What risk is particularly increased when bitter orange is taken alongside other stimulants?

When bitter orange, also known as Citrus aurantium, is taken alongside other stimulants, the risk of cardiovascular events is particularly increased. Bitter orange contains synephrine, which has similar effects to ephedrine, a known stimulant that can elevate blood pressure and heart rate. When combined with other stimulants, such as caffeine or certain herbal supplements, the additive effects can lead to overstimulation of the cardiovascular system.

This overstimulation may manifest as increased heart rate (tachycardia), elevated blood pressure, and higher risk of arrhythmias (irregular heartbeats). In certain individuals, especially those with pre-existing heart conditions, this combination can significantly heighten the risk of serious cardiovascular complications, including heart attacks or strokes.

While weight gain, fatigue, and dehydration are concerns in the context of supplementation and overall health, they are not directly related to the stimulant effects of bitter orange and the risks associated with its interaction with other stimulants. Therefore, the specific elevation in risk for cardiovascular events is the primary concern with this combination.