Like scores of players in the NFL, Jonathan Ogden sought the advantage that dietary supplements could afford him.
Unlike many of those players, however, the Ravens' All-Pro left tackle didn't need last year's ban of ephedrine products to persuade him to abandon them.
Ogden did that on his own, giving up Ripped Fuel - his supplement of choice - once his heart began to race and after he began to feel "jumpy."
"I used it for three or four years," he said, indicating its use was commonplace among Ravens players. He said they would take one or two ephedra capsules "on game day. And sometimes [for] practice."
"I stopped using it," Ogden said, "because I felt the gains I was getting weren't worth it, the way it made me feel sometimes."
The NFL came down hard on dietary supplements in September, just one month after the Minnesota Vikings' Korey Stringer died from heatstroke.
It banned all supplements that contain ephedra, a Chinese herbal stimulant that has been highly popular inside NFL locker rooms the past decade.
The league set last Monday as the date when it would begin random testing for use of the substance that has been called "legal speed." The NFL plans to suspend players who violate the policy.
Ephedra is an ingredient found in some 200 supplements, including Xenadrine RFA-1, Ultimate Orange, Ma Huang and Ripped Fuel. Those products are used for weight loss, to raise energy levels or for building muscle mass. It is also contained in cold and allergy medications.
When used in excessive dosages or in hot weather, ephedra can lead to severe problems. From January 1993 to February 2000, the U.S. Food and Drug Administration recorded 1,400 adverse effects associated with the use of ephedra, including 81 deaths and 32 heart attacks.
Side effects range from nervousness, insomnia and hypertension to heart palpitations, seizure, stroke and death.
The Public Citizen, a consumer watchdog organization, has called ephedra "the most lethal dietary supplement" and has urged the FDA to ban it. The FDA was unsuccessful in its attempt even to impose dosage limits.
Tragedy prompts action
Unregulated dietary supplements remain a source of concern to the NFL.
Last year, three college football players died while undergoing various conditioning drills. Two of the three had traces of ephedra in their system at the time of their death.
More highly publicized was the shocking case of Stringer, the Pro Bowl left tackle of the Vikings who died Aug. 1. Stringer collapsed on the field after a steamy morning practice at training camp July 31. By 1:50 a.m. the next day, he was dead.
While a toxicology report showed no evidence of supplements, Stringer's locker that day reportedly held an empty bottle of Ripped Fuel, a vial of an anti-inflammatory prescription drug, an unopened bottle of the weight-loss product Xenadrine, and the herbal supplement Mo Power.
According to league and team officials, ephedra had been on the NFL's radar screen before Stringer's death. But the tragedy prompted the league to re-examine the issue of supplements.
Individual teams like the Ravens have long cautioned players on the dangerous combination of stimulants and heat.
"We've taken a stand on it," Ravens trainer Bill Tessendorf said. "Use of stimulants and ephedrine substances, especially in hot weather, is counterproductive. What it does, it causes your metabolism to increase, which heats your core temperature, which limits the ability of the body to cool, and in a long and hot environment can probably just cook your brain."
Tessendorf said the Ravens have had one incident in practice - sometime in the past two years - in which a player had a reaction to a dietary supplement. The unnamed player suffered from a racing heart but no long-term symptoms.
"Sometimes it happens because of underlying medical problems," Tessendorf said. "In this case, there was no underlying medical problem. It was a case of the use of a supplement that has a stimulant in it, in a hot condition. I was told that 'I just took the normal dose,' whether that was true or not."
Dosage is part of the problem. Players would sometimes increase their dosage to achieve a new heightened state, believing that more is better. It is not.
"It's a safety issue," said Sue James, a registered dietitian and consultant to the Ravens. "If you take too much of it, you're going to get yourself in trouble."
Ogden didn't have any adverse effects when he first began taking Ripped Fuel capsules. Those came later.
"I took one before [kickoff] and one at halftime," he said of his game-day regimen. "I felt it gave me a slight edge, kind of got you going, ready to play. But it really wasn't worth it."
Ogden said he became jittery: "You kind of get the shakes. ... That didn't happen originally. It's not like I was getting chills for three years."
Those symptoms notwithstanding, Ogden frowns at the NFL ban.
"I disagree with it personally because I think people should have the choice," he said. "I think you need to be careful because some people might abuse it, but if [players] want to take Ripped Fuel on game day, which a million other people take in this country to get through work, then I really don't see a problem."
Wide-scale usage
Edwin Mulitalo, Ogden's linemate with the Ravens, estimates that as many as 70 percent of players in the league have used ephedra.
Giants trainer Ronnie Barnes told the New York Daily News he believes 75 percent of the players on New York's active roster were using ephedra before the ban.
Mulitalo said he took Ripped Fuel in college at Arizona - and not just for football.
"I used to take many things in college so I could stay up and study," he said. "I used it outside of football. Me and my family drive cross country a lot. I've taken ephedrine. I thought that we were only able to get it at truck stops."
When Mulitalo had a particularly good college game after taking Ripped Fuel, he stuck with it. "I think it was more superstitious," he said.
Mulitalo said he took two capsules before a game until ephedra was banned.
"Obviously, it's detrimental to some guys. If [the ban] is solely to protect the players, I'm all for it," he said.
The NFL Players Association approved the ban. Executive director Gene Upshaw knew from his own team visits that usage was high. The union also knew there would be some resistance.
"I think players have different opinions about it," assistant executive director Doug Allen said of the ban. "Some were very supportive about it. Some agree with Jonathan. We think one of the things that will help create an even larger consensus supporting it is more discussion and education.
"We will be meeting with players about scientific evidence we're aware of that leads us to the conclusion pseudoephedrine and methyl ephedrine are substances, when used in large doses in very hot conditions, that are dangerous to players' health."
Impact on the game
In addition to health concerns, Allen also raised the issue of competitive balance - that ephedra users will hold an unfair advantage over non-users. "We don't want that kind of influence in games," he said.
The ban on dietary supplements falls under the league policy for anabolic steroids and related substances. It carries with it a four-game suspension for first-time offenders.
In response, the Ephedra Education Council issued a statement that endorsed the NFL's desire to prevent unfair competition but also insisted that scientific evidence had not supported the connection between ephedra and harmful conditions.
"Therefore, it is not appropriate or scientifically justified for the NFL or any other sports league to question the safety of ephedra dietary supplements based on such reports," the statement read. "Consumers should be made aware that sound scientific research supports the safety and benefits of ephedra dietary supplements when used as directed. For example, the landmark Harvard/Columbia study found that overweight, healthy adults lost between 11 and 12 pounds safely without adverse effects."
Dr. Andrew Tucker, the team physician for the Ravens and director of primary care sports medicine for the University of Maryland Medical Center, acknowledged that when used as directed, these supplements "have a very safe profile."
"But there are a couple of things people need to remember," Tucker said. "Because these agents are not regulated by the Food and Drug Administration, the actual content in a given pill or preparation can vary widely from pill to pill or bottle to bottle.
"The other thing is, ephedrine is not the only stimulant in these preparations. Many times there's caffeine as well. So you get the added effect of two stimulants, which increases the risk of bad side effects."
The success of the NFL's testing program might depend on the ability to coincide with peak usage by athletes on game day, most commonly on Sunday. Tucker acknowledged the league's dilemma of when to test.
"These substances have very short shelf lives," he said. "They don't hang around the system very long, some just a matter of hours. It's going to be interesting to see how the league approaches this.
"If they test for stimulants Monday or Tuesday, they're not going to find anything because the drug will be gone or undetectable. They can test for stimulants in hopes of catching offenders, or deterring people who are using them as a fat-burner."
A positive ephedra test will show a higher degree of the substance in the body than what would ordinarily be found for someone taking a decongestant, for example. Ravens coach Brian Billick is concerned about where the NFL draws that line.
"With the new rules, something as simple as cough medicine could put a player at risk for testing positive," Billick said. "I support the league totally in what it's trying to do. As is typical, though, I'm a little concerned about the administration of it, that it's not too arbitrary, and that the players are indeed being told and know what they should and shouldn't do."
The policy might alert non-NFL athletes to also use caution, including some who might not be heeding the recommendation of the Ephedra Education Council that ephedra not be used by anyone under 18. Tucker hopes young athletes pay attention.
"I think it sends a very strong message to college, high school and recreational athletes," he said. "Will it eradicate abuse and misuse? No, because there's always going to be the new drug or the new fad.
"The players at the professional level certainly have access to a lot of information. They've got trainers and doctors constantly hounding them with information. The potential for abuse or misuse is just as great or greater at the high school level."