Ephedra, or ma-huang, is a Chinese shrub which has been used medicinally for more than 5,000 years, according to the National Center for Complementary and Alternative Medicine, or NCCAM. In April 2004, ephedra was banned from the American market by the U.S. Food and Drug Administration when studies showed that it raised blood pressure and otherwise stressed the circulatory system. Shortly thereafter, a previously obscure herb called bitter orange -- a natural source of synephrine -- gained wider use as a weight-loss supplement.
Uses
Traditionally, ephedra has been used to treat colds, flu, asthma, fevers and nasal congestion. Until 2004, it was included in dietary supplements that were purported to elevate your metabolic rate, enhance athletic performance and accelerate the breakdown of fat. As a constituent of bitter orange, synephrine is mainly touted as a safe substitute for ephedra. Bitter orange is marketed as both the fruit and as concentrated extracts in various weight-loss supplements. It's often combined with other compounds, such as caffeine and guarana, which is simply a natural caffeine source. Caffeine is included in weight loss products to exploit its thermogenic properties, or speeding up the time it takes to burn fat.
Research
In 2003, after reviewing scientific data regarding ephedra's use as a weight-loss and performance-enhancing supplement, NCCAM reported that there was little evidence of benefit from taking this herb. In contrast, there was strong evidence of a risk of serious side effects, including some fatal ones. Similarly, in 2004, researchers at Georgetown University in Washington, D.C., argued that there was no evidence to support the use of bitter orange for weight loss and that synephrine was only likely to induce weight loss in humans at doses that would cause side effects.
Safety
Ostensibly, ephedra was banned on the basis of its ability to raise your blood pressure and otherwise unduly stress your heart and cardiovascular system. In 2003 Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, claimed that 155 people, including some high-profile athletes, had died as the result of ephedra use. On the other hand, synephrine is "exceedingly safe," according to a review published in the April 2011 edition of "Phytotherapy Research." Nevertheless, doctors at Walter Reed Medical Center in Washington, D.C., said that the most likely cause of a fatal heart attack in an otherwise healthy 24-year-old man was related to his administration of synephrine.
Considerations
Both ephedra and synephrine are stimulatory substances with similar physiologic effects. Although traditional uses of ephedra and bitter orange are associated with few side effects, the concentration of their active constituents and the consumption of excessive doses can cause health problems. Ephedra was banned due to reports of serious adverse events. To date, few reports of adverse events arising from the use of bitter orange have been forthcoming. However, scientists are concerned that synephrine may repeat ephedra's history.
References
- National Center for Complementary and Alternative Medicine: Ephedra
- U.S. Food and Drug Administration: FDA Acts to Remove Ephedra-Containing Dietary Supplements From Market
- "Experimental Biology and Medicine"; Citrus Aurantium, an Ingredient of Dietary Supplements Marketed for Weight Loss: Current Status of Clinical and Basic Research; A. Fugh-Berman, A. Myers; September 2004
- ConsumerAffairs.com: FDA Moves to Ban Ephedra
- "Phytotherapy Research"; The Safety of Citrus aurantium (Bitter Orange) and Its Primary Protoalkaloid p-Synephrine; S.J. Stohs, et al.; April 2011
- "Texas Heart Institute Journal"; STEMI in a 24-Year-Old Man After Use of a Synephrine-Containing Dietary Supplement: A Case Report and Review of the Literature; J.E. Thomas, et al.; 2009
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