Excerpted from Detroit Free Press, Tuesday, 4 February 2003.

More Doctors Advise Against Ephedra Use

Ephedra, an herb found in weight-loss and bodybuilding supplements, is unsafe even when taken in recommended doses and should be restricted, say doctors who studied reports of bad reactions to the herb.

U.S. poison control centers reported 1,178 adverse reactions to ephedra dietary supplements in 2001, said the study, which will be posted on the Annals of Internal Medicine's Web site today (www.annals.org) and published in the journal next month.

Ephedra accounted for 64 percent of all reported adverse reactions involving herbs, even though it's found in fewer than 1 percent of all herbal products sold.

"It comes down to a risk-benefit ratio," said one of the report's authors, Dr. Stephen Bent of the San Francisco Veterans Affairs Medical Center. "The benefits for ephedra are not at all well established. It is a minimal benefit that goes away when you stop using the product. And the risks are really substantial."

The study, based on data collected by the American Association of Poison Control Centers, is the latest to question ephedra's safety.

The Food and Drug Administration has reports of nearly 100 deaths of people who took the herb, a stimulant that can quicken the heart rate and cause blood vessels to constrict.

The American Medical Association has advised people not to use ephedra. It has been banned by the International Olympic Committee, the National Football League and the National Collegiate Athletic Association.

The Bush administration ordered a review of ephedra's safety in June.

Wes Seigner, a lawyer for the Ephedra Education Council, a group funded by the supplement industry, said that while the industry agrees that ephedra supplements should come with a warning label and shouldn't be marketed to children, to ban them would be to ignore a potential treatment for obesity.

Ephedra, also known by the Chinese name Ma huang, once was once used widely in the United States as a decongestant and asthma treatment. Doctors stopped prescribing it in the 1930s in favor of safer medications.

Now it shows up most in "performance enhancing" dietary supplements marketed to athletes.

Last year an Alabama jury ordered supplement maker Metabolife International to pay $4.1 million to four people who suffered strokes or heart attacks after taking an ephedra-based appetite suppressant.

Excerpted from Detroit Free Press, Tuesday, 4 February 2003.