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To the Editor: Dr McBride and colleagues¹ suggested that ephedra might be responsible for prolongation of the QT interval, increased P-wave duration, and elevated systolic blood pressures noted with the use of Metabolife 356. The authors acknowledged that the multi-ingredient nature of this product precludes a definite statement regarding causation but argued that the findings were unlikely to be due to caffeine. They did not discuss the other components of the supplement.

Ephedra has been reported to produce psychiatric, gastrointestinal, autonomic, and cardiovascular adverse effects,² and concerns about its safety have led the Food and Drug Administration to ban the product from the US market. However, close attention should also be paid to the other components of Metabolife 356. Ginseng has been previously associated with the development of hypertension.³ Spirulina, an algae commonly found in saltwater, may have a high iodine content and contribute to thyroid imbalance and, consequently, to . . . [Full Text of this Article]

Jose Ness, MD
jose-ness{at}uiowa.edu
University of Iowa Hospitals and Clinics
Iowa City

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