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Primary Pulmonary Hypertension(PPH) CAUSED BY EPHEDRA IN HERBAL DIET DRUGS ?

According to medical research, less than 1000 people as year in the United States are diagnosed with Primary Pulmonary Hypertension (PPH). Secondary pulmonary hypertension affects many more. Pulmonary hypertension (PH) is a state of too-high pressure in the blood vessels inside your lungs. PH is hard to diagnose because until it gets very bad, symptoms are vague and could be caused by almost anything. There are lots of tiny blood vessels inside your lungs called capillaries. These capillaries are lined with a special kind of cell called endothelial cells. The outside of each capillary is covered with smooth muscle cells. The endothelial cells normally keep blood from leaking out of the blood vessel. The smooth muscle cells normally allow the vessel to expand or shrink, depending on how much blood is inside them.
 
In patients with PH, some of the endothelial cells lining the capillaries weaken, and may enlarge. Since these cells line the inside of the capillaries, when they get bigger they make the inside of the blood vessel smaller - less room for blood to pass through. Blood may leak out as well. Also, the outer smooth muscle cells shrink. This muscle shrinkage tightens the blood vessels - like holding a sponge in your hand and squeezing, the muscle cells on the outside of the blood vessel squeeze, making the capillary smaller. This increases the pressure inside them.
The high pressure in these capillaries resists the heart's efforts to pump blood through them. When this happens in enough capillaries, the flow of blood between the heart and lungs is seriously reduced.
 
CAUSES OF PRIMARY PULMONARY HYPERTENSION
 
PPH may be genetic or partly genetic - it often runs in families. It may be set off by a "trigger" that might be something like use of certain appetite suppressants ( Fen Phen, Pondimin fenfluramine, dexfenfluramine, Redux), cocaine, meth (speed), amphetamines, inhaled solvents, contaminated oils such as rapeseed oil used for cooking, or L-tryptophan.
 

EPHEDRA IN HERBAL DIET DRUGS SIMILAR TO AMPHETAMINES THAT CAUSE PPH

Ephedrine (e-fed-rin) a-methylamino-l phenyl-l propanol, is an alkaloid from the leaves of Ephededra equisetina, E. Sinica, and other species  (family Gnetaceae) It is also called Ephedra & Ma Huang, the plant source   for the Alkaloid ephedrine. M a Huang is a Chinese herb that is also referred to as Chinese Ephedra and herbal ephedrine. The active compounds, ephedra or ephedrine alkaloids are also found in other herbals such as Mormon Tea and Sida Cordifolia (there are about 40 species of plants that contain versions of ephedra). Ma Huang, and its various herbal cousins, functions as a sympathomimetic, meaning that it mimics some of the effects of the body's own sympathetic (stimulant) hormones such as epinephrine (adrenaline) and norepinephrine (either by increasing the levels of these hormones or by reducing their breakdown). Many of the popular herbal diet and energy products of the late 1990's through the the ephedra ban including Metabolife 356, Metabolite,Metab-o-lite,  Metabolift, Hydroxycut, Advocare MNS Orange, Ripped Fuel, Diet Fuel, Stacker, Ripped Force, Ephedra Ma Huang, Metab-Rx Ultra, Yellow Jackets, Metab-o-lite, Xenaless, Stacker 2, Dexatrim Natural, and numerous other diet & nutritional supplements, muscle enhancers, appetite suppressants, and other products.

ephedra pph, metabolife, primary pulmonary hypertension
Ephedrine is a "non-selective" sympathomimetic, which means that it acts as a general stimulant on many parts of the body simultaneously (lungs, heart, blood vessels, adrenal glands, etc.). It is most often used as a central nervous system stimulant (for alertness or energy), as a decongestant (for asthma/breathing aid) and as an appetite suppressant in a wide variety of weight loss and "thermogenic" type products.
 
Because ephedrine acts as a general sympathetic nervous system stimulant, it can give users a "boost" or "pick up" similar to what you might feel after a cup or two of strong coffee. By mimicking the effects of epinephrine, ephedra can increase the output of blood from the heart, enhance muscle contractility, raise blood sugar levels and open bronchial pathways for easier breathing. In many cases, ephedra can result in a temporary suppression of appetite, which may help efforts aimed at dietary restriction and weight loss.

Primary Pulmonary Hypertension (PPH) Risk Factors

Taken from the World Health Organization executive summary, the following risk factors have been categorized based on the strength of the association with PPH and their probable causal role. "Definite" indicates an association based on several concordant observations, including a major controlled study or a clear epidemic. Definite risk factors are considered to play a causal role in the development of the disease. "Very likely" indicates several concordant observations (including large case series and studies) that are not attributable to considered biases, or a general consensus among experts. "Possible" indicates as association based on case series, registries, or expert opinions. "Unlikely" indicates risk factors that have been proposed but have not been found to have any association from controlled studies.

A.     Drugs and Toxins

    1.    Definite

    • Aminorex
    • Fenfluramine
    • Dexfenfluramine
    • Toxic Rapeseed Oil

    2.    Very Likely

    • Amphetamines
    • L-tryptophan

    3.   Possible

    • Meta-amphetamines
    • Cocaine
    • Chemotherapeutic Agents

    4. Unlikely

    • Antidepressants
    • Oral Contraceptives
    • Estrogen Therapy
    • Cigarette Smoking
 
The research findings concerning the effects of Ma Huang and other ephedra-containing products is equivocal - some studies show absolutely no beneficial effect, while a handful of others show a modest increase in metabolic rate, suppression of appetite and enhanced weight loss when compared to a placebo. A possible reason for the inconsistent findings is the variable levels of the active alkaloids responsible for the stimulatory effects associated with Ma Huang and other ephedra-containing products. As with many naturally derived compounds, levels of the active chemicals can vary significantly from product to product and from batch to batch - a MAJOR problem when considered in light of the potential adverse side effects associated with ephedra-containing products (see below)

Because ephedrine is a stimulant, it is logical that either a single dose or chronic repeated use would elevate metabolic rate somewhat (meaning that you would burn more calories at rest and during exercise). One study showed that overweight men and women who were dieting were better able to maintain their resting metabolic rate (which typically falls during a weight loss program) when they consumed 150mg of ephedrine per day (although no additional weight loss was noted). The combination of ephedrine (20-40mg) and caffeine (200-400mg), sometimes combined with theophylline from tea (50mg) or salicylates from white willow (100mg), has been found to work better then either agent alone in producing a slight increase in resting metabolism and appears to be about as effective as prescription weight loss medications such as dexfenfluramine. In another study, ephedrine (30mg) combined with caffeine (100mg) and aspirin (300mg) increased energy expenditure following a meal in obese women. This combination, known to many consumers as the "ECA stack" (for Ephedrine/Caffeine/Aspirin), has become one of the most popular weight loss supplements on the market.Ephedrine can be converted into the street drug methamphetamine ("meth" or "speed"). The active ingredient in Ma Huang is ephedrine, sale of which has been restricted in 16 states. Ephedrine is considered a banned substance by the International Olympic Committee (IOC) the United States Olympic Committee (USOC), and the National Collegiate Athletic Association (NCAA). The FDA has received nearly 1000 reports of "adverse events" from consumers using one of over 100 supplements containing ephedrine alkaloids. Complaints have ranged from nervous system and cardiovascular system effects such as elevated blood pressure, heart palpitations, insomnia, irritability, headaches, and serious adverse effects such as seizures, stroke, heart attack, and even death (about 15-20 thus far). Most of these adverse events occurred in otherwise healthy young to middle-aged adults using the products for weight control or increased energy. In response to the relatively large number of adverse reports (compared to other dietary supplements), the FDA proposed to limit the amount of ephedra alkaloids that could be consumed per dose (8mg) and per day (24mg). Quite recently, however, the General Accounting Office (GAO) has determined that the majority of these reports cannot be substantiated or linked directly to any ephedra-containing product, nor did the FDA have adequate scientific evidence that any restrictions on ephedra dosing or daily intake was needed. To put the overall safety question into proper perspective, ephedrine-alkaloids are NOT for everyone - but 1000 adverse reports against the backdrop of several hundred million doses over the last couple of years hardly qualified as the "public health menace" that many media stories have suggested

Virtually all dietary supplements that contain ephedra-alkaloids also carry a strong warning on their labels which reads:
Women who are pregnant or nursing should avoid using ephedra-containing products. Keep out of reach of children. Avoid using ephedra- ephedrine-containing products if you have high blood pressure - hypertension, heart or thyroid disease, diabetes, difficulty in urination due to prostate enlargement, or if taking monoamine oxidase (MAO) inhibitors or any other prescription drug. Reduce or discontinue use if nervousness, tremor, irritability, rapid heartbeat, sleeplessness, loss of appetite, or nausea occur.
 
Because ephedrine is similar in structure to amphetamines and can increase heart rate and blood pressure in susceptible individuals, the FDA has recommended that ephedrine consumption should be limited to less than 24 mg per day and that dietary supplements contain no more than 8mg of ephedrine or related alkaloids per serving (recently, the FDA has indicated that they may be backing away from this recommendation, but it still stands in the public record for now). It is very important, should you decide to use ephedra-containing products, to understand that there are a variety of ephedrine-like compounds (alkaloids) present in Ma Huang and related herbs, including ephedrine, norephedrine, pseudoephedrine, methylephedrine, and norpseudoephedrine - and products should be standardized to a TOTAL ALKALOID content. For example, a product that states 356mg of Ma Huang or related herb per serving and is standardized to 6% ephedra alkaloids, would have 21.36mg of ephedra alkaloids per serving (356 X 0.06 = 21.36) - make sure that the "standardization" is to TOTAL alkaloids rather than simply to ephedrine

In the few studies which have been conducted on ephedra-containing products for weight loss, the total amount of ephedrine ingested per day has ranged between 60-75mg (usually in 3 divided doses of 20-25mg/dose).

The above dosage recommendations should be considered in light of a recent study from the University of Arkansas which analyzed the content of ephedra alkaloids in 20 dietary supplements. The study showed that the alkaloid content varied considerably among products - from ZERO to 18.5mg per dose and significant lot-to-lot variations in alkaloid content were observed for at least 4 products (meaning that even if you selected the same brand each time, you would be getting a different level of ephedra). For 1 product, the alkaloid content varied by as much as 1000% between lots. Perhaps the most disturbing finding of the study was that fully half of the products showed discrepancies of more than 20% between the label claim for ephedra alkaloids and the actual alkaloids measured in the study.

Actual Ephedra clients of Willis Law Firm           

 39 year old woman diagnosed with PPH -heart lung damage after ephedra use - Death
 24 year old woman has heart attack while taking ephedra.
 37 year old woman has massive stroke shortly after taking an ephedra product

 41 year old woman diagnosed with PPH -heart lung damage after ephedra use 
  Alaska . Alabama . Arkansas . Arizona . California . Colorado . Connecticut . Delaware . Florida . Georgia . Hawaii . Iowa . Idaho . Illinois . Indiana . Kansas . Kentucky . Louisiana . Massachusetts . Maryland . Maine . Michigan . Minnesota . Missouri . Mississippi . Montana . North Carolina . Nebraska . New Hampshire . New Jersey . New Mexico . Nevada . New York . Ohio . Oklahoma . Oregon . Pennsylvania . Rhode Island . South Carolina . South Dakota . Tennessee . Texas . Utah . Virginia . Vermont . Washington . Wisconsin 55 year old man diagnosed with PPH, Ephedra consumed from Metabolife 356
 41 year old woman diagnosed with PPH, Ephedra from Herbalife energy and diet product
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 40 year old woman diagnosed with PPH after taking ephedra diet energy product
 metabolife verdict in texas, metabolife trial in texas, metabolife settlement, class action 59 year old man has stroke shortly after taking an ephedra product
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NOTE: Many other ephedra injury cases are currently being reviewed by our team of lawyers and medical experts.

LEGAL OPTIONS FOR EPHEDRA USERS WITH PPH

ephedra,PPH,cause,primary pulmonary hypertension,ephedra, phentermine, ephedra,PPH, ephedrine,ma huang, does ephedra cause pph, metabolife pph,pulmonary hypertension,pph causes, fastin, cause,dietary,amphetamine,nutritional herbal,supplements,link,medical,legal,lawyerIf you or a loved one have been diagnosed with Primary Pulmonary Hypertension (PPH), then you may have a right to file a individual legal action against the manufacturers of the diet pills or others. Due to the nature of this serious and devastating disease process, PPH patients are urged to contact an attorney immediately after he or she has been informed of their Primary Pulmonary Hypertension diagnosis. Many important legal issues need to be addressed early after a PPH diagnosis, that can affect the outcome of the PPH litigation. Call us for a Free Confidential Consultation. Talk with a Board Certified Personal Injury Trial Lawyer about your legal rights of a PPH claim against the diet drug industry and others. No Fees or Expenses Charged unless we make a Recovery for You. 

Call Us Toll Free at 1-800-883-9858 or 1-800-468-4878 or E-mail us your questions on Free Case Evaluation Form

 

SOURCES FOR SOME MATERIAL ABOVE 1. Astrup, A., et al., The effect and safety of an ephedrine/caffeine compound compared to ephedrine, caffeine and placebo in obese subjects on an energy restricted diet. A double blind trial. Int J Obes Relat Metab Disord, 1992. 16(4): p. 269-77. 2. Astrup, A., L. Breum, and S. Toubro, Pharmacological and clinical studies of ephedrine and other thermogenic agonists. Obes Res, 1995. 3 Suppl 4: p. 537S-540S. 3. Breum, L., et al., Comparison of an ephedrine/caffeine combination and dexfenfluramine in the treatment of obesity. A double-blind multi-centre trial in general practice. Int J Obes Relat Metab Disord, 1994. 18(2): p. 99-103. 4. Bruno, A., K.B. Nolte, and J. Chapin, Stroke associated with ephedrine use. Neurology, 1993. 43(7): p. 1313-6. 5. Capwell, R.R., Ephedrine-induced mania from an herbal diet supplement [letter]. Am J Psychiatry, 1995. 152(4): p. 647. 6. Daly, P.A., et al., Ephedrine, caffeine and aspirin: safety and efficacy for treatment of human obesity. Int J Obes Relat Metab Disord, 1993. 17 Suppl 1: p. S73-8. 7. Flurer CL, Lin LA, Satzger RD, Wolnik KA. Determination of ephedrine compounds in nutritional supplements by cyclodextrin-modified capillary electrophoresis. J Chromatogr B Biomed Appl. 1995 Jul 7;669(1):133-9. 8. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000 May 15;57(10):963-9. 9. Gurley BJ, Gardner SF, White LM, Wang PL. Ephedrine pharmacokinetics after the ingestion of nutritional supplements containing Ephedra sinica (ma huang). Ther Drug Monit. 1998 Aug;20(4):439-45. 10. Gurley BJ, Wang P, Gardner SF. Ephedrine-type alkaloid content of nutritional supplements containing Ephedra sinica (Ma-huang) as determined by high performance liquid chromatography. J Pharm Sci 1998 Dec;87(12):1547-53. 11. Gurley BJ, Wang P, Gardner SF. Ephedrine-type alkaloid content of nutritional supplements containing Ephedra sinica (Ma-huang) as determined by high performance liquid chromatography. J Pharm Sci. 1998 Dec;87(12):1547-53. 12. Josefson, D., Herbal stimulant causes US deaths [news]. Bmj, 1996. 312(7043): p. 1378-9. 13. Ros JJ, Pelders MG, De Smet PA. A case of positive doping associated with a botanical food supplement. Pharm World Sci. 1999 Feb;21(1):44-6. 14. Roxanas, M.G. and J. Spalding, Ephedrine abuse psychosis. Med J Aust, 1977. 2(19): p. 639-40. 15. Toubro, S., et al., Safety and efficacy of long-term treatment with ephedrine, caffeine and an ephedrine/caffeine mixture. Int J Obes Relat Metab Disord, 1993. 17 Suppl 1: p. S69-72. 16. Toubro, S., et al., The acute and chronic effects of ephedrine/caffeine mixtures on energy expenditure and glucose metabolism in humans. Int J Obes Relat Metab Disord, 1993. 17 Suppl 3: p. S73-7; discussion S82. 17. Van Mieghem, W., E. Stevens, and J. Cosemans, Ephedrine-induced cardiopathy. Br Med J, 1978. 1(6116): p. 816. 18. White LM, Gardner SF, Gurley BJ, Marx MA, Wang PL, Estes M. Pharmacokinetics and cardiovascular effects of ma-huang (Ephedra sinica) in normotensive adults. J Clin Pharmacol. 1997 Feb;37(2):116-22. 19. White LM, Gardner SF, Gurley BJ, Marx MA, Wang PL, Estes M. Pharmacokinetics and cardiovascular effects of ma-huang (Ephedra sinica) in normotensive adults. J Clin Pharmacol. 1997 Feb;37(2):116-22http://wwwsupplementwatch.com/supatoz/supplement.asp?supplementId=111

PPH LAWYER

Primary Pulmonary Hypertension (PPH) Legal Assistance LawyerIf you or a loved one took diet drugs and recently have been given a diagnosis of Primary Pulmonary Hypertension (PPH), idiopathic pulmonary hypertension, pulmonary arterial hypertension, PAH or pulmonary hypertension, then call us for a Free PPH Lawsuit Consultation. Talk to a Personal Injury Trial Lawyer with over 20+ years of product liability trial experience that understands the complications of PPH, legal options for patients with PPH and diet drug related PPH lawsuits and litigation.

Since 1997, we have aggressively represented PPH patients in diet drug lawsuits against the makers of Fen -Phen, Redux and PPH lawsuits against the nutritional supplement industry on herbal ephedrine / ephedra / ma huang PPH lawsuits. Get PPH Lawsuit Help. Talk to a PPH Attorney now. Call Toll Free 1-800-883-9858 or E-mail us.

Primary Pulmonary Hypertension (PPH) Legal Assistance Lawyer

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Primary Pulmonary Hypertension (PPH) Legal Assistance LawyerIf you have been diagnosed with PPH then it very important that you talk with an attorney. Mr. Willis is a Board Certified Personal Injury Trial Lawyer, certified by the Texas Board of Legal Specialization since 1988. No Fees or Court Costs or Expenses charged to the client unless we obtain a recovery for you. We never send you a bill for our services! Call us if you have a question.

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