Ephedra: Physiological effects

Last modified: Sunday, 31. May 2009 - 2:15 pm

There are a number of Physiological effects related to ephedra consumption, and it is these side effects and reports of adverse events that are causing both the FDA and several state regulatory bodies to consider regulating it.
Some medical experts have testified about ephedrine’s physiological side effects, which include hypertension and an increased risk of heart attack or stroke. The Halt Ephedrine Abuse Today survey found that more than 60% of respondents reported feeling physiological side effects such as a rapid heartbeat, nervousness, headaches, insomnia, shortness of breath, and chest pain. Physiological effects reported in the New England Journal of Medicine include palpitations and insomnia.
At higher doses, ephedra may be toxic. An overdose of ephedra can cause nausea, vomiting, fever, palpitations, tachycardia, hypertension, psychosis, respiratory depression, convulsions, and coma.
The FDA has been receiving reports of adverse effects related to ephedra use since the early 1990s. Many of the initial concerns were linked to one ephedra product — Formula One. However, when state and federal agencies investigated the product, they could not prove that it contained ephedra, and after the manufacturer of Formula One reformulated the product, reports of adverse events linked with the product ceased. But there have been many reports of adverse events associated with ephedra since 1994. The severity of those events spurred the FDA to action, which sought an independent review in an attempt to determine if ephedra had been the cause. Another purpose of the independent review was to determine the risks of consuming ephedra.
The researchers determined that ephedra posed serious risks to users. In addition, the ephedra research study published in 2000 in the New England Journal of Medicine claimed that ephedra could cause heart attacks, strokes, seizures, and death.
According to the researchers, nearly half of the adverse events definitely, probably, or possibly caused by ephedra were cardiovascular side effects. The most common cardiovascular side effect was hypertension, or high blood pressure. Other reported cardiovascular events were palpitations, tachycardia (an abnormally fast heartbeat), stroke, and seizures. The researchers stated that 10 of the adverse events definitely, probably, or possibly caused by ephedra resulted in death, and 13 of the events caused permanent disability. In one-fifth of the cases, there was not enough evidence or information about the incident, and the remaining complications were not related to ephedra.
Researchers found that the majority of the complications in the study occurred in young, healthy ephedra users. Victims did not need to be long-time users of ephedra to experience complications; some adverse events occurred in people who took ephedra for days or weeks. Two women who became pregnant while using ephedra had miscarriages. It was concluded that supplements containing ephedra might pose a serious health risk to some users. Moreover, it was suggested that a better understanding of the risks of ephedra use is required. With a better understanding of the incidence of adverse events and the at-risk population, the FDA can recommend appropriate dosing guidelines, and it can warn users about the potentially serious side effects of ephedra.
Adverse event reporting
It is important to note that the FDA’s MedWatch reports, or reports of adverse events, do not include all adverse events associated with ephedra. Some studies indicate that less than 15% of adverse events are reported to the FDA. Furthermore, the rate of adverse event reporting for herbal products or supplements may be even lower than 15%, as people do not make the connection between an herbal product they believe is safe and an adverse event. As a result, there may be more adverse events linked with ephedra use than the FDA or medical experts are aware of. Consequently, users may actually run a greater risk of adverse events.
Manufacturers of dietary supplements take a different stance when it comes to adverse events reporting. They claim that adverse events are anecdotal records and do not prove that ephedra caused the side effect or adverse event. The ephedra manufacturers’ trade group also contends that victims may not recall which product they took or when. While these points are worth considering, they are made by companies and groups that have a vested interest in keeping ephedra on the market with as few regulations as possible.
Harmful side effects
Potential harmful side effects associated with ephedra include nervousness, irritability, headaches, insomnia, palpitations, depression, and paranoia. Other possible side effects are hypertension and rapid heartbeat. Ephedra users also face an increased risk of seizures, heart attack, and stroke. A heart attack or stroke caused by ephedra can result in death.
Long-term health effects
The long-term health effects of ephedra use are unknown; however, users who suffer a heart attack or stroke face the long-term health consequences of those ailments.

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