Shane Freedman, general counsel for Xenadrine’s manufacturer, Cytodyne Technologies, calls the link “extremely premature and bordering on reckless.” But for years, watchdog groups and physicians have been saying the same thing about the hype surrounding ephedra. Bechler’s death has reignited an intense debate about the safety of the herb, one that began almost as soon as its popularity mushroomed thanks to aggressive advertising in 1994–the same year that the FDA lost power to regulate dietary supplements. Since then, more than 1,400 adverse reactions and 100 deaths have been blamed on ephedra-based supplements–and some 12 million dieters and athletes want to know if they are at risk.
There’s little doubt about ephedra’s popularity. The herb is found in all four of America’s best-selling weight-loss products–which together generate more than $161 million in annual sales–and is a hit with athletes, particularly bodybuilders, despite being banned by many sports leagues (but not Major League Baseball). Athletes are especially prone to ephedra abuse, notes nutritionist Rehan Jalali, head of the Supplement Research Foundation, a fitness-information center. Teens are more likely to ignore guidelines and overuse the products, too. Since most ephedra pills aren’t meant for kids under 18, health stores like GNC have recently started carding potential buyers. Minors can still get their hands on ephedra, though. The cheap Yellow Jackets brand was a favorite of 16-year-old Illinois football player Sean Riggins. He died last year; the coroner blamed an ephedra-induced heart attack. The brand is now banned, but others still crowd shelves.
Athletes and teens aren’t the only ones taking chances. Though healthy users who take recommended doses are probably safe, many doctors say the herb poses a serious risk for patients with hypertension, heart disease, overactive thyroids, or diabetes. Bechler belonged to the first group. His high blood pressure, combined with rapid weight loss, may have weakened his body–already strained by ephedra and workouts in the Florida heat.
Ephedra’s potential danger is a function of its active ingredient, ephedrine, which stimulates beta receptors on fat cells. This increases metabolism, causing the body to burn more fat. Heart cells also carry beta receptors. When combined with caffeine–as it almost always is in supplements–ephedrine stimulates those cells, too, raising the heart rate and blood pressure and sometimes causing insomnia, an irregular heartbeat or even a heart attack or stroke.
Bad publicity, skyrocketing insurance rates and GNC’s carding policy have convinced many makers to pull their ephedra products and introduce new alternatives in the past few months. All are heavy on caffeine; some also contain substances similar to ephedra, like bitter orange and octopamine. The new products may be safer than ephedra, and anyone can buy them, but they’re largely untested and their huge caffeine loads aren’t heart-healthy. Jalali, who sometimes uses ephedra, is switching to several new substitutes. You could do the same. But there’s only one sure way to avoid risk: don’t take weight-loss supplements at all.
