tag:blogger.com,1999:blog-13621512053376622932024-03-05T05:32:30.317-08:00EPHEDRA SIDE EFFECTS-பக்க விளைவுகள் பக்க விளைவுகள்-HERBALIFE SIDE EFFECTS-EPHEDRA-SINICA- MA HAUNGHerbalife Side Effects:unpleasant side effects :Herbalife products:Bloating:Heart Palpitations:Stimulants:Stomach Acidity:Pregnancy:Rashes:GeneralDetoxing Effects:Bloating:Heart Palpitations:Stimulants:Stomach Acidity:Pregnancy:Rashes:GeneralDetoxing Effects:Caffeine Overload:Lead:Hypertension:Unsubstantiated Claims:Side Effects:Questionable Ingredients:Ephedra,cause psychosis,tremors,kidney stones,high blood pressure, sweats,rapid heartbeat, organs,strokes,seizures death:Shellfish:BowelHEALTH AND ISLAMhttp://www.blogger.com/profile/06536764381723086936noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-1362151205337662293.post-42104777793017964352012-11-12T10:13:00.001-08:002012-12-09T01:56:02.508-08:00HERBALIFE PLUS EPHEDRA பக்க விளைவுகள்<div dir="ltr" style="text-align: left;" trbidi="on">
<h3 class="post-title entry-title" itemprop="name" style="text-align: center;">
<span style="font-size: x-large;">SIDE EFFECTS பக்க விளைவுகள்</span><span style="font-size: x-large;"> </span></h3>
<div class="post-header">
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiczRClBp0hsxliRdFpMTN7TM-zEfW7FMCBGvHZdYGXWrvcxUeBqSrQcgz7MCWssL7DnmYUTe2y9g9cn6heg73tCJ9gC4XKGpCqFK5A4hDXaZUuX2Y9TTYHNGvHDXa4WPGJgKzvXAnm1zo/s1600/ephedrine.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="262" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiczRClBp0hsxliRdFpMTN7TM-zEfW7FMCBGvHZdYGXWrvcxUeBqSrQcgz7MCWssL7DnmYUTe2y9g9cn6heg73tCJ9gC4XKGpCqFK5A4hDXaZUuX2Y9TTYHNGvHDXa4WPGJgKzvXAnm1zo/s320/ephedrine.jpg" width="320" /></a></div>
<div dir="ltr" style="text-align: left;">
<div id="textbox1">
<div style="text-align: left;">
<span style="font-size: large;"><i><b> </b></i></span></div>
<h1 class="title" style="text-align: center;">
</h1>
<div style="text-align: left;">
<span style="font-size: large;"><i>
</i></span>
</div>
</div>
<div style="text-align: center;">
<span style="font-size: large;">
</span><span style="font-size: large;"><span style="font-size: x-large;"><i><b>Ephedra பக்க விளைவுகள் </b></i></span></span></div>
<br />
<span style="font-size: x-large;"><i><b><span style="font-weight: bold;"><span style="color: red;">Questionable Ingredients<br /><br />
Ephedra, a main ingredient in Herbalife, has been known to cause
psychosis, tremors, kidney stones, high blood pressure, sweats, rapid
heartbeat, and damage to the heart and other organs. It has been linked
to strokes, seizures and death.</span></span> </b></i></span><br />
<h3 class="post-title entry-title" itemprop="name" style="text-align: center;">
<a href="http://livertox.nlm.nih.gov/Ephedra.htm#casereport" target="_blank"><span style="font-size: x-large;">DRUG RECORD</span></a></h3>
<h2 style="text-align: center;">
<span style="font-size: x-large;"><a href="http://livertox.nlm.nih.gov/Ephedra.htm#casereport" target="_blank"> EPHEDRA (EPHEDRA</a> </span></h2>
<h2>
<span style="font-size: x-large;"> SINICA, MA HUANG)</span> </h2>
<div style="text-align: center;">
</div>
<h3>
<span style="font-size: large;"><b> Introduction </b></span></h3>
<span style="font-size: large;"></span>
<br />
<h3>
<span style="font-size: large;">
Ephedra has been used in traditional Chinese medicine (known as Ma
Huang) for centuries as a stimulant and antiasthmatic agent, and was
recently introduced into use in the United States and Europe as a weight
loss agent and aid in body building. Ephedra has been linked to
multiple potentially severe side effects including clinically apparent
liver injury and has been banned from sale in the United States and
elsewhere.
</span></h3>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZDgrysqWDrHvjcbWkUKa8nokzYhmWk7yUvlYzZpn1uNdZfZH6o9_iEufNUKfXO83D6OR4NBoi7f861HeBQFUqe5w-VPKumKyVaIGZ30K-aPDfuEoIQfaS1AP7QM6wdy7wHV7NpoyTBvw/s1600/628x471.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="298" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZDgrysqWDrHvjcbWkUKa8nokzYhmWk7yUvlYzZpn1uNdZfZH6o9_iEufNUKfXO83D6OR4NBoi7f861HeBQFUqe5w-VPKumKyVaIGZ30K-aPDfuEoIQfaS1AP7QM6wdy7wHV7NpoyTBvw/s320/628x471.jpg" width="320" /></a></div>
<br />
<span style="font-size: large;">
</span>
<br />
<h3>
<span style="font-size: large;"><b> Background </b></span></h3>
<span style="font-size: large;"></span>
<br />
<h3>
<span style="font-size: large;">
Ephedra is prepared from the aerial parts of plants belonging to the
genus Ephedra, family Ephedraceae. The 45 species of Ephedra are found
worldwide, but Ephedra sinica is used predominantly and is native to
China where it was first used therapeutically. Ephedra is an herbaceous
perennial with a strong pine odor and astringent taste which accounts
for its Chinese name – Ma Huang – which can be translated as “yellow
astringent” or “yellow hemp.” Ephedra is purported to increase mental
acuity and to improve sexual performance, increase circulation, and
decrease weight through an increase in sympathetic nervous system
activity and thermogenesis. It is also used for allergies, allergic
rhinitis, colds, flu, fever, chills, nasal congestion, bronchospasm and
asthma. The active ingredient of ephedra appears to be ephedrine and
other related sympathomimetic alkaloids, which probably account for its
therapeutic efficacy as well as its adverse effects. Ephedra was a
component of many herbal weight loss and body-building preparations,
including Ma Huang, <span style="color: red;"><span style="font-size: x-large;">Herbalife, </span></span>Hydroxycut and others. The typical dose
is 1.5 to 9 grams of the decocted herb daily or as herbal tea prepared
by boiling dried green stems in water. Side effects are not uncommon
and include nervousness, anxiety, palpitations, tachycardia,
gastrointestinal upset, nausea, diarrhea, headache, and dizziness.
Ephedra has also been implicated in an increased risk for myocardial
infarction, stroke and sudden death and was banned from sale in the
United States in April 2004.
</span></h3>
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSfhK-UvHjZwm_-NuhBq8aKdmzUV9duAQVCsZF_KUmvs2dzySP_T2yvolpNyfx0Ic4flP5Lwew0Hxw-wbYnfdkmoc8de7W8LM_RweFYI6bkTnbDrm4SbaIpxhp33rYb6kPZ8GwDXNkwVY/s1600/Heart_Attack.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="372" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSfhK-UvHjZwm_-NuhBq8aKdmzUV9duAQVCsZF_KUmvs2dzySP_T2yvolpNyfx0Ic4flP5Lwew0Hxw-wbYnfdkmoc8de7W8LM_RweFYI6bkTnbDrm4SbaIpxhp33rYb6kPZ8GwDXNkwVY/s400/Heart_Attack.jpg" width="400" /></a></div>
<span style="font-size: large;">
</span>
<span style="font-size: large;"><b>Hepatotoxicity </b></span><br />
<span style="font-size: large;"></span>
<br />
<h3>
<span style="font-size: large;">
Despite its apparent safe use for centuries in Chinese traditional
medicine, ephedra has been linked to many serious and potential fatal
side effects since its wide-scale use in Western countries for weight
loss. The major reported serious adverse events were cardiovascular,
including hypertension, palpitations, myocardial infarction, seizures,
transient ischemic attacks, cerebrovascular accidents and sudden death.
Ephedra preparations have also been implicated in more than a dozen
instances of clinically apparent, acute liver injury. The time to onset
has ranged from a few weeks to more than 6 months, but averages 12
weeks, presenting with symptoms of fatigue, nausea and abdominal
discomfort followed by jaundice. The serum enzyme elevations are
typically hepatocellular and the clinical syndrome resembles acute viral
hepatitis. Immunoallergic features (rash, fever and eosinophilia) are
uncommon as are autoantibodies. Recovery occurs within 1 to 6 months of
stopping the ephedra preparation, but instances with acute liver
failure and death or need for emergency liver transplantation have been
reported.
</span></h3>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3yeuPRXOv1EVWsxWMD3uqf1DbS56XiKpWUZRM8gLcmyH0nTW8936CrzFRLCCVGqemiLk_m7LHTtckGvvPCsfDSJwr0VI5navx_Ge6Fv5O7XGs0yBxiXYVtQ9VqhxU0Y9r2_c5Cw6FsdA/s1600/uchr_04_img0433.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="252" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3yeuPRXOv1EVWsxWMD3uqf1DbS56XiKpWUZRM8gLcmyH0nTW8936CrzFRLCCVGqemiLk_m7LHTtckGvvPCsfDSJwr0VI5navx_Ge6Fv5O7XGs0yBxiXYVtQ9VqhxU0Y9r2_c5Cw6FsdA/s320/uchr_04_img0433.jpg" width="320" /></a></div>
<span style="font-size: large;">
</span>
<span style="font-size: large;"><b>Mechanism of Injury </b></span><br />
<span style="font-size: large;"></span>
<br />
<h3>
<span style="font-size: large;">
Ephedra extracts contain multiple compounds including the
sympathomimetic alkaloids ephedrine, pseudoephedrine, methylephedrine
and norephedrine. The cardiovascular side effects and complications of
ephedra use have been attributed to these sympathomimetic constituents.
The liver injury has been attributed to ephedrine as well, but other
constituents may be responsible for this idiosyncratic liver injury.
</span></h3>
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGdbs3Mt4i3Y2sgtCamaV8mW98i8gh9yo4NS1fNkz2HWe61sTJCBdjcLVsa5lLC_uZDeYth45M6Jh8C7a2RvC6ATDPOh7erE62HjheSNmIQQaCvk5PCCGZa8kyHX9O9cx3HRxsUz5ZCzk/s1600/no-drugs-480-300x300+-+Copy.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGdbs3Mt4i3Y2sgtCamaV8mW98i8gh9yo4NS1fNkz2HWe61sTJCBdjcLVsa5lLC_uZDeYth45M6Jh8C7a2RvC6ATDPOh7erE62HjheSNmIQQaCvk5PCCGZa8kyHX9O9cx3HRxsUz5ZCzk/s320/no-drugs-480-300x300+-+Copy.jpg" width="281" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIz2w6TXoS3YldGfvrePCrcX1BRGvteNNylqqKFzjxNeuRWR6CvZzRgJfWFwZmSMlL_oTBCWCFNJ61LA0Z8uXWJKaBfKwjzE_wqFtWpF9COZiVIcs_u2FZOYig0cwkBeNw_OsLfmJEvFg/s1600/herbalife2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><br /></a></div>
<span style="font-size: large;">
</span><span style="font-size: x-large;">
<b>Outcome and Management </b></span><br />
<span style="font-size: large;"></span>
<br />
<h3>
<span style="font-size: large;">
The severity of liver injury due to ephedra ranges from mild,
asymptomatic elevations in serum enzymes to clinically apparent acute
liver injury and to acute liver failure. Chronic use of ephedra has
been linked to a chronic hepatitis-like syndrome, but recovery is prompt
when ephedra is stopped. There have been no instances of vanishing
bile duct syndrome attributed to ephedra. Recurrence of liver injury is
typical when ephedra is restarted, and rechallenge should be avoided.
There is no apparent cross sensitivity to liver injury between ephedra
and other weight loss agents or herbal preparations, but ephedra was
previously found in many commercial herbal preparations.<br /><br />
Other names: Ma Huang, belcho, Chinese ephedra, desert herb,
ephedrine, heral ecstasy, Joint fir, Mongolian ephedra, Pakistani
ephedra, popotillo, sea Grade, Teamster’s tea, yellow astringent, yellow
horse.
</span>
</h3>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3hZvvoescLLHdvRb1tJRWH78qAP2EK0bkUoizlkzlKO31DJx-DcjEIMsVBwZPPWT_ujpPpZdLMfifliAROOeC0vq6ZFsN5Q85cD-o_bBBgKqcsHodvd7ccq1nlpSkcWYz_WTkeOCaY7g/s1600/The-Dangers-of-Mixing-Caffeine-and-Alcohol-mdn.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="391" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3hZvvoescLLHdvRb1tJRWH78qAP2EK0bkUoizlkzlKO31DJx-DcjEIMsVBwZPPWT_ujpPpZdLMfifliAROOeC0vq6ZFsN5Q85cD-o_bBBgKqcsHodvd7ccq1nlpSkcWYz_WTkeOCaY7g/s400/The-Dangers-of-Mixing-Caffeine-and-Alcohol-mdn.jpg" width="400" /></a></div>
<div style="text-align: center;">
<span style="font-size: large;">
<b><span style="font-size: x-large;"> </span></b></span><b><span style="font-size: x-large;">
Drug Class: <a href="http://livertox.nlm.nih.gov/Herbals_and_Dietary_Supplements.htm">Herbals and Dietary Supplements</a></span></b></div>
<h3>
</h3>
<h3>
<span style="font-size: large;">
Other drugs within this class:
</span><ul style="margin-bottom: 0px;">
<li><span style="font-size: large;"><a href="http://livertox.nlm.nih.gov/ChineseAndOtherAsianHerbalMedicines.htm">Chinese And Other Asian Herbal Medicines</a></span>
<ul>
<li><span style="font-size: large;"><a href="http://livertox.nlm.nih.gov/BaJiaoLian.htm">Ba Jiao Lian</a>,
<a href="http://livertox.nlm.nih.gov/Ephedra.htm">Ephedra</a>,
Bol Gol Zhee,
<a href="http://livertox.nlm.nih.gov/Noni.htm">Noni</a>,
<a href="http://livertox.nlm.nih.gov/ChiRYun.htm">Chi R Yun</a>,
<a href="http://livertox.nlm.nih.gov/JinBuHuan.htm">Jin Bu Huan</a>,
<a href="http://livertox.nlm.nih.gov/ShoSaikoTo_DaiSaikoTo.htm">Sho Saiko To and Dai Saiko To</a>,
<a href="http://livertox.nlm.nih.gov/ShouWuPian.htm">Shou Wu Pian</a></span></li>
</ul>
</li>
</ul>
</h3>
<h3>
<span style="font-size: large;"><a href="http://livertox.nlm.nih.gov/Ephedra.htm#top">Top of page</a></span></h3>
<h3>
<span style="font-size: large;"> </span></h3>
<div id="textbox1">
<span style="font-size: large;"><b><span style="font-size: x-large;"><a href="http://www.blogger.com/blogger.g?blogID=162178159833053852" name="casereport">Case Report</a></span></b></span><span style="font-size: large;"><i>
Ephedra </i></span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIz2w6TXoS3YldGfvrePCrcX1BRGvteNNylqqKFzjxNeuRWR6CvZzRgJfWFwZmSMlL_oTBCWCFNJ61LA0Z8uXWJKaBfKwjzE_wqFtWpF9COZiVIcs_u2FZOYig0cwkBeNw_OsLfmJEvFg/s1600/herbalife2.jpg" style="margin-left: 1em; margin-right: 1em;"></a>
</div>
<span style="font-size: large;">
</span>
<br />
<h3>
<span style="font-size: large;">
Case 1. Acute hepatitis due to Ma Huang.<br />
[Modified from: Nadir A, Agrawal S, King PD, Marshall JB. Acute
hepatitis associated with the use of a Chinese herbal product, ma-huang.
Am J Gastroenterol 1996; 91: 1436-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8678010">PubMed Citation</a>]</span></h3>
<h3>
<span style="font-size: large;">
A 33 year old woman developed nausea and abdominal discomfort
a few days after starting Ma Huang for weight loss. She continued
taking the product for another 3 weeks when she noted jaundice and
sought medical attention. She had no history of liver disease, alcohol
abuse or risk factors for viral hepatitis and liver tests were known to
be normal two years earlier. She was taking no other medications.
Initially, she did not reveal that she was taking an herbal product. On
examination, she was jaundiced and had hepatic tenderness but no fever,
rash or signs of chronic liver disease. Laboratory tests showed raised
serum bilirubin (4.5 mg/dL) and prominent elevations in serum
aminotransferase levels (ALT 832 U/L, AST 376 U/L), with minimal
increase in alkaline phosphatase (178 U/L). Tests for hepatitis A, B
and C and a monospot were negative. Autoantibodies were present in
moderate titers with ANA 1:160 and SMA 1:80. Ultrasound and
computerized tomography of the liver were normal. She was initially
thought to have viral hepatitis and sent home. She restarted Ma Huang
but quickly felt worse, stopped and returned to the hospital where liver
tests were found to be worse (Table). A liver biopsy showed changes of
acute hepatitis with occasional eosinophils and plasma cells suggestive
of drug-induced liver disease. She stopped taking Ma Huang and when
seen four months later, all liver tests were again normal.</span></h3>
<div style="text-align: center;">
<span style="font-size: large;">
</span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNkIgqKGA5lu_3dh1g1VO5z3b1XtGlamVYn7EBMinORRyvLvKTJfc19O-ru3Whyg-7BhkDuQBql8QEVl0vGwC72X2NXzmkHwnZPCkUKs_9ncfRrC5KkO5bRp5Pw-Iz088iJiIyr8p-t3s/s1600/6a01310fae6765970c0177432ffbc3970d+-+Copy+-+Copy.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="80" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNkIgqKGA5lu_3dh1g1VO5z3b1XtGlamVYn7EBMinORRyvLvKTJfc19O-ru3Whyg-7BhkDuQBql8QEVl0vGwC72X2NXzmkHwnZPCkUKs_9ncfRrC5KkO5bRp5Pw-Iz088iJiIyr8p-t3s/s400/6a01310fae6765970c0177432ffbc3970d+-+Copy+-+Copy.jpg" width="400" /></a>
</div>
<h3>
<span style="font-size: x-large;"><b>Key Points</b></span></h3>
<span style="font-size: large;"><span style="font-size: x-large;">
</span></span>
<br />
<h3>
<table id="nobordertable">
<tbody>
<tr><td id="title"><span style="font-size: large;">Medication:</span></td><td><span style="font-size: large;">Ma Huang (Ephedra: unknown dose)</span></td></tr>
<tr><td id="title"><span style="font-size: large;">Pattern:</span></td><td><span style="font-size: large;">Hepatocellular (R=9.8)</span></td></tr>
<tr><td id="title"><span style="font-size: large;">Severity:</span></td><td><span style="font-size: large;">3+ (Jaundice, hospitalization)</span></td></tr>
<tr><td id="title"><span style="font-size: large;">Latency:</span></td><td><span style="font-size: large;">~4 Weeks</span></td></tr>
<tr><td id="title"><span style="font-size: large;">Recovery:</span></td><td><span style="font-size: large;">Within 16 Weeks</span></td></tr>
<tr><td id="title"><span style="font-size: large;">Other medications:</span></td><td><span style="font-size: large;">None</span></td></tr>
</tbody></table>
</h3>
<span style="font-size: large;">
</span>
<br />
<h3>
<span style="font-size: large;"><b>Laboratory Values</b></span></h3>
<span style="font-size: large;">
</span>
<br />
<table id="thinbordertable">
<tbody>
<tr id="title">
<th width="88"><span style="font-size: large;">Time After Starting</span></th>
<th width="82"><span style="font-size: large;">Time After Stopping</span></th>
<th width="67"><div style="margin-bottom: 0px; margin-top: 0px;">
<span style="font-size: large;">ALT </span></div>
<div style="margin-bottom: 0px; margin-top: 0px;">
<span style="font-size: large;">(U/L)</span></div>
</th>
<th width="75"><div style="margin-bottom: 0px; margin-top: 0px;">
<span style="font-size: large;">Alk P </span></div>
<div style="margin-bottom: 0px; margin-top: 0px;">
<span style="font-size: large;">(U/L)</span></div>
</th>
<th width="90"><span style="font-size: large;">Total Bilirubin (mg/dL)</span></th>
<th width="160"><span style="font-size: large;">Other</span></th>
</tr>
<tr>
<td><span style="font-size: large;"><br /></span></td>
<td><span style="font-size: large;"><br /></span></td>
<td colspan="4"><span style="font-size: large;">Ma Huang taken for 3-4 weeks</span></td>
</tr>
<tr>
<td><span style="font-size: large;">4 weeks </span></td>
<td><span style="font-size: large;">0</span></td>
<td><span style="font-size: large;">832</span></td>
<td><span style="font-size: large;">178</span></td>
<td><span style="font-size: large;">4.5</span></td>
<td><span style="font-size: large;"><br /></span></td>
</tr>
<tr>
<td><span style="font-size: large;"><br /></span></td>
<td><span style="font-size: large;"><br /></span></td>
<td colspan="4"><span style="font-size: large;">Ma Huang restarted for a few days</span></td>
</tr>
<tr>
<td><span style="font-size: large;">5 weeks </span></td>
<td><span style="font-size: large;">0</span></td>
<td><span style="font-size: large;">1586</span></td>
<td><span style="font-size: large;">175</span></td>
<td><span style="font-size: large;">8.0</span></td>
<td><span style="font-size: large;">Protime 13.2 seconds</span></td>
</tr>
<tr>
<td><span style="font-size: large;">5 months </span></td>
<td><span style="font-size: large;">4 months </span></td>
<td><span style="font-size: large;">40</span></td>
<td><span style="font-size: large;">51</span></td>
<td><span style="font-size: large;">0.5</span></td>
<td><span style="font-size: large;"><br /></span></td>
</tr>
<tr>
<td colspan="2"><span style="font-size: large;"><b>Normal Values</b></span></td>
<td><span style="font-size: large;"><b><65</b></span></td>
<td><span style="font-size: large;"><b><136</b></span></td>
<td><span style="font-size: large;"><b><1.2</b></span></td>
<td><span style="font-size: large;"><br /></span></td>
</tr>
</tbody></table>
<h3>
<span style="font-size: large;"><b>Comment</b></span></h3>
<h3>
<span style="font-size: large;">
A typical case of an acute hepatitis due to Ma Huang. The time to onset
was difficult to assess, because she reported having nausea and
abdominal discomfort “soon after” starting Ma Huang, but the time to
jaundice was about 4 weeks. The clinical presentation was similar to
acute viral hepatitis, which was the initial diagnosis, because the
patient did not admit to using an herbal product (and this was the first
report of Ma Huang related acute liver injury). The finding of
autoantibodies might suggest an autoimmune drug-induced hepatitis.
Immunoglobulin levels and serial ANA titers were not provided, but the
liver histology did not suggest autoimmune hepatitis. Moderate levels
of autoantibodies are not infrequent in cases of acute liver injury due
to Ma Huang, but autoimmune features (hyperglobulinemia, prolonged
course, response to corticosteroids) are not found.</span></h3>
<h3 style="text-align: center;">
<span style="font-size: large;"><span style="font-size: large;"><i><b><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEij-Cl_2U2AK7z1Fsc5uJIPcErGvtdqwTowDr3BDCQBFxtm1fho25JOw6YE4fb3W9gBnzR2_LzL2QTGPOOhC45zdGHIia3CxWBINdHBopQ2z6ft5l_QvM8pXKUiBPEC7dkj9BwP9jM2PkwH/s1600/herbalife+could+damage.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="81" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEij-Cl_2U2AK7z1Fsc5uJIPcErGvtdqwTowDr3BDCQBFxtm1fho25JOw6YE4fb3W9gBnzR2_LzL2QTGPOOhC45zdGHIia3CxWBINdHBopQ2z6ft5l_QvM8pXKUiBPEC7dkj9BwP9jM2PkwH/s320/herbalife+could+damage.jpg" width="320" /></a></b></i></span> </span></h3>
<br />
<span style="font-size: large;"><br /></span>
<br />
<div id="textbox2">
<span style="font-size: large;">SUMMARY & LABELING<br /><i>
Ephedra
</i></span>
</div>
<span style="font-size: large;">
</span>
<br />
<h3>
<center>
<span style="font-size: large;"><b>
REPRESENTATIVE TRADE NAMES<br />
</b>
Ephedra – Generic
</span></center>
</h3>
<h3>
<center>
<span style="font-size: large;"><b>
DRUG CLASS<br />
</b>
Herbals and Dietary Supplements
</span></center>
</h3>
<h2>
<center>
</center>
</h2>
<div style="margin-bottom: 0px;">
<span style="font-size: large;"><br /></span></div>
<h3 style="margin-top: 0px;">
<span style="font-size: large;"><a href="http://livertox.nlm.nih.gov/Ephedra.htm#top">Top of page</a></span></h3>
<span style="font-size: large;"><br /></span>
<br />
<div id="textbox1">
<span style="font-size: large;"><span style="font-size: x-large;"><b><a href="http://www.blogger.com/blogger.g?blogID=162178159833053852" name="structure">CHEMICAL FORMULA AND STRUCTURE</a></b></span><br /><i>
Ephedra
</i></span>
</div>
<span style="font-size: large;">
</span>
<br />
<table id="thinbordertable">
<tbody>
<tr id="title">
<th><span style="font-size: large;">DRUG</span></th>
<th><span style="font-size: large;">CAS REGISTRY NUMBER</span></th>
<th><span style="font-size: large;">MOLECULAR FORMULA</span></th>
<th><span style="font-size: large;">STRUCTURE</span></th>
</tr>
<tr>
<td><span style="font-size: large;">Ephedra</span></td>
<td><span style="font-size: large;">ID: OM54525000</span></td>
<td><span style="font-size: large;">Herbal mixture </span></td>
<td><span style="font-size: large;">Not applicable </span></td>
</tr>
</tbody></table>
<h3>
<span style="font-size: large;"><a href="http://livertox.nlm.nih.gov/Ephedra.htm#top">Top of page</a></span></h3>
<span style="font-size: large;"><br /></span>
<br />
<div id="textbox1">
<span style="font-size: large;"><a href="http://www.blogger.com/blogger.g?blogID=162178159833053852" name="reference">REFERENCES</a><br /><i>
Ephedra
</i></span>
</div>
<span style="font-size: large;">
</span>
<br />
<h3>
<span style="font-size: large;">
References Last Updated: 10 March 2012
</span></h3>
<span style="font-size: large;"><br /></span>
<br />
<ol>
<li><h3>
<span style="font-size: large;">
Zimmerman HJ. Unconventional drugs. Miscellaneous drugs and
diagnostic chemicals. In, Zimmerman, HJ. Hepatotoxicity: the adverse
effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia:
Lippincott,1999: pp. 731-4. <i>(Expert review of hepatotoxicity published in 1999; Chinese herbals are discussed but not Ma Huang or ephedra specifically).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Liu LU, Schiano TD. Hepatotoxicity of herbal medicines,
vitamins and natural hepatotoxins. In, Kaplowitz N, DeLeve LD, eds.
Drug-induced liver disease. 2nd ed. New York: Informa Healthcare USA,
2007, pp. 733-54. <i>(Review of hepatotoxicity of herbal and dietary
supplements [HDS] published in 2007; Ma Huang has been linked to
numerous instances of acute, clinically apparent liver injury presenting
with an acute hepatitis, often with fever, resolving rapidly on
stopping).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
No authors listed. Ma huang: ephedra sinica. In, PDR for Herbal
Medicines. 4th ed. Montvale, New Jersey: Thomson Healthcare Inc. 2007,
pp 543-52. <i>(Compilation of short monographs on herbal medications and dietary supplements).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Dulloo AG, Stock MJ. Ephedrine in the treatment of obesity. Int J Obesity 1993; 17(suppl 1): S1-2. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8384172">PubMed Citation</a> <i>(Ephedrine
is a sympathomimetic alkaloid found in several species of ephedra,
which acts as a thermogenic agent increasing the metabolic rate; the
safety of this approach to obesity has not been fully established).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Nadir A, Agrawal S, King PD, Marshall JB. Acute hepatitis
associated with the use of a Chinese herbal product, ma-huang. Am J
Gastroenterol 1996; 91: 1436-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8678010">PubMed Citation</a> <i>(33
year old woman developed nausea within days of starting Ma Huang for
weight loss, followed at 3 weeks by jaundice [bilirubin 4.5 rising to 8
mg/dL, ALT 832 U/L, Alk P 178 U/L, ANA 1:160, asterixis], resolving
within 4 weeks of stopping: Case 1).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Haller CA, Benowitz NL. Adverse cardiovascular and central
nervous system events associated with dietary supplements containing
Ephedra alkaloids. N Engl J Med 2000; 343: 1833-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11117974">PubMed Citation</a> <i>(Systematic
review of 140 reports of adverse events due to ephedra products
submitted to the FDA over a 2 year period; including hypertension,
palpitations, arrhythmias, myocardial infarction, seizures and stroke,
10 were fatal and 13 led to disability; no mention of hepatotoxicity).</i></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Borum ML. Fulminant exacerbation of autoimmune hepatitis after the use of Ma Huang. Am J Gastroenterol 2001; 96: 1654-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11374728">PubMed Citation</a> <i>(58
year old woman developed jaundice 4 months after starting Ma Huang for
weight loss [bilirubin 9.3 mg/dL, ALT 293 U/L, Alk P 320 mg/dL, protime
21.1 sec, SMA 1:320, ANA negative], developed ascites and was referred
for transplant, but resolved spontaneously after stopping herbal).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
De Smet PAGM. Herbal remedies. N Engl J Med 2002; 347: 2046-56. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12490687">PubMed Citation</a> <i>(Review
of status and difficulties of herbal medications, including lack of
standardization, federal regulation, contamination, safety,
hepatotoxicity and drug-herb interactions; specific discussion of 4
herbs with therapeutic promise: ginkgo, hawthorn, saw palmetto and St.
John’s wort).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Schiano TD. Hepatotoxicity and complementary and alternative medicines. Clin Liver Dis 2003; 7: 453-73. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12879994">PubMed Citation</a> <i>(Comprehensive
review of herbal associated hepatotoxicity; mentions a single case of
severe hepatitis attributed to Ma Huang [Nadir, 1996]).</i></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Bajaj J, Knox JF, Komorowski R, Saeian K. The irony of herbal
hepatitis: Ma-Huang-induced hepatotoxicity associated with compound
heterozygosity for hereditary hemochromatosis. Dig Dis Sci 2003; 48:
1925-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/14627335">PubMed Citation</a> <i>(44
year old man developed jaundice 4 months after starting Hydroxycut with
Ma Huang [bilirubin 3.5 mg/dL, ALT 3600 U/L], resolving within 1 month
of stopping; HFE testing revealed compound heterozygosity: C282Y/H63D).</i></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Pittler MH, Ernest E. Systematic review: hepatotoxic events
associated with herbal medicinal products. Aliment Pharmacol Ther 2003;
18: 451-71. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12950418">PubMed Citation</a> <i>(Systematic
review of published cases of hepatotoxicity due to herbal medications,
listing 52 case reports or case series, most common agents being
celandine [3], chaparral [3], germander [8], Jin Bu Huan [3], kava [1],
Ma Huang [3], pennyroyal [1], skullcap [2], Chinese herbs [9] and
valerian [1]).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Estes JD, Stolpman D, Olyaei A, Corless CL, Ham JM, Schwartz
JM, Orloff SL. High prevalence of potentially hepatotoxic herbal
supplement use in patients with fulminant hepatic failure. Arch Surg
2003; 138: 852-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12912743">PubMed Citation</a> <i>(Among
20 patients undergoing liver transplantation for acute liver failure
during 2001-2, 10 were potentially caused by herbals: 3 Ma Huang, 3
kava, 2 LipoKinetix, 1 chaparral, 1 skullcap and 2 miscellaneous Chinese
herbs).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Abourashed EA, El-Alfy AT, Khan IA, Walker L. Ephedra in perspective – a current review. Phytother Res 2003; 17: 703-12. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12916063">PubMed Citation</a> <i>(Review
of history, botany, chemistry, pharmacology, clinical efficacy and
safety of ephedra; by the year 2000, the FDA had received 1000 injury
reports, often attributed to misuse, abuse or mislabeling of the
product; only one report of hepatitis).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Russo MW, Galanko JA, Shrestha R, Fried MW, Watkins P. Liver
transplantation for acute liver failure from drug-induced liver injury
in the United States. Liver Transpl 2004; 10: 1018-23. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15390328">PubMed Citation</a> <i>(Among
~50,000 liver transplants reported to UNOS between 1990 and 2002, 270
[0.5%] were done for drug-induced acute liver failure, including 7 [5%]
for herbal medications, one due to chaparral and one to kava; Ma Huang
and ephedra not mentioned).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Nelson R. FDA issues alert on Ephedra supplements in the U.S.A. Lancet 2004; 363: 135. <a href="http://www.ncbi.nlm.nih.gov/pubmed/14733193">PubMed Citation</a> <i>(Report
on FDA ruling that ephedrine alkaloids present an unreasonable risk of
injury, after review of ~155 deaths blamed on ephedra).</i></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Neff GW, Reddy R, Durazo FA, Meyer D, Marrero R, Kaplowitz N.
Severe hepatotoxicity associated with the use of weight loss diet
supplements containing Ma Huang or usnic acid. J Hepatol 2004; 41:
162-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15582145">PubMed Citation</a> <i>(Review
of 12 patients with hepatotoxicity due to herbal weight loss agents, 10
due to Ma Huang [ephedra] with onset within 6 months in all but one
[bilirubin 9.9-45 mg/dL, ALT 664-10,265 U/L], 1 died and 2 underwent
liver transplantation, remaining recovered within 4-8 weeks).</i></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Skoulidis F, Alexander GJM, Davies SE. Ma huang associated acute
liver failure requiring liver transplantation. Eur J Gastroenterol
Hepatol 2005; 17: 581-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15827451">PubMed Citation</a> <i>(57
year old woman developed nausea soon after starting Ma Huang and
jaundice one week later [bilirubin 24.9 mg/dL, ALT 1061 U/L, Alk P 196
U/L], with progressive liver failure and transplantation, the explant
showing massive collapse).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Clark BM, Schofield RS. Dilated cardiomyopathy and acute liver
injury associated with combined use of ephedra, gamma-hydroxybutyrate,
and anabolic steroids. Pharmacotherapy 2005; 25: 756-61. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15899737">PubMed Citation</a> <i>(40
year old man developed congestive heart failure and jaundice several
months after starting anabolic steroids, ephedra and γ-hydroxybutyrate
[bilirubin 3.9 mg/dL, ALT 2173 U/L, Alk P normal, INR 1.9], with slow
recovery over next 18 months).</i></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Elinav E, Pinsker G, Safadi R, Pappo O, Bromberg M, Anis E,
Keinan-Boker L, et al. Association between consumption of Herbalife
nutritional supplements and acute hepatotoxicity. J Hepatol 2007; 47:
514-20. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17692424">PubMed Citation</a> <i>(12
cases of liver injury attributed to Herbalife products in Israel, 11
women, 1 man, ages 32 to 78 years, onset after 2 to 35 months [mean peak
bilirubin 9.1 mg/dL, ALT 1481 U/L, Alk P 282 U/L, 1 with ANA], on
stopping, 11 recovered and one died of hepatitis B reactivation; 3 had a
positive rechallenge).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Schoepfer AM, Engel A, Fattinger K, Marbet UA, Criblez D,
Reichen J, Zimmermann A, Oneta CM. Herbal does not mean innocuous: ten
cases of severe hepatotoxicity associated with dietary supplements from
Herbalife products. J Hepatol 2007; 47: 521-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17692989">PubMed Citation</a> <i>(10
cases of hepatotoxicity due to Herbalife products in Switzerland; ages
30-69 years, 3 men and 7 women, with onset after 2 to 144 months, 9 with
jaundice [bilirubin 0.4-28.2 mg/dL, ALT 4-50 times ULN, Alk P 1.1-6.5
times ULN], 2 with recurrence on rechallenge, 3 requiring liver
transplant, 1 with sinusoidal obstruction syndrome, 1 with cirrhosis).</i></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Stickel F. Slimming at all costs: Herbalife-induced liver injury. J Hepatol 2007; 47: 444-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17692988">PubMed Citation</a> <i>(Editorial
in reference to Schoepfer [2007] and Elinay [2007] discussing the
difficulties in assigning causality and identifying the toxic component
in herbal mixtures, many patients take multiple products and each
includes multiple components).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Duque JM, Ferreiro J, Salgueiro E, Manso G. [Hepatotoxicity
associated with the consumption of herbal slimming products]. Med
Clin(Barc) 2007; 128: 238-9. Spanish. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17335732">PubMed Citation</a> <i>(3
cases of hepatotoxicity attributed to Herbalife products, women ages
49-54 years, with onset of liver injury after 1, 6 and 36 months
[bilirubin 0.7, 0.8, and 26.6 mg/dL, ALT 138, 505 and 1890 U/L, Alk P
112, 166 and 425 U/L], resolving in all 3 upon stopping).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Chao S, Anders M, Turbay M, Olaiz E, Mc Cormack L, Mastai R.
[Toxic hepatitis by consumption Herbalife products: a case report].
Acta Gastroenterol Latinoam 2008; 38: 274-7. Spanish. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19157382">PubMed Citation</a> <i>(63
year old woman developed jaundice and pruritus 2.5 months after
starting Herbalife products [peak bilirubin 17.5 mg/dL, ALT 847 U/L, Alk
P 3 times ULN], resolving within 5 months of stopping).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Manso G, López-Rivas L, Duque JM, Salgueiro E. Spanish reports
of hepatotoxicity associated with Herbalife products. J Hepatol 2008;
49: 289-90; author reply 290-1. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18571274">PubMed Citation</a> <i>(Discussion
of 4 cases of Herbalife hepatotoxicity from Spain [3 reported by Duque
2007], 2 occurring in sisters, suggesting a genetic propensity and an
idiosyncratic drug reaction).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Ignarro L, Heber D, Henig YS, Bejar E. Herbalife nutritional
products and liver injury revisited. J Hepatol 2008; 49: 291-3; author
reply 293-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18550201">PubMed Citation</a> <i>(Comment
on publications on Herbalife hepatotoxicity [Elinav and Schoepfer 2007]
questioning whether their product was involved, as the product is used
by millions).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Chitturi S, Farrell GC. Hepatotoxic slimming aids and other herbal hepatotoxins. J Gastroenterol Hepatol 2008; 23: 366-73. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18318821">PubMed Citation</a> <i>(Review
of hepatotoxicity of herbal medications focusing upon those used for
weight loss including nitrosofenfluramine, usnic acid, ephedra,
germander, skullcap and green tea).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Dara L, Hewett J, Lim JK. Hydroxycut hepatotoxicity: a case
series and review of liver toxicity from herbal weight loss supplements.
World J Gastroenterol 2008; 14: 6999-7004. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19058338">PubMed Citation</a> <i>(Two
women ages 33 and 40 years with onset of symptoms 1 and 4 weeks after
starting Hydroxycut [bilirubin 0.7 and 20.9 mg/dL, ALT 1150 and 934 U/L,
Alk P 299 and 112 U/L], resolving rapidly, ingredients including green
tea but not ephedra; review of liver injury due to weight loss
supplements including Ma Huang, Lipokinetix, Kava, green tea, Shou Wu
Pian, germander and usnic acid).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
García-Cortés M, Borraz Y, Lucena MI, Peláez G, Salmerón J,
Diago M, Martínez-Sierra MC, et al. [Liver injury induced by “natural
remedies”: an analysis of cases submitted to the Spanish Liver Toxicity
Registry]. Rev Esp Enferm Dig 2008; 100: 688-95. Spanish. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19159172">PubMed Citation</a> <i>(Among
521 cases of drug-induced liver injury submitted to Spanish registry,
13 [2%] were due to herbals but none were attributed to ephedra or Ma
Huang).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T,
Serrano J, Yang H, Rochon J; Drug Induced Liver Injury Network(DILIN).
Causes, clinical features, and outcomes from a prospective study of
drug-induced liver injury in the United States. Gastroenterology 2008;
135: 1924-34. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18955056">PubMed Citation</a> <i>(Among
300 cases of drug-induced liver disease in the US collected between
2004 and 2008, 9% of cases were attributed to herbal medications).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Navarro VJ. Herbal and dietary supplement hepatotoxicity. Semin Liver Dis 2009; 29: 373-82. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19826971">PubMed Citation</a> <i>(Overview
of the regulatory environment, clinical patterns, and future directions
in research with HDS; specific discussion of Herbalife and traditional
Chinese herbal medicines).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Chen GC, Ramanathan VS, Law D, Funchain P, Chen GC, French S,
Shlopov B, et al. Acute liver injury induced by weight-loss herbal
supplements. World J Hepatol 2010; 2: 410-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21173910">PubMed Citation</a> <i>(Three
women, ages 31, 37 and 53 years, taking Hydroxycut or Herbalife for
weight loss developed jaundice 3, 4 and 12 months after starting product
[bilirubin 15.3, 29.9, and 18.2 mg/dL, ALT 1227, 2068 and 983 U/L, Alk P
268, 185 and 292 U/L], resolving within 2-3 months of stopping).</i></span></h3>
</li>
<li><h3>
<span style="font-size: large;">
Fong TL, Klontz KC, Canas-Coto A, Casper SJ, Durazo FA, Davern
TJ 2nd, Hayashi P, et al. Hepatotoxicity due to hydroxycut: a case
series. Am J Gastroenterol 2010; 105: 1561-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20104221">PubMed Citation</a> <i>(Details
of 17 US cases of hepatotoxicity due to Hydroxycut in the United States
between 2002-9, latency to onset 2 to 12 weeks [2 outliers at 1 and 2
years], hepatocellular pattern of injury, often severe, 4 were fatal or
led to liver transplantation).</i></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Jóhannsson M, Ormarsdóttir S, Olafsson S. [Hepatotoxicity
associated with the use of Herbalife]. Laeknabladid 2010; 96: 167-72.
Icelandic. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20197595">PubMed Citation</a> <i>(Five
cases of Herbalife hepatotoxicity found in a survey in Iceland; 4
women, 1 man, ages 29 to 78 years, after 1 to 7 months of use, 4 with
hepatocellular injury [bilirubin 1.5 to 18.2 mg/dL, ALT 456 to 2637 U/L,
Alk P 149 to 712 U/L], all resolving upon stopping).</i></span></h3>
</li>
<li>
<h3 style="margin-bottom: 0px; margin-top: 0px;">
<span style="font-size: large;">
Reuben A, Koch DG, Lee WM; Acute Liver Failure Study Group. Drug-induced acute<br />
liver failure: results of a U.S. multicenter, prospective study. Hepatology 2010; 52: 2065-76. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20949552">PubMed Citation</a>. <span style="color: black;">(Among
1198 patients with acute liver failure enrolled in a U.S. prospective
study between 1998 and 2007, 133 [11%] were attributed to drug
induced liver injury of which 12 [9%] were due to herbals including
usinic acid [2], thermoslim [1], ma huang [1], horny goat weed [1],
black cohosh [1], hydroxycut [1] and unspecified herbals [4]). </span></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;"><span style="color: #003366;">Molleston JP, Fontana RJ, Lopez MJ,
Kleiner DE, Gu J, Chalasani N: Drug-induced Liver Injury
Network. Characteristics of idiosyncratic drug-induced liver injury in
children: results from the DILIN prospective study. J Pediatr
Gastroenterol Nutr 2011; 53: 182-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21788760">PubMed Citation</a>. </span><span style="color: black;">(Among 30 children with suspected drug-induced liver injury, only one case was attributed to an herbal; hydroxycut).</span></span></h3>
</li>
<li>
<h3>
<span style="font-size: large;">
Stickel F, Kessebohm K, Weimann R, Seitz HK. Review of liver
injury associated with dietary supplements. Liver Int 2011; 31:
595-605. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21457422">PubMed Citation</a>. <span style="color: black;">(Review
of current understanding of liver injury from herbals and dietary
supplements focusing upon herbalife and hydroxycut products, green
tea, usnic acid, Noni juice, Chinese herbs, vitamin A and anabolic
steroids). </span></span></h3>
</li>
</ol>
<br />
<br />
<div id="textbox1">
<a href="http://www.blogger.com/blogger.g?blogID=162178159833053852" name="other_refs"></a><span style="font-size: large;"><b>OTHER REFERENCE LINKS<br /><i>
Ephedra
</i></b></span>
</div>
<br />
<ol>
<li>
<h3 style="margin-bottom: 0; margin-top: 0;">
<a href="http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search&db=pubmed&pubmedfilters=true&term=Ephedra+AND+Human%5BMH%5D+AND+%28drug+induced+liver+injury+OR+jaundice/CI+OR+bile+duct+diseases/CI+OR+liver/DE+OR+liver+diseases/CI%29+AND+%28%221900/1/1%22%5BEDat%5D%3A%222999/12/31%22%5BEDat%5D%29" target="_blank"><img align="middle" alt="PubMed logo" border="0" height="32" hspace="3" src="http://livertox.nlm.nih.gov/images/title_pubmed.gif" vspace="5" width="128" />Recent References on Ephedra</a> </h3>
</li>
<li>
<h3 style="margin-bottom: 0; margin-top: 0;">
<b><a href="http://clinicaltrials.gov/ct2/results?term=Ephedra" target="_blank"><img align="middle" alt="Clinical Trials logo" border="0" height="32" hspace="3" src="http://livertox.nlm.nih.gov/images/clinicaltrials.gif" vspace="5" width="128" />Trials on Ephedra</a></b></h3>
</li>
<li>
<h3 style="margin-bottom: 0; margin-top: 0;">
<a href="http://toxnet.nlm.nih.gov/cgi-bin/sis/search/r?dbs+toxline%3A%40and+Ephedra+%40rel+%28cholestasis+hepatocellular+jaundice+hepatitis+steatosis+transaminase+%22liver+disease%22+%22liver+function%22+%22autoimmune+reaction%22%29+%40not+%40org+pubmed+%40not+%40org+pubdart" target="_blank"><img align="middle" alt="TOXLINE logo" border="0" height="30" hspace="3" src="http://livertox.nlm.nih.gov/images/toxline_000.png" vspace="5" width="128" />TOXLINE Citations on Ephedra </a> </h3>
</li>
</ol>
</div>
</div>
HEALTH AND ISLAMhttp://www.blogger.com/profile/06536764381723086936noreply@blogger.com0tag:blogger.com,1999:blog-1362151205337662293.post-47353474999609414582012-11-11T03:52:00.000-08:002012-11-24T09:29:03.328-08:00WHAT IS EPHEDRINE ?<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-size: large;"><b><img align="BOTTOM" height="57" src="http://www.ephedrine-ephedra.com/pics/what_is_ephedrine.gif" width="340" /><br /><br />
<span style="font-size: x-large;">What is Ephedrine, Ephedra and Ma Huang?</span></b></span>
<br />
<span style="font-size: large;"><b>These terms are used to refer to the same substance derived
from the plant Ephedra. (There are many common names for these
evergreen plants, including squaw tea and Mormon tea.) Ephedra
is a shrub-like plant that is found in desert regions in central
Asia and other parts of the world. The dried greens of the plant
are used medicinally. Ephedra is a stimulant containing the herbal
form of ephedrine, an FDA-regulated drug found in over-the-counter
asthma medications.<br /><br />
In the United States, ephedra and ephedrine are sold in health
food stores under a variety of brand names. Ephedrine is widely
used for weight loss, as an energy booster, and to enhance athletic
performance. These products often contain other stimulants, such
as caffeine, which may have synergistic effects and increase
the potential for adverse effects. Ephedra is often touted as
the "herbal fen-phen."</b>
<b><img align="LEFT" height="144" src="http://www.ephedrine-ephedra.com/pics/ephedra_plant.gif" width="176" /></b></span><span style="font-size: large;"><b><br /><br /><br />
Ephedra's main active medical ingredients are the alkaloids ephedrine
and pseudoephedrine. The ephedras also contain various tannins
and related chemicals.The stem contains 1-3% total alkaloids,
with ephedrine accounting for 30-90% of this total. The concentrations
of these alkaloids depends upon the particular species of ephedra
used. </b>
<b><br /><br />
Ephedrine alkaloids are amphetamine-like compounds used in OTC
and prescription drugs with potentially lethal stimulant effects
on the central nervous system and heart. The FDA has received
more than 800 reports of adverse effects associated with use
of products containing ephedrine alkaloid since 1994. These serious
adverse effects, include hypertension (elevated blood pressure),
palpitations (rapid heart rate), neurophathy (nerve damage),
myopathy (muscle injury), psychosis, stroke, memory loss, heart
rate irregularities, insomnia, nervousness, tremors, seizures,
heart attacks, and death. The agency has proposed to prohibit
the marketing of dietary supplements containing 8 milligrams
or more of ephedrine alkaloids per serving.</b></span>
<br />
<br />
<span style="font-size: large;"><b> <img align="BOTTOM" alt="Ephedrine Legal Advice" border="0" height="113" ismap="ismap" src="http://www.ephedrine-ephedra.com/pics/ephedrine_ephedra.gif" usemap="#ephedrine_ephedra" width="520" /></b></span><br />
<span style="font-size: large;"><b></b></span><br />
<span style="font-size: large;"><b></b></span><br />
<span style="font-size: large;"><b></b></span><br />
<span style="font-size: large;"><b></b></span><br />
<span style="font-size: large;"><b><img align="BOTTOM" height="57" src="http://www.ephedrine-ephedra.com/pics/ephedrine_dangers.gif" width="340" /></b></span>
<br />
<br />
<a href="http://ephedrine-ephedra.com/pages/ephedrine_side_effects.html" target="_blank"><span style="font-size: large;"><b><span style="font-size: x-large;">Ephedra is one of the most dangerous of the dietary supplements.</span></b></span></a><br />
<span style="font-size: large;"><b></b></span><br />
<span style="font-size: large;"><b></b></span><br />
<span style="font-size: large;"><b></b></span><br />
<span style="font-size: large;"><b></b></span><br />
<div style="text-align: center;">
<span style="font-size: large;"><b><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCOOosY1FtzHsf3CFdQ2_wCMWXUFIU0-wBXVJPqnqllOv4Y6u5OhbtxxcJdSAAQ5K-w3SjS_z3BNxCu7sKX5I4sfK0H8hFza6KgHpQx3sgQ5TY0rizRWnO5_HwFLC0bdXnwPTmij0N1CU/s1600/The-Dangers-of-Mixing-Caffeine-and-Alcohol-mdn.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="313" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCOOosY1FtzHsf3CFdQ2_wCMWXUFIU0-wBXVJPqnqllOv4Y6u5OhbtxxcJdSAAQ5K-w3SjS_z3BNxCu7sKX5I4sfK0H8hFza6KgHpQx3sgQ5TY0rizRWnO5_HwFLC0bdXnwPTmij0N1CU/s320/The-Dangers-of-Mixing-Caffeine-and-Alcohol-mdn.jpg" width="320" /></a></b></span></div>
<br />
<span style="font-size: large;"><b>
Over 800 injuries have been reported by users and doctors to
the FDA and various state medical bodies, including more than
50 deaths.</b>
<b><br />
Most of these cases involve the heart attacks or high blood pressure
leading to bleeding in the brain or stroke.<br /><br /><img align="BOTTOM" height="57" src="http://www.ephedrine-ephedra.com/pics/50_deaths.gif" width="416" /></b></span>
<br />
<span style="font-size: large;"><b>Recent studies sho wthat many people are seriously injured
by the use of ephedrine. They are often unaware that ephedrine
suppliers are can make wide ranging health claims about the product
that have no scientific basis. Nor is there any mention of the
potential for dangerous side effects. Because the industry was
lobbyed to pass a law deregulating these products in l994, the
FDA has been unable to regulate these products.</b></span><br />
<hr align="LEFT" />
<span style="font-size: large;"><b><br /></b></span>
<br />
<center>
<span style="font-size: large;"><b><img align="BOTTOM" height="87" src="http://www.ephedrine-ephedra.com/pics/fda_warning.gif" width="400" /></b></span>
<table border="0" cellpadding="2" cellspacing="4" style="height: 210px; width: 571px;">
<tbody>
<tr>
<td width="49%"><span style="font-size: large;"><b>FDA statement on street drugs containing botanical
ephedrine<br /><br />FDA is warning consumers not to purchase or consume
ephedrine-containing dietary supplements with labels that often
portray the products as apparent alternatives to illegal street
drugs such as "ecstasy." Possible adverse effects of
ephedrine range from clinically significant effects such as heart
attack, stroke, seizures, psychosis, and death, to clinically
less significant effects that may indicate the potential for
more serious effects (for example, dizziness, headache, gastrointestinal
distress, irregular heartbeat, and heart palpitations). Ingredient
panels on these products may list ma huang, Chinese ephedra,
ma huang extract, ephedra, Ephedra sinica, ephedra extract, ephedra
herb powder, or epitonin, all of which indicate a source of ephedrine.</b></span>
</td>
<td width="51%"><center>
<span style="font-size: large;"><b> <img align="BOTTOM" height="125" src="http://www.ephedrine-ephedra.com/pics/bottles.gif" width="112" /></b></span></center>
</td>
</tr>
</tbody></table>
<hr />
</center>
<span style="font-size: large;"><b>Original FDA statement on Epedrine Regulation <br /><br />
The Food and Drug Administration proposed to reduce risks associated
with dietary supplement products containing ephedrine alkaloids
by limiting the amount of ephedrine alkaloids in products and
requiring labeling and marketing measures that give adequate
warning and information to consumers.</b></span>
<br />
<span style="font-size: large;"><b>Ephedrine alkaloids are amphetamine-like compounds with potentially
powerful stimulant effects on the nervous system and heart. Hundreds
of consumer illnesses and injuries associated with the use of
these products have been reported.</b></span><br />
<span style="font-size: large;"><b>The proposal would not ban dietary supplements that contain
ephedrine alkaloids.</b></span><br />
<span style="font-size: large;"><b>"Consumers should be aware that just because a product
is labeled 'natural' or from an herbal source it is not guaranteed
to be safe," said Dr. Michael Friedman, Deputy Commissioner
of Food and Drugs. "The effects of ephedrine alkaloids are
potentially powerful ones. We urge people to talk to their doctors
before using dietary supplements containing ephedrine alkaloids,
and to always use them with caution."</b></span><br />
<span style="font-size: large;"><b>Because ephedrine alkaloids are heart and nervous system stimulants,
certain individuals including those with hypertension, heart
conditions and neurologic disorders, should avoid their use.
Pregnant women, too, should avoid the use of dietary supplements
with ephedrine alkaloids.</b></span><br />
<span style="font-size: large;"><b>The proposal would prohibit the marketing of dietary supplements
containing 8 milligrams or more of ephedrine alkaloids per serving.
Labeling that recommends or suggests conditions of use that would
result in an intake of 8 mg or more in a 6-hour period or a total
daily intake of 24 mg or more also would not be allowed.</b></span><br />
<span style="font-size: large;"><b>In addition, the proposal would require label statements instructing
consumers not to use the product for more than 7 days, and would
not allow label claims for uses for which long-term intake would
be necessary to achieve the purported effect. These safety measures
are based on the fact that long-term intake of ephedrine alkaloids
increases the likelihood of serious adverse events.</b></span><br />
<span style="font-size: large;"><b>Another measure in the proposal would apply to products with
claims that encourage short-term excessive intake to enhance
the claimed effect, such as energy enhancement. Such products
would be required to bear a labeling statement that "Taking
more than the recommended serving may result in heart attack,
stroke, seizure or death."</b></span><br />
<span style="font-size: large;"><b>The proposal also would prohibit the use of other stimulant
ingredients such as botanical sources of caffeine with ephedrine
alkaloids because the combination increases the stimulant effects
of ephedrine alkaloids and the chance of consumer injury.</b></span><br />
<span style="font-size: large;"><b>Dietary supplement products containing ephedrine alkaloids
are currently sold for a variety of purposes including weight
loss, increased energy and body building.</b></span><br />
<span style="font-size: large;"><b>Since 1994, the agency has received and investigated more
than 800 reports of adverse events associated with the use of
these products. Reported adverse events range from episodes of
high blood pressure, irregularities in heart rate, insomnia,
nervousness, tremors and headaches, to seizures, heart attacks,
strokes and death. Most events occurred in young to middle aged,
otherwise healthy adults using the products for weight control
and increased energy.</b></span><br />
<span style="font-size: large;"><b>Ephedrine alkaloids in dietary supplements are usually derived
from one of several species of herbs of the genus Ephedra, sometimes
called Ma huang, Chinese Ephedra and epitonin. Other botanical
sources include Sida cordifolia.</b></span><br />
<span style="font-size: large;"><b>
The proposed measures were developed based on the FDA's review
of its adverse event reports, the scientific literature, and
public comments reviewed by the agency, including comments generated
by an October 1995 advisory working group public meeting and
an August 1996 public meeting of the FDA's Food Advisory Committee.
These experts suggested a number of steps the agency might take
to reduce injuries associated with use of dietary supplements
containing ephedrine alkaloids.</b></span><br />
<span style="font-size: large;"><b><br /></b></span>
<br />
<span style="font-size: large;"><b><img align="BOTTOM" alt="Ephedrine Legal Advice" border="0" height="113" ismap="ismap" src="http://www.ephedrine-ephedra.com/pics/ephedrine_ephedra.gif" usemap="#ephedrine_ephedra" width="520" /><br /><br /><br /><img align="BOTTOM" height="51" src="http://www.ephedrine-ephedra.com/pics/fda_warn.gif" width="332" /></b></span>
<br />
<br />
<span style="font-size: large;"><b><span style="color: #c53f3f;"><a href="http://www.ephedrine-ephedra.com/pages/ephedrine_FDA_456.html"><span style="font-size: x-large;">Lack of FDA Regulation</span></a><br />
<br />
</span>People are unaware that suppliers of ephedra products
are virtually free to make health claims about the substances
that have no scientific basis. People are also unaware of the
potentially deadly side effects of these products. Dietary supplements
are routinely marketed without undergoing a safety review by
FDA.</b></span><br />
<span style="font-size: large;"><b>A law known as the Dietary Supplements Health and Education
Act or "DSHEA," prevents the FDA from regulating these
products. Prior to the DSHEA, dietary supplements were in regulatory
limbo. The FDA claimed it had the power to regulate them and
tried to make the manufacturers and suppliers prove their safety
claims for their products.</b></span><br />
<span style="font-size: large;"><b>The DSHEA reduced the FDA's and federal control over these
products, compared with food and drugs, which are subjected to
strict regulation and compliance mointering by the FDA. Under
the DSHEA, dietary supplements like ephedrine are loosely defined
as products intended to supplement the diet. These supplements
contain herbs, minerals, amino acids, vitamins and combinations
of these things. The supplement industry can sell any product
that meets that definition in stores and its supplier can make
claims about its alleged healthful qualities.</b></span><br />
<span style="font-size: large;"><b><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWnZQFGQYJgWfCP17xIoupEPQVparZhqZaijTSuCVB5XKR-XrmoIFF_plEd25A0nuY0CvD89sokvaarIwm0L5V6KLf6JTVOfjhIPs6B1EoQnBBDOQYTElDfxBP1iy0e8Q0cqZXSzgpkY0/s1600/no-drugs-480-300x300+-+Copy.jpg" style="margin-left: 1em; margin-right: 1em;"></a></b></span><br />
<span style="font-size: large;"><b><span style="color: #c53f3f;">Increased Use</span></b></span>
<br />
<span style="font-size: large;"><b>Herbal usage in the United States has increased dramatically
since the passage of the DSHEA. In 1997, 60 million Americans
spent $3.24 billion on herbs for reasons such as migraines, hypertension,
depression, weight loss, and sexual stamina. An estimated 15
million adults are at risk for potential herb-drug interactions.</b></span><br />
<span style="font-size: large;"><b></b></span><br />
<div style="text-align: center;">
<span style="font-size: large;"><b><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWnZQFGQYJgWfCP17xIoupEPQVparZhqZaijTSuCVB5XKR-XrmoIFF_plEd25A0nuY0CvD89sokvaarIwm0L5V6KLf6JTVOfjhIPs6B1EoQnBBDOQYTElDfxBP1iy0e8Q0cqZXSzgpkY0/s1600/no-drugs-480-300x300+-+Copy.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWnZQFGQYJgWfCP17xIoupEPQVparZhqZaijTSuCVB5XKR-XrmoIFF_plEd25A0nuY0CvD89sokvaarIwm0L5V6KLf6JTVOfjhIPs6B1EoQnBBDOQYTElDfxBP1iy0e8Q0cqZXSzgpkY0/s320/no-drugs-480-300x300+-+Copy.jpg" width="281" /></a></b></span></div>
<br />
<span style="font-size: large;"><b><span style="color: #c53f3f;">Deceptive Marketing<br />
</span><br />
The deception occurs when the supplements industry selects brand
names or uses wording on labels such as "fat burner"
or "detoxifies" or "natural viagra" or the
"#1 rated herbal" for impotence or "herbal fen-phen"
to suggest the impossible. Under DSHEA, a herbal product label
can state the way the product is intended to affect "the
structure or function" of the body but cannot claim its
use for a specific disease. Manufacturers use creative borderline
language that complies technically with the law, but is generally
confusing and deceptive. For example, one manufacturer claims
its product "promotes regularity" instead of "treats
constipation." How many consumers can discern the difference?
Rather than stating Echinaeu "treats the flu" one manufacturer
deftly says its product "promotes wellness during the flu
season." These types of misleading claims are apparently
permissible under the new laws and mislead consumers into believing
these products are safe, when many clearly can have serious side
effects.</b></span><br />
<span style="font-size: large;"><b> </b>
<b><br /><br /><span style="color: #c53f3f;">Ephedrine<br />
<br />
</span></b></span><span style="font-size: large;"><b>Some companies have named their ephedrine tablets
after illegal street drugs such as "Ecstasy" and "Black
Beauties," as well as brand names such as Easy Trim, Advocare,
Metabolite, Metab-Rx Ultar, Epitonin, Chinese Ephedra, Metabolife
356 and Ripped Fuel. Other manufacturers have taken a more subtle
approach to sell their ephedrine products. These companies make
representations that they are vitamin or nutrition companies
that sell only "natural" diet supplements. Drug companies
have taken advantage of the current status of ephedrine and have
attempted to produce a "legal" </b></span><br />
<br />
<div style="text-align: center;">
<span style="font-size: large;"><b> </b></span><span style="font-size: large;"><b><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCOOosY1FtzHsf3CFdQ2_wCMWXUFIU0-wBXVJPqnqllOv4Y6u5OhbtxxcJdSAAQ5K-w3SjS_z3BNxCu7sKX5I4sfK0H8hFza6KgHpQx3sgQ5TY0rizRWnO5_HwFLC0bdXnwPTmij0N1CU/s1600/The-Dangers-of-Mixing-Caffeine-and-Alcohol-mdn.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="313" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCOOosY1FtzHsf3CFdQ2_wCMWXUFIU0-wBXVJPqnqllOv4Y6u5OhbtxxcJdSAAQ5K-w3SjS_z3BNxCu7sKX5I4sfK0H8hFza6KgHpQx3sgQ5TY0rizRWnO5_HwFLC0bdXnwPTmij0N1CU/s320/The-Dangers-of-Mixing-Caffeine-and-Alcohol-mdn.jpg" width="320" /></a> </b></span></div>
<span style="font-size: large;"><b>amphetamine by mixing
ephedrine with other stimulants such as caffeine. Ephedrine use
is highly popular among college students and people who work
out. Most remain completely unaware of the potential dangers
of these products.</b>
<b><br /><br /><span style="color: #c53f3f;">Natural Herbs</span></b>
<b><br /><br />
People continue to believe that because herbs are "natural"
they are therefore, harmless. However, many herbal remedies are
dangerous. Many can interact with prescription medication. Some
herbs become toxic if taken with certain drugs, and fatal herb-drug
interactions can occur.</b></span>
<br />
<span style="font-size: large;"><b>"Herbs are not regulated the same as other dietary supplements,"
says Donald D. Hensrud, M.D., a consultant in preventive medicine
and endocrinology at Mayo Clinic in Rochester, Minn. "This
means they can be misidentified, contaminated or contain multiple
ingredients. There is no quality control for herbs."</b></span><br />
<span style="font-size: large;"><b>"Patients electing to use herbal supplements for a serious
disease in place of proven therapy are truly taking their lives
in their own hands," says Thomas P. Moyer, Ph.D., director
of the toxicology laboratory at Mayo Clinic, Rochester. "The
growing trend of self-therapy is very concerning."</b></span>
<br />
<hr align="LEFT" />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWnZQFGQYJgWfCP17xIoupEPQVparZhqZaijTSuCVB5XKR-XrmoIFF_plEd25A0nuY0CvD89sokvaarIwm0L5V6KLf6JTVOfjhIPs6B1EoQnBBDOQYTElDfxBP1iy0e8Q0cqZXSzgpkY0/s1600/no-drugs-480-300x300+-+Copy.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWnZQFGQYJgWfCP17xIoupEPQVparZhqZaijTSuCVB5XKR-XrmoIFF_plEd25A0nuY0CvD89sokvaarIwm0L5V6KLf6JTVOfjhIPs6B1EoQnBBDOQYTElDfxBP1iy0e8Q0cqZXSzgpkY0/s320/no-drugs-480-300x300+-+Copy.jpg" width="281" /></a></div>
<br />
<span style="font-size: large;"><b><span style="color: #c53f3f;">Excerpts from an article on the dangers
of herbal supplements from<br />
Journal of The New England Journal of Medicine</span><br /><br />
Now, with the increased interest in alternative medicine, we
see a reversion to irrational approaches to medical practice,
even while scientific medicine is making some of its most dramatic
advances. Exploring the reasons for this paradox is outside the
scope of this editorial, but it is probably in part a matter
of disillusionment with the often hurried and impersonal care
delivered by conventional physicians, as well as the harsh treatments
that may be necessary for life-threatening diseases.</b></span>
<br />
<span style="font-size: large;"><b>Fortunately, most untested herbal remedies are probably harmless.
In addition, they seem to be used primarily by people who are
healthy and believe the remedies will help them stay that way,
or by people who have common, relatively minor problems, such
as backache or fatigue. Most such people would probably seek
out conventional doctors if they had indications of serious disease,
such as crushing chest pain, a mass in the breast, or blood in
the urine. Still, uncertainty about whether symptoms are serious
could result in a harmful delay in getting treatment that has
been proved effective. And some people may embrace alternative
medicine exclusively, putting themselves in great danger. In
this issue of the Journal, Coppes et al. describe two such instances.</b></span><br />
<span style="font-size: large;"><b>Also in this issue, we see that there are risks of alternative
medicine in addition to that of failing to receive effective
treatment. Slifman and her colleagues report a case of digitalis
toxicity in a young woman who had ingested a contaminated herbal
concoction. Ko reports finding widespread inconsistencies and
adulterations in his analysis of Asian patent medicines. LoVecchio
et al. report on a patient who suffered central nervous system
depression after ingesting a substance sold in health-food stores
as a growth hormone stimulator, and Beigel and colleagues describe
the puzzling clinical course of a patient in whom lead poisoning
developed after he took an Indian herbal remedy for his diabetes.
These are without doubt simply examples of what will be a rapidly
growing problem.</b></span><br />
<span style="font-size: large;"><b>What about the FDA? Shouldn't it be monitoring the safety
and efficacy of these remedies? Not any longer, according to
the U.S. Congress. In response to the lobbying efforts of the
multibillion-dollar "dietary supplement" industry,
Congress in 1994 exempted their products from FDA regulation.
(Homeopathic remedies have been exempted since 1938. Since then,
these products have flooded the market, subject only to the scruples
of their manufacturers. They may contain the substances listed
on the label in the amounts claimed, but they need not, and there
is no one to prevent their sale if they don't. In analyses of
ginseng products, for example, the amount of the active ingredient
in each pill varied by as much as a factor of 10 among brands
that were labeled as containing the same amount. Some brands
contained none at all.</b></span><br />
<span style="font-size: large;"><b>Herbal remedies may also be sold without any knowledge of
their mechanism of action. In this issue of the Journal, DiPaola
and his colleagues report that the herbal mixture called PC-SPES
(PC for prostate cancer, and spes the Latin for "hope")
has substantial estrogenic activity. Yet this substance is promoted
as bolstering the immune system in patients with prostate cancer
that is refractory to treatment with estrogen. Many men taking
PC-SPES have thus received varying amounts of hormonal treatment
without knowing it, some in addition to the estrogen treatments
given to them by their conventional physicians.</b></span><br />
<span style="font-size: large;"><b>The only legal requirement in the sale of such products is
that they not be promoted as preventing or treating disease.
To comply with that stipulation, their labeling has risen to
an art form of doublespeak (witness the name PC-SPES). Not only
are they sold under the euphemistic rubric "dietary supplements,"
but also the medical uses for which they are sold are merely
insinuated. Nevertheless, it is clear what is meant. Shark cartilage
(priced in a local drugstore at more than $3 for a day's dose)
is promoted on its label "to maintain proper bone and joint
function," saw palmetto to "promote prostate health,"
and horse-chestnut seed extract to "promote... leg vein
health." Anyone can walk into a health-food store and unwittingly
buy PC-SPES with unknown amounts of estrogenic activity, plantain
laced with digitalis, or Indian herbs contaminated with heavy
metals. Caveat emptor. The FDA can intervene only after the fact,
when it is shown that a product is harmful.</b></span><br />
<br />
<div style="text-align: center;">
<span style="font-size: large;"><b><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCOOosY1FtzHsf3CFdQ2_wCMWXUFIU0-wBXVJPqnqllOv4Y6u5OhbtxxcJdSAAQ5K-w3SjS_z3BNxCu7sKX5I4sfK0H8hFza6KgHpQx3sgQ5TY0rizRWnO5_HwFLC0bdXnwPTmij0N1CU/s1600/The-Dangers-of-Mixing-Caffeine-and-Alcohol-mdn.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="313" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCOOosY1FtzHsf3CFdQ2_wCMWXUFIU0-wBXVJPqnqllOv4Y6u5OhbtxxcJdSAAQ5K-w3SjS_z3BNxCu7sKX5I4sfK0H8hFza6KgHpQx3sgQ5TY0rizRWnO5_HwFLC0bdXnwPTmij0N1CU/s320/The-Dangers-of-Mixing-Caffeine-and-Alcohol-mdn.jpg" width="320" /></a> </b></span></div>
<span style="font-size: large;"><b><br /></b></span>
<br />
<a href="http://www.ephedrine-ephedra.com/pages/ephedra_products.html" target="_blank"><span style="font-size: x-large;"><b>Ephedra Containg Products</b></span></a><br />
<table border="0" cellpadding="4" cellspacing="4" style="height: 408px; width: 557px;">
<tbody>
<tr>
<td valign="TOP" width="50%"><span style="font-size: large;"><b><br />
Ephedrine products are sold under dozens of brand names, to the
right are some of the more popular brands.<br /><br />
The products are sold for a variety of reasons: ranging from
weight loss to engery for work outs.</b>
<b><br /><br />
Many consumers may not be aware of the ephedra in the products
or the levels or potency of the products.</b></span>
<br />
<span style="font-size: large;"><b>If you have taken one of these products and have been injured
you may want to <a href="http://www.ephedrine-ephedra.com/pages/case_submit_ephedrine_2007.html">Contact
Ephedra Injury Lawyers</a></b></span>
</td>
<td width="50%"><span style="font-size: large;"><b>Product list:<br /><br />
Metabolife 356® (Metabolife International) </b>
<b><br /><br />
Ripped Fuel (TwinLab Laboratories) </b>
<b><br />
Extreme Ripped Force (American Bodybuilding) <br />
Diet Fuel (Twin Laboratories) <br />
GH Fuel (TwinLab Laboratories) <br />
Herba Fuel (TwinLab Laboratories) <br />
MetaboLift (TwinLab Labortories) <br />
ThermiCare® (Met-Rx USA) <br />
ETA Stack® (Nutra Sport) <br />
Xenadrine RFA-1® (Cytodyne Technologies) <br />
Ultimate Orange (Next Nutrition, Inc) <br />
UltraCuts (BioPlex) <br />
Vasopro (Mega Pro International) <br />
Adipokinex (Syntrax Innovations, Inc) <br />
ThermoPlex (Bioplex) <br />
Thermogenic Power (Nature's Herbs) <br />
Chinese Ephedra (Frontiers, Inc.) <br />
MetaCuts (Metaform) <br />
Chinese Ma Huang (Gaia Herbs, Inc) <br />
Lipokinetix (Syntrax Innovations, Inc) <br />
Clenbutrx (Vital Pharm, Inc) <br />
BetaLean HP (EAS) <br />
Diet Pep (Natural Balance, Inc) <br />
Diurlean (ISS Research) <br />
Dyma-Burn Xtreme (Dymatize Nutrition)</b></span></td>
</tr>
</tbody></table>
<span style="font-size: large;"><b><br /></b></span>
<br />
<div style="text-align: center;">
<h1 class="headline entry-title">
<span style="font-size: large;"><span style="color: red;"><b>FOR MORE DETIAL <a href="http://herbalife-sideeffects.blogspot.in/">http://herbalife-sideeffects.blogspot.in</a></b></span></span></h1>
</div>
</div>
HEALTH AND ISLAMhttp://www.blogger.com/profile/06536764381723086936noreply@blogger.com1