Xenadrine Ultra Weight Loss is marketed as a dietary supplement that can help individuals lose weight and increase energy levels. It has been a popular brand for those seeking to enhance their energy and lose weight. This article delves into the ingredients of Xenadrine, its purported effectiveness based on clinical studies, and, importantly, the safety concerns associated with some of its components, particularly ephedra.
Key Ingredients and Claims
Xenadrine is advertised as containing clinically proven key ingredients that promote weight loss. The "Powerful Weight Loss Complex" includes:
- Frauenmantle:
- Wild Olive:
- Cormino:
- Horsemint:
Additionally, Xenadrine contains caffeine anhydrous (1,3,7-Trimethylxanthine), which is included to provide extreme energy and act as a metabolic intensifier. The product claims that this potent key ingredient has been scientifically shown to support increased metabolism.
The manufacturers of Xenadrine state that test subjects using the key ingredients (Powerful Weight Loss Complex) lost an average of nearly 17 lbs versus 2 lbs for the placebo group in an 8-week randomized, double-blind, placebo-controlled clinical study funded by them. Moreover, in a 12-week third-party, randomized, double-blind, placebo-controlled clinical study, test subjects using the same key ingredients in Xenadrine lost an average of nearly 21 lbs versus the placebo group, who lost an average of nearly 2 lbs. Both groups followed a calorie-reduced diet.
Ephedra and Cardiovascular Risks
One of the most significant concerns surrounding Xenadrine and similar weight loss supplements is the inclusion of ephedra, also known as ma huang. Ephedra alkaloids are naturally occurring stimulants that have been used to enhance athletic performance and promote weight loss. However, these substances have been linked to serious adverse cardiovascular events.
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Adverse Cardiovascular Events
Ephedra use has been associated with:
- Acute myocardial infarction (heart attack)
- Severe hypertension (high blood pressure)
- Myocarditis (inflammation of the heart muscle)
- Lethal cardiac arrhythmias (irregular heartbeats)
- Hemorrhagic and ischemic strokes
Case Study: Myocardial Infarction and Xenadrine RFA
To illustrate the potential dangers, consider the case of a 24-year-old body builder who experienced an acute myocardial infarction after using Xenadrine RFA, an ephedra-containing supplement. The patient had been taking the supplement at recommended doses for nearly a year. Coronary angiography revealed thrombotic occlusion of the anterior descending artery with no demonstrable underlying atherosclerotic plaque and no evidence of active coronary spasm. Other possible causes of myocardial infarction, as well a hypercoagulable state, were ruled out. There was no evidence of illicit drug use.
The myocardial infarction was likely caused by in situ coronary thrombosis, perhaps related to transient coronary spasm and transient platelet activation as a result of intense sympathetic activity.
Xenadrine RFA contained 335 mg of ma huang (ephedra alkaloid) and 910 mg of guarana seed (equivalent to caffeine) per recommended dose. Ma huang increases the availability of catecholamines at adrenergic synapses in the brain and in the heart, directly stimulating α- and β-adrenergic receptors. As a result, the heart rate increases and the blood pressure rises secondary to elevated cardiac output and peripheral resistance. The combined effects of caffeine and ephedra increase myocardial oxygen consumption by increasing heart rate, contractility, and peripheral resistance (afterload), while potentially diminishing coronary blood flow by increasing coronary resistance and promoting frank coronary spasm. The diminished blood flow may lead to the development of in situ thrombosis. Enhanced sympathetic activity increases platelet reactivity, which likely contributes to a prothrombotic state in the presence of ephedra alkaloids.
This case highlights the potential for ephedra-containing supplements like Xenadrine RFA to cause severe cardiovascular problems, even in individuals with no apparent underlying coronary atherosclerosis or hypercoagulable state.
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FDA Action and Ephedra Ban
The Food and Drug Administration (FDA) took action to address the safety concerns associated with ephedra. In December 2003, the FDA announced that it would be removing ephedra from the marketplace, and the final ruling went into effect on 12 April 2004. This was the first time that the FDA had banned an herbal supplement.
Concerns Regarding Ingredients and Dosages
Even after the ban on ephedra, concerns remain about the safety and effectiveness of other ingredients in Xenadrine and similar supplements.
Variable Amounts of Ingredients
Herbal products such as Xenadrine RFA may contain variable amounts of ephedra alkaloids. It has been observed that herbal products such as Xenadrine RFA may contain variable amounts of ephedra alkaloids.
Adverse Effects Within Recommended Dosages
Adverse effects can occur even when the dose taken was within the manufacturers' guidelines.
The Role of Caffeine
Xenadrine formulations often contain high doses of caffeine, typically from sources like guarana. The combined effects of caffeine and ephedra increase myocardial oxygen consumption by increas-ing heart rate, contractility, and peripheral resistance (afterload), while potentially diminishing coronary blood flow by increasing coronary resistance and promoting frank coronary spasm. The diminished blood flow may lead to the development of in situ thrombosis.
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Importance of Further Research and Regulation
The exact incidence of serious adverse effects related to ma huang and other ephedra alkaloids may be underestimated due to a lack of suspicion at the time of diagnosis, or to inadequate reporting.