Ephedra, a substance common in dietary supplements popular with high school and college athletes, has been linked to at least 80 deaths, and has been targeted in numerous lawsuits against the manufacturers of such products.
Use of supplements containing derivatives of ephedra, a central nervous system stimulant, has been linked to three football players who died recently--Rashidi Wheeler of Northwestern, Devaughn Darling of Florida State and Curtis Jones, a former San Pedro High player who was a defensive lineman for a Utah-based team in a professional indoor football league.
Since 1994, at least 1,400 reports have been made by consumers complaining of adverse effects after consuming products containing ephedra, according to federal regulators. The complaints included high blood pressure, mood swings, paranoia, diarrhea, heart attacks, insomnia, headaches, nervousness, strokes and seizures.
"This stuff is nothing more than legalized speed," said Barb Michal, a prominent critic of the dietary supplement industry.
Ephedrine, an ephedra derivative that is a regulated substance, is the primary ingredient used in the manufacture of methamphetamine, the illegal drug commonly known as "speed." Medically, ephedrine is used in decongestants and asthma medicines.
Michal founded Halt Ephedrine Abuse Today (HEAT) after her son, Kris, died in 1997 as the result of consuming over-the-counter pep pills that contained ephedrine, also known as ma huang.
Michal, a paralegal in the San Bernardino offices of Moore, Winter, Skebba and McLennan, works with ephedra experts and seeks to inform the public about the dangers of consuming supplements that contain the substance before working out.
"Athletes are putting themselves at risk," Michal said. "You've even got kids taking this stuff at the behest of their coaches. People from the supplement stores go and talk to the coaches and kids," encouraging its usage.
A December report by the New England Journal of Medicine said, "The use of dietary supplements that contain ephedra alkaloids may pose a health risk to some persons. These findings indicate the need for a better understanding of individual susceptibility to the adverse effects of such dietary supplements."
The Food and Drug Administration has received 80 reports of ephedra-linked deaths, the New York Daily News reported recently. Dietary supplements, which gained popularity during the 1990s, have not been carefully studied or regulated, said Dr. Neal R. Benowitz, a professor of medicine at UC San Francisco.
Supplements containing ephedra derivatives and commonly used by athletes and body builders include Ultimate Orange, Xenadrine, Ripped Fuel and Spark. Ultimate Orange was discontinued in May by Next Nutrition, a Carlsbad-based company.
An advertisement for Ultimate Orange boasted, "Drink and explode with a new level of muscle-blasting workout intensity."
However, leading physicians say these supplements pose health risks and, in extreme cases, can cause death when combined with rigorous exercise. David Jenkins, president of Next Nutrition, said, "The warning on [Ultimate Orange] is clear. Do see your physician before you use it."
Benowitz has studied supplements that contain ephedra and is concerned about their use as athletic enhancers.
Benowitz says ephedra causes two dangerous side effects:
* It increases blood pressure, which is exacerbated when combined with caffeine, a common ingredient in dietary supplements.
* It constricts blood vessels, making it more difficult for the body to rid itself of heat.
"This drug promotes hyperthermia," Benowitz said.
(This is the opposite of hypothermia, when the body's temperature falls below normal).
The NFL, concerned about the effects of mixing supplements with harsh weather at training camps, warned players in December to avoid ephedra. These products are not banned by the NFL, but a memo sent to teams and posted in locker rooms said ephedra posed serious health risks and urged players using it to stop immediately.
"You just have to be careful because the ephedrine already speeds up your heart rate," said Minnesota Viking receiver Cris Carter. "When you crash on it, you crash. I mean you really come down. It hurts the performance of the athlete. He's trying to do things in the third and fourth quarter he thought he was going to be able to do because of the boost he had before the game--and it's just not there."
Carter said he had no knowledge that Korey Stringer was taking a supplement. The Viking offensive lineman died Aug. 1 from the effects of heatstroke.
Bill Gurley, associate professor of pharmaceutical sciences at the University of Arkansas, keeps a can of Ultimate Orange in his lab for testing purposes. He says he wouldn't recommend the product to anyone.