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Ephedra Far Riskier Than Other Herbs
By Jim Kling WebMD Medical News
Reviewed By Brunilda Nazario, MD , on Monday, February 03, 2003
Feb. 3, 2003 -- A new study concludes that the herb ephedra -- a key ingredient in weight-loss products like Metabolife 356 -- is hundreds of times riskier than other kinds of herbal supplements.
The estimate comes from an analysis of herbal-related reports made to poison centers in the United States in 2001. With that data, the researchers compared the risks of ephedra with those from other herbal products.
They found that ephedra-based complaints made up 62% of all such complaints, despite the fact that the herb accounts for less than 1% of all herbal product sales. Taking into account volume of sales, ephedra has 200 times the risk of all other herbal products combined, the researchers say. Common complaints include anxiety, insomnia, increases in heart rate and blood pressure, and even heart attacks and strokes, which can lead to death.
"Our study shows that ephedra is unsafe for routine and unsupervised use," Michael Shlipak, MD, MPH, an assistant professor medicine and epidemiology and biostatistics at the University of California at San Francisco, said in a statement. The study appears in the March edition of the Annals of Internal Medicine.
Ephedra is a stimulant, much like caffeine, and probably works by increasing heart rate and metabolism, according to Stephen Bent, MD, who is a clinical researcher at the San Francisco VA Medical Center. Studies that show ephedra assists in weight loss over the short term, but there is no evidence that the weight stays off when use of the product is stopped.
The federal government is currently mulling over possible limitations or regulations on the sale of ephedra. In anticipation of changes, companies like Metabolife are rolling out new product lines containing other herbs. "[There is] great concern that another herb that has ephedra-like properties is going to bust in there, with no evidence to support its safety," Bent tells WebMD.
Phil Harvey, PhD, chief science officer for National Nutritional Foods Association, a trade association for makers and sellers of dietary supplements, herbs, and functional foods, agrees that ephedra has well-known side effects. "We have, over the years, strongly said that cautionary language on the label should be voluntarily used, and the vast majority of companies that sell these products do have that," he tells WebMD. "You have to use it with caution. It's not like vitamin C... you have to carefully monitor this."
"If it is available, there ought to be significant warnings on the product stating that it can cause these severe reactions," says Bent. "That's one of the biggest problems: Consumers aren't always aware that dietary supplements aren't tested for safety and efficacy. People have this feeling that if something is on the shelf next to the Tylenol, it must have the same level of safety testing, and it doesn't." Dietary supplements are not regulated by the FDA; prescription and over-the-counter drugs are.
Those who want to take herbal products should do so in consultation with their doctor, Bent says, and it is best to stick to bigger-name brands. There are no manufacturing regulations for dietary supplements, so a product may not contain the amount of active ingredient claimed by the packaging.
The researchers write that various prominent medical associations including the American Medical Association and Health Canada have recommended banning of the sale of the herb, and many sports organizations have prohibited its use. They also conclude the herb should be restricted or banned to prevent serious adverse effects.
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SOURCES: Annals of Internal Medicine, March 2003 * Stephen Bent, MD, clinical researcher, San Francisco VA Medical Center * Phil Harvey, PhD, chief science officer, National Nutritional Foods Association * news release, University of California-San Francisco.
By Jim Kling WebMD Medical News
Reviewed By Brunilda Nazario, MD , on Monday, February 03, 2003
Feb. 3, 2003 -- A new study concludes that the herb ephedra -- a key ingredient in weight-loss products like Metabolife 356 -- is hundreds of times riskier than other kinds of herbal supplements.
The estimate comes from an analysis of herbal-related reports made to poison centers in the United States in 2001. With that data, the researchers compared the risks of ephedra with those from other herbal products.
They found that ephedra-based complaints made up 62% of all such complaints, despite the fact that the herb accounts for less than 1% of all herbal product sales. Taking into account volume of sales, ephedra has 200 times the risk of all other herbal products combined, the researchers say. Common complaints include anxiety, insomnia, increases in heart rate and blood pressure, and even heart attacks and strokes, which can lead to death.
"Our study shows that ephedra is unsafe for routine and unsupervised use," Michael Shlipak, MD, MPH, an assistant professor medicine and epidemiology and biostatistics at the University of California at San Francisco, said in a statement. The study appears in the March edition of the Annals of Internal Medicine.
Ephedra is a stimulant, much like caffeine, and probably works by increasing heart rate and metabolism, according to Stephen Bent, MD, who is a clinical researcher at the San Francisco VA Medical Center. Studies that show ephedra assists in weight loss over the short term, but there is no evidence that the weight stays off when use of the product is stopped.
The federal government is currently mulling over possible limitations or regulations on the sale of ephedra. In anticipation of changes, companies like Metabolife are rolling out new product lines containing other herbs. "[There is] great concern that another herb that has ephedra-like properties is going to bust in there, with no evidence to support its safety," Bent tells WebMD.
Phil Harvey, PhD, chief science officer for National Nutritional Foods Association, a trade association for makers and sellers of dietary supplements, herbs, and functional foods, agrees that ephedra has well-known side effects. "We have, over the years, strongly said that cautionary language on the label should be voluntarily used, and the vast majority of companies that sell these products do have that," he tells WebMD. "You have to use it with caution. It's not like vitamin C... you have to carefully monitor this."
"If it is available, there ought to be significant warnings on the product stating that it can cause these severe reactions," says Bent. "That's one of the biggest problems: Consumers aren't always aware that dietary supplements aren't tested for safety and efficacy. People have this feeling that if something is on the shelf next to the Tylenol, it must have the same level of safety testing, and it doesn't." Dietary supplements are not regulated by the FDA; prescription and over-the-counter drugs are.
Those who want to take herbal products should do so in consultation with their doctor, Bent says, and it is best to stick to bigger-name brands. There are no manufacturing regulations for dietary supplements, so a product may not contain the amount of active ingredient claimed by the packaging.
The researchers write that various prominent medical associations including the American Medical Association and Health Canada have recommended banning of the sale of the herb, and many sports organizations have prohibited its use. They also conclude the herb should be restricted or banned to prevent serious adverse effects.
----------------------------------------
SOURCES: Annals of Internal Medicine, March 2003 * Stephen Bent, MD, clinical researcher, San Francisco VA Medical Center * Phil Harvey, PhD, chief science officer, National Nutritional Foods Association * news release, University of California-San Francisco.