Douglas S. Kalman, MS, RD; Jose Antonio, PhD; Richard B. Kreider, PhD
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Kalman DS, Antonio J, Kreider RB. The Relative Safety of Ephedra Compared with Other Herbal Products. Ann Intern Med. 2003;138:1006. doi: 10.7326/0003-4819-138-12-200306170-00018
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Published: Ann Intern Med. 2003;138(12):1006.
TO THE EDITOR:
In their Brief Communication concerning the safety of the dietary supplement ephedra (1), Bent and colleagues compared the 2001 Toxic Event Surveillance System (TESS) report with ephedra sales data provided to them by various sources (2). The design and conclusions of their study have several fundamental flaws.
Clinical trials of drugs and herbal products provide a basis for understanding the potential for serious adverse events as well as the intended population. The TESS data indicate that 55.5% of all reports related to ma huang (ephedra) alone or in combination with another herb involved people younger than 19 years of age. In addition, 27.9% of exposures were in children younger than 6 years of age (3). People younger than 19 years of age should not take ephedra; there simply have been no studies performed on the herb ephedrine in that age group. Bent and colleagues' data are therefore misleading to the intended consumer. Furthermore, Bent and colleagues mistakenly stated that ephedra accounts for 64% of all herb-related adverse reactions. However, hundreds of herbal products are sold in the United States, not 12 as the TESS report stated (Watson B. Personal communication. 22 February 2003).
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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