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Ephedra link to death disputed by industry


Representatives of the makers of an herbal supplement linked to the death of Orioles prospect Steve Bechler fought back yesterday against allegations that the supplement - ephedra - contributed to his fatal heatstroke.

Bechler, 23, died Monday after collapsing during workouts the day before at Orioles spring training camp in Fort Lauderdale, Fla. Pills of a product containing ephedra were found in his locker, and the local medical examiner said the substance almost certainly played a role in the death and should be banned by Major League Baseball. It is banned by the NFL, but not baseball.

Participants in a telephone news conference arranged by the Ephedra Education Council of the American Herbal Products Association yesterday said the drug is safe if used properly and likely played no role in Bechler's death.

"I don't see how ephedra could have contributed," said Carlon Colker, a physician and medical director of Peak Wellness Inc., a private center in Greenwich, Conn., that features "traditional and complementary medicine."

Ephedra contributes only a fraction of the body heat that an athlete generates while undergoing strenuous exercise, said Colker, a former competitive weightlifter and author of The Greenwich Diet and Sex Pills A to Z: What Works and What Doesn't.

"Certainly the scientific research is supportive of the fact that ephedra consumption is safe and effective when taken as directed," he said.

Richard Kreider, chairman of the Exercise and Sport Nutrition Laboratory at Baylor University, said other factors should be considered in Bechler's death, such as the fact that he was overweight, had a history of heat-related episodes and was not acclimated to the high humidity.

"Ephedra could not have been a primary factor," Kreider said.

The supplement Bechler was apparently taking, Xenadrine, manufactured by Cytodyne Technologies, is marketed as a weight-loss aid. Cytodyne is a member of the Ephedra Education Council, an industry-supported lobbying group.

Because ephedra-containing products are not regulated by the Food and Drug Administration, any adverse effects are not necessarily reported to the government. However, a study published in 2000 in the New England Journal of Medicine implicated ephedra in dozens of cases of hypertension, palpitations, strokes, and seizures - some of them fatal.

Also, a review of reports to poison-control centers found a disproportionate rate of complaints about the substance. The review, scheduled for publication next month in the Annals of Internal Medicine, found ephedra-containing products accounted for 64 percent of all the adverse reactions to herbal medicines, despite accounting for less than 1 percent of all herbal product sales.

"The sale of ephedra as a dietary supplement should be restricted or banned to prevent serious adverse reactions in the general population," the study's authors concluded.

The U.S. Health and Human Services Department has hired the Rand Corp. to review ephedra, and the FDA is considering whether it should be reclassified as a drug.

Wes Siegner, general counsel for the Ephedra Education Council, said they would oppose reclassification - something that would restrict its use to those with a doctor's prescription and require manufacturers to prove its safety and effectiveness.

He disputed the methodology of the Annals of Internal Medicine study and said consumers should wait for the Rand review to decide whether to stop taking the supplement.

"Diet and exercise, we all agree, are the best way to lose weight. But many Americans cannot do it that way alone," he said.

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