Many Fans of Herb Had Moved On to Newer Supplements

Long before the federal government acted to ban ephedra, many Americans already had embraced a new generation of dietary supplements to help them lose weight and ramp up their workouts, industry experts and consumer groups said Tuesday.

Years of bad publicity over health problems linked to ephedra led many supplement companies to develop alternative products that are marketed in health food stores, gyms and over the Internet as “ephedra-free.” Among the most popular are herbal products containing bitter orange, which is chemically similar to ephedra.

The emergence of a new group of ephedra-free products suggests not only the public’s continued appetite for weight-loss and energy-boosting remedies, but also the supplement industry’s ability to move nimbly to meet that demand. It also suggests that new products will continue to pose significant challenges for Food and Drug Administration regulators.

Some health experts said the planned ban on ephedra would do little to protect consumers from other supplement products that might be unsafe and emphasized that the federal government needed tougher enforcement powers. But FDA officials and some supplement industry executives said Tuesday’s announcement demonstrated that the government had the authority it needed to protect consumers.

“This is the first time that the dietary supplement law, which has been on the books for 10 years, has actually been used to restrict or in effect ban the use of a dietary supplement on safety grounds,” FDA Commissioner Mark B. McClellan said in an interview Tuesday on PBS’ “The NewsHour With Jim Lehrer.” “We’re laying out a new framework here for how we think the law should be interpreted, and we have done all the work necessary to prove that case.”

Sales of ephedra had been plunging as the controversy over its safety grew. But that doesn’t mean the public has shied away from herbal weight-loss products, said Michael McGuffin, president of the American Herbal Products Assn., a trade group in Silver Spring, Md. “More likely,” he said, “[consumers] have moved on to other weight-loss products.”

It wouldn’t be the first time American consumers had changed allegiance to a product after controversy. Ephedra’s popularity came after a scandal over fen-phen, a popular weight-loss drug pulled from the market in 1997 over safety concerns.

Such major manufacturers as Twinlab and Herbalife stopped selling ephedra products last year, and General Nutrition Centers, a national chain of health products stores, followed suit this year. Manufacturers have generally cited ephedra’s poor image and the threat of lawsuits as their reasons for abandoning the once-popular products.

“We voluntarily stopped the sale of ephedra products in response to consumer demand, which we found was moving toward ephedra-free products,” said Jaime Young, a spokeswoman for Pittsburgh-based GNC.

Even so, some consumers continued to use ephedra.

Mike Scinocca, owner of the Max Muscle health store in Pasadena, said the ban would be unpopular with his customers and would hurt his business. “Some people are treating it like they’re banning coffee,” he said. “They want the energy.”

Scinocca expects some customers will turn to ephedra-free substitutes, which he has used and says provide a similar or greater energy boost. “It was like I was working out on speed,” he said of one such product.

Brook Radenbaugh, general manager of Gold’s Gym in Pasadena, said the planned ban was the buzz among gym patrons on Tuesday. He said most were unhappy with the government’s announcement. “I don’t think there’s a bodybuilder or person interested in training that hasn’t used ephedra,” he said.

Radenbaugh said he had used ephedra-containing supplements for six years and had not had any deleterious effects.

Among athletes and coaches, ephedra has long been associated with danger, said Frank Uryasz, president of the National Center for Drug Free Sport. “Nearly all major sports organizations have banned ephedra, and athletes are pretty protective about using banned substances,” he said.

It’s common for coaches to caution their athletes against using ephedra, said Sean Norton, a quarterback for Newhall Hart High School’s football team in Santa Clarita. “I’ve stayed away from [ephedra], and I don’t know people in my community using it.”

The ban is overdue, said Dr. Sidney M. Wolfe, director of Public Citizen’s Health Research Group, a Washington consumer group that petitioned the FDA to ban ephedra more than two years ago.

“One reason major manufacturers have stopped selling ephedra is that the companies have become uninsurable because of massive losses in product liability cases,” Wolfe said. “Most, if not all, of the manufacturers have switched to bitter orange or Seville orange -- which have their own problems.”

Though the ingredients of new ephedra-free products vary, many contain herbs such as bitter orange, green tea, grape seed extract and guarana. Bitter orange, which is also known as Seville orange or citrus aurantium, is perhaps the best known of the ephedra-free products. The herb contains a chemical called synephrine that is similar to the pseudoephedrine found in many over-the-counter cold and allergy remedies. Dozens of companies market products containing bitter orange, including Twinlab, which sells a product called Ripped Fuel, and Herbalife, which markets one called Gold Weight Loss Supplement.

Both ephedra and synephrine are so-called thermogenic weight-loss aids that, manufacturers claim, boost the body’s metabolism, increase caloric expenditure and break down fat, according to Supplement Watch, a private company that advises consumers on dietary supplements. Some manufacturers claim that bitter orange does not affect the central nervous system and heart in the same manner as ephedra. Ephedra can act as a stimulant to speed up the heart and respiration rate, and also raise blood pressure.

However, there is scant published scientific data on the effects of bitter orange for weight loss and its potential side effects. Preliminary research at the University of Arkansas suggests that bitter orange reacts with many prescription medications. Moreover, combining bitter orange with other substances may increase the body’s ability to absorb the herb, thus increasing its potency and potential for causing side effects. On its Internet site, Supplement Watch scientists called citrus aurantium “one of the most over-hyped ingredients on the weight-loss scene,” noting the lack of research about the product. The herb has been shown to raise blood pressure in animals and should be avoided by people with hypertension and other cardiovascular problems.

The FDA’s McClellan said consumers should be reassured that the FDA would continue to monitor reports of problems with dietary supplements.

However, Wolfe said the government is hamstrung in its efforts to regulate dietary supplements because, unlike with over-the-counter and prescription medications, manufacturers are not required to prove that supplements are safe and effective for use in humans before putting them on the market. The FDA can ban a supplement only after showing evidence of injury, Wolfe said.

“Do they have the authority to keep these things from coming on the market? The answer is no,” he said. “The substitute for ephedra is a major case in point. Manufacturers, say, OK no more ephedra, so we’ll just go to bitter orange and Seville orange, which interact with prescription drugs and can increase pulse and blood pressure. There is no barrier to putting anything on the market as long as it’s natural. But something pharmacologically active should have to pass safety and efficacy regulations.”

Certainly, athletes and consumers battling weight problems will be keen to try other products that will help them meet their goals, said Angelo Gasca, a football coach at Venice High School. Though he discourages the use of supplements, Gasca said the pressure to earn college scholarships and excel at the next level drives some high school players to experiment.

“People want to get bigger and stronger faster,” he said. “Sometimes they don’t see the results they want fast enough from lifting weights. They get overzealous. There’s a lot at stake for a lot of kids. It drives people to do things that aren’t the healthiest for them in the long run.”

Times staff writers Joy Buchanan, Mike DiGiovanna, Rob Fernas, John Ortega, Eric Sondheimer and Peter Yoon contributed to this report.