Studies suggest that bitter orange increases energy expenditure and lipolysis and that it acts as a mild appetite suppressant [ 25 , 27 ]. After the FDA banned the use of ephedrine alkaloids in dietary supplements in 2004 [see section on ephedra (má huáng)], manufacturers replaced ephedra with bitter orange in many products; thus, bitter orange became known as an “ephedra substitute” [ 29 ]. Although synephrine has some structural similarities to ephedrine, it has different pharmacological properties [ 27 , 30 ].
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