title: [Ma Huang, from dietary supplement to abuse].
abstract: Dietary supplements containing Ma Huang (chinease ephedra) are available on the web sites and dietary shops in USA. They are widely promoted and used as a mean of weight reduction and energy enhancement. They contain Ma Huang alone or combined with Guarana (caffeine), creatine, St John's wort, carnitine and are proposed with different labels. Numerous reports of adverse reactions and acute intoxication related to these products use were described in the medical literature. In the light of the severity of these cases, some of which resulted in permanent injury and death, the Food and Drug Administration has proposed limits on the dose and duration of use of such supplements. A review of 140 reports submitted to the FDA between June 1997 and March 1999, 47% involved cardiovascular symptoms, 18% neurological symptoms. Severe hypertension was the single most frequent adverse effect followed by tachycardia, myocardial infarction, stroke, seizure. Ten events resulted in death and 13 produced permanent impairment. In France, ampleness of the use of dietary supplements containing ephedra alkaloids is unknown. Two French recent severe poisonings (one with "ripped Fuel" for losing weight and the other with "Energy pills" in a body builder) show that there is serious health risks for the chronic users. Dietary supplements are not subject to control under "la Direction Générale de la Santé". Informations for general public, medical community and health-care authorities are necessary to be aware of potential health hazards of these products use.
authors.affiliation: Hôpital Salvator, Laboratoire de Toxicologie Centre antipoison 249 boulevard de Sainte Marguerite-13009 Marseille.
authors.forename: J
authors.initials: J
authors.lastname: Arditti
authors.forename: J H
authors.initials: JH
authors.lastname: Bourdon
authors.forename: M
authors.initials: M
authors.lastname: Spadari
authors.forename: L
authors.initials: L
authors.lastname: de Haro
authors.forename: N
authors.initials: N
authors.lastname: Richard
authors.forename: M
authors.initials: M
authors.lastname: Valli
mesh_terms: D002318:Cardiovascular Diseases / Q000139:chemically induced*; D019587:Dietary Supplements; D029790:Ephedra sinica / Q000009:adverse effects*; D005602:France; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D008517:Phytotherapy; D028321:Plant Preparations / Q000009:adverse effects* / Q000627:therapeutic use*; D011640:Public Policy; D012307:Risk Factors; D014481:United States; D015431:Weight Loss
chemical_list: D028321:Plant Preparations