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Hello Dr. Khosrowshahi,

I have an important question about my health that's been bothering me for quite a while now. It's the result of a poor decision I've personally made and that I regret VERY much.

About a year and a half ago, I began obsessing about my body image (I am a male, 26 years old). I started getting into the bodybuilding community and I began using Ephedrine HCL and Caffeine to help me lose weight faster. Over the course of roughly a year, with 2 week breaks every 3 months or so, I was ingesting 24mg of ephedrine in combination with 200mg of Caffeine spaced out 3x per day every 4-6 hours (total of 72mg of ephedrine hcl per day). There was a period of time during a 2 week period where I even ingested 96mg per day spaced out throughout a day. I never went over 96mg though. I did in fact lose a lot of weight, but also experienced a lot of anxiety and paranoia as a side effect.

The good news is that I have COMPLETELY STOPPED worrying about my body image and have stuck to natural ways of losing weight. I regret using the ephedrine and caffeine, and would like to know if what I used is enough to cause some sort of permanent neurotoxicity (I really hope not, I regret this very much). Please doc, help me and hopefully I learned my lesson and will NEVER use fat loss drugs again.

Thank you very, very much for your time it means a lot to me. Enjoy your day...


Dear Ronnie,
 Thanks for the email.  It is unclear if you have suffered some sort of permanent neurotoxicity from the ephedrine and caffeine use.  There are only a handful of studies about this subject and the information is a bit outdated (ie from early 2000s).  The caffeine and ephedrine studies used animals for subjects.  Most likely you should be okay.  However, if you experience any side effects please inform your physician.




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Nanaz Khosrowshahi


Being a pharmacist, I can answer questions on medications. This includes how drugs work in the body, drug interactions, drug side effects, warnings and precautions to take when using certain medications, dosage forms and strengths, management of overdosing, storage of medications, drug administration, contraindications, and drug indications. I am able to guide them on lab work that needs to be drawn and monitored while on certain medications. I am able to help patients save money when purchasing medications by directing them to cost-effective therapies. I am able to answer questions on federal laws governing pharmacy practice in the United States. I am unable to answer questions legally as if I am diagnosing the patient's disease or illness. For example, if a patient stated he had upper flank pain, I am unable to say he definitely has a urinary tract infection. However, I am able to direct the patient to the correct next step, which is to call his physician with such a side effect.


I have been a licensed pharmacist since 2007, holding licenses in CT and MA. I have a PHARM.D from an accelerated pharmacy school program. Currently, I work at the Hebrew Home and Hospital in West Hartford, CT as a pharmacist. I am a well-rounded pharmacist, with experience in long-term care, IV home infusion, retail, hospital, and hospice. I serve as the pharmacy unit coordinator for Mass Dispensing Area #31 in CT, where I am called upon as a volunteer pharmacist in case of public emergencies, such as anthrax threats. I helped run the swine flu vaccine clinic in 2009. I am on the Editorial Advisory Board for Pharmacy Today, a publication of the American Pharmacists Association. My position on the board runs for three years. Every month I make suggestions and offer ideas that would help improve the magazine. I have undergone extra training to administer vaccines to patients, which is training that only a certain percentage of registered pharmacists in the country have.

American Pharmacists Association 2007

Massachusetts College of Pharmacy and Health Sciences, Worcester, MA- PHARM.D 2007 University of California, Irvine- BA psychology 2001 cum laude

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