April 16, 2004 | On April 12, the Food and Drug Administration (FDA) officially banned the sale of all dietary supplements containing ephedra – a naturally occurring substance found in plants that has powerful stimulant effects on the nervous system and heart. Bill Gurley, Ph.D., a professor of pharmaceutical sciences in the College of Pharmacy at the University of Arkansas for Medical Sciences, has been investigating the possible health risks from taking ephedra-based supplements for eight years, and knows just how badly this ban was needed.

Gurley is known nationwide as a leading expert on the subject of ephedra-based dietary supplements. In fact, he is such a noted expert in his field that he has become a heavily quoted source for news reporters around the country. More than 150 national and local news outlets have contacted him for his comment. He was most recently featured in the April issue of “O,” The Oprah Magazine and on April 12 in the Los Angeles Times.

He first became interested in ephedra in 1998 when he headed a study funded by the UAMS Department of Pharmaceutical Sciences on the ephedrine alkaloids commonly found in products marketed as “natural stimulants” or “diet aids.” By measuring the content of these ephedrine alkaloids in the bloodstream, he discovered that when these ephedra-based products are not used properly, the adverse effects could be dangerous – and sometimes fatal.

“Ephedrine has been around for years, and when used properly it is generally safe, but when mixed with other stimulants, such as caffeine, it’s a totally different animal,” Gurley said. “Hundreds of adverse health effects, including heart attack, stroke and seizures, have been reported to the Food and Drug Administration (FDA), and more than 200 documented deaths have been reported as well. But less than 1 percent of cases are ever reported, so it’s likely that those deaths are just the tip of the iceberg.”

The biggest problem with ephedra-based products, Gurley explained, is that because the FDA considers these products nutritional supplements and not drugs, the manufacturers of these supplements do not have to provide any evidence that their products are safe. This leads to the misperception that the health risks associated with these products are minimal or even non-existent. “The general public has essentially been a guinea pig for the nutritional supplement industry,” Gurley said.

In 2000, Gurley and his colleagues published a study on the poor quality of ephedra-containing supplements in the American Journal of Health-System Pharmacy, a well-known national journal. “This got the dietary supplement industry in an uproar,” Gurley said. “Major manufacturers of the products started claiming that the study was ‘bad science’ and it became a very controversial topic.”

But the FDA and other researchers later confirmed Gurley’s findings. “The FDA tried to take the products off the market in 1997, but failed to do so. Soon after that, people who suffered adverse effects from taking ephedra products began filing lawsuits against the manufacturers,” he said. In January 2000, Gurley served as an expert witness in the first case that went to trial and the plaintiff won $13 million. “After that case, the floodgates opened.”

Gurley’s phone soon began ringing off its hook with reporters wanting to get his comment. “Every time anything happens in the news about ephedra, I get a call,” he said. Gurley has been interviewed by such noteworthy news outlets as CNN, Newsweek, The New York Times, U.S. News & World Report, ESPN, Wall Street Journal, ABC, CBS, NBC, USA Today and Consumer Reports, just to name a few. Last summer, Gurley was even asked to testify before Congress on the dangers of ephedra-based products. He has served as an expert witness in other court trials as well.

“It has been one wild roller coaster ride,” Gurley said. “But it has gained UAMS a lot of notoriety. Our group at UAMS has published more studies on the topic than any other group in the United States.”

Gurley warns that although the ephedra-products have been taken off the market, consumers should still be cautious of the new “ephedra-free” products manufacturers are making now. “These ephedra-free products contain drugs similar to ephedrine, and we may be in the same situation with these ephedra-free supplements in a few years,” Gurley predicted. “You have to be so careful about the claims these companies make.”

Currently, Gurley said UAMS researchers are performing studies to test the effects of these newest ephedra-free products.