by Mary J. Shomon
November 2000 -- The stimulant ephedra, an herbal component found in many popular over-the-counter diet, weight loss
and energy supplements and teas, poses too great a risk to warrant its use, according to [link
url=http://www.nejm.org/content/haller/1.asp]research on ephedra commissioned by the Food and
Drug Administration and reported by the New England Journal of Medicine in November of
Ephedra is contained in popular products such as Metabolife, Herbalife, Ripped Fuel, Diet-Phen, and
hundreds of other popular diet and energy products. An estimated 12 million Americans took a product
containing ephedra in 1999.
According to the research, the most common adverse effect of this supplement is hypertension (high blood
pressure,) followed by palpitations, rapid heartbeat (known as tachycardia), stroke, seizures, and death
- and these effects can occur in people who are young and otherwise healthy. According to experts, at
least 54 known deaths and about 1,000 reports of various complications have been associated with the
use of ephedra since the mid-1990s.
The FDA is proposing limits on the dose and duration of use of these supplements. The FDA has said
that it will determine by the end of the year whether to restrict ephedra or study it further.
The study was slated for publication in the December 21, 2000 issue of the New England Journal,
but results were released early by the journal due to the importance of the finding.
At the same time as publication of these findings, the New England Journalalso pushed up release
of information regarding a study on phenylpropanolamine, an ingredient in over-the-counter cold remedies and popular appetite
suppressants such as Dexatrim. The FDA is taking steps to ban PPA, phenylpropanolamine, because it
can cause strokes.
Implications for Thyroid Patients
Speaking to Reuter's Health, the study's lead investigator, Dr. Neal L. Benowitz of the University of
California, San Francisco said he believes that anyone with heart disease, high blood pressure, a previous
stroke, psychiatric problems, an overactive thyroid or kidney disease should steer clear of any products
contain ephedra and caffeine.
These products, including ephedra supplements and drugs containing the synthetic version
pseudoephedrine (i.e., Sudafed), already carry warnings for thyroid patients. The main concern was
assumed to be for those who are hyperthyroid, as some stimulant drugs can have an exaggerated response
in people with hyperthyroidism, and cause tachycardia in hearts already overstimulated by
But, as reported in my book, "Living Well With
Hypothyroidism," there are also potential concerns for people with hypothyroidism. There are
anecdotal reports of people with thyroid disease becoming extra-sensitive to stimulantsm, and in
particular, to the norepinephrine that is released by exposure to ephedra. As quoted in the book: ". . .
some people with hypothyroidism seem to develop sensitivities to caffeine, or to pseudoephedrine, and
even natural ephedra, an herb used in many diet and energy supplements. In my case, for example, I used
to be able to take a Sudafed without a problem. Now, I find I can only take half without developing some
heart palpitations. And I really have to be careful not to take it with a caffeinated beverage, or I definitely
have an hour of palpitations. I can take other cold products and antihistamines for example, without a
problem, so I typically will choose cold medicines that don't include pseudoephedrine to avoid the
problem I have with them. "
What CAN You Take?
The reality is, most of the over-the-counter diet drugs are not suitable for thyroid patients, and now,
according to the FDA, are a concern for those without thyroid conditions as well. If you are interested
in a diet supplement, you'll need to talk to a trained herbalist or naturopath about other options for weight
loss support that might be helpful, or consult your doctor about the prescription options available.
Also, make sure you're optimizing your own thyroid situation as relates to weight loss, by reading the Thyroid Diet & Weight Loss Guide,
which looks at the surprising reasons why it's so difficult to lose weight with
hypothyroidism - including metabolic set point, changes in brain chemistry, and insulin resistance. Also,
the article provides an indepth look at insulin resistance and thyroid disease, how to lose weight and fight
insulin resistance, and the essential books to help you in your fight.