Executive Summary

Ephedrine, creatine use may be responsible for recent upswing in heatstroke-related deaths in football, Julian Bailes, MD, West Virginia University, et al., contend in an editorial in the August Neurosurgery. Since 1995, 15 football players have died of heatstroke, compared to only six deaths from 1985 to 1994, researchers report, citing National Center for Catastrophic Sports Injury Research data. This upswing "may, in part, be attributable to or aggravated by the use of dietary supplements," Bailes et al. say. They cite evidence that "creatine usage causes shifts of body water into skeletal muscle cells" that may result in "unsuspected depletion in intravascular volume." Researchers suggest improving education for athletes, trainers and coaches about "dangers," misuse and potential adverse effects of supplements...