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November 23, 2009

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Editorial: Watch out for pills’ downside

Friday, Feb. 21, 2003 | 8:59 a.m.

The death during spring training of a 23-year-old pitcher for the Baltimore Orioles has focused a lot of attention on ephedra, an herbal product found in many prescription drugs as well as over-the-counter dietary supplements. Oftentimes, the non-prescription supplements are advertised for their ability to burn fat, add muscle and increase energy. Ephedra, including its potent component ephedrine, is an active ingredient in Xenadrine RFA-1, the brand of over-the-counter pills that were found in the pitcher's locker. Although it is not yet known whether ephedra was in the pitcher's system when he died of heatstroke, his death has renewed debate about the organic substance, which has been linked to many other deaths, heart problems and strokes.

Ephedra use in Asia dates back thousands of years and it was used widely in the United States in the 1920s. The American College of Physicians, in a recent study on the safety of ephedra compared with other herbal products, said it was used in this country to stimulate the central nervous system and as a treatment for nasal congestion and asthma. It also reported that its use here declined substantially in the 1930s because of safety concerns. Because ephedra, which has made a huge comeback over the past decade, is an herb regulated only as a dietary supplement, approval from the U.S. Food and Drug Administration is not required. The ACP study, however, concluded that ephedra has risks far exceeding other herbs and its use should be restricted.

That study is only the latest in a string of negative reports about ephedra. The American Medical Association, for example, is against sale of the herb. Because of such concerns, the FDA is undertaking a study to determine if the herb should be banned. Our view is that, starting immediately, any product containing ephedra should be clearly labeled with warnings of its potential side effects. Most products now contain only fine print. Additionally, baseball should follow the lead of other major sports organizations, including the National Football League, and ban its use by players. Finally, anyone considering taking the herb should read more than just the advertisements for it.

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