The Relative Safety of Ephedra Compared with Other Herbal Products
Authors: Stephen Bent, Thomas N. Tiedt, Michelle Odden, Michael G. Shlipak
Journal: Annals of Internal Medicine (2003)

Letters17 June 2003The Relative Safety of Ephedra Compared with Other Herbal ProductsStephen Bent, MD, Thomas N. Tiedt, PhD, Michelle Odden, BS, and Michael G. Shlipak, MD, MPHStephen Bent, MDSan Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Bent)Med-Tox Group; Longboat Key, FL 34228 (Tiedt)San Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Odden, Shlipak)Search for more papers by this author, Thomas N. Tiedt, PhDSan Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Bent)Med-Tox Group; Longboat Key, FL 34228 (Tiedt)San Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Odden, Shlipak)Search for more papers by this author, Michelle Odden, BSSan Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Bent)Med-Tox Group; Longboat Key, FL 34228 (Tiedt)San Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Odden, Shlipak)Search for more papers by this author, and Michael G. Shlipak, MD, MPHSan Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Bent)Med-Tox Group; Longboat Key, FL 34228 (Tiedt)San Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Odden, Shlipak)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-12-200306170-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: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 ...References1. Litovitz TL, Klein-Schwartz W, Rodgers GC, Cobaugh DJ, Youniss J, Omslaer JC, . 2001 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2002;20:391-452. [PMID: 12216043] CrossrefMedlineGoogle Scholar2. Ephedrine, Ephedra & Ma Huang Exposures, 1994-2001: Report 31. Toxic Event Surveillance System. Washington, DC: American Association of Poison Control Centers; 2001. Google Scholar3. Adverse event reporting for dietary supplements: an inadequate safety valve. OEI-01-00-00180. April 2001. Office of the Inspector General, U.S. Department of Health and Human Services. Accessed at oig.hhs.gov/oei/reports/oei-01-00-00180.pdf on 28 March 2003. Google Scholar4. Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, . Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA. 2003;289:1537-45. [PMID: 12672771] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: San Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Bent)Med-Tox Group; Longboat Key, FL 34228 (Tiedt)San Francisco Veterans Affairs Medical Center; San Francisco, CA 94121 (Odden, Shlipak) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Relative Safety of Ephedra Compared with Other Herbal Products Stephen Bent , Thomas N. Tiedt , Michelle C. Odden , and Michael G. Shlipak The Relative Safety of Ephedra Compared with Other Herbal Products Douglas S. Kalman , Jose Antonio , and Richard B. Kreider Metrics 17 June 2003Volume 138, Issue 12Page: 1006-1007KeywordsAdverse eventsAdverse reactionsAge distributionDeath ratesNauseaRelative riskSafetySafety studiesSystematic reviewsVomiting ePublished: 17 June 2003 Issue Published: 17 June 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...