Ephedra (Ephedra sinica) / ma huang
Natural Standard® Patient Monograph, Copyright © 2013 (www.naturalstandard.com). All Rights Reserved. Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
On February 6, 2004, the U.S. Food and Drug Administration (FDA) issued a final rule prohibiting the sale of dietary supplements containing ephedrine alkaloids (ephedra) because such supplements present an unreasonable risk of illness or injury. The rule became effective 60 days from the date of publication.
In 2005 this rule was struck down in Utah but reversed again four months later, so ephedra is currently banned throughout the United States. It remains unclear whether ephedra will re-appear on the market, despite widespread acknowledgement of significant safety risks, including serious potential cardiovascular events or death.
Ephedra sinica , a species of ephedra (ma huang), contains the alkaloids ephedrine and pseudoephedrine, which have been found to induce central nervous system stimulation, bronchodilation, and vasoconstriction. In combination with caffeine, ephedrine appears to elicit weight loss (in trials of 1-12 months duration). However, studies of ephedra or ephedrine monotherapy have been equivocal. Numerous trials have documented the efficacy of ephedrine in the management of asthmatic bronchoconstriction and hypotension. However, commercial preparations of non-prescription supplements containing ephedra have not been systematically studied for these indications.
Major safety concerns have been associated with ephedra or ephedrine use, including hypertension (high blood pressure), tachycardia, CNS excitation, arrhythmia, myocardial infarction (heart attack), and stroke.
Despite widely publicized safety concerns and the highly publicized 2003 death of a U.S. major league baseball pitcher thought to be related to ephedra, prior to the ban on ephedra, 14% of individuals using non-prescription weight-loss products in the United States continued to take ephedra or ephedrine-containing products.