Nutrition & Health OnLine Magazine
The Ephedra Debate: Do You Know the Truth?
Ben Kennedy
For the last several years there has been a lot of debate concerning the safe use of products that contain Ephedra, or the herbal form MaHuang. Among those claiming that such products are unsafe are many Doctors and others in the medical establishment. On the other side of the debate are the millions of consumers who rely on such products to aid in conditions ranging from weight loss to asthma. The only way to understand the truth about Ephedra is to examine all the available evidence as well as the motives behind those advocating it's use and those wanting it controlled by the FDA.
The first question to answer in regard to Ephedra is whether or not the ingredient is actually effective. There have been hundreds of studies done on Ephedra in regard to reducing bodyfat and every one of them has demonstrated that supplementation with Ephedra will reduce bodyfat levels substantially. Several notable studies that have been done in recent years include one by Harvard Medical School and Columbia University that is the most comprehensive yet on Ephedra. In this study, 167 men and women were given at random either a combination containing Ephedra and Caffeine or a placebo. The results showed that the group that was given the Ephedra/Caffeine combination lost an average of 15.2 lbs over a six-month period verses a loss of only 6.8 pounds for the placebo group. What is even more significant is the data that showed that the group using Ephedra/Caffeine reduced their bodyfat level by 3.2% while the placebo grouped dropped just 0.6% in bodyfat.1
Another study done at Columbia University that involved MaHuang had similar results. This study used a combination of MaHuang and Guarana, which are the herbal forms of Ephedra and Caffeine and demonstrated the effectiveness of the herbal ingredients for reducing bodyfat. The results of this study were similar to other studies done with Ephedra and Caffeine in that the test subjects who were given MaHuang/Guarana combination lost nine more pounds and decreased their bodyfat level by two percent more than the placebo group. These two studies are just recent examples showing how effective combinations that contain Ephedra or Mahuang can be for reducing bodyfat.2
Now that the question of effectiveness has been answered conclusively the next question involves whether Ephedra can safely be used. This question is really the crux of the whole debate since the overwhelming evidence from research clearly shows how well Ephedra works for weight loss and has never really been questioned even by opponents. The interesting part of this whole story is the fact that the same research studies that show how effective Ephedra is at promoting fat loss have also demonstrated that the ingredient is extremely safe when taken at the prescribed dosage. In the Harvard/Columbia study shown above the conclusion of researches involved in the study as well as by those who later examined the data can best be summed up by Dr. Stephen Kimmel, an epidemiologist at the University of Pennsylvania who, after reviewing this study as well as many others said "available information does not demonstrate an association between the use of dietary supplements containing Ephedra and serious adverse events."
Despite a lack of research findings to support a case against Ephedra the FDA still tried to limit all over-the-counter sales in 1997 basing their case instead on Adverse Event Reports (AER) collected over a three-year period. They claimed to have over 800 reports that showed the dangers of Ephedra but after closer scrutiny by the General Accounting Office (GAO) of the United States it was found that the FDA was basing it's case on only 13 reports to which many were highly suspicious and were later proven to have nothing to do with the use of Ephedra.3 The FDA was soundly criticized for "bad science" by the GAO in a report issued in 1999 as well as by members of Congress whose comments are best represented by the those below from U.S. Senator Tom Harkin:
    "The major finding of this report that the scientific basis upon which the FDA acted is clearly inadequate is quite disturbing. American consumers count on the FDA to provide them with recommendations based on careful, scientifically sound analysis. To base a recommended dosage level on 13 adverse events is highly questionable. More troubling, however, is GAO's finding that FDA did not even determine that these adverse events were caused by the ingestion of dietary supplements containing Ephedra. In fact, GAO found that many of the adverse events were clearly not related to the taking of Ephedra supplements. For example, of the 13 reports, three contain physician reports that stated that the cause of the person's adverse event was not related to their taking a dietary supplement. Also, three individuals reporting adverse events had experienced similar problems prior to or well after taking the supplement."
The actions of the FDA in trying to ban Ephedra are even more disturbing when taken in the context of how other over-the-counter products are handled. In June of 1999 it was reported the as many as 16,500 people die each year as the result of using Non-Steroidal Anti-Inflammatory Drugs(NSAID's) which include popular products such as aspirin and ibuprofen.4 Where is the FDA in this instance? How can you even compare 16,500 deaths to 13 adverse event reports and yet the FDA has taken no action against such products and probably never will. The evidence is clear, the motives of the FDA in trying to limit the sale of Ephedra have nothing to do with safety.
The question that now must be answered in light of the evidence we have just discussed is if the FDA's actions were not motivated by safety concerns then what were their true motivations and who is really behind efforts to restrict Ephedra. As with many questions in this World, the answer is best determined by looking at who stands to gain the most from the strict regulation of Ephedra. The pharmaceutical companies of the World along with many medical doctors (MD's) have become an International Pharmaceutical Industrial Complex that easily rivals the US Military Industrial Complex in terms of economic power. This whole scandalous case surrounding Ephedra just shows the lengths to which pharmaceutical interests will go to protect their sales revenue. The whole debate over Ephedra has never been about safety but is instead just an excuse to eliminate opposition in the marketplace and protect the sales of prescription drugs.
I think the evidence to support this conclusion is overwhelming. The fact that the FDA is completely controlled by MD's who are closely tied to pharmaceutical companies probably explains the actions of the FDA in regard to Ephedra. How many MD's do you know that will treat any kind of physical ailment with something other than a prescription drug? More evidence comes from the problems pharmaceutical companies have had in developing safe effective prescription drugs to promote weightloss. The only really effective prescription weight loss products that have been on the market were Redux and Fen-Phen, which of course are no longer available because of the damage these drugs do to heart valves. But even at the height of sales for Fen-Phen and Redux there was at least one research study that showed how the combination of Ephedra and Caffeine was still more effective than Redux.5 Is there really any doubt that faced with such competition from an OTC product costing one hundredth as much as the drug they were marketing that the pharmaceutical companies took steps to limit the competition.
I hope that anyone reading this article will look at all the evidence that has been presented and then make their own determination about Ephedra and the whole debate surrounding it's safe use. Whatever you choose to believe as far as the motives behind the bad publicity and the efforts by the FDA to restrict use, I hope you can see by now that there is a lot of research data and evidence to support the use of products that contain Ephedra or MaHuang as weight loss aids. If you are one of the millions of people who need help in reducing your bodyfat then do not dismiss such a product simple because someone else told you they are dangerous. Remember that God gave you a brain and that ultimately only you can determine what is best for your body.
In 2004 Ben wrote a book titled Why Is America So Fat? that expands upon the issues discussed in this article and looks at the Epehdra controversy and ban as part of a larger effort by the government and the helath care industry to prevent people from using viable nutritional supplements like Ephedra products to stay healthy so as to protect profits in the health care industry.
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1C.N. Boozer, et al., "Herbal Ephedra/Caffeine for Weight Loss: A Six Month Safety And Efficacy Trial." New York 2000
2Boozer CN, Nasser JA, Heymsfield SB, Wang V, Chen G, Solomon JL. "An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial." Int J Obes Relat Metab Disord. 2001 Mar;25(3):316-24.
3U.S. GAO B-281581 Dietary Supplements: Uncertainties in Analysis Underlying FDA's Proposed Rule on Ephedrine Alkaloids. July 2, 1999.
4Wolfe M. M., Lichtenstein D. R., Singh G. "Medical Progress: Gastrointestinal Toxicity of Nonsteroidal Antiinflammatory Drugs" N Engl J Med 1999; 340:1888-1899, Jun 17, 1999.
5Breum L, Pedersen JK, Ahlstrom F, Frimodt-Moller J, "Comparison of an ephedrine/caffeine combination and dexfenfluramine in the treatment of obesity. A double-blind multi-centre trial in general practice." Int J Obes Relat Metab Disord 1994 Feb;18(2):99-103.

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