EPHEDRA (Ephedra sinica)

Latin: Ephedra sinica
Chinese: Ma huang

WHAT IT DOES: Ephedra is pungent and slightly bitter in taste, and warming in action.  It relaxes the muscles surrounding the lungs, dilates the surfaces vessels of the skin and increases metabolism.  SPECIAL NOTE: THIS HERB HAS BEEN BANNED FOR USE IN SEVERAL COUNTRIES, INCLUDING THE UNITED STATES.

RATING: Red, due to high potential for misuse

SAFETY ISSUES: Here are the the warnings I wrote in 1999, prior to the banning of this herb due to problems caused by inappropriate use of extracts of this herb in weight loss products:

Use only under professional medical guidance.  Do not use long term.  Do not use during pregnancy or nursing.  Do not exceed recommended dosage.  Do not use with MAO-inhibiting drugs, blood pressure lowering drugs, steroids, beta-blockers or anti-depressants.  Do not use if you have glaucoma, hypertension, heart disease, insomnia, cardiac asthma, adrenal weakness, prostate enlargement, arteriosclerosis, hyperthyroidism, diabetes, anorexia or bulimia, kidney disease or a history of kidney stones.  Do not use as a weight-loss agent unless under medical supervision.

Symptoms of ephedra overdose include rapid heartbeat, increased blood pressure, nervousness, insomnia and sweating.  Discontinue immediately if you experience any of these symptoms.

• Total alkaloids: 15-30 mg per dose, not to exceed 300 mg per day
• Crude herb: no more than 1.5-9 grams per day in divided doses as a tea
• Total alkaloids: 0.5 mg per dose per weight kilogram, not to exceed 2.0 mg per kilogram per day

total alkaloids in crude herb can be as high as 3.3%

Ephedra (ma huang) is a very useful herb that the Chinese use to disperse coldness, open the pores and promote perspiration, which can be helpful in treating chills, fever and headache.  It also controls wheezing and relaxes the muscles around the lungs, which explains its wide use as a treatment for asthma and cough.  This plant contains ephedrine and pseudoephedrine, powerful alkaloids found in many over-the-counter asthma medications (ephedrine) and nasal decongestants (pseudoephedrine).  These components also stimulate the central nervous system.  If you have high blood pressure, ephedra can be deadly.  TCM doctors do not generally consider ephedra to be dangerous, but they prescribe the whole plant, not the extracted alkaloids, to patients with specific symptoms, and usually as only 10% of a prescription.  Ephedra is an essential herb of TCM that simply is not prescribed when there are signs of heat or hypertension.

It is possible for healthy people to safely use products containing ephedra when consumed in moderate amounts, and many people taking over-the-counter hay fever remedies do so with little or no trouble.  Unfortunately, ephedra is now sold as a stimulant and a weight-loss product for its metabolism-stimulating and appetite-suppressing properties.  Many people who are overweight also have hypertension–just imagine how dangerous ephedra can be in these particular cases.  That’s not to say the herb doesn’t work for weight loss.  In fact it does, and the result is even more powerful when combined with green tea, due to the additional action of caffeine.  The combination of these two types of stimulants can be especially powerful.  But again, this should be done under the guidance of a professional with experience about safety and dosage.  Asthma and weight loss are both complex, serious problems.  You can’t treat them safely just by swallowing over-the-counter herbal pills.

Research Highlights

• When used over time, ephedra can weaken the adrenal glands. Michael Murray N.D., faculty member at the John Bastyr Naturopathic Univeristy and best-selling author, recommends combining it with adrenal supportive herbs such as licorice root, ginseng root and nutrients like vitamin C, magnesium, zinc, B-6 and pantothenic acid (Murray, 1991).

• There continue to be numerous reports of ephedrine-related toxicity and death.  In a random study of nine commercially available supplements, only three contained the ephedrine content listed on the label, and the alkaloid content ranged from 1.08-13.54 mg.  per pill.  There were also significant variations among different lots of the same product (Gurley et al., 1998).  In a second study, the same researcher concluded that ephedra toxicity “results from accidental overdose often prompted by exaggerated off-label claims and a belief that ‘natural’ medicinal agents are inherently safe” (Gurley et al., 1998).

• Ephedra exhibits anti-inflammatory activity (Ling et al., 1995) which may enhance its usefulness for treating asthma.

• In the Canadian Forces Warrior Test, the combination of caffeine and ephedrine improved performance.  Doses tested were 375 mg of caffeine and 75 mg of ephedrine, within safe levels for healthy subjects (Bell and Jacobs, 1999).

• In a study of obese monkeys, the combination of caffeine and ephedrine caused an increase in energy expenditure, a decrease in food intake, and weight loss (Ramsey et al., 1998).

• Although unsupervised use of ephedra or ephedrine can be dangerous, researchers conducted a controlled double-blind study on 136 obese and normal patients undergoing proper treatment with blood pressure lowering drugs as they attempted to lose weight.  Subjects took 20 mg of ephedrine and 20 mg of caffeine.  All groups lost weight, and the combination of ephedrine and caffeine did not reverse the effects of the blood pressure medications (Svendsen et al., 1998).  An earlier clinical trial also found that ephedrine plus caffeine was as effective as dexfenfluramine (Astrup et al., 1995).

• A Harvard Medical School study found that the combination of ephedrine, caffeine and aspirin was “well tolerated in otherwise healthy obese subjects, and supports modest, sustained weight loss even without prescribed caloric restriction (dieting)” (Daly et al., 1993).

Despite FDA Ban, Ephedra won’t go away

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