title: Safety concerns regarding ephedrine-type alkaloid-containing dietary supplements.
abstract: OBJECTIVE
  The U.S. Air Force has adopted a policy "strongly discourag(ing) the use of ... ephedra." However, the literature regarding this topic is limited and widely opinioned. In light of growing public and medical debate over the safety and efficacy of ephedrine-type alkaloid-containing dietary supplements, a review of the literature and assessment of the data were accomplished.
  
  
  METHODS
  Studies regarding Ma Huang, ephedra, ephedrine-type alkaloids, ephedrine, and dietary supplements were reviewed (from databases Medline, HealthSTAR, CINAHL, Cochrane Clinical Trials Database). Food and Drug Administration and Government Accounting Office documents (including reports and interagency communications) were reviewed.
  
  
  RESULTS
  Significant manufacturing quality control issues exist. Few studies support their efficacy or safety. Weight loss and athletic performance appear to be only modestly improved, for short durations, in the setting of large numbers of (some serious) adverse event reports. Studies examining over-the-counter use are minimal.
  
  
  CONCLUSIONS
  The current U.S. Air Force policy strongly discouraging the use of ephedrine-type alkaloid-containing dietary supplements appears to be supported.
authors.affiliation: 74MDOS/SGOHE, 4881 Sugar Maple Drive, Wright Patterson Air Force Base, Wright State University, Dayton, OH 45433, USA.
authors.forename: Shannon Corey
authors.initials: SC
authors.lastname: Miller
mesh_terms: D018663:Adrenergic Agents / Q000009:adverse effects* / Q000494:pharmacology; D019587:Dietary Supplements; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence* / Q000639:trends; D029789:Ephedra / Q000737:chemistry; D004809:Ephedrine / Q000009:adverse effects* / Q000494:pharmacology; D006801:Humans; D008887:Military Medicine / Q000331:legislation & jurisprudence*; D014481:United States; D014486:United States Food and Drug Administration / Q000592:standards
chemical_list: D018663:Adrenergic Agents; D004809:Ephedrine