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Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers

      Herbal products containing ephedra (a natural source of ephedrine alkaloids) in combination with other ingredients exhibiting sympathomimetic properties (kola nut, guarana, and green tea extract) are widely available under names such as Xenadrine RFA-1 (Cytodyne Technologies, Lakewood, New Jersey), Metabolife 356 (Metabolife International, San Diego, California), and Ripped Fuel (Twin Laboratories, Inc., Hauppauge, New York). These products are most often taken to promote weight loss and to enhance exercise performance. Metabolife 356 has become the nation’s best-selling weight loss supplement, capturing 45% of the weight loss supplement market. Metabolife 356 contains a variety of herbs, including ma huang, guarana, ginger, ginseng, and gotu kola, as well as various other vitamins and minerals. Only a few studies have evaluated the effectiveness of ephedra-containing products on weight loss, yet the safety aspects of these products remains equivocal. Ephedra-containing dietary supplements have been associated with serious adverse effects, including myocardial infarction, cardiac arrhythmia, hypertension, hepatitis, seizure, stroke, and death.
      • Josefson D.
      Herbal stimulant causes U.S deaths.
      ,
      • Haller C.A.
      • Benowitz N.L.
      Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids.
      ,

      Nightingale SL. Warning issued about street drugs containing botanical sources of ephedrine. JAMA 1996;275:1534

      ,
      • Ault A.
      FDA proposes limits on ephedrine supplements.
      ,
      • Nadir A.
      • Agarawal S.
      • King P.D.
      • Marshall J.B.
      Acute hepatitis associated with the use of a Chinese herbal product, ma-huang.
      ,
      • Samenuk D.
      • Link M.S.
      • Houmoud M.K.
      • Contreras R.
      • Theohardes T.C.
      • Wang P.J.
      • Estes III, N.A.M.
      Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine.
      ,
      • Rezkalla S.H.
      • Mesa J.
      • Sharma P.
      • Kloner R.A.
      Myocardial infarction temporally related to ephedra—a possible role for the coronary microcirculation.
      ,
      • Morgenstern L.B.
      • Viscoli C.M.
      • Kernen W.N.
      • Brass L.M.
      • Broderick J.P.
      • Feldmann E.
      • Wilterdink J.L.
      • Brott T.
      • Horwitz R.I.
      Use of ephedra-containing products and risk for hemmorhagic stroke.
      This study was conducted to evaluate the short-term effects of Metabolife 356 on blood pressure, heart rate, 24-hour Holter monitoring, and hemostatic parameters in healthy subjects.
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