Conscious Choice: Ephedra: A Bad Rap for a Good Supplement

November 2002 | Health Conscious

Ephedra: A Bad Rap for a Good Supplement

by Barbara Zeitlin Kravets, CCN, LNC

How is your weight? Going up, not down? Have you tried diet and exercise? We are so fat in America that it has been called a national emergency. Six out of ten of us are overweight or obese.

And, obesity matters! As a matter of fact, obesity is a greater risk to health than is smoking, heavy drinking, or being poor. No wonder people are reaching for supplements such as ephedra, along with proper nutrition and exercise, to help in the battle of the bulge.

More than 12 million Americans take ephedra safely and effectively for weight loss. With the on-going controversy over the diet product Metabolife, it’s interesting to note that in approximately 12,000 pages of consumer comments on the product, there were actually only 89 calls alleging significant side effects. This information comes from Steven B. Krach, M.D., assistant medical examiner for San Francisco.

In light of this, it’s difficult to understand why last summer Senator Dick Durbin (D-IL), chair of the Senate Governmental Affairs Oversight Subcommittee, called for an immediate determination as to whether dietary supplements such as ephedra constitute an "imminent hazard" to the nation’s public health.

Is this a bad rap for a good supplement?

Quite likely it is. After all, Ephedra sinica, also known as ma huang, is a plant that has been used for thousands of years in Chinese medicine. Ephedra contains "ephedrine alkaloids" and other alkaloids, which are naturally occurring (as opposed to "pseudo" ephedra alkaloids such as those found in Sudafed).

The Chinese have used ephedra for many reasons, but here in America we use ephedra to help with weight loss. Specifically it’s useful for burning fat. Daniel Mowrey, Ph.D., is president of the non-profit American Phytotherapy Research Laboratory, is author of Fat Management: The Thermogenic Factor, and is a scientific investigator who’s been on the frontline of ephedra research for 12 years. He says, "Ephedra enhances the working of brown adipose tissue (BAT) and other calorie wasting tissue. Ephedra is the only plant material currently known to safely stimulate BAT to burn fat. That makes ephedra the most effective weight loss product we’ve ever had."

Although knowledgeable healthcare providers and millions of American consumers know that ephedra is effective and safe if used responsibly, research studies underscore its safety. Researchers at prestigious Harvard and Columbia Universities have confirmed the safety and effectiveness of ephedra supplements for weight loss in healthy Americans when used as directed with appropriate serving limits, warnings, and precautions. Here are their own powerful words about the effect and the safely of ephedra. "In this six-month placebo-controlled trial, herbal ephedra/caffeine (90/192 mg per day) promoted body weight and body fat reduction and improved blood lipids without significant adverse events." This is but one of the numerous studies showing the effectiveness and safety of ephedra when taken responsibly.

Then what is the bad rap for ephedra? It has to do with the side effects. Yes, there are side effects, as there are with other stimulating substances, including coffee. If you misuse, or overuse ephedra, (or coffee) you might experience: nervousness, dizziness, tremor, alternation in blood pressure or heart rate, headache, gastrointestinal distress, chest pain, myocardial infection, hepatitis, stroke, seizures, psychosis, and death.

That is why herbal manufacturers of ephedra have warnings on their labels. Just as they say on TV, "it is not for everyone." Ephedra should not be used by anyone who is under 18, or pregnant or nursing. An informed healthcare provider should be consulted before using ephedra if you have any of the following: heart disease, thyroid heart disease, diabetes, high blood pressure, a psychiatric condition, difficulty in urinating, prostate enlargement, or seizure disorder. You should consult a provider if you are using a monoamine oxidase inhibitor (MAOI) or any other prescription drug, or if you are using an over-the-counter drug containing ephedrine, pseudoephedrine or phenylpropanolamine (ingredients found in certain allergy, asthma, cough/cold and weight control products).

The reason the Harvard-Columbia study is so reliable in its results is that study participants were excluded from the study if they had any of the problems stated above. The researchers were smart to do this. They knew what it said on the labels for ephedra. But, there are people who don’t read labels and who abuse ephedra, who have not yet figured out how to use ephedra with common sense. Lack of responsible usage of ephedra increases side effects, which alerts government agencies.

As Dr. Mowrey and numerous other doctors and scientists have pointed out, the FDA has tried before to get ephedra off the market, but they failed. They failed because at the hearings there were many more pros than cons about ephedra. Dr. Mowrey is now concerned that some medical journals, emphasizing side effects stemming from improper use of the herb, are printing negative opinion articles about it. Studies that shed positive light on the use of ephedra, like the Harvard study, are not printed in conjunction with the negative opinion articles, and Dr. Mowrey’s own letter of protest to the editor was ignored. Worse yet, ephedra suffered a bad public relations blow over the Metabolife ephedra product. This came when the president of the company said there were no "Adverse Events Reports" when there were actually many thousands of calls to his company about the product. Even though the overwhelming majority of the calls were about harmless occurrences, the fact that he was not immediately forthcoming shed a very bad light on his product and ephedra in general.

The Ephedra Education Council has some good "common sense" legal advice for Senator Dick Durbin and his committee. The Council supports a California consumer protection bill on ephedra that reflects a "common sense" approach, including strict warning labels and a prohibition on sales to minors that have long been supported by the industry. With this bill, consumers will continue to have access to ephedra dietary supplements in all states. Consumers should check products to ensure that recommended serving limits and warnings are included and follow the label warnings carefully.

And, what is good "common sense" advice for the consumer? If you are considering ephedra for weight loss because it is effective, read the label on the box, then consult your doctor. If your doctor is not knowledgeable about ephedra, then find an integrative medical practitioner who is savvy about this subject and follow her instructions. Incorporate a proper diet and exercise. Stay in touch with your health practitioner and report any side effects.

In this way, there will be no bad rap for a good supplement.

Disclaimer: This column is for information only and no part of its contents should be construed as medical advice, diagnosis, recommendation, or endorsement.

Barbara Zeitlin Kravets is a licensed and board certified clinical nutritionist in private practice in Highland Park, IL. She is the editor of The NutritionNews, an internationally distributed nutrition newsletter. She can be reached at licnutrition@hotmail.com.

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