DEAR DR. DONOHUE: I hear lots of talk about the dangers of ephedra and ephedrine as stimulants and diet pills, but are they still considered safe in asthma medicines? My husband uses an albuterol inhaler and takes Advair Diskus daily. Should we be concerned about those medications? – C.V.

ANSWER:
Ephedrine and ephedra are similar compounds. Ephedrine is synthesized in laboratories. Ephedra comes from the ephedra plant and is an herbal remedy.

Both are stimulants. Both expand airways. Narrowing of the airways is a major characteristic of asthma and is one of the reasons why asthmatics have such difficulty getting enough air. Both can speed the heart, cause extra heartbeats, cause insomnia and raise blood pressure.

Ephedrine, as a medicine, is carefully compounded, and the exact amount that goes into each pill is precisely known. It has been a safe asthma medicine for many years. Its use is directed by a doctor. Asthmatics should have no fear of employing it.

Ephedra, on the other hand, as an herbal stimulant and diet pill, is not so closely regulated. People often take it in large doses that can create large problems. You might have read of the death of a Baltimore Orioles baseball pitcher this past February. He had taken ephedra, and there is a strong suspicion that it figured into his tragic death.

Neither of your husband’s medicines has ephedrine or ephedra. All asthmatics ought to consult their doctors before using herbal ephedra as an appetite suppressant or a stimulant.

People who don’t have asthma should also be careful if they decide to use ephedra. Investigations into banning it are being conducted. I would discourage everyone from taking it.

DEAR DR. DONOHUE: Last year, my 16-year-old son developed a rapid heartbeat while playing baseball. Our doctor saw him immediately and took an ECG. My son’s heart slowed down on its own, and the doctor said he needed no medicine. The doctor made a diagnosis of WPW, about which we know nothing. Is it safe for my son to play baseball this year? – L.C.

ANSWER:
WPW is the Wolff-Parkinson-White syndrome, named for the three doctors who were the first to describe it. People with this syndrome are born with a heart that has a wiring anomaly. Normally, the electric beep generated by heart pacemaker cells travels down two large bundles to the lower heart chambers, the ventricles.

Once there, it causes the ventricles to contract and pump blood. The right ventricle pumps blood to the lungs to restore its oxygen content. The left ventricle pumps oxygenated blood to the entire body.

A WPW patient has an extra cable that can conduct electric signals to the ventricles. When the signal travels down this aberrant route, the heart might race or develop peculiar heartbeats. Many people have the syndrome and are not treated because they have few instances of heartbeat irregularities. For them, medicine could be more harmful than helpful. For people who have repeated episodes of heart racing or whose hearts beat erratically, treatment is given.

Treatment can be medicine, or it can be a procedure to eradicate the aberrant route that the electrical signal takes. Often that can be achieved with a catheter whose tip is equipped to deliver an electric current. A catheter is a soft, pliable tube that is inserted into an arm or groin vessel and inched into the heart until it reaches the precise position of the aberrant path.

The doctor turns on the electric current, and the extra pathway is destroyed.

For safety’s sake, have the boy see a cardiologist. My guess is that he will allow your son to participate in sports without treatment.

DEAR DR. DONOHUE: Please settle a point that’s been bugging me. I read the contents on all food labels. Sometimes I see “folic acid,” and sometimes I see “folate.” Are these two different substances? – C.P.

ANSWER:
They are the same. Folic acid (folate) is one of the B vitamins.

I hope you have now been debugged.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.