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HEALTH concerns have moved the Navy to ban the sale of the popular weight loss and sports dietary supplements containing ephedrine from stores at Pearl Harbor and the Marine base at Kaneohe Bay.
The Navy and Marines ban the sale
of products containing a potentially
dangerous substance
Linked to death, disability
By Gregg K. Kakesako
Star-BulletinThe dietary supplement had been sold under brand names such as Metabolife, Beyond Ripped, Herbal Phen-Fast, Kwik Energy, Ripped Fuel, Metacuts, Ultra Ripped and Chroma Slim at its Pearl Harbor exchange, the Navy said.
Although no law bans the sale of ephedrine products, local law enforcement officials say it poses a problem because it is used to make the narcotic crystal methamphetamine or "ice."
Keith Kamita, administrator of the state Narcotics Enforcement Division, said ephedrine and pseudo-ephedrine drugs are the building blocks in the compound used to make ice.
'All three military services have documented medical cases where significant adverse events and deaths have occurred among active duty service members taking certain dietary supplements, specifically preparations containing ephedrine alkaloids.' Vice Adm. Richard Nelson
NAVY SURGEON GENERAL
That is why it is against the law to purchase ephedrine or pseudo-ephedrine with the intent to manufacture a controlled substance, Kamita said.
Allen Gelfius, training and data manager for the Health Department's food and drug branch, said there are no federal regulations governing dietary supplements that contain ephedrine.
"Prior to 1994, food supplements like food additives and prescription drugs had to prove to the FDA (U.S. Food and Drug Administration) that they were safe and suitable for what they claimed to do before they could be marketed," Gelfius said.
A 1994 federal law changed that and "the liability of proof fell to the FDA and the states."
Kamita said Hawaii is one of the few states where large sales of over-the-counter ephedrine are monitored.
"If you buy large quantities, you now have to show an ID," Kamita said, "and the pharmacy has to report the sale."
Gelfius said the move in Washington is now to limit the amount of ephedrine in a product since neither the state nor the federal government has the resources "to prove that one particular product is safe.
"There are hundreds and hundreds of these products on the market after the law was liberalized."
The Navy Bureau of Medicine and Surgery believes products containing ephedrine alkaloids, also known as Ma Huang or ephedra, can have dangerous side effects if the label instructions are not followed carefully.
Ma Huang, a Chinese herb, is sold as a stimulant and weight-loss product.
Taken in combination with other natural caffeine substances, such as kola nut, Gelfius said, it can "cause serious medical problems."
Ephedrine alkaloids are found in dietary supplements as well as body-building and performance-enhancing drugs.At one time the FDA considered banning the dietary supplement if it was promoted for weight loss or body building and would have required a label warning that excessive intake of ephedra "may result in serious adverse health effects."
Vice Adm. Richard Nelson, Navy Surgeon General, said these dietary supplements can aggravate pre-existing medical conditions, alter human physiology and interact with prescription drugs.
"All three military services have documented medical cases where significant adverse events and deaths have occurred among active duty service members taking certain dietary supplements, specifically preparations containing ephedrine alkaloids."
Reported side effects include cardiac arrest, strokes, seizures, loss of consciousness, hyperactivity, lethargy, numbness and heat intolerance.
The Navy stopped the sale of the dietary supplements at Pearl Harbor and its exchanges in Japan on Feb. 1.
An Army spokesman at Fort Shafter said he was looking into the matter. An Air Force spokeswoman at Hickam Air Force Base said it has no policy dealing with ephedrine products.
In ordering the Marine Corps to discontinue of the sale of ephedrine products, Gen. James Jones, Marine Corps commandant, acknowledged that "dietary supplements, herbs, vitamins, and ergogenic agents have created a $12 billion industry in the United States.
"These products are increasingly popular among Marines and their families. By and large, dietary supplements are generally safe when used as directed.
"However, a growing number of products are marketed for weight loss, body building and performance enhancers. These products, while attractive to Marines' ever-vigilant pursuit of fitness, may place our active duty population at risk when used without adequate hydration, during temperature extremes and with physical exertion."
At the Kaneohe Bay's exchange the Marines have posted signs noting the risks associated in taking dietary supplements and that supplements containing ephedrine alkaloids are no longer being sold.
EXERCISE and a medical checkup are better remedies than relying on dietary supplements to lose weight and combat fatigue, says an island internist. Herb linked to death,
disabilityBy Gregg K. Kakesako
Star-Bulletin
Dr. Kathleen Kozak, internal medicine specialist at Straub Hospital, said a person will never correct problems such as fatigue and being overweight by using dietary supplements.
Even natural substances like the Chinese herb Ma Huang, containing ephedrine, have side affects that are very serious.
This is because ephedrine speeds up a person's metabolism.
But that could lead to "a false sense of increased energy, decreasing normal sleep patterns and could lead to other medical complications."
Other side effects include heart palpitations, increased levels of nervousness and anxiety, sleeplessness, headaches and in some cases numbness in parts of the body, such as the face.
Those complications could result in elevated blood pressure, heart attacks, strokes and other cardiovascular-related problems.
Diet pills also contain ephedrines.
In Alaska, a state jury on Wednesday awarded $13.3 million to a woman who suffered a debilitating stroke after taking a weight-loss product containing ephedrine. The Anchorage jury ordered E'Ola International of St. George, Utah, to pay Rosalie Talbert $12 million in punitive damages for creating an unsafe product, misrepresenting it as "all natural" when it contained synthetic ephedrine in additional to the herb ephedra. Last Friday, the jury had awarded $1.3 million in compensatory damages dealing with the product AMP II Pro drops.
Talbert, 34, had been using the drops for three years to lose weight. She won the verdict on a retrial.
Christine Haller and Neal Benowitz, in an article in The New England Journal of Medicine last year, said they reviewed 140 reports of adverse events dealing with supplements containing ephedra alkaloids reported to the Food and Drug Administration between June 1, 1997, and March 31, 1999.
"Ten events resulted in death," the two wrote in the Journal's Dec. 21 issue, "and 13 events produced permanent disability, representing 26 percent of the definite, probable and possible cases."
Thirty-one percent of 140 cases were considered to be related to the use of dietary supplements containing ephedra alkaloids and 31 percent were possibly related.
Of those cases deemed definitely, probably or possibly related to use of dietary supplements containing ephedrine, 47 percent involved cardiovascular systems and 18 percent involved the central nervous system.
"Hypertension was the single most frequent adverse effect (17 reports)," the two said, "followed by palpitations (13), stroke (10) and seizures (7)."
Ephedra alkaloids are found in dietary supplements as well as body-building and performance-enhancing drugs.
Never again. UH student had
jittery high before
crashingLeila Fujimori
Star-BulletinThat's what 23-year-old Biancha Yalung said after the two tablets of pure ma huang she ingested wore off.
A friend offered it to her while she was out dancing and that, she said, was her first and last time.
"I couldn't keep still," Yalung said. "I was always fidgety, even while sleeping."
The University of Hawaii senior said she was up a day and a half and slept just two hours during that period.
But when the effects wore off completely, Yalung fell asleep for a solid 12 hours.
"Once it wears out you can't even open your eyes," she said.
Yalung drank coffee, but nothing could keep her up.
She knows people who take four to six diet pills containing ephedra, the same ingredient in ma huang, for energy.
Yalung knew the herb had dangerous and sometimes deadly effects, but reasoned: "It's an herb, even though it has crack-like effects."
"I still did it because, you know, when you are young and you want to try things," Yalung said.
