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New Workout Supplements Rely on Potentially Risky Ingredients

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Chicago Tribune


CHICAGO - Searching for a legal way to rev up her metabolism and burn fat, Chicago fitness competitor Beth Horn, 29, turned to an ephedra-free supplement. Though she found the effects less potent than with ephedra, she also didn't get the coveted adrenaline kick she wanted for her intense workouts.

"Without ephedra, it's just caffeine to get you going," said Horn. "I don't think it's enough."

Six months after Illinois led the nation by banning the sale of supplements containing the herb ephedra, alternative products promising even better results have popped up on drugstore shelves. But while less potent and perhaps easier on the system, researchers say an "ephedra-free" label doesn't guarantee safety or efficacy.

Many of the products now contain synephrine, a weaker relative of ephedra, which has undergone far less scrutiny. Synephrine, found in the herb citrus aurantium - commonly known as bitter orange - has been used for ages by Chinese healers to treat allergies, digestive problems and colds.

It works much as ephedra does - by charging up the metabolism and stimulating the central nervous system - but has some of the same potential side effects such as increased blood pressure, said Christine Haller, a clinical pharmacologist at the University of California at San Francisco. Products with synephrine can cause hypertension, heart attacks and strokes, especially when mixed with concentrates of other caffeine-rich herbs such as guarana and mate.

Studies also have shown that bitter orange has an effect similar to grapefruit: It can prevent a specialized enzyme from working and metabolizing certain medications. "Thus, like grapefruit juice, it can cause an alarming increase in the blood levels of many drugs," said Sidney M. Wolfe, director of the Health Research Group for Public Citizen, a consumer advocacy group pushing for a nationwide ban on ephedra products.

Meanwhile, the New Jersey attorney general has charged that the supplement company Cytodyne Technologies did not disclose that some of the ingredients in its ephedra-free Xenadrine EFX - including the banned horse stimulant Hordonine - have many of the same adverse health effects as ephedra. The company, which had changed its name to Nutraquest Inc., filed for bankruptcy last month, suspending litigation.

"From a policy standpoint, getting rid of ephedra won't take care of the problem," said Haller, who studies ephedra-free products. "The law allows for these snake-oil medications to be put out as food products and lets the consumer be guinea pigs. It just means there is less known about (new products)."

The lucrative ephedra market crashed this year after the herb was implicated in the deaths of professional, college and high school athletes including Baltimore Orioles pitcher Steve Bechler and 16-year-old Sean Riggins, who suffered a heart attack. Northwestern football player Rashidi Wheeler had ephedra in his system when he died of a chronic asthma attack in 2001, the Cook County medical examiner found.

Meanwhile, petitions to the Food and Drug Administration to ban the substance, class-action lawsuits against manufacturers and ephedra bans in Illinois, New York and, most recently, California alarmed consumers. Another blow to ephedra, also known as ma huang, was the skyrocketing insurance premiums for companies that make and sell it.

Scrambling to fill the dietary supplement void, many companies developed products to increase thermogenesis, the production of heat in the body. When a person's metabolic temperature rises, the body taps more of its fat stores for energy.

In addition to caffeine and bitter orange extract - also found in orange marmalade - new ephedra-free formulas include green tea extract, yerba mate, kola nut and guarana.

Although pregnant women should avoid bitter orange because it may stimulate uterine contractions, other studies have found benefits, and it has been used around the world as a digestive aid, said Neil Levin, marketing manager of Fruitful Yield, a chain of suburban health food stores. "One study indicated that bitter orange improved the electrical signals and `stroke volume' of the heart's pumping action, maintaining peripheral blood flow despite constricted arteries," said Levin. "Bitter orange may be useful to reduce mild heart arrhythmias."

Meanwhile, a study published in the Journal of Medicine in 2002 found that although bitter orange may be the best thermogenic substitute for ephedra, more studies are needed to establish a definitive link.

For bodybuilders and fitness competitors who loved ephedra for its near-magical ability to suppress appetite and cut fat without cannibalizing body mass, the new products are, at best, `ephedra light.'

"It's like drinking six cups of coffee, and that doesn't work near as well as ephedra because it had the combination of ephedra, caffeine and aspirin for a synergistic effect," said Ottawa's Jeff Johnson, vice chairman of the National Physique Committee, which oversees amateur bodybuilding.

Athletes will just have to work harder, he said. The irony? "Ephedra products are one of the few supplements that actually work."


(c) 2003, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.

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