Obesity today is a widely spread nutritional disorder that can affect anybody at any age across North America. (figur1) Obesity can be defined in many terms. Practically, obesity is typically evaluated in absolute terms by measuring BMI (Body Mass Index), but also in terms of its distribution through waist circumference or waist-hip circumference ratio measurements. However, presence of risk aspects and diseases related to obesity are also used to establish a clinical diagnosis. Coronary heart disease, type 2 diabetes, and sleep apnea are possible life-threatening risk factors that would indicate clinical treatment of obesity. Smoking, hypertension, age, and family history are other risk factors that may indicate treatment as well (Wikipedia). Moreover, many people who are having obesity would try any solution to cure their selves. In addition, the majority of people, if they were given the opportunity, they would like to be in good physical shape. It takes discipline and dedication to mold the body to an ideal shape, but who has either one of these virtues, let alone in combination? Therefore, most of those who desire to have a great body; an even superior majority of these people would like to achieve this with as little effort as possible. Recent developments in the biotechnological industry boast claims that they discovered many ways for losing weight and gaining that perfect figure that people desire in easy modern methods. However, Ephedra is one of the methods that people are using not only to be in good physical shape but also to cure their selves of obesity. Ephedra is one of the major issues that people are arguing for or against it. Ephedra causes many health problems.
Ephedra is an herb native to central Asia, which can also be found under the name Ma Huang.. Ephedra and ephedrine, which many people get confused about the difference between them, are related together where ephedra is a plant and ephedrine id the active ingredient in ephedra. Asian cultures were the first ones to use ephedra nearly 2000 years ago as a cure for bronchial asthma. "Ephedrine mimics the effects of hormones like epinephrine (adrenaline) and nor epinephrine,"(1) production it useful as a decongestant and stimulant. In addition to its usefulness as a decongestant, ephedrine has also been found to encourage the fat-burning processes in humans' bodies through thermogenesis.
Thermogenesis is a regular chemical reaction that happens in all human beings. Mainly, human body does three things with obsessive calories: use them to convene its daily energy needs; save them for future energy needs; or it wastes or burns calories in special cells in the body known as Brown Adipose Tissue, (BAT). This process is called thermogenesis, meaning the generation of heat. While thermogenesis works along with the metabolic process, it is different. Fat buildup occurs primarily when the BAT cells are not working right or not being activated often enough. The body deals with the excess nutritional calories by storing them as body fat. The function of the BAT cells is to burn the calories in the body doesn't need (2)
Ephedrine is one of the main ingredients in today's most popular thermogenesis, products that stimulate thermogenesis. There are literally many thermogenesis there; some of the most popular ones are Hydroxycut, Xenadrine, Ripped Fuel, GNC Herbal Rush, Diet-Phen, and Metabolift among others. It should also be noted that in most of these products, ephedrine is combined with caffeine to produce greater results.
Molecular biochemistry aside, does ephedrine work. In a new report was published in the American Journal of Clinical Nutrition (1998; 68:42-51), moderate amounts of ephedrine-caffeine supplements were administered to overweight and lean monkeys for eight weeks. The purpose of using laboratory monkeys was to evaluate under carefully controlled conditions. The effects of ephedrine and caffeine and body weight, food intake and other metabolic parameters as a fact that will gladden the hearts of human dieters. Changes in body weight in both groups of monkeys were primarily the result of decreases in fat mass. This monkey study helps to validate the weight loss that can occur with the proper use of supplements containing ephedrine and caffeine. (3)
Ephedrine has been found to affect the lungs, heart, blood vessels, glands, and the central nervous system. More specifically, side effects of ephedrine include insomnia, anxiety, irritability and nervousness, as well as a dangerously fast heartbeat and a drastic increase in blood pressure. These last two effects, along with strenuous exercise, (could result) in a heart attack, stroke, or seizures. (5) The list of side effects doesn't stop there, however, for ephedrine has also been found to cause hypertension and tachycardia.
As far as ephedrine's efficiency as a weight loss utility, studies indicate that weight loss with the aid of such products is only temporary. In addition, as people continue to take ephedrine-containing supplements, the body becomes tolerant, and they must take more to get the same effect. {4} Because the body becomes tolerant to the effects of ephedrine, the potential for abuse is high. Furthermore, ephedrine-containing products are considered addictive.
A high-profile case involving ephedrine's possible role in an athlete's death occurred on August 3, 2001. Rashidi Wheeler, a Northwestern University football player collapsed and died during preseason conditioning drills. He was believed to have taken the supplement Xenadrine the day of his death. Use of a stimulant containing ephedrine could be especially dangerous for Wheeler, a chronic asthmatic, who was carrying an inhaler with him on the field. Combining asthma medication with ephedrine is a bad, "bad combination," said Prof. Bill Gurley, an ephedrine expert at the University of Arkansas College of Pharmacy. (5)
Another infamous case involving the death of an athlete and the consumption of ephedrine is that of Devaughn Darling of Florida State University. In February of 2001, the freshman linebacker collapsed and died during workouts. Although the autopsy could not pinpoint the precise cause of Darling's death ephedrine was found in his system at the time of his death.
While there undoubtedly are some stories that attest to the benefits of using ephedrine-containing products, there are also others stories that tell of the dangers of the same products. In the summer of 2001, a navy corporal narrowly escaped death during a routine survival swim test. The corporal, whose name has been withheld, began panicking and then slowly started sinking towards the floor of the pool. Upon being rescued, the corporal told those tending to him that he felt nauseated. A corpsman checked him out, found his pulse and blood pressure to be excessively high, and referred him to the base hospital. A doctor diagnosed the corporal with tachycardia, which resulted from ingesting a dietary supplement called Hydroxycut (the corporal was a regular user). (5)
Who stands to gain or lose from these decisions in regards to the future handling of ephedrine? First off all, the most obvious stakeholders are those people who are looking for easiest way to lose weight. Then there are the companies that produce these dietary supplements, who stand to make a lot of money of these products if they are allowed to continue selling them, of course. In the case of athletics, there are those who take these supplements, who take dietary supplements in order to increase athletic performance, but what about those athletes that do not take these supplements, many of which have been deemed banned substances by some of sport's governing bodies. Lastly, there are those who would be a part of the research process, both scientists and test subjects, whose lives would be greatly impacted by any decision regarding the regulation of ephedrine.
To fully realize one's actions, it is best to understand the consequences that would result before any action is even taken. In the case of keeping the status quo in check, things would most likely continue on their current path. In all likelihood, the sale of these products will not diminish, which is obviously a benefit for the companies producing these supplements, because as long as there are lazy, overweight people these same people will continue to look for the quickest and easiest methods for losing weight. Of course, with this in mind, it should come as no surprise that there would be people who abuse this drug, whether it is due to a lack of knowledge about ephedrine or because of plain addiction. In the case of athletics, ephedrine is currently regarded as a banned substance, which is similar to the bans imposed by the IOC, USOC, and NCAA on anabolic steroids. Even though the substance is illegal in competition and training, those athletes that are willing to risk the consequences of using ephedrine can continue to do so through over-the-counter ephedrine products, thereby putting all other "clean" athletes at a disadvantage. Although the manufacturers' right to conduct business without interference is upheld, the consumers' right to know what they are introducing into their bodies is simultaneously denied.
If a total ban on ephedrine were to be issued, it should come as no surprise that certain people's lives would undergo some drastic changes. Certainly, the manufacturers of these products stand to lose a lot of money if the selling of ephedrine were to be prohibited. No one should feel so bad for these companies, though, because more than likely, they have a few tricks up their sleeves. With all the money they have made up until the ban, these companies would undoubtedly pour a lot of money into the research of a new drug that could produce similar, if not better, effects as ephedrine. As ridiculous as it may sound now, a ban on ephedrine could potentially make the demand for it similar to that of many other illegal drugs, like marijuana and cocaine. Just because a product becomes illegal, it does not necessarily mean that the demand for it will go down; in fact, in some cases, the demand for such a product may actually go up! Of course, this would largely hinge on whether or not a new alternative could be developed. If no suitable substitute were found, the prices of ephedrine would undoubtedly skyrocket because of the risk that goes along with smuggling anything that is illegal. If a safer and more effective method of weight-loss were discovered, the demand for ephedrine would slowly wither away to nothingness. Athletes could still get their hands on ephedrine by simply going to a place where there are no restrictions, such as Mexico, where substances banned in the US are bought by American athletes on a regular basis. People may wonder how this would change an athlete's life if they can still obtain this drug through little or no effort. Their lives would change if they were ever caught in the US with ephedrine, because since it is considered an illegal drug, these athletes, who would usually face disqualification and suspension/banishment for their sport, would now also be risking the possibility of winding up in prison.
Lastly, there is the option of require proper labeling of all ephedrine-containing products while more research is conducted. In this case, the chance of abuse is reduced considerably. Although there will continue to be those who abuse this drug for their own self-gratification, there should be a sharp reduction in the amount of abuse by consumers who usually would not know any better because now, consumers would be aware of all the hazards that come with ephedrine. In this case, consumers are granted the right to choose whether they want to introduce a potentially harmful substance into their system. The manufacturers would continue to make an exorbitant amount of money because of continuing to sell these popular products, upholding their right to make a living. Scientists would be able to further their understanding of this drug, while at the same time; new alternatives could also be developed. In a way, the test subjects' rights are upheld because in this case, they still have the right to do their duty for the betterment of humanity. Of course, this period of required labeling could possibly only temporary. If research proved that ephedrine posed a serious health risk, then all ephedrine-containing products would be banned. If not, the sale of ephedrine, still with proper labeling, would continue.
In conclusion, After examining the most feasible options, it should be quite clear that ephedrine can continue to be sold, but only if it is labeled in a way that makes it clear to general consumers that they are taking a drug that is known to have severe side-effects and may even cause death if not used properly. This goes especially for those consumers who are at a high-risk due to existing health conditions, Since ephedrine-containing supplements are stimulants, it is suspected that the people who should avoid them are those who have kidney disease, those with pre-existing heart disease, high blood pressure, over-active thyroid, or psychiatric disorders, and those with autonomic insufficiency. "Abnormailities in the nerves controlling their cardiovascular system, and those with histories of seizures and diabetes," (4) says Dr. Neal Benowitz, a UCSF professor of medicine, psychiatry, and biopharmaceutical sciences at the San Francisco General Medical Hospital Medical Center. Clearly, ephedrine, particularly when it is combined with caffeine, is very effective for weight-loss, when used properly. Those who are interested in taking it should do some careful research to determine whether this drug is right for them because, as it has been pointed out, these products are not for everyone. Although, ephedrine has not been found to pose a serious risk to the public, more scientific studies must be conducted in order to make a more permanent decision regarding ephedrine. Of course, for those who truly wish to lose weight and keep it off, nothing can replace a practical diet in combination with exercise.
On the other hand, Todd Harrison wrote, "the district court would have placed a heavy burden on the FDA by requiring it to have specific evidence that a lower dose level of ephedra presented a significant or unreasonable risk of harm. The district court's decision was hailed by some as an important vindication of the Dietary Supplement Health and Education Act (DSHEA). Others, including me, thought the judge's legal reasoning was flawed and that if the decision stood, it would reopen the debate within Congress on whether dietary supplements are properly regulated. After initial rumblings in Congress everything eventually settled down, not because Congress was concerned, but because FDA decided to appeal the Utah court decision. FDA's decision was a fateful one, as it vindicated what many in the industry had been arguing since the passage of DSHEA--that FDA does have sufficient power to regulate the industry if it chooses to use that authority in a responsible manner." (6)
Farther more, Thomson Gale says that, " Unfortunately, it is. Current laws state that manufacturers of dietary supplements do not have to prove that their products are safe, as is required with prescription medications. In his article "Taking Ban on Ephedra to Heart" (Sept./Oct. 2006 issue), noted cardiology expert Dr. Douglas Zipes explains that ephedra is an amphetamine-like compound that increases heart rate and blood pressure--sometimes with tragic results. New legislation is a step in the right direction. Beginning this December, product labels on dietary supplements and over-the-counter drugs must list an address or telephone number that consumers can use to report serious adverse reactions. In addition, the information must be promptly provided to the FDA, a big improvement from the old voluntary reporting program." (7)
The web site, Ephedra.com, explains, "As ephedra is a stimulant and a thermogenic, it should NOT be used by people / in situations where these properties might be harmful. There are some common sense rules about using ephedra: Do not use ephedra if you have any medical problems as the use of a stimulant might overtax your system. Do not use ephedra if your activity / environment will prevent you from dissipating heat. Your body core temperature might exceed safe levels. And do not take more than the manufacturer's recommended amount. What this means is: If you have a heart condition, do not take ephedra. And if you plan to wear clothes to raise your body temperature, do not take ephedra. And do not think that playing baseball on a hot muggy day will counteract these two common sense conditions and make it okay to take ephedra. (8)
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Work Cited
(1) A Serious Supplemental Hazard http://www.safetycenter.navy.mil/media/groundwarrior/issues/Summer01/serious.htm
by Ltjg. Jeff Repass and HM3 Joseph Entrekin
(2) Weight Loss Thermogenesis
http://www.betrimtoo.com/bthermo.htm
BeTrimToo
(3) When the Heat is On?The Weight Come Off
http://www.lef.org/magazine/mag98/dec98_heat.html
LE Magazine December 1998
(4) The Dangers of Ephedra
http://www.healthierliving.org/alternative/ephedra1.html
(5) Herbs of Concern
http://armypharmacy.org/ephedra.htm
by COL Allen F. Almquist
(6) Harrison, Todd. "Ephedra: the real story. (INDUSTRY NEWS)." Nutraceuticals World 9.9 (Oct 2006): 24(2). InfoTrac OneFile. Thomson Gale. Denver Public Library. 3 Aug. 2007
(7) "Ban Ephedra: a call to action.(MEDICAL MAILBOX)(Brief article)." Saturday Evening Post 279.3 (May-June 2007): 100(1). InfoTrac OneFile. Thomson Gale. Denver Public Library. 3 Aug. 2007
(8) Ephedra.com. 2007. 9 July 2007.
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