Ephedra or Ma Huang Chinese
Ephedra (Ephedra sinica), also known as Ma-Huang, is an herbal stimulant drug composed of two active compounds (pseudoephedrine and ephedrine) that are ingredients in many over-the-counter products.
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| © Steven Foster |
The FDA regulates ephedrine, the synthesized form of ephedra. Ephedrine can be produced by chemical synthesis and in its pure form (ephedrine sulfate) is a bitter tasting, white, crystalline powder. Ephedrine and pseudoephedrine stimulate the opening of air passages in the lungs and are used as decongestants for the short-term treatment of asthma, bronchitis, and certain allergic reactions. Ephedrine and pseudoephedrine are also used in dietary supplements that claim to promote weight loss and enhance athletic performance. The active compounds are structurally related to amphetamines; they play similar, although less potent, roles in stimulating the central nervous system. Ephedrine is often the primary ingredient found in illegally synthesized drugs, including methamphetamines
- Ephedra is an evergreen shrub-like plant native to central Asia, and Mongolia; it also grows in the southwestern United States.
- People have used ephedra for centuries in China for colds, fever, flu, headaches, asthma, nasal congestion, and wheezing.
- The U.S. Food and Drug Administration (FDA) banned the sale of dietary supplements containing ephedrine alkaloids (compounds found in some ephedra species) in the United States in 2004. It was an ingredient in some dietary supplements marketed for weight loss, increased energy, and enhanced athletic performance.
- The dried stems and leaves of the ephedra plant have been used to create capsules, tablets, extracts, and teas.
How Much Do We Know?
A large amount of research led to ephedrine alkaloids becoming main oral asthma medications in the 1940s and 1950s. Ephedra also has been used as a weight-loss agent and energy enhancer for athletic performance. However, the increasing number of reported adverse events caused the FDA to ban dietary supplements that contain ephedrine alkaloids.
What Have We Learned?
According to the FDA, there is little evidence of ephedra’s effectiveness, except for short-term weight loss. However, the increased risk of heart problems and stroke outweighs any benefits.
What Do We Know About Safety?
1. The FDA banned the U.S. sale of dietary supplements containing ephedrine alkaloids. It found that these supplements had an unreasonable risk of injury or illness—particularly cardiovascular complications—and a risk of death. The ban does not apply to traditional Chinese herbal remedies.
2. Using ephedra may worsen many health conditions such as heart disease and kidney disease. Ephedra has been associated with stroke. It also may contribute to increased blood sugar levels.
3. Ephedra may intensify or cause seizures in people with seizure disorders.
4. Taking ephedra may also cause anxiety, dizziness, difficulty urinating, dry mouth, headache, irritation of the stomach, nausea, psychosis, restlessness, sleep problems, and tremors. Some of these side effects may be associated with long-term use of ephedra.
5. Women who are pregnant or breastfeeding and children should avoid taking ephedra.
Ephedra use may lead to serious health problems when used with other dietary supplements or medicines.
6. Combining ephedra with caffeine increases the risk of potentially serious side effects.
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