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drine stimulates the release of norepinephrine, which stimulates the release of adenosine and the synthesis of prostaglandins by the activated tissue. Adenosine and prostaglandins both inhibit the effect of norepinephrine. Caffeine opposes the effect of adenosine and so increases norepinephrine release. Aspirin inhibits the synthesis of prostaglandins and so enhances the effect of norepinephrine.1 Side Effects What users may not understand or take seriously when they seek the performance enhancing benefits of the supplement are the adverse effects it can produce. Ephedrine raises heat production and body temperature and may increase the athlete’s risk of developing a heat injury during exercise in warm weather. In addition to increased heat production, other effects may include dizziness, headache, gastrointestinal distress, irregular heartbeat, and heart palpitations to heart attack, stroke, seizures, psychosis and even death. These side effects can vary among individuals and occasions and don't always depend on how much is consumed. Also, combining caffeine (from coffee, Guarana, mate, or any other source) with ephedrine-containing products (such as those mentioned earlier) greatly increases the risks.2,3 If the knowledge of these adverse effects isn’t enough to deter users, the International Olympic Committee, the National Collegiate Athletic Association (NCAA) and the National Football League (NFL) are hoping some of their recent policies banning the drug—and suspending players for doping—will be. Research Findings Still, are these organizations’ concerns about ephedrine really valid? In December of 2000, a study commissioned by the Food and Drug Administration (FDA) set out to answer that question by examining the adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. In the study, records from 140 ephedra users who experienced complications (heart attack, stroke, seizure and death) between 1997 and 1999 were reviewed. These users were young and healthy—and some had only been taking ephedrine for a few days. 2 The researchers found that: One-third of the patients’ complications were definitely or probably caused by ephedrine use. Another third of the problems were possibly caused by ephedrine. In one-fifth of the cases there was not enough information to determine the cause. While these results illustrate the risks associated with ephedrine, the results of research illustrate its effectiveness. According to research: A combination of ephedrine and caffeine (0.8 to 1.0 mg of ephedrine per kg and 4 to 5 mg of caffeine per kg consumed 1½ hours before exercise) may improve both anaerobic and high-intensity aerobic performance.4,5 Combining ephedrine and caffeine (20 mg ephedrine and 200 mg caffeine, consumed three times per day) with a low calorie diet (1,000 calories) may also help to promote weight loss in obese individuals. 6,7 Fed

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