ECA stack

ECA Stack

ECA stack refers to a combination of drugs, primarily used for weight loss and as a stimulant. The acronym stands for ephedrine, caffeine, and aspirin. There exists a variant known as the EC stack, which omits the aspirin component to cater to individuals with aspirin intolerance. Supplements containing or based on the ECA composition were notably in vogue during the 1990s and early 2000s. However, contemporary marketing and sales of such combinations, especially when containing ephedra or ephedrine, are largely restricted or prohibited in countries including the United States, Canada, and the Netherlands due to associated health risks.

Efficacy

Promoters of the ECA stack once championed its potential in weight loss, enhancing athletic prowess, and boosting energy.

Fat Loss

Controlled studies with placebos consistently found that the combination of ephedrine and caffeine could promote moderate fat loss in individuals who are obese. Herbal supplements that contain Ephedra, also termed Ma Huang, when coupled with or without caffeine, have also been deemed safe and effective in studies of durations ranging from 8 weeks to half a year. Meta-analyses, which pool data from diverse studies, have estimated an average weight loss of about 1 kg/month over placebo effects.

Athletic Performance

Most research indicates insignificant to nil benefits in terms of enhancing athletic performance.

Risks

Certain natural supplements containing ephedra (Ma Huang) as a substitute for ephedrine have been correlated with cases of heart attack, stroke, and even death in healthy young adults, even when consumed as per the labeled dosage. While anecdotal evidence from unregulated supplement users highlights potential harm, controlled studies and medically prescribed uses of EC do not convincingly demonstrate cardiovascular risks.

A meta-analysis conducted in 2003 concluded that dietary supplements containing ephedrine or ephedra might amplify the risk of psychiatric and autonomic symptoms, upper gastrointestinal symptoms, and heart palpitations. However, another study from 2008 contradicted these findings, suggesting no adverse cardiovascular outcomes linked to ephedrine/caffeine prescriptions.

Use in Denmark

In Denmark, an EC formulation named Letigen, combining 20 mg of synthetic ephedrine with 200 mg of caffeine, was sanctioned for prescription sale in 1990. Around 1999, about 2% of the Danish populace was using this product. Despite the discontinuation of its marketing in 2002 due to adverse event reports similar to other nations, a 2008 follow-up study found no evidence of cardiovascular risks associated with its consumption.

Legal Status

The linkage of deaths to ephedra-based dietary supplements and the potential misuse of ephedrine in illegal methamphetamine production prompted many nations to implement regulatory measures.

Status in the United States

In the USA, the marketing of products laced with ephedrine or ephedra alkaloids as dietary supplements is illegal. The U.S. Food and Drug Administration imposed a ban on ephedra, a natural source of ephedrine alkaloids, in 2004 owing to severe safety concerns. Nonetheless, ephedrine remains legal and can be procured over-the-counter in the US, with specific regulations varying by state.

Status in Canada

As of January 2002, Health Canada advocated for the voluntary recall of ephedrine products exceeding 8 mg per dose or those combined with stimulants like caffeine. The recall also extended to ephedrine products promoted for weight loss or bodybuilding due to significant health risks.

See Also

• Ephedrine
• Caffeine
• Aspirin
• Weight Loss Supplements

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