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Doctors to Continue Push for Elimination of Ephedra Products in Dietary Supplements: Presented at AMA

By Ed Susman

CHICAGO, IL -- June 25, 2003 -- The American Medical Association's House of Delegates Thursday approved a report that called for continuation of its efforts to remove ephedra alkaloid dietary supplements from sale in the United States.

"Specifically the AMA has urged the Food and Drug Administration to initiate proceedings to remove dietary supplements containing ephedra alkaloids from the market because the risks associated with the use of these products outweigh the benefits," said Robert McCaffree, MD, of Oklahoma City, Oklahoma, chairman of the special committee which heard testimony on the subject at the AMA's annual meeting.

The report was approved without dissent by the entire House of Delegates.

Edward Hill, MD, chairman of the AMA Board of Trustees, noted in the report that a recent review of adverse reactions reported to the American Association of Poison Control Centers' Toxic Surveillance System showed that ephedra accounted for 64% of all adverse reaction reports for herbs, while ephedra-containing dietary supplements represented only 0.82% of herbal product sales.

"These products, which are classified as food supplements, present an unreasonable risk to American consumers," Dr. Hill said in his report.

Dr. Hill's report also noted that several prescription medicines are available for use in treating obesity, including phentermine, phendimetrazine, orlistat and sibutramine. He also noted that surgical procedures are also available to overcome obesity. "It should be noted, that in Denmark, ephedra alkaloids are available to treat obesity, but these products can be obtained only by prescription," the report stated.

The AMA has advocated removal of ephedra as a food supplement for at least the past 5 years.

Another resolution, sponsored by the Illinois delegation to the AMA, called for a ban on ephedra products as an over-the-counter product and called for the definition of ephedra as a prescription drug. However, Dr. McCaffree's committee folded those recommendations into the overall report.

"Ephedrine remains available as a legitimate prescription drug, so we recommend adoption of the Board of Trustees Report in lieu of the Illinois resolution," Dr. McCaffree suggested.

John Armstrong, MD, of San Antonio, Texas, a member of the AMA Board of Trustees, said, "There is no valid medical use for ephedra as a dietary supplement."

When brought before the entire House of Delegates, the Dr. McCaffree committee's recommendations were approved, along with several other proposals, without debate.

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