Excerpted from Yahoo! News, Monday, 3 February 2003.

Ephedra Has More Side Effects Than Other Herbs

New York, Alison McCook, Reuters Health -- Ephedra is linked to more than 100 times as many reports to US poison control centers as other herbs, and the substance should be banned or restricted out of safety concerns, US researchers said Monday.

Based on an analysis of reports to the American Association of Poison Control Centers, Dr. Stephen Bent and his colleagues discovered that products with ephedra made up 64% of the bad reactions to herbal products reported in the US in 2001.

This finding is remarkable, the authors note, given that less than 1% of herbal products sold that year contain ephedra.

Ephedra, also known as ma huang, is contained in some supplements touted for weight loss. The herb affects the cardiovascular and central nervous systems, and has already been linked to the risk of seizure, heart attack and sudden death, even in healthy people.

Last year, Canadian health officials issued a voluntary recall of a wide range of products containing the herb or its chemical derivative ephedrine.

In the US, dietary supplements, including those that contain ephedra, are not evaluated by the Food and Drug Administration for safety and effectiveness before hitting the market.

Although awareness of the potential dangers of ephedra is growing among consumers, many still purchase ephedra-containing products, Bent told Reuters Health.

"I think people are starting to learn that ephedra may be dangerous, but the mere fact that companies are still producing and selling this product suggests that the public is still buying it, and some people are not fully aware of these substantial risks," said the researcher, who is with the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center.

Bent noted that there is resistance among product manufacturers to the idea that ephedra be banned or restricted. They argue that all studies into hazards of ephedra are cases where one person taking the drug experienced, for example, a heart attack. In that instance, Bent said, it's difficult to show that the heart attack was a result of the drug.

But the finding that ephedra is linked to many more side effects than other herbs adds support to the theory that it can be dangerous, Bent said.

How ephedra stacked up against other products varied from herb to herb, Bent and his colleagues note--but in all cases, it outnumbered other products in bad reactions by a factor of at least 100, the authors write in the advance online edition of the March 18 issue of Annals of Internal Medicine.

Overall, there were 1,178 adverse reactions reported for ephedra, compared with 28 for ginkgo biloba, 31 for St. John's wort and 69 for echinacea (news - web sites), among others.

Bent said that he believes that ephedra should be banned or at least restricted. "In my opinion, if substances used to treat illness have not been proven to have significant benefits, and have a high chance of causing significant bad reactions, they should be banned," he noted.

And if these products continue to be available, consumers should be clearly warned about the potential dangers associated with their use, Bent added.

"I would like to see warning labels on these products if they continue to be sold, similar to the situation with cigarettes, so people clearly understand that use of ephedra may cause very severe side effects."

Excerpted from Yahoo! News, Monday, 3 February 2003.