Controlled burn: How ephedrine-based fat-burners work and how you can use them properly

Muscle & Fitness/Hers, Feb-March, 2002

by Beth Sonnenburg

Sarah (*) was about two months from the body of her dreams, but her extreme diet and demanding training schedule left her drained and even depressed. "I mostly took a fat-burner for energy, but near the end I took it to kick my metabolism into high gear," she says. "I felt like I needed help to get the results I wanted."

After adding an ephedrine-based supplement to her diet-and-exercise regimen, Rachel (*) explains: "It's been easier to lose the abdominal fat that had plagued my self-esteem for the past few years. I use it as a thermogenic supplement primarily, and secondarily as an energy-booster to exercise."

Looking to burn calories more efficiently and quickly, Amanda (*) gradually increased her intake of her fat-burner of choice from the recommended dosage to three pills three times a day. "I was losing weight, but I began to feel I couldn't work out as intensely as I had before because my heart rate was so elevated, I felt sick and would break into a cold sweat. I felt jittery and clammy all the time," she states.

Providing just a glimpse into the popularity of ephedrine-based fat-burners, these three letters are among hundreds submitted by M&F HERS readers around the country. Many share the same story -- wanting that extra boost to stimulate weight loss and increase energy for training. While many readers praised the products unconditionally, others reported mild to severe side effects such as chest pain, dizziness and insomnia, causing them to discontinue use.

We know ephedrine-based fat-burners do work in many cases for many people, but they certainly aren't without risk. If you choose to take these products, here's what you need to know about their effectiveness, the risks involved and how to minimize your probability of experiencing adverse effects.

What is it?
Ephedrine comes from a plant called ephedra, a perennial shrub with about 40 different species that grow in regions of Asia, Europe, North America and South America. Many of the Asian and European varieties contain active constituents called ephedrine alkaloids (EAs). Ephedrine is the major EA. Chinese ephedra plants are known as mahuang, meaning "yellow astringent." (Ephedrine also occurs in the heartleaf plant Sida cordifolia.) In his newsletter "The Dietary Supplement," Paul Thomas, EdD, RD, notes that the Chinese have used mahuang for more than 5,000 years to treat conditions including asthma, colds, fever and even malaria.

Ephedrine products, sometimes called thermogenics, are sold in pill, drink and even bar form. They're often combined with caffeine and/or aspirin, as well as a variety of other herbs touted to help burn fat. Caffeine is often added or "stacked" to ephedrine-based products, as it enhances and prolongs ephedrine's effects; the herb guarana is also a source of caffeine. "Studies suggest that ephedra works better with caffeine [up to 240 mg/day] for weight loss," says Thomas. If you do take a product stacked with ephedrine and caffeine, be especially cognizant of your caffeine intake at other times of the day. "Those consuming large quantities of [caffeinated] coffee, tea and soft drinks are at greater risk of adverse effects," notes Cliff Morris, MD, medical director of cardiac rehabilitation at the John Randolph Medical Center in Hopewell, Virginia. Especially if you consume ephedrine, limit your caffeine intake to 300 mg/day; 6 ounces of regular brewed coffee contains 103 mg caffeine. Additionally, stay well hydrated, as caffeine has a diuretic effect. We don't recommend stacking the two if you're sensitive to ephedrine or you're a heavy caffeine user.

You might also find aspirin, caffcine and ephedrine (ECA) in what's called an ECA stack. "[Aspirin] is often added to fat-burner products because it appears to reduce urinary excretion of ephedrine, thus keeping it in the blood longer and prolonging ephedrine's stimulating effects," explains Sheri Barke, MPH, PD, a nutritionist at the UCLA Arthur Ashe Student Health and Wellness Center Salicin, a compound similar to aspirin, is often used in place of aspirin in an ephedrine stack "Because salicin can prolong ephedtine's stimulating effects, it increases ephedra's potential risks," Thomas explains.

How it works
Heard of the "fight or flight" reaction? In response to a stressful situation, your sympathetic nervous system gears up to either go to battle or escape a situation immediately. Heart rate and blood pressure increase to prepare the body for action. Ephedrine mimics the effects of epinephrine and norepinephtine, the two naturally occurring chemicals in the body primarily responsible for the fight or flight syndrome. When you take ephedrine, then, you're basically stimulating your sympathetic nervous system, causing:

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  • a faster heartbeat, increased force of heart contraction and increased blood flow
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  • increased blood pressure
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  • increased thermogenesis (the body's heat production, generated by calorie-burning)
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  • increased blood flow to the brain
  • slightly increased basal metabolic rate.
  • The bottom line is that ephedrine may cause you to bum a few more calories and "rev up" your metabolism slightly. It may also act as an appetite suppressant by affecting the brain's hypothalamus, which regulates hunger and satiation.

    In addition to metabolic effects, EAs work as bronchodilators. "Ephedra [ephedrine] acts on the bronchial smooth muscles to promote relaxation during asthmatic attacks," explain Jacqueline Berning and Suzanne Steen in the Journal Nutrition for Sport & Exercise (Aspen, 1998). Hence, you'll often find synthetic ephedrine and pseudoephedrine in over-the-counter medications for asthma, hayfever and nasal congestion.

    Ephedrine can definitely be effective in weight loss. Honestly, you'd be hard-pressed to find a fitness competitor who doesn't use such products for an extra metabolic kick before a competition. If used as part of a healthy, balanced diet and exercise regimen, a low to moderate dose of ephedrine just might give you that fat-burning boost you've been looking for as long as you don't experience any side effects.

    Warning sings

    Ephedrine interacts with many other substances and can be potentially dangerous for users with a pre-existing medical condition of which they may not even be aware. However, implicating ephedrine in a serious reaction is hardly a black-and-white issue. "It is very difficult to establish a direct causal link between an 'event' and ephedra usage," notes Dr. Morris. "Essentially, the older you are and the more medical conditions you have, particularly involving the cardiovascular or central nervous system, the more likely you are to experience an adverse event."

    These include increased blood pressure, arrhythmias [heart rate irregularities], insomnia, nervousness [anxiety], tremors, headaches, seizures, heart attacks and strokes, explains Barke. You'll find hundreds of "adverse event reports" such as these on the U.S. Food and Drug Administration's website, but such events are self-reported by consumers and difficult to authenticate. Countless sports organizations have banned the substance, including the International Olympic Committee, NCAA and the NFL.

    Further, individual susceptibility varies greatly -- while one person may experience very few or no side effects, another may feel sick, jittery and dizzy. "This is where good old-fashioned common sense may be lifesaving. If intolerance to ephedra is experienced, it is not wise to continue using it," Dr Morris warns.

    The right dose for you

    To determine the amount of ephedrine to take, calculate the total milligrams of EAs listed on the product label. The recommended dose per day (24 hours) ranges from 20 mg to 90 mg of EAs total. Start slow, perhaps at one-half of one pill per day Gradually increase it and back off if you experience any negative side effects. Do not exceed a total of 90 mg EAs per day.

    The amount of ephedrine per dose varies greatly from product to product, so you'll need to carefully check the label to determine dosage. Additionally, "Despite what is listed on the label, the actual amount of ephedra alkaloid present in the product can vary," says Dr. Morris. "What you see is not always what you get." Stick with reliable companies with extensive label information rather than buying a no-name brand off the Internet.

    The big picture

    We advise looking at the big picture before deciding to use an ephedrine-based product. First get your diet and exercise plan in order, and investigate whether your lifestyle is contributing to your lack of fat loss or energy to train. Then consider your individual cost-to-benefit ratio and take careful note of any side effects you experience with ephedrine.

    Stay safe by following the guidelines provided in "Safety Tips to Keep in Mind," above. The bottom line? "Listen to what your body tells you," Dr. Morris suggests. "If taking ephedra creates intolerable side effects even when taken as recommended, don't press your luck."

    (*.) Names have been changed for privacy

     

    Related article: Safety tips to keep in mind

    If you choose to take ephedrine-based fat burners follow these guidelines:

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  • Let your doctor or pharmacist know that you're taking it, especially if you're on any other over-the-counter or prescription medications, says Sheri Barke, MPH, RD.
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  • Choose a product with no more than 20-25 mg ephedrine per pill, and do not exceed 90 mg total per day.
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  • If the label doesn't list the precise quantities of all ingredients and/or doesn't carry a warning label, don't buy it, says Barke.
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  • If you already consume caffeine through your usual food and beverage intake and aren't willing to give these up, choose a caffeine-free product, advises Barke.
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  • Brake recommends avoiding products containing yohimbe, any herbal laxatives (like senna and cascara) or herbal diuretics (such as nettle leaf and sarsaparilla).
  • Don't use if you have heart disease, thyroid disease, diabetes, high blood pressure, depression or other psychiatric disorder, glaucoma, difficulty urinating, prostate enlargement or seizure disorder; if you're using a monoamine oxidase inhibitor (MAQI) or any other prescription drug; or if you're using any other over-the-counter products containing ephedrine, pseudoephedrine or phenyl-propanolamine (ingredients found in certain allergy, asthma, cough/cold and weight-control products). Do not use if you're pregnant or plan to become pregnant or are breastfeeding.
  • Discontinue use of ephedrine-based fat-burners and call a health professional immediately if you experience rapid heartbeat, dizziness, severe headache, shortness of breath or other similar symptoms. Performance plus?

    Many people swear that ephedrine improves their workouts, but Leslie Bonci, MPH, RD, director of sports medicine nutrition at the University of Pittsburgh Medical Center Health System, recommends taking a closer look at the relationship between ephedrine and exercise performance. She advises keeping a detailed training log of the reps, sets and pound ages you to in an exercise session so you can really tell if ephedrine improves your performance.
  • COPYRIGHT 2002 Weider Publications

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