Brain & Drugs 

Ephedra Causes Strokes

"Ephedra is an amphetamine-like alkaloid that was incorporated into many weight loss, fat-burner, and energy boosting products. Haller and Benowitz warned that: “Dietary supplements that contain ephedra alkaloids (also known as ma huang) and guarana-derived caffeine are widely consumed in the United States for purposes of weight reduction and energy enhancement. The herb ma-huang, which consists of the dried stems of the Ephedra equisetina plant, contains ephedrine, norephedrine, pseudoephedrine, and norpseudoephedrine. It has been used for centuries in China. Ephedrine was first isolated in 1885 and, shortly after, was used to treat asthma. Many OTC medications contain ephedrine and pseudoephedrine for treating asthma and allergic rhiniti.s

 A number of reports of adverse reactions to dietary supplements that contain ephedra alkaloids, some of which resulted in permanent injury or death, have appeared in the medical literature. In response to growing concern about the safety of ephedra alkaloids in dietary supplements, the Food and Drug Administration (FDA) requested an independent review of reports of adverse events related to the use of ephedra alkaloids to assess causation and determine the level of risk these products pose to consumers.”

Weight loss products such as Stacker 3 and Ripped Fuel Extreme were sold with false claims and product hype such as the "ECA stack" that referred to the combination of ephedrine, caffeine and aspirin. Between January 1993 and October 2000, the FDA received 1,398 reports of adverse health events and 81 deaths attributed to ephedra supplements. Ephedra-related products accounted for less than 1% of all dietary supplement sales but lead to 64% of adverse event reactions reported to poison control centers. Ephedra effects included hypertension, seizures, cerebrovascular accidents, cardiac arrhythmias, myocardial infarctions, psychosis, and cognitive impairments. In December 2003, the FDA issued a consumer alert warning and later prohibited ephedra sales in February 2004" From Reuter's Health. In February 2004, the US FDA prohibited the sale of dietary supplements containing ephedrine citing that they constitute an unreasonable risk due to their potential health risks and questionable health benefits.

Moawad et al reported a case study of a 29-year-old who had a seizure while playing basketball. He had never experienced a seizure activity before. He on a “weight loss program” using the ephedra-containing supplements, Stacker 3 and Ripped Fuel Extreme. On admission to hospital he had high blood pressure, evidence of a heart attack and confusion. His symptoms subsided with blood pressure control, but one week later, he developed complete visual loss. His blood pressure was markedly elevated. The visual areas of his brain were abnormal on scan. The diagnosis was posterior reversible encephalopathy, a syndrome characterized by headache, mental status changes, generalized seizures and transient cortical blindness. The development of the syndrome, especially cortical blindness, may be delayed up to several weeks after the initial insult. An acute rise in systemic blood pressure resulting in hypertensive encephalopathy is the most commonly reported cause. Fortunately for this patient, cortical blindness, mental status changes and radiographic abnormalities resolved with control of his blood pressure.

J. Moawad et al; Transient Blindness Due to Posterior Reversible Encephalopathy Syndrome Following Ephedra Overdose. South Med J.2006;99(5):511-514.


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