A baseball player known to have been taking ephedra, a controversial dietary supplement associated with a higher risk of adverse reactions than other herbal preparations, has died in Florida after a training workout.
Baltimore Orioles pitcher Steve Bechler, 23, died of heatstroke last week after his body temperature rose to 42°C. The Broward County medical examiner, Dr Joshua Perper, concluded that he died of complications of heatstroke, which resulted in multiorgan failure.
Dr Perper said that he was told that Bechler was taking three Xenadrine RFA-1 capsules, an over the counter dietary supplement, every morning for weight reduction. Each capsule contained 20 mg of ephedrine.
It will not be known how much of the supplement may have contributed to Bechler's death until toxicology reports are completed in two to three weeks.
Last year Dr Sidney Wolfe of Public Citizen, a consumer watchdog group, urged the Food and Drug Administration to ban dietary supplements containing ephedrine alkaloids (BMJ 2002; 325:924).
Last month a study published in the online version of Annals of Internal Medicine found that products containing ephedra accounted for 64% of all adverse reactions to herbs notified to US poison control centres in 2001, even though they accounted for only 1% of the market (www.acponline.org/journals/annals/ephedra.htm).
Figure.
AP PHOTO/ROBERTO BOREA
Steve Bechler is driven off the field suffering from heat exhaustion