An Ephedra Story

Lisa*, a fit woman in her early thirties came to my clinic a couple of weeks ago to be treated for anxiety. Her anxiety was out of character, out of control, and punctuated by full-blown panic attacks that landed her in the emergency room on a couple of occasions. Her symptoms ranged from shortness of breath and chest pains, to irregular heartbeats.

Lisa was frantic and afraid. She feared having another panic attack, especially while she was driving. This anxiety was consuming her life, and she wanted help.

The interesting part of this story is that Lisa’s problems began shortly after she started taking a supplement called Yellow Cross. She was looking for a little more energy and to drop a few pounds. The ads at the vitamin store for Yellow Cross promised all that and more; it would increase your energy, suppress your appetite, and help you get rid of fat without dieting or exercising.

These promises sound too good to be true, and there’s a dark side to using this supplement, which can be summed up in one word—Ephedra.

Ephedra is an herb that has been used in Chinese medicine for thousands of years. Also called Ma Huang, Ephedra is a coarse, shrubby herb. Its main actions are as a diaphoretic (it makes you sweat), as a diuretic (it makes you pee), and a bronchodilator, which is what you want when you’re having an asthma attack. It’s used in Chinese medicine for short periods of time (a couple of days) for the symptoms of a cold or the flu, especially if there’s shortness of breath or wheezing involved.

The problem with Ephedra is that it also is a stimulant, and has been used for years by body builders as a way of increasing energy and decreasing appetite. Ephedra is often used in products that are called ECA stackers, in which they “stack” Ephedra with a dose of caffeine and aspirin, supposedly to enhance the fat burning effects of the mix.

What most people who take this kind of supplement don’t know is that Ephedra can be toxic. It can raise your body temperature, cause stomach pain, nausea, vomiting, and dangerous heart arrhythmias. In Lisa’s case, it caused uncontrollable anxiety. For Minnesota Viking, Corey Stringer, it was implicated in his 2001 death.

Ephedra is also a substance that has been banned in the United States by the FDA since 2004. However, the way supplement makers get around this ban is by using extracts from species of Ephedra that don’t contain alkaloids of ephedrine, the active ingredient in Ephedra.

Beyond Ephedra, the label on the bottle of Yellow Cross that Lisa had been taking also listed synephrine, caffeine, Yohimbe, White Willow Bark (aspirin), Yerba Mate, Guarana, and Kola Nut. With the exception of the White Willow Bark, every ingredient in this supplement is an herbal form of speed. Whether or not the Ephedra was active is pretty much a moot point—a couple of these pills a day could send even the beefiest of weightlifters to the moon.

So what’s my point? Well, first that this herb is being misused. In Chinese medicine it was never intended for weight loss or an energy boost. Unfortunately, because of this misuse, practitioners of Chinese medicine are no longer able to use Ephedra in the way it was intended.

It is also my point that consumers are unaware of the side effects of Ephedra when it is misused. It can very quickly build up to toxic doses in your body causing a variety of scary symptoms. Many consumers believe that if they are using a supplement that is herbal, it cannot be harmful because it’s natural, which is simply not true. In Lisa’s case, taking this herbal supplement resulted in anxiety and panic attacks, a sensitivity to any stimulants, a prescription for a beta blocker to calm her down, and about $7,000 in medical bills from emergency room visits.

 

*Names and identifying details have been changed.