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Major league baseball and fans everywhere were horrified when Baltimore Orioles pitcher Steve Bechler, 23, died during spring training after collapsing with heat stroke.
A Florida medical examiner said the death was linked to an ephedra-containing supplement found in the pitcher's locker. According to Sports Illustrated and CNN, family members told the medical examiner, Dr. Joshua Perper of Broward County, that Bechler took three pills daily of Xenadrine FRA-1®, a supplement containing ephedra.
Because of growing health concerns, the Food and Drug Administration (FDA) in 2004 banned the sale of dietary supplements containing ephedra, also known as ma hung. Ephedra may harm the cardiovascular system by increasing blood pressure and causing a dangerously irregular heart rhythm. The FDA has reports of at least 100 deaths linked to the use of such supplements.
Ephedra is a naturally occurring substance found in plants. Its principal active ingredient is ephedrine, an amphetamine-like compound that potentially has powerful stimulant effects on the nervous system and heart. Like amphetamine, ephedra increases blood pressure and heart rate, decreases appetite and makes the user feel energetic. These dangerous reactions have been linked to serious health problems, including heart ailments and strokes.
The FDA reviewed reports and information for years about ephedra's effects in the body, its safety and effectiveness, and the adverse event reports associated with its use. The agency found that supplements containing ephedra didn't seem to do much, but might cause short-term weight loss.
A RAND Corporation study commissioned by the National Institutes of Health found a higher risk of side effects such as heart palpitations, psychiatric and gastrointestinal effects, tremors, and insomnia. The RAND study also looked at 16,000 adverse events related to ephedra use that included two deaths, four heart attacks and nine strokes.
Another study, reported in the journal Neurology, concluded that the rate of hemorrhagic (bleeding) strokes among ephedra users was significantly higher than among non-users, for people who take doses above 32 milligrams a day.
Many companies have reformulated their products to remove ephedra, while others pulled products from the market altogether. The FDA is looking at some alternative ingredients to ephedra, such as bitter orange, which contains synephrine, another form of stimulant with properties similar to ephedrine.
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Food and Drug Administration
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This article was reviewed and updated June 2007.
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