Guest guest Posted February 3, 2004 Report Share Posted February 3, 2004 Tue, 3 Feb 2004 09:17:08 -0500 HSI - Jenny Thompson Caution: Contents May Be Hot! Caution: Contents May Be Hot! Health Sciences Institute e-Alert February 3, 2004 ************************************************************** Dear Reader, As hot buttons go, the ephedra controversy is a few degrees above white-hot. Or it is among HSI members anyway. In the e-Alert " Circle the Wagons " (1/8/04) I offered some comments about the FDA's move to ban the sale of all ephedra products by early spring. And the e-mails came pouring in - some agreeing and some passionately disagreeing with HSI's take on the situation. Reading the e-mails, I realized two things: 1) There are still some basic misconceptions about what ephedra is and why it's been singled out by the FDA, and 2) Many members want to take action to prevent the ban, but don't know how to go about it. So it's time to open up a fresh can of Clear Thinking, and take a look at some member mail. Caution: Contents may be steaming hot! ---------------------------- Helping or hurting? ----------------------------- HSI members Michael and Tonya wrote to say that I was " 100% right " in my assessment of the FDA ban, but a member named Diana didn't agree, stating, " I believe that the FDA is trying to help instead of hurt. I do not believe they are taking away our freedoms just making sure we live long enough to still have them. " Diana says she just recently started receiving the e-Alert, so she may have missed some of the important points about ephedra that I've covered in previous e-Alerts. Much of the confusion about ephedra lies in the unwillingness or inability of the media to make the simple distinction between ephedra and ephedrine. In the e- Alert " Jekyll and Hyde " (1/16/03), HSI Panelist Linda Page, Ph.D., explained the difference between ephedra and ephedrine. In a nutshell: Ephedra is a broncho-dilator that herbalists value as a natural and effective alternative to asthma and allergy drugs. Ephedrine is the active constituent of ephedra. In a 50 mg dose of ephedra (which Dr. Page describes as an " effective dose " ) you're getting 0.5 mg of ephedrine. But certain products that isolate and boost ephedrine (as most of the weight-loss products do) may contain as much as 20 mg of ephedrine - 40 times the amount that you get in the natural herb. As Dr. Page points out: " No wonder there are problems! " So when you hear about athletes, for instance, who have died while taking ephedra, you can be just about certain that they weren't taking a 50 mg dose of ephedra, but a boosted ephedrine product that can be dangerous when not taken as directed. Nevertheless, ephedra is blamed for these deaths, and now this herb is about to be banned for the sins of its hyped-up cousin, which in most of the fatal cases was used recklessly. ----------------------------- Extremely energizing ----------------------------- An e-mail from a member named Don observes that " The consumer is in a real quagmire of 'information,' not necessarily facts. " And I agree. Don adds, " Your comments on ephedra may be valid in some areas, but there are other points of view to consider. The Jan 2004 issue of Consumer Reports has some interesting comments that are quite different than yours. " Consumer Reports! Don't get me started! I've taken Consumer Reports to task a number of times for offering health advice, which is way out of their area of expertise. When I want electric grill ratings, I go to Consumer Reports. When I want herbal supplement advice I go to... Consumer Reports? I don't think so. Don refers to an article that describes the numerous weight- loss and energy-boosting products that contain ephedrine. And while the article recognizes that ephedra is the " natural source of the chemical ephedrine, " it incorrectly identifies ephedra - not the hyped up ephedrine - as the ingredient in " performance enhancing " products that are sold at drug store chains and convenience stores nationwide. With flashy brand names emphasizing boosts of energy in the extreme, I think it's safe to say that many of these products are produced by companies that might be described as " fly by night. " Not your best choice when looking for a reputable supplement. The article explains how these products manage to combine ephedra (again, read: hyped ephedrine) and large doses of caffeine by listing aliases for caffeine, such as " kola nut, " and names such as sinica to describe ephedrine. And why do they do that? Because in 1983 the FDA banned the combination of ephedrine and caffeine in over-the-counter products. Okay then, let's think about this. In spite of the FDA ban of the ephedrine-caffeine combo, here we are more than two decades later, and you can still purchase such products easily at your local quick mart. So I think it's safe to say that the ehpedra ban will have little or no effect on the production and sale of potentially dangerous products like these that contain boosted ephedrine. The first ban didn't stop them - why should another? But the ban will have a huge effect on established and respected herbal manufacturers. Most of them have already stopped producing ephedra formulas for fear of being shut down. As a result, any allergy or asthma sufferer who has relied on herbal ephedra for relief will now be forced to use pharmaceuticals. So here's what the FDA ban of ephedra will do: It will effectively prohibit the sale of something useful - ephedra - while hyped ephedrine will most likely still be out there, often in a dangerous combination with caffeine, available to any young athlete who wishes to " enhance performance. " And the ban won't even touch the synthetic version of ephedrine, which will still be widely available in many sinus and cold medications such as Sudafed (taking its name from " pseudo ephedrine " ). In short: The FDA ban is destructive and pointless. But Consumer Reports and other misguided do-gooders will hail it as a victory. ----------------------------- The big picture ----------------------------- So... What to do? A member named Steve writes: " Can't we start a petition and/or send letters somewhere to try to make an impact on the decision to ban Ephedra? " In a word: No. When the FDA issues the rule on ephedra (expected any day now), the ban of the herb will take effect 60 days later. During that time, the ban may be challenged in court. What happens then is anyone's guess, but I don't believe that any amount of petitions or e-mails will influence a court's decision. So while it ain't over til it's over - I think for ephedra it's just about over. But ephedra is only one skirmish. There are more to come. And FDA officials have made no secret of the fact that they would like to do away with the Dietary Supplement Health and Education Act (DSHEA), which keeps them from regulating supplements the same way they regulate drugs. A congressional bill titled " Dietary Supplement Safety Act of 2003 " (S. 722) is currently making it's way through the senate. This bill is designed to broadly expand the FDA's authority to control the dietary supplement market. If passed, the bill could seriously inhibit your freedom to make your own health care decisions. Fortunately, another bill has been introduced that makes S. 722 unnecessary. Under this alternative bill - " DSHEA Full Implementation and Enforcement Act, " (S. 1538) - the FDA would receive additional funding to ensure that DSHEA is fully carried out, as originally intended. The new bill also increases funding for dietary supplement research and consumer information through the National Institutes of Health. ----------------------------- Pen to paper ----------------------------- I'm no fan of regulations and I don't believe that the way to solve problems is to throw money at them. But I do believe that DSHEA provides more than enough regulation of dietary supplements. Therefore, S. 1538 offers a reasonable and responsible alternative to the completely unnecessary extremes of S. 722. I strongly urge you to join me in taking a moment to send a brief letter or e-mail to your Senators. (You can easily find congressional street addresses and e-mail addresses at congress.org just by entering your zip code. And we've heard that snail mail gets more attention from our public servants than e-mail.) If you don't have time to compose a letter or an e-mail, you can follow the lead of a member named Clifford, who writes: " I took your article and copied it to an email and sent it to the two Senators from California and requested that they correct this injustice concerning ephedra, in light of what acetaminophen also does when misused. " It may be too late to correct the injustice concerning ephedra, but it's not to late to save the freedoms provided under DSHEA. ************************************************************** To start receiving your own copy of the HSI e-Alert, visit: http://www.hsibaltimore.com/ealert/freecopy.html Or forward this e-mail to a friend so they can sign-up to receive their own copy of the HSI e-Alert. ************************************************************** ... and another thing I have an important message for diabetics and anyone who may have symptoms of a pre-diabetic condition. It's time for a PAD check. " PAD " is peripheral arterial disease, an ailment that reduces blood flow to the legs due to arteries that have been narrowed by damage associated with diabetes. A panel organized by the American Diabetes Association (ADA) recently concluded that more than 12 million Americans may have PAD, but most of them are undiagnosed because they're not even aware of the potential problem. What's worse, many general practitioners are also uninformed about the PAD- diabetes connection, so they don't include PAD testing as a standard element of diabetic care. Fortunately, testing is very simple. It's called " ankle brachial index. " Blood pressure is checked in the ankle and compared to a blood pressure reading from the arm. PAD is indicated if the ankle BP is significantly lower than the arm BP. A diagnosis of PAD is also a tip that the cardiovascular system may be in greater danger of heart attack and stroke. The ADA panel recommends regular PAD testing for all diabetics over 50, as well as anyone who finds their legs hurting or tiring easily after walking. Although PAD occurs mostly among older diabetics, the panel says that young diabetics should also be checked if they've had diabetes for more than 10 years, and especially if they have other PAD risk factors, such as smoking and high blood pressure. In cases of advanced PAD, surgery is sometimes needed to bypass obstructed arteries. For milder cases, exercise is recommended, and medications are often prescribed to thin the blood and reduce heart attack risk. But if your doctor should find evidence of PAD and immediately prescribes a statin drug or a beta blocker, you might want to seek a second opinion from an M.D. who's not so quick to follow the pharmaceutical route. To Your Good Health, Jenny Thompson Health Sciences Institute ************************************************************** Sources: " Ephedra: Heart Dangers in Disguise " Consumer Reports, January 2004, consumerreports.com " The DSHEA Full Implementation and Enforcement Act " Senate Bill 1538, 108th Congress, 1st Session, thomas.loc.gov " Dietary Supplement Safety Act of 2003 " Senate Bill 722, 108th Congress, 1st Session, thomas.loc.gov " Diabetics Urges to Get Tested for Leg Disease " Associated Press, 1/19/04, msnbc.com Copyright ©1997-2004 by www.hsibaltimore.com, L.L.C. 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