Many fitness clubs sell nutritional supplements, and some trainers recommend them to enhance workouts. But the practice is coming under scrutiny following the death of a New York apparel designer last fall.
The menu of supplements and herbs varies widely but may contain dangerous products. The stimulant ephedrine can cause heart attack or stroke, and steroids can damage organs and sexual function. Gym sales of another potentially lethal "performance booster" known as GBL, or gamma butyrolactone, is the subject of a warning in the July issue of the U.C. Berkeley Wellness Letter.The focus on supplement safety was sharpened after the October death of 37-year-old Anne Marie Capati. The Long Island, N.Y., woman died after suffering a stroke during her workout at Crunch Fitness in Manhattan.
A knitwear designer who made $220,000 a year, Ms. Capati joined Crunch to tone up after the birth of her second child. What is in dispute is why she was also taking supplements, including ephedrine. In an interview, her husband, Douglas Hanson, alleges she took the supplements at the recommendation of her trainer. Mr. Hanson has retained New York attorney Paul Rheingold to represent his family.
John Mitchell, who runs personal-trainer programs for the $66 million-a-year Crunch chain, said any such recommendations would have been strictly against policy. After an inquiry into the death, Mr. Mitchell says he found nothing wrong with Ms. Capati's exercise regimen. But Crunch dismissed the trainer last month for reasons unrelated to the death, Mr. Mitchell says.
The Food and Drug Administration posts chilling statistics on its Web site cautioning consumers about ephedrine, which is the active ingredient in the plant Ephedra, also known as ma huang. The agency links it to high blood pressure, heart attacks and strokes, and it has been implicated in 44 deaths. Ms. Capati suffered from hypertension, which heightened her risk from the substance. While ephedrine is found in many products, she took it in a "fat burning" supplement called Thermadrene by SportPharma USA Inc. of Concord, Calif. SportPharma declined to comment on allegations by Ms. Capati's family, but noted Thermadrene's label warns that people with high blood pressure or cardiovascular disease "should consult a physician when using this product."
On Oct. 1, Ms. Capati rose at her usual hour of 4:45 a.m., kissed her sleeping husband and drove to Manhattan for a prejob workout. Mr. Hanson, a consultant, remained at home with their two children.
Arriving at Crunch Fitness, Ms. Capati complained of a headache but began doing light squats. Feeling wobbly and nauseated, she stopped, vomited and lost consciousness.
Ms. Capati was taken by ambulance to St. Vincent's Hospital, where a CAT scan revealed a large hemorrhage in her brain, her husband says he learned on arriving at the ER, where his wife was on a ventilator. "You're never prepared to see someone you care about so much like that," he said, his voice faltering. Around 9:45 p.m ., she died.
Ephedra and related compounds are specifically off-limits to people with cardiovascular disease. Ms. Capati, who was taking the antihypertension drug Normodyne, clearly wasn't a candidate for it.
While stressing Crunch's anti-supplement policy, Mr. Mitchell says it is impossible to police all trainer-client conversations. The trainer couldn't be reached for comment.
Mr. Mitchell said the trainer denied recommending Thermadrene and stated Ms. Capati decided to taper off her blood-pressure medication against the trainer's advice. Mr. Hanson termed this scenario "pure poppycock."
As their Web sites attest, many other health and fitness centers offer nutritional supplements. At Gold's Gym in Albuquerque, N.M., buyer Jacquelyn Maxwell says clients can buy drinks containing ephedrine compounds, along with standard protein and carbo snacks. Asked about the risks around ephedrine, she says, "The drinks do have warning labels," noting they contain a small amount of it.
Other gyms such as Equinox Fitness Clubs in New York offer an array of supplements but no ephedrine, a spokesman adds.
David Herbert, a Canton, Ohio, attorney specializing in fitness-related litigation says, "Lots of facilities are supplementing their income" this way, raising the issue of whether trainers cross the line into the practice of medicine.
Sports medicine and fitness-certification groups try to discourage gyms from promoting supplements. In Dallas, the Cooper Institute for Aerobics Research this spring drafted a policy urging trainers to refrain from recommending herbs "for ethical and safety reasons."
Even expert trainers lack the background to recommend supplements, says Ann Partlow, director of certification for the American College of Sports Medicine, whose journals reject supplement ads.
Clubs say they provide one-stop shopping for their clientele.
"People were asking trainers what supplements they should be taking," says Jason Frye of Equinox. "This is a place they can work out, and buy their supplements on the way out."
"Gyms get off prescribing medicine," says Mr. Rheingold, the attorney. "The whole herbal industry is getting out of hand. Ephedra is an easy target -- the bad poster boy. But there are certainly other substances" that are potentially risky.