I have a 20-year-old nephew who is taking supplements that a personal trainer gave him. These pills contain ephedra and caffeine. There is also an additional pill containing caffeine. Please advise me as to the risks of taking ephedra with caffeine. I have heard stories on TV and am very concerned about his health with these supplements.

A.

I assume that your nephew is taking the ephedra and caffeine for their stimulant action. I personally do not recommend using either for that reason. Ephedra is a good herb to use in the treatment of asthma as it is an effective bronchodilator. However, ephedra has other effects in the body including increasing blood pressure and heart rate, constriction of peripheral blood vessels and increased bladder tone. Because of these effects, it is contraindicated in anyone with heart disease, high blood pressure, thyroid disease, diabetes, prostate gland enlargement and Raynaud's disease. It should also not be used by anyone taking anti hypertensive or antidepressant medications. Since caffeine has similar effects, it should not be combined with ephedra as these effects will be increased. Side effects of ephedra include insomnia, anxiety and tremor.

I would recommend that your nephew consult with his health care provider to evaluate the supplements he is taking and whether or not they are contraindicated because of any medical conditions.

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