Ballplayers looking for an edge aren't the only ones taking dietary supplements containing the controversial herb ephedra.
Truck drivers in for a long haul. Bodybuilders wanting more defined muscles. Young women trying to shed a few pounds. College students cramming for final exams.
All of these types of people use ephedra in one form or another, whether it's called Truckers Luv It, Metabolife or Ripped Fuel.
"There's lots and lots of supplements that it's found in," said Staci Nix, director of the University of Utah Nutrition Clinic.
And there are lots and lots of Americans using ephedra, perhaps some 12 million to 17 million per year, according to the Ephedra Education Council. That amounts to about 5 percent of the U.S. population.
Loren Israelsen, executive director of the Utah Natural Products Alliance, said he expects Utahns would be consuming it at about the same rate.
As the federal government Friday began building a case to ban the popular herb, Health and Human Services Secretary Tommy Thompson said he doesn't know why anyone would take ephedra.
The high-profile death of Baltimore Orioles pitcher Steve Bechler last month renewed the debate over the pros and cons of ephedra. Bechler died a day after collapsing with heatstroke during spring training in Florida. Food and Drug Administration investigators are trying determine if an ephedra-based diet pill, Xenadrine RFA-1, played a role.
The FDA has again proposed strong new warning labels that the pills can cause heart attacks and strokes or even kill. The powerful dietary supplements lobby derailed that effort in 1997.
Sen. Orrin Hatch, R-Utah, who has been a champion of the dietary supplement industry, applauded the FDA and Department of Health and Human Services Friday.
"Today's action reassures me that it will now be a priority of HHS and FDA to police the marketplace and apply the law as necessary," Hatch said. "Today's announcement appears to be a reasonable, if long overdue, step in designing science-based rules pertaining to the use of a product about which public concern has been expressed for many, many years.
Thompson said an outright ban of ephedra remains possible, and the new FDA actions would serve to make a case. Meantime, he advised people — particularly athletes and exercise lovers — to stay away from ephedra. He cited a recent Rand Corp. review of the herb that found it does nothing to enhance sports performance and causes only temporary weight loss.
Results and side effects
Ephedra is a stimulant derived from the Chinese herb ma huang that speeds up the body's metabolism, therefore burning more calories. It is typically combined with other stimulants such as caffeine or kola nut. Its principal active ingredient is ephedrine, which when chemically synthesized is regulated as a drug, found mostly in cold medicines.
Ephedra-based dietary supplements are easily obtained over the counter in health-food stores, supermarkets and convenience stores. Because the pills are not regarded as drugs, the FDA does not test them for safety.
"It increases alertness. It reduces the sense of fatigue. Sometimes it makes people more aggressive," said Susan Fullmer, a registered dietitian and professor at Brigham Young University.
But, she said, it also causes negative reactions such as high blood pressure, irregular heartbeats, headaches and worse. The FDA has investigated at least 100 deaths linked to ephedra.
At least two Utah families — the widow of a deceased football player in one case — have filed lawsuits.
"When it's properly used, it seems to be really, really beneficial," said Brenda Blakesly, a former bodybuilder and National Physique Committee district chairman who promotes local contests.
Improper use, as the Provo woman found out a decade ago, brings harmful side effects. She used to pop six Ripped Fuel pills before lunch and three more in the afternoon, along with a river of coffee. She quit after her heartbeat went haywire.
"I've kind of been up and down that roller coaster," Blakesly said.
The family of one Utahn, former Granger High School assistant football coach and semi-pro player Curt Jones, believes a combination of ephedra and caffeine killed him, a lawsuit contends. He suffered a massive heart attack after an indoor football game in Las Vegas two years ago.
Jones washed down two ephedra-based Up Your Gas tablets with Red Bull Energy Drink before the game.
A Utah County judge last spring awarded $458,646 to Jan Heriford, whose lawsuit claimed a product called MetaboBurn damaged her heart. The manufacturer, Vitanova, did not show up in court.
Ephedra is used mainly for weight loss and enhancing athletic performance, but others also use it for a pick-me-up.
"That's been a staple for truck drivers for years and years because it does give you that alert feeling," Nix said. "It's a huge thing that's sold in gas stations and truck stops, or at least used to be."
Safety, liability concerns
Reported heart attacks, strokes and deaths in young to middle-aged otherwise healthy adults have caused some distributors and manufacturers to discontinue sales.
There are fewer ephedra-based supplements on the market than a year ago, and the number will dwindle further in the next year, Israelsen said.
Wild Oats Natural Marketplace in Salt Lake City pulled them from its shelves three years ago, said Shari Martin, who works in the store's natural-living section.
"Ephedra is a bad thing," she said. "Whether it's over the counter, under the counter or wherever it is, it doesn't matter."
Citing liability, convenience store chain 7-Eleven announced in January it would no longer sell products containing ephedra due to its link to heart attacks, strokes and seizures.
Twinlab, the maker of Ripped Fuel and Metabolift, said last fall that it intends to stop selling ephedra by March 31. The New York-based company, which has a plant in American Fork, cited increasing safety concerns and rising insurance costs. Twinlab now sells "ma huang-free" supplements, as do many dietary supplements manufacturers.
Consumers Union, publisher of Consumer Reports magazine, last week reiterated its call to bar ephedra from the marketplace.
The Ephedra Education Council says only a "minute fraction" of the millions of consumers have reported problems to the FDA. Ephedra is as safe and as effective as other food and over-the-counter products when used as directed, according to the council. Product labels include a lengthy list of those who should avoid using it. The council says it is effective for weight loss but athletes shouldn't use it to gain a competitive edge.
Israelsen doesn't know whether ephedra is getting a bad rap. But Bechler's death, he said, caused officials to jump too quickly to conclusions.
"I'm a little surprised at how fast the sides lined up before we really have any evidence," he said. "Let's just wait and see what the evidence says."
As far as Nix and Fullmer are concerned, there's no doubt ephedra is harmful. Neither would recommend taking it.
Well-conditioned athletes dying, Fullmer said, should be enough to scare anyone away from it.
"People think because it's natural, it's got to be safe," she said. "That just isn't true."
Contributing: Deseret News Washington correspondent Lee Davidson, Associated Press