ABSTRACT
Ephedra-containing products were available to consumers in the USA as dietary supplements following the enactment of the Dietary Supplement Health and Education Act (DSHEA, 1994)1 for almost a decade. These supplements, which were claimed to promote weight loss2,3 and to enhance physical performance4, were aggressively marketed. However, numerous, severe adverse event reports associated with the use of ephedra were received by the FDA during this period. A resulting in-depth review of all data by the FDA led to the conclusion that ephedra use presented an unreasonable risk of illness or injury to the consumer and ultimately led to the prohibition of sale of ephedra supplements in accordance with the DSHEA5 (Table 8.1). Although a few controlled clinical studies did report a short-term weight loss with supervised ephedra use (alone or in combination with caffeine)6,7, the risks of keeping ephedra on the market were considered to far outweigh any benefits. This chapter reviews the probable reasons that made ephedra-containing supplements hazardous and discusses possible measures that can be undertaken to make dietary supplements safer.
