Diet Dangers: Ephedra Substitute Risky

Safe Alternative to Weight Loss Put to Question

From the WebMD Archives

Aug. 30, 2004 -- Dieters beware. An ingredient found in many "ephedra-free" weight loss products could trigger the same dangerous heart problems that prompted the FDA to yank ephedra off the shelves last year.

The banning of ephedra prompted an entire new line of so-called 'safe alternatives' to weight loss products. Many of these weight loss products contain the herb Citrus aurantium (C. aurantium), otherwise known as Seville orange or sour orange. C. aurantium has also been used in traditional Chinese medicine to treat digestive problems.

But there is no evidence that the herb actually helps shed pounds, according to a new review of these products by Georgetown University Medical Center researchers.

More worrisome is the concern that C. aurantium is loaded with potential health risks. The herb contains an epinephrine-like compound called synephrine, which can cause high blood pressure like ephedra.

"C. aurantium has many of the same potential deleterious cardiovascular effects as ephedra," Georgetown physiology professor and review co-author Adam Myers, PhD, says in a news release.

The dietary supplement can be especially dangerous in those with existing heart disease, according to the review in the September issue of Experimental Biology and Medicine.

In addition, people who take C. aurantium along with certain medications risk serious drug interactions. The herb can affect the breakdown of many medications, which can lead to toxic amounts of a medication in the bloodstream. People taking blood thinners, such as Coumadin, and calcium channel blockers for blood pressure should be especially cautious. Grapefruit juice causes the same effect, especially in patients on heart medications.

So far no adverse effects have been associated with the ingestion of C. aurantium, yet researchers warn that ephedra's lesson should be taken to heart -- and this new product should be avoided until short- and long-term safety is established.

"Given what we know about the cardiovascular effects of synephrine, modern usage in weight loss products should not be presumed to be safe," the researchers write in the journal.

Always check with your doctor before trying an herbal weight loss product.

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SOURCES: Experimental Biology and Medicine, September 2004; vol 229. News release, Georgetown University Medical Center.
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