Stephen Bent, MD; Thomas N. Tiedt, PhD; Michelle Odden, BS; Michael G. Shlipak, MD, MPH
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Bent S., Tiedt T., Odden M., Shlipak M.; The Relative Safety of Ephedra Compared with Other Herbal Products. Ann Intern Med. 2003;138:1006-1007. doi: 10.7326/0003-4819-138-12-200306170-00019
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Published: Ann Intern Med. 2003;138(12):1006-1007.
While our study certainly has some limitations, the letter from Mr. Kalman and his colleagues is unfortunately characterized by incorrect statements and invalid analyses of the data. They initially refer to the age distribution of “reports” related to ephedra. However, as we clearly stated, our analysis was limited to adverse reactions, which are defined as “adverse events occurring with normal, prescribed, labeled, or recommended use” (1). Fewer than 25% of these occur in persons younger than 20 years of age (2). Although the TESS annual report lists only nine herbs, it includes totals for all single-herb and multiherb products. Ephedra-containing products accounted for 64% of all herb-related adverse reactions in the 2001 report, as reported in our paper.
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