements and vitamins to help balance blood sugar and increase energy.
“By cutting 500 calories a day, you can lose about a pound a week,” Hawkins said. “If you lose in a sensible way, you will not gain it back.”
Other names for ephedra
Cao Mahuang, Desert Herb, Ephedrae herba, Ephedra sinesis, Herbal Ecstasy, Joint Fir, Mahuang, Ma Huang, Muzei Mahuang, Popotillo, Sea Grape, Teamster’s Tea, Yellow Astringent.
Common side effects: Dizziness, restlessness, anxiety, irritability, personality changes, difficulty concentrating, insomnia, headache, anorexia, nausea, heartburn and increased blood pressure.
Serious side effects: Hypertension, myocardial infarction, cerebral hemorrhage, seizures, stroke and death.