Ephedra
Encyclopedia
Traditional Chinese medicine
Traditional Chinese Medicine refers to a broad range of medicine practices sharing common theoretical concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage , exercise , and dietary therapy...
for 5,000 years for the treatment of asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
and hay fever
Hay Fever
Hay Fever is a comic play written by Noël Coward in 1924 and first produced in 1925 with Marie Tempest as the first Judith Bliss. Laura Hope Crews played the role in New York...
, as well as for the common cold
Common cold
The common cold is a viral infectious disease of the upper respiratory system, caused primarily by rhinoviruses and coronaviruses. Common symptoms include a cough, sore throat, runny nose, and fever...
. Several additional species belonging to the genus
Genus
In biology, a genus is a low-level taxonomic rank used in the biological classification of living and fossil organisms, which is an example of definition by genus and differentia...
Ephedra
Ephedra (genus)
Ephedra is a genus of gymnosperm shrubs, the only genus in its family, Ephedraceae, and order, Ephedrales. Ephedra grows in dry climates over wide areas of the northern hemisphere, including southwestern North America, Europe, north Africa, and southwest and central Asia, and, in the southern...
have traditionally been used for a variety of medicinal purposes, and are a possible candidate for the Soma
Soma
Soma , or Haoma , from Proto-Indo-Iranian *sauma-, was a ritual drink of importance among the early Indo-Iranians, and the subsequent Vedic and greater Persian cultures. It is frequently mentioned in the Rigveda, whose Soma Mandala contains 114 hymns, many praising its energizing qualities...
plant of Indo-Iranian
Indo-Iranian
Indo-Iranian can refer to:* Indo-Iranian languages* Prehistoric Indo-Iranians * Indo-European languages* Proto-Indo-Iranian religion* Proto-Indo-Iranian language...
religion. Native Americans
Native Americans in the United States
Native Americans in the United States are the indigenous peoples in North America within the boundaries of the present-day continental United States, parts of Alaska, and the island state of Hawaii. They are composed of numerous, distinct tribes, states, and ethnic groups, many of which survive as...
and Mormon pioneers drank a tea brewed from an Ephedra, called Mormon Tea.
Dietary supplement
A dietary supplement, also known as food supplement or nutritional supplement, is a preparation intended to supplement the diet and provide nutrients, such as vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may not be consumed in sufficient quantities in a person's diet...
s has been questioned by the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
(FDA), the National Center for Complementary and Alternative Medicine, and the medical community as a result of a high rate of serious side effects and ephedra-related deaths. In response to accumulating evidence of adverse effects and deaths related to ephedra, the FDA banned the sale of ephedra-containing supplements on April 12, 2004. A suit by an ephedra manufacturer was upheld by a Federal District Court
United States district court
The United States district courts are the general trial courts of the United States federal court system. Both civil and criminal cases are filed in the district court, which is a court of law, equity, and admiralty. There is a United States bankruptcy court associated with each United States...
judge in Utah
Utah
Utah is a state in the Western United States. It was the 45th state to join the Union, on January 4, 1896. Approximately 80% of Utah's 2,763,885 people live along the Wasatch Front, centering on Salt Lake City. This leaves vast expanses of the state nearly uninhabited, making the population the...
on April 14, 2005. The FDA appealed this ruling, and on August 17, 2006 the U.S. Court of Appeals for the Tenth Circuit upheld the FDA's ban of ephedra. The sale of ephedra-containing dietary supplements remains illegal in the United States due to evidence of adverse ephedra-related effects.
Ephedra biochemistry
The alkaloidAlkaloid
Alkaloids are a group of naturally occurring chemical compounds that contain mostly basic nitrogen atoms. This group also includes some related compounds with neutral and even weakly acidic properties. Also some synthetic compounds of similar structure are attributed to alkaloids...
s ephedrine
Ephedrine
Ephedrine is a sympathomimetic amine commonly used as a stimulant, appetite suppressant, concentration aid, decongestant, and to treat hypotension associated with anaesthesia....
and pseudoephedrine
Pseudoephedrine
Pseudoephedrine is a sympathomimetic drug of the phenethylamine and amphetamine chemical classes. It is used as a nasal/sinus decongestant and stimulant, or as a wakefulness-promoting agent....
are the active constituents of the plant. Pseudoephedrine is used in over-the-counter
Over-the-counter drug
Over-the-counter drugs are medicines that may be sold directly to a consumer without a prescription from a healthcare professional, as compared to prescription drugs, which may be sold only to consumers possessing a valid prescription...
decongestants. Derivatives of ephedrine are used to treat low blood pressure
Hypotension
In physiology and medicine, hypotension is abnormally low blood pressure, especially in the arteries of the systemic circulation. It is best understood as a physiologic state, rather than a disease. It is often associated with shock, though not necessarily indicative of it. Hypotension is the...
, but alternatives with reduced cardiovascular risk have replaced it for treating asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
. Ephedrine is also considered a performance-enhancing drug and is prohibited in most competitive sports. Some species in the Ephedra genus have no alkaloid content and are therefore essentially inert; however, the most commonly used species, E. sinica, has a total alkaloid content of 1–3% by dry weight. Ephedrine constitutes 40–90% of the alkaloid content, with the remainder consisting of pseudoephedrine and the demethylated forms of each compound.
Effects and uses
Ephedra is both a stimulantStimulant
Stimulants are psychoactive drugs which induce temporary improvements in either mental or physical function or both. Examples of these kinds of effects may include enhanced alertness, wakefulness, and locomotion, among others...
and a thermogenic; its biological effects are due to its ephedrine and pseudoephedrine content. These compounds stimulate the brain, increase heart rate
Heart rate
Heart rate is the number of heartbeats per unit of time, typically expressed as beats per minute . Heart rate can vary as the body's need to absorb oxygen and excrete carbon dioxide changes, such as during exercise or sleep....
, constrict blood vessels (increasing blood pressure
Blood pressure
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...
), and expand bronchial tubes (making breathing easier). Their thermogenic properties cause an increase in metabolism, evidenced by an increase in body heat.
In traditional Chinese herbology
Chinese herbology
Chinese Herbology is the theory of Traditional Chinese herbal therapy, which accounts for the majority of treatments in Traditional Chinese medicine ....
, E. sinica is included in many herbal formulas used to treat cold and flu such as 麻黃湯 ma huang tang (ephedra decoction) or 麻杏石甘湯 ma xing shi gan tang (ephedra, apricot kernel, gypsum, and licorice decoction). Ephedra is used therapeutically as a diaphoretic to help expel exterior pathogens and regulate the proper functioning of the lungs.
Ephedra is widely used by athletes, despite a lack of evidence that it enhances athletic performance. Ephedra may also be used as a precursor in the illicit manufacture of methamphetamine
Methamphetamine
Methamphetamine is a psychostimulant of the phenethylamine and amphetamine class of psychoactive drugs...
.
Ephedra has also been used for weight loss, sometimes in combination with aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...
and caffeine
Caffeine
Caffeine is a bitter, white crystalline xanthine alkaloid that acts as a stimulant drug. Caffeine is found in varying quantities in the seeds, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants...
. Some studies have shown that ephedra, when taken in a regulated and supervised environment, is effective for marginal short-term weight loss (0.9kg/month more than the placebo), although it is unclear whether such weight loss is maintained. However, several reports have documented the large number of adverse event
Adverse event
An adverse event is any adverse change in health or side effect that occurs in a person who participates in a clinical trial while the patient is receiving the treatment or within a previously specified period of time after the treatment has been completed.AEs in patients participating in...
s attributable to unregulated ephedra supplements.
Side effects
Side Effects
Side Effects is an anthology of 17 comical short stories written by Woody Allen between 1975 and 1980, all but one of which were previously published in, variously, The New Republic, The New York Times, The New Yorker, and The Kenyon Review. It includes Allen's 1978 O...
of ephedra may include severe skin reactions, irritability, nervousness, dizziness, trembling, headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...
, insomnia
Insomnia
Insomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...
, profuse perspiration, dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...
, itchy scalp and skin, vomiting, hyperthermia
Hyperthermia
Hyperthermia is an elevated body temperature due to failed thermoregulation. Hyperthermia occurs when the body produces or absorbs more heat than it can dissipate...
, irregular heartbeat, seizure
Seizure
An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...
s, heart attack
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
, stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
, or death
Death
Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
.
Purity and dosage
There are no formal requirements for standardizationStandardization
Standardization is the process of developing and implementing technical standards.The goals of standardization can be to help with independence of single suppliers , compatibility, interoperability, safety, repeatability, or quality....
or quality control
Quality control
Quality control, or QC for short, is a process by which entities review the quality of all factors involved in production. This approach places an emphasis on three aspects:...
of dietary supplements in the United States, and the dosage of effective ingredients in supplements may vary widely from brand to brand or batch to batch. Studies of ephedra supplements have found significant discrepancies between the labeled dose and the actual amount of ephedra in the product. Significant variation in ephedrine alkaloid levels, by as much as 10-fold, was seen even from lot to lot within the same brand.
Safety and regulatory actions in the United States
Escalating concerns regarding the safety of ephedra supplements led the FDA to ban the sale of ephedra-containing supplements in the United States in 2004. This ban was challenged by supplement manufacturers and initially overturned, but ultimately upheld.Initial concerns and supplement industry response
In 1997, in response to mounting concern over serious side effects of ephedra, the FDA proposed a ban on products containing 8 mg or more of ephedrine alkaloids and stricter labeling of low-dose ephedra supplements. The FDA also proposed that ephedra labels be required to disclose the health risks of ephedra, such as heart attackMyocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
, stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
, or death.
In response, the supplement industry created a public relations
Public relations
Public relations is the actions of a corporation, store, government, individual, etc., in promoting goodwill between itself and the public, the community, employees, customers, etc....
group, the Ephedra Education Council, to oppose the changes, and commissioned a scientific review by a private consulting firm, which reported that ephedra was safe. The Ephedra Education Council also attempted to block publication of a study confirming wide discrepancies between the labeled potency of supplements and the actual amount of ephedra in the product.
During this time, Metabolife
Metabolife
Metabolife International, Inc., is an multi-level marketing company based in San Diego, California which manufactures dietary supplements. Metabolife's best-selling product, an ephedra-based supplement called Metabolife 356, once generated hundreds of millions of dollars in annual sales...
, makers of the best-selling brand of ephedra supplement, had received over 14,000 complaints of adverse events associated with its product; these reports were not provided to the FDA. Co-founder of Metabolife, Michael J. Ellis, has been sentenced to six months in Federal prison for his failure to report adverse effects from his company's products to the FDA. Senators Orrin Hatch
Orrin Hatch
Orrin Grant Hatch is the senior United States Senator for Utah and is a member of the Republican Party. Hatch served as the chairman or ranking member of the Senate Judiciary Committee from 1993 to 2005...
and Tom Harkin
Tom Harkin
Thomas Richard "Tom" Harkin is the junior United States Senator from Iowa and a member of the Democratic Party. He previously served in the United States House of Representatives ....
, authors of the Dietary Supplements Health and Education Act, questioned the scientific basis for the FDA's proposed labeling changes and suggested that the number of problems reported were insufficient to warrant regulatory action. At the time, Hatch's son was working for a firm hired to lobby
Lobbying
Lobbying is the act of attempting to influence decisions made by officials in the government, most often legislators or members of regulatory agencies. Lobbying is done by various people or groups, from private-sector individuals or corporations, fellow legislators or government officials, or...
Congress and the FDA on behalf of ephedra manufacturers.
In addition to the activities of the Ephedra Education Council, Metabolife spent more than $4 million between 1998 and 2000 lobbying against state regulation of ephedra in Texas. Business Week reported that efforts to regulate ephedra and other potentially harmful supplements had been "beaten down by deep-pocketed industry lobbying."
Ultimately, in 2000, the FDA withdrew the proposed labeling changes and restrictions.
Additional evidence
A review of ephedra-related adverse reactions, published in the New England Journal of MedicineNew England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...
in 2000, found a number of cases of sudden cardiac death
Sudden Cardiac Death
Sudden cardiac death is natural death from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of acute symptoms. Other forms of sudden death may be noncardiac in origin...
or severe disability resulting from ephedra use, many of which occurred in young adults using ephedra in the labeled dosages. Subsequently, in response to pressure from the consumer advocacy group Public Citizen
Public Citizen
Public Citizen is a non-profit, consumer rights advocacy group based in Washington, D.C., United States, with a branch in Austin, Texas. Public Citizen was founded by Ralph Nader in 1971, headed for 26 years by Joan Claybrook, and is now headed by Robert Weissman.-Lobbying Efforts:Public Citizen...
, Metabolife was compelled by the Department of Justice
United States Department of Justice
The United States Department of Justice , is the United States federal executive department responsible for the enforcement of the law and administration of justice, equivalent to the justice or interior ministries of other countries.The Department is led by the Attorney General, who is nominated...
in 2002 to turn over reports of over 15,000 ephedra-related adverse events, ranging from insomnia
Insomnia
Insomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...
to death, which the company had previously withheld from the FDA. Use of ephedra was considered to have possibly contributed to the death of Minnesota Vikings
Minnesota Vikings
The Minnesota Vikings are a professional American football team based in Minneapolis, Minnesota. The Vikings joined the National Football League as an expansion team in 1960...
offensive lineman Korey Stringer
Korey Stringer
Korey Damont Stringer was an American football player who died from complications brought on by heat stroke, during training camp in Mankato, Minnesota while in training camp with the Minnesota Vikings of the National Football League.-College career:Stringer was born in Warren, Ohio and attended...
from heatstroke in 2001.
Death of Steve Bechler
Steve BechlerSteve Bechler
Steven Scott Bechler was a Major League Baseball pitcher for the Baltimore Orioles in 2002.Steve Bechler died of heatstroke at the beginning of spring training with the Orioles in 2003. An autopsy performed by Dr...
, a pitcher for the Baltimore Orioles
Baltimore Orioles
The Baltimore Orioles are a professional baseball team based in Baltimore, Maryland in the United States. They are a member of the Eastern Division of Major League Baseball's American League. One of the American League's eight charter franchises in 1901, it spent its first year as a major league...
, died of complications from heatstroke following a spring training
Spring training
In Major League Baseball, spring training is a series of practices and exhibition games preceding the start of the regular season. Spring training allows new players to try out for roster and position spots, and gives existing team players practice time prior to competitive play...
workout on February 17, 2003. The medical examiner
Medical examiner
A medical examiner is a medically qualified government officer whose duty is to investigate deaths and injuries that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictions to initiate inquests....
found that ephedra toxicity played a "significant role" in Bechler's sudden death. Following Bechler's death, the FDA re-opened its efforts to regulate ephedra use. According to Bruce Silverglade, legal director for the Center for Science in the Public Interest
Center for Science in the Public Interest
Center for Science in the Public Interest is a Washington, D.C.-based non-profit watchdog and consumer advocacy group focusing on nutritional education and awareness.-History and funding:...
, "All of a sudden [after Bechler's death] Congress dropped objections to an ephedra ban and started demanding the FDA act."
Senator Orrin Hatch
Orrin Hatch
Orrin Grant Hatch is the senior United States Senator for Utah and is a member of the Republican Party. Hatch served as the chairman or ranking member of the Senate Judiciary Committee from 1993 to 2005...
, who in 1999 had helped block the FDA's attempts to regulate ephedra, said in March 2003 that "...it has been obvious to even the most casual observer that problems exist," and called FDA action to regulate ephedra "long overdue." Given Hatch's prior defense of ephedra, Time
Time (magazine)
Time is an American news magazine. A European edition is published from London. Time Europe covers the Middle East, Africa and, since 2003, Latin America. An Asian edition is based in Hong Kong...
described his statement as "a dazzling display of hypocrisy."
Ephedra banned
In response to renewed calls for the regulation of ephedra, the FDA commissioned a large meta-analysisMeta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...
of ephedra's safety and efficacy by the RAND Corporation. This study found that while ephedra promoted modest short-term weight loss, there was no evidence that it was effective for long-term weight loss or performance enhancement. The use of ephedra in this study was associated with significant gastrointestinal, psychiatric, and autonomic
Autonomic nervous system
The autonomic nervous system is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The ANS affects heart rate, digestion, respiration rate, salivation, perspiration, diameter of the pupils,...
side effects. Almost simultaneously, a study in Annals of Internal Medicine
Annals of Internal Medicine
Annals of Internal Medicine is an academic medical journal published by the American College of Physicians . It publishes research articles and reviews in the area of internal medicine. Its current editor is Christine Laine...
found that ephedra was 100 to 700 times more likely to cause a significant adverse reaction than other commonly used supplements such as kava
Kava
Kava or kava-kava is a crop of the western Pacific....
or Ginkgo biloba.
On December 30, 2003, the FDA issued a press release recommending that consumers stop buying and using ephedra, and indicating its intention to ban the sale of ephedra-containing supplements. Subsequently, on April 12, 2004, the FDA issued a final rule banning the sale of ephedra-containing dietary supplements. Tommy Thompson
Tommy Thompson
Thomas George "Tommy" Thompson , a United States Republican politician, was the 42nd Governor of Wisconsin, after which he served as U.S. Secretary of Health and Human Services. Thompson was a candidate for the 2008 U.S. Presidential Election, but dropped out early after a poor performance in polls...
, the Secretary of Health and Human Services, stated that "...These products pose unacceptable health risks, and any consumers who are still using them should stop immediately."
Legal challenges
Nutraceutical Corporation, a supplement manufacturer based in Park City, UtahPark City, Utah
Park City is a town in Summit and Wasatch counties in the U.S. state of Utah. It is considered to be part of the Wasatch Back. The city is southeast of downtown Salt Lake City and from Salt Lake City's east edge of Sugar House along Interstate 80. The population was 7,558 at the 2010 census...
, challenged the legality of the FDA's ban of ephedra as exceeding the authority given the agency by the Dietary Health Supplements and Education Act. Nutraceutical Corporation stated that they did not intend to start marketing ephedra, but were concerned about the scope of the FDA's regulatory action. Judge Tena Campbell of the Utah Federal District Court ruled that the FDA had not proven that low doses of ephedra were unsafe, although she also noted that studies to address the safety of low-dose ephedra would be unethical
Medical ethics
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.-History:Historically,...
. Nevertheless, her ruling overturned the ban on the sale of ephedra in the state of Utah, and called into question whether the ban could be enforced anywhere in the United States.
The ruling was appealed to the U.S. Court of Appeals for the Tenth Circuit in Denver, Colorado
Denver, Colorado
The City and County of Denver is the capital and the most populous city of the U.S. state of Colorado. Denver is a consolidated city-county, located in the South Platte River Valley on the western edge of the High Plains just east of the Front Range of the Rocky Mountains...
. On August 17, 2006, the Appeals Court upheld the FDA's ban of ephedra, finding that the 133,000 page administrative record compiled by the FDA supported the agency's finding that ephedra posed an unreasonable risk to consumers. Nutraceutical Corp. filed a petition for a writ of certiorari seeking a rehearing on the ban of ephedra; however, on May 14, 2007 the United States Supreme Court declined to hear this petition. The sale of ephedra-containing dietary supplements remains illegal in the United States.
Use in sports
Ephedrine is listed as a banned substanceDoping (sport)
The use of performance-enhancing drugs in sport is commonly referred to by the term "doping", particularly by those organizations that regulate competitions. The use of performance enhancing drugs is mostly done to improve athletic performance. This is why many sports ban the use of performance...
by both the International Olympic Committee
International Olympic Committee
The International Olympic Committee is an international corporation based in Lausanne, Switzerland, created by Pierre de Coubertin on 23 June 1894 with Demetrios Vikelas as its first president...
and the World Anti-Doping Agency
World Anti-Doping Agency
The World Anti-Doping Agency , , is an independent foundation created through a collective initiative led by the International Olympic Committee . It was set up on November 10, 1999 in Lausanne, Switzerland, as a result of what was called the "Declaration of Lausanne", to promote, coordinate and...
. The U.S. National Football League
National Football League
The National Football League is the highest level of professional American football in the United States, and is considered the top professional American football league in the world. It was formed by eleven teams in 1920 as the American Professional Football Association, with the league changing...
banned players from using ephedra as a dietary supplement in 2001 after the death of Minnesota Vikings
Minnesota Vikings
The Minnesota Vikings are a professional American football team based in Minneapolis, Minnesota. The Vikings joined the National Football League as an expansion team in 1960...
offensive tackle Korey Stringer
Korey Stringer
Korey Damont Stringer was an American football player who died from complications brought on by heat stroke, during training camp in Mankato, Minnesota while in training camp with the Minnesota Vikings of the National Football League.-College career:Stringer was born in Warren, Ohio and attended...
; ephedra was found in Stringer's locker and lawyers for the team contend that it contributed to his death. The substance is also banned by the National Basketball Association
National Basketball Association
The National Basketball Association is the pre-eminent men's professional basketball league in North America. It consists of thirty franchised member clubs, of which twenty-nine are located in the United States and one in Canada...
. Nonetheless, ephedra remains widely used by athletes; a 2006 survey of collegiate hockey players found that nearly half had used ephedra in the belief it would enhance athletic performance.
Prominent cases of ephedra use
In the 1994 FIFA World Cup, the ArgentineArgentina
Argentina , officially the Argentine Republic , is the second largest country in South America by land area, after Brazil. It is constituted as a federation of 23 provinces and an autonomous city, Buenos Aires...
footballer Diego Armando Maradona
Diego Maradona
Diego Armando Maradona is a retired Argentine football player and widely regarded as one of the greatest football players of all time. Over the course of his professional club career Maradona played for Argentinos Juniors, Boca Juniors, Barcelona, Napoli, Sevilla and Newell's Old Boys, setting...
tested positive for ephedrine. The Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
ese motorcycle
Motorcycle
A motorcycle is a single-track, two-wheeled motor vehicle. Motorcycles vary considerably depending on the task for which they are designed, such as long distance travel, navigating congested urban traffic, cruising, sport and racing, or off-road conditions.Motorcycles are one of the most...
racer Noriyuki Haga
Noriyuki Haga
, is a Japanese professional motorcycle racer. Haga has been runner-up in the Superbike World Championship three times, and has finished 3rd in the series four times....
tested positive for it in 2000, being disqualified from two races and banned from two more as a result. NFL punter
Punter (football position)
A punter in American or Canadian football is a special teams player who receives the snapped ball directly from the line of scrimmage and then punts the football to the opposing team so as to limit any field position advantage. This generally happens on a fourth down in American football and a...
Todd Sauerbrun
Todd Sauerbrun
Todd Scott Sauerbrun is an American football punter who is currently a free agent. He was originally drafted by the Chicago Bears in the second round of the 1995 NFL Draft...
of the Denver Broncos
Denver Broncos
The Denver Broncos are a professional American football team based in Denver, Colorado. They are currently members of the West Division of the American Football Conference in the National Football League...
was suspended for the first month of the 2006 season after testing positive for ephedra.
External links
- United States FDA links to actions
- FDA Rule
- United States NIH Factsheet regarding weight loss and athletic performance
- Dietary Supplements: Balancing Consumer Choice and Safety. A report of the New York State Task Force on Life & the Law.
- The history of Ephedra (ma-huang).