However, these studies did not separate the effects of ephedrine from that of caffeine and so more intense research is awaited in this direction. [Robert a] it is to be noted that caffeine and ephedrine work synergistically which could be dangerous in patients with pre-existing cardiac or blood pressure abnormalities. Caffeine affects the adenosine-mediated dilation of blood vessels by antagonizing its receptors. The resulting increased availability of free adenosine monophosphate furthers the activity of ephedrine and catecholamine stimulation resulting in reduced cardiac refractory periods and increased cardiac output and consequently elevated blood pressure. [Charles N. Krome] It is necessary to look into the inherent risks associated with the use of ephedrine. Ephedrine has a very high percentage of adverse reactions compared to all other herbal supplements. As reported by Bent et al. (2003), ephedrine alone accounts for around 64% of all adverse medical reactions due to herbal products. This in view of the fact that ephedrine products constitute only 1% of the total herbal market is a shocking and revealing statistic. [Robert a] Haller and Benowitz reviewed 140 adverse cases of ephedrine usage and submitted them to the FDA between 1996 and 1999. These cases clearly indicate that ephedrine usage has both cardiovascular as well as cerebrovascular complications. Ephedrine has also been clinically documented to cause nephrolithiasis in cases of severe and long-term abuse. Cardiomyopathy, arrhythmia and sudden deaths have been reported in relatively young people. In one of the reported cases ephedrine and beta agonists (used for asthma) interacted resulting in ventricular arrhythmia followed by cardiac arrest. [Charles...

Krome]
Conclusion

It is a disconcerting fact that many of the athletes consume supplements without knowing the constituents. Over the last decade, ephedrine usage had continued to be on the rise among young athletes in the form of supplements. Today however, the use of Ephedrine has become a heated debate with the growing awareness about its adverse effects and with professional bodies such as MLB banning the herbal product in the wake of recent deaths of young players. While the battle between supplement manufacturers, lobbyists, and the FDA continues, it is the responsibility of sports physicians and the athletic fraternity to protect young athletes from becoming unsuspecting victims to this silent killer.

Bibliography

Daniel Ari Kapner, 'Infofacts Resources: Ephedra and Energy Drinks on College Campuses," Accessed 26th April 2008, Available at, http://www.higheredcenter.org/pubs/factsheets/energy-drinks.html

Michael P. Schaefer, Jay Smith, Diane L. Dahm and Matthew C. Sorenson, 'Ephedra Use in a Select group of Adolescent Athletes'. Journal of Sports Science and Medicine (2006) 5, 407-414, available at http://www.jssm.org/vol5/n3/6/v5n3-6pdf.pdf

3) Robert a. Robergs1, Tommy Boone2, Donna Lockner3, "Exercise Physiologists Should not Recommend the Use of Ephedrine and Related Compounds as Ergogenic Aids or Stimulants for Increased Weight Loss," Journal of Exercise Physiology Online, Volume 6 Number 4 November 2003, available at http://faculty.css.edu/tboone2/asep/RobergsV2.doc

4) Charles N. Krome, 'Cardiac Arrhythmia in a Professional Football Player. Was Ephedrine to Blame?' The physician and Sportsmedicine Vol31, No 12, Dec 2003.