It’s a good news—bad news story.

The good news is that ephedra is out. The Food and Drug Administration’s ban on ephedra finally took effect in April.

A powerful natural stimulant, ephedra had been implicated in numerous deaths and illnesses from circulatory problems, including heart attacks and stroke.

But when ephedra was sold as a dietary supplement for weight loss or energy enhancement or other purposes, the burden of proof was on the government and consumers to show that ephedra’s dangers outweighed its benefits. It took several years to do it, during which more people died, many others became sick or suffered permanent injury. But it’s done.l

Now for the bad news: there are plenty of other products pouring into the vacuum left by ephedra's withdrawal, and while we’ve learned a lot about ephedra, the new products hitting the market put consumers up against a whole new array of dangerous unknowns.

And the worst news is that most of us aren’t even aware of that. A 2002 Harris poll showed that 59 percent of adults believe dietary supplements are approved by a government agency before being sold (they aren’t); 55 percent said they thought manufacturers need to have scientific evidence supporting their safety claims (they don’t); and 68 percent believe the government requires warning labels about supplements’ potential side effects (it doesn’t).

So supplement buyer beware, now more than ever. The devil you know is better than the devil you don’t know, and some of the most likely suspects are also most likely to be complete strangers to the average consumer. Here are some chief offenders to watch for:

The “Also-Banned”

Aristolochia herbs have been included in weight-loss formulas, but they have also frequently been associated with serious kidney damage, often because more toxic species of plants containing aristolochic acid were used in place of other, usually benign varieties.

Researchers find this kind of formula adulteration – whether deliberate or inadvertent – among the most troublesome in the unregulated world of dietary supplements. There simply is no production oversight, so you just don’t know what you’re getting.

To help limit the dangers, the FDA banned imports of aristolochic botanicals in 2001, but many products remain available online that contain aristolochic acid. Watch for mu tong and fang ji, but also beware of products containing clematis and stephania.

Just this March, the FDA sent 23 U.S. manufacturers of androstenedione (andro) a letter warning them to cease manufacture of the muscle-building supplement. But andro also is readily available online, with some sellers actually hyping the ban as a promotional tool – “Buy Andro and prohormones before they are banned!”

Of course, those sites won’t tell you about the risks, including heart and liver damage, and some gender-specific problems: testicular atrophy, impotence and breast development in men, and facial hair, menstrual problems and greater risks of breast and uterine cancer for women.


Page 2: Ephedra's gone, but alternatives are unfamiliar and untested