The prevalence of overweight individuals in the United States is on the rise. This
has lead to a steady increase in the use of weight loss products, both as prescription
and over-the-counter preparations. Ephedra alkaloid (EA), also known as ma huang,
is widely used as a weight-loss product by millions of people [
[1]
]. In fact, adverse event reports have increased resulting in an inquiry by the Justice
Department into Metabolife, a product that contains ephedra as a major constituent.
Only a few cases of liver injury associated with ma huang use have been reported [
2
,
3
]. Usnic acid (UA), a lichen alkaloid, is a compound found in crude medicines and dietary
supplements including Lipokinetix®, another herbal supplement that is marketed as a weight loss agent and is known to
cause hepatotoxicity and acute liver failure in patients [
[4]
]. This prompted the Food and Drug Agency (FDA) to issue a warning about Lipokinetix® and it has subsequently been taken off the market, although other usnic acid containing
products remain available [
[5]
].To read this article in full you will need to make a payment
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References
- The need for regulation of dietary supplements—lessons from ephedra [comment].J Am Med Assoc. 2003; 289: 1568-1570
- Fulminant exacerbation of autoimmune hepatitis after the use of ma huang.Am J Gastroenterol. 2001; 96: 1654-1655
- Acute hepatitis associated with the use of a Chinese herbal product, ma-huang [comment].Am J Gastroenterol. 1996; 91: 1436-1438
- Severe hepatotoxicity associated with the dietary supplement LipoKinetix.Ann Intern Med. 2002; 136: 590-595
- Two ephedra methods successfully refined, validated, and now advanced to the AOAC collaborative study.J AOAC Int. 2002; 85: 74A-77A
- Fulminant liver failure due to usnic acid for weight loss.Am J Gastroenterol. 2004; 99: 950
- Usnic acid-induced necrosis of cultured mouse hepatocytes: inhibition of mitochondrial function and oxidative stress.Biochem Pharmacol. 2004; 67: 439-451
- Modelling the cardiovascular effects of ephedrine.Br J Clin Pharmacol. 2004; 57: 552-562
- Pharmacology of ephedra alkaloids and caffeine after single-dose dietary supplement use.Clin Pharmacol Ther. 2002; 71: 421-432
- Pharmacokinetics and cardiovascular effects of ma-huang (Ephedra sinica) in normotensive adults.J Clin Pharmacol. 1997; 37: 116-122
- FDA issues alert on ephedra supplements in the USA.Lancet. 2004; 363: 135
- Hepatic injury in 12 patients taking the herbal weight loss aids chaso or onshido.Ann Intern Med. 2003; 139: 488-492
- Acute hepatitis na gebruik van een plantaardig preparaat met stinkende gouwe (Chelidonium majus).Nederlands Tijdschrift voor Geneeskunde. 2002; 146: 124-128
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Article info
Publication history
Published online: September 01, 2004
Identification
Copyright
© 2004 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
