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Ergogenic aids: An update on ephedra

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Current Sports Medicine Reports

Abstract

Ephedra has been used medicinally for thousands of years dating back to ancient Chinese medicine. Since its introduction to Western medicine in the 20th century, ephedra has been used for various ailments. The amphetamine-like activity of ephedra made it a popular supplement for promotion of weight loss and enhancement of athletic performance, despite limited supporting data. With the implementation of the Dietary Supplement Health and Education Act of 1994, the US Food and Drug Administration’s (FDA) regulation of ephedra-containing supplements diminished. As these products became increasingly available, adverse effects associated with their use also increased. These adverse effects are mainly a result of ephedra’s sympathomimetic activity and have been manifested by premature cardiovascular and central nervous system disease. With mounting evidence concerning the unsafe nature of these products, the FDA was able to ban the sale of ephedra-containing dietary supplements in April of 2004.

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References and Recommended Reading

  1. McBroom E: Ethnobotanical Leaflets: Ephedra (Ma Huang). http://www.siu.edu/~ebl/leaflets/ephedl.htm

  2. Schweinfurth J, Pribitkin E: Sudden hearing loss associated with ephedra use. Am J Health Syst Pharm 2003, 60:375–377.

    PubMed  Google Scholar 

  3. Auerbach PS: Wilderness Medicine, edn 4. Philadelphia: Mosby; 2001:1167–1168.

    Google Scholar 

  4. Weintraub J: Adverse effects of botanical and non-botanical ephedrine products, http://www.hsph.harvard.edu/organizations/ddil/ephedrine.html

  5. FDA Medical Bulletin: Adverse events with ephedra and other botanical dietary supplements, http://www.cfsan.fda.gov/ ~dms/ds-ephe2.html

  6. US Department of Health and Human Services News: FDA proposes safety measures for eph7edrine dietary supplements. http://www.cfsan.fda.gov/~lrd/hhsephed.html

  7. Walton R, Manos G: Psychosis related to ephedra-containing herbal supplement use. South Med J 2003, 96:718–720.

    Article  PubMed  Google Scholar 

  8. Krome C, Tucker A: Cardiac arrhythmia in a professional football player: was ephedrine to blame? Physician Sportsmed 2003, 31:21–25.

    Google Scholar 

  9. Dentali S: Ephedra’s alkaloids provide its kick. Nutr Sci News October 1999.

  10. Geiger JD: Adverse events associated with supplements containing ephedra alkaloids. Clin J Sport Med 2002, 12:263.

    Article  PubMed  Google Scholar 

  11. Saper R, Eisenberg D, Phillips R: Common dietary supplements for weight loss. Am Fam Physician 2004, 70:1731–1738.

    PubMed  Google Scholar 

  12. Thearle M, Aronne L: Obesity and pharmacologie therapy. Endocrinol Metab Clin North Am 2003, 23:1005–1024.

    Article  Google Scholar 

  13. Shekelle P, Hardy M, Morton S, et al: Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003, 289:1537–1545. A meta-analysis that utilizes existing literature to demonstrate the minimal effect of ephedra use on athletic performance and weight loss while increasing the risk of adverse events.

    CAS  PubMed  Google Scholar 

  14. Congeni J, Miller S: Supplements and drugs used to enhance athletic performance. Pediatr Clin North Am 2002, 49:435–461.

    Article  PubMed  Google Scholar 

  15. Krauss M: Need for Ephedra Awareness Increases. The NCAA News, http://www.ncaa.org/news/2003/20030414/active/ 4008n27.html April 14, 2003.

  16. Guharoy R, Noviasky J: Time to ban ephedra - now. Am J Health Syst Pharm 2003, 60:1580–1582.

    PubMed  Google Scholar 

  17. Ford M, Delaney KA, Ling L, Erickson T: Clinical Toxicology, edn 1. Philadelphia: WB Saunders; 2001:318–319.

    Google Scholar 

  18. Wooltorton E, Sibbald B: Ephedra/ephedrine: cardiovascular and CNS effects. Can Med Assoc J 2002, 166:633.

    Google Scholar 

  19. McBride B, Karapanos A, Krudysz A, et al: Electrocardiographic and hemodynamic effects of a multicomponent dietary supplement containing ephedra and caffeine: a randomized controlled trial. JAMA 2004, 291:216–221.

    Article  CAS  PubMed  Google Scholar 

  20. Morgenstern LB, Viscoli CM, Kernan WN, et al: Use of ephedra-containing products and risk for hemorrhagic stroke. Neurology 2003, 60:132–135.

    Article  CAS  PubMed  Google Scholar 

  21. Phillips G: Medicolegal issues and ergogenic aids: trade, tragedy, and public safety, the example of ephedra and the Dietary Supplement Health and Education Act. Curr Sports Med Rep 2004, 3:224–228. A very thorough review of the events leading to the FDA ban on ephedra use in supplements.

    Article  PubMed  Google Scholar 

  22. Sola S, Helmy T, Kacharava A: Coronary dissection and thrombosis after ingestion of ephedra. Am J Med 2004, 116:645–646.

    Article  PubMed  Google Scholar 

  23. Bent S, Ko R: Commonly used herbal medications in the united states: a review. Am J Med 2004, 116:478–485.

    Article  PubMed  Google Scholar 

  24. FDA News: HHS Acts to Reduce Potential Risks of Dietary Supplements Containing Ephedra. http://www.fda.gov/bbs/ topics/NEWS/2003/NEW00875.html February 28, 2003.

  25. FDA News: FDA Announces Plans to Prohibit Sales of Dietary Supplements Containing Ephedra. http://www.fda.gov/oc/initiatives/ephedra/december/2003

  26. FDA News: FDA Issues Regulation Prohibiting Sale of Dietary Supplements Containing Ephedrine Alkaloids and Reiterates Its Advice That Consumers Stop Using These Products, http://www.cfsan.fda.gov/~lrd/fpephed6.html

  27. Thompson C: Ephedrine alkaloids banned from dietary supplements. Am J Health Syst Pharm 2004, 61:750–753.

    PubMed  Google Scholar 

  28. The NCAA News: Ephedrine Ban Being Promoted in Congress. www.ncaa.org/news/2002/20021111/active/3923nll.html. November 11, 2002.

  29. The NCAA News: Ephedrine Added to NCAA Year-round Testing Program, http://www.ncaa.org/news/2002/20020722/ digesthtml July 22, 2002.

  30. National Football League News: NFL Bans Ephedrine, Other Stimulants, http://www.nfl.com/news/2001/ ephedrine_092701.html September 27, 2001.

  31. Major League Baseball News: MLB Looking to Ban Ephedra. www.mlb.com January 14, 2004.

  32. Major League Baseball News: Agreement on Tougher Drug Testing, http://www.mlb.com January 13, 2005.

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Authors and Affiliations

  1. Primary Care Sports Medicine Fellowship, University of Kentucky, K308 Kentucky Clinic, 740 S. Limestone, 40536, Lexington, KY, USA

    Robert G. Hosey MD, CAQ

Authors
  1. Brian D. Keisler MD
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  2. Robert G. Hosey MD, CAQ
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Keisler, B.D., Hosey, R.G. Ergogenic aids: An update on ephedra. Curr Sports Med Rep 4, 231–235 (2005). https://doi.org/10.1007/s11932-005-0042-4

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