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Title: Stroke danger from "energy" supplement

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Journal of Neurology, Neurosurgery and Psychiatry 2000;68:112-13
12/23/1999
By Bruce Yates

Energy supplements containing MaHuang extract, taken by many sportsmen to enhance performance, could be dangerous. The warning comes from French clinicians who report a case of extensive cerebral infarct in a 33-year-old body builder who consumed high doses of MaHuang extract and creatine monohydrate. He was perfectly fit, trained two hours a day, did not smoke, had no risk factors nor any evidence of deep vein thrombosis. The patient was a baggage handler for an international airline and had just returned from an international flight which possibly might have precipitated the stroke. He had been using "energy pills" for about six weeks which he bought over the counter in Florida. Energy supplements purporting to enhance performance are freely available in many countries, the authors point out, but buyers may not be aware that what they think are benign drugs could be harmful. Analysis showed that one compound contained MaHuang extract, corresponding to 20 mg ephedra alkaloids; 20 mg caffeine; 100 mg L-carnitine and 200 microgram chromium per two capsules. A second contained 6000 mg creatine monohydrate; 1000 mg taurine; 100 mg inosine and 5 mg coenzyme Q10. Clinicians point out that MaHuang extract contains ephedrine. Ischaemic and haemorrhagic stroke have been reported in the past after taking ephedrine, and a combination of ephedrine and caffeine are known to have adverse effects on the heart if taken in large quantities. The report adds that creatine has not been associated with such effects but it is possible it can act in concert with preparations which affect the sympathetic nervous system.

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