The hoopla over weight-loss drugs is just the beginning (“Healthy, Wealthy, But Wise?” by Matthew Heller, Feb. 1). Supplements are supposed to be benign, like food, rather than dangerous, like drugs. Some natural products are harmless, and some aren’t. Dosage is the critical issue. Coffee is natural and rather benign, but a teaspoon of pure alkaloid caffeine would kill you. The milky juice in the central stem of lettuce contains compounds similar to opiates, but salads don’t have the same effect as heroin, and the most fanatical just-say-no campaigner wouldn’t refuse a plate of crudites.
Ephedrine is no different. A little bit, such as in a tea made of ephedra, is no worse (and maybe no better) than a cup of coffee. However, it is utter bilge to call the pure alkaloid harmless. If we were rational all the time, none of this would be a problem. Labels would never make big promises and would clearly list the maximum dose and possible side effects. Consumers would never look for hope in a bottle. Drugs are drugs, whether packaged by nature or Merck. Low dosages aren’t the same as high dosages. If we grasp this, a more rational approach becomes possible--no matter whether drugs are legal or illegal, herbal or pharmaceutical, safe or unsafe.