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Is Ephedra Dangerous?    Posted: 03.05.03
Following the death of Baltimore Orioles pitcher Steve Bechler last month new questions are arising about the safety of the dietary supplement ephedra.
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Major league baseball players can run fast, steal bases or stop on a dime. But when 23-year-old Orioles pitcher Steve Bechler collapsed during practice on Feb. 16 and died the next day, questions arose about what players do to stay in peak condition.

In Bechler's case, authorities blamed his death on a little bottle of pills found in his locker containing an herb called ephedra. People use it to lose weight or enhance their sports performance. But Bechler collapsed with a 108-degree body temperature and died of heatstroke. Now some lawmakers want to ban ephedra completely.

What is ephedra?

Ephedra is a Chinese herb used for asthma in the 1960s. Athletes now use it to get an energy "high" during games and to lose weight, which reportedly appealed to Bechler, who was ten pounds over his category.

SupplementsAccording to industry estimates, Americans use more than 3 billion doses of ephedra products each year to alter their weight or sports performance.

But ephedra has also been linked to almost 100 deaths, among them high school and college athletes who have collapsed during games or practice. The supplement is banned from the NFL, NCAA and the Olympics, but not from Major League Baseball. Pills like the one used by Bechler can still be bought over the counter.

Even before Bechler's death, ephedra had a dangerous reputation. It makes up less than one percent of herbal supplement sales, but Food and Drug Administration commissioner Mark B. McClellan said ephedra causes 64 percent of all reported side effects from herbs.

And it's not even clear whether ephedra has any benefits. A government-commissioned study from the Rand Corporation found that, despite being sold to up to 17 million Americans, ephedra only had "limited use" for dieting and "no demonstrable effect" when it came to playing sports.

The government's response

Health and Human Services Secretary Tommy Thompson said he wouldn't give ephedra to his family. He proposed warning labels on all ephedra supplements, linking the drug to heart attack, stroke, seizures and death. The government is also demanding that 24 companies stop promoting ephedra as an athletic enhancer. Labeled, scrutinized and barred from the minor leagues, ephedra is now everything but banned altogether.

So why doesn't the government ban ephedra?

Because health officials need to prove it's dangerous first. The Dietary Supplement Health and Education Act, drafted in 1994, requires companies prove a dietary supplement is safe before it hits the shelves, but they don't have to do pre-market screening or report negative side effects.

Sec. Tommy ThompsonAccording to its own rules, the FDA cannot ban ephedra unless it shows a "significant or unreasonable risk of illness or injury." No long-term studies have been done with ephedra. And although it is linked to fatal side effects, nothing has been proven.

Some lawmakers are looking to change the rules, saying ephedra is too dangerous to be sold. Senators Richard Durbin (D.-Ill.) and Charles Schumer (D.-N.Y.) are pushing for a complete ban. Durbin has been asking for an ephedra ban since August.

During a press conference following Bechler's death, Thompson said he would "caution" Americans, especially athletes, not to take ephedra, but did not say he would ban it.

Cytodyne Technologies, which manufactured the bottle inside Bechler's locker, said ephedra may not have caused his death. Bechler already had a history of hypertension and liver disease, and was dieting to lose weight. Instead, Cytodyne is blaming the Orioles' training program. Oriole managers stand by their regimen's quality and point a finger at ephedra.

Ephedra in professional baseball

Drugs and supplements aren't that unusual in the locker rooms. According to a recent Washington Post article, Major League players admit they pass around pills to boost energy and that it is "accepted."

Steve BechlerNew York Yankees pitcher David Wells said Bechler probably "overdid" it and didn't follow the supplement's instructions. But Wells himself was hospitalized seven years ago, when he used to pitch for the Orioles: his heart rate reached 200 beats per minute and even flatlined. He had been taking ephedra.

The government is asking the public for its opinion on ephedra to better evaluate its potential dangers. The Broward County medical examiner will release a full autopsy report in two weeks, after which the baseball's players' union will decide whether to ban ephedra from the major leagues.

The Ephedra Education Council, a group made up almost entirely of ephedra manufacturers, claims the government is inflating the risks. At a press conference, Thompson responded, "Why take the risk?"

Bechler's pregnant widow, Kiley, is planning to sue Cytodyne.

-- By Irene Noguchi, Online NewsHour