The weight-loss pill industry is in a bit of a panic. It lost its major cash cow when supplements containing ephedrine were banned in North America. We’re not talking pennies here, we are talking about billions of dollars. So the scramble is on to find a replacement which can be marketed using the key words, “natural,” “effective” and “safe.” Those were in fact the terms that fueled the runaway sales of ephedra products. Ephedra was natural. Not that this means anything in terms of safety, but it was derived from a plant often referred to as Ma Huang. Whether it was effective or not is arguable. Ephedrine certainly stimulates the activity of the body’s sympathetic nervous system, which in turn leads to increased thermogenesis, a phenomenon loved by marketers. This basically means that the body temperature rises slightly. The energy to do this comes from breaking down fat in fat cells, particularly the ones that make up what we call brown adipose tissue. So, at least in theory, ephedra products could have offered some slight aid in weight loss. But as it turned out, they were not safe. Stimulating the sympathetic nervous system can also cause elevated blood pressure, increased heart rate, insomnia and anxiety.
Once ephedra was banned, the race was on to find a substitute. An extract of the Citrus Aurantium plant was a good candidate because it contained synephrine, a compound that like ephedrine could stimulate thermogenesis. And it was legal! If the name sounds familiar, it is because you may associate it with Neo-Synephrine, a common over-the counter decongestant. The active ingredient in this product is neo-synephrine, also known as phenylephrine. If you take a look at the label, you will see all sorts of warnings about possible side effects including an increase in blood pressure. The risk, however, is very small since such medications are used for a very short period. Synephrine differs only slightly in molecular structure. So its side effect profile is expected to be roughly the same. The difference, though, is that such weight control products are used for months, meaning the risk increases. That’s why Health Canada has stepped in and issued a warning about weight control products containing synephrine. Their sale and importation into Canada are now illegal. The common name for the Citrus Aurantium plant is “bitter orange,” and I suspect some marketers may want to hide behind this name and not mention their product contains synephrine. They may even make use of “zhi shi,” the Chinese name for the plant. There is yet a further issue with synephrine. It is not the only compound in the plant that can raise blood pressure. Octopamine and tyramine can do that as well, and nobody knows how much of these is present in any product that contains “bitter orange” extract. It’s about time that our government starts exercising its regulatory muscle to protect the public from questionable products.