Is there any danger to taking ephedra (ma huang)?

Ephedra equisetina is the desert shrub from which ephedrine is extracted. Ephedrine is a thermogenic aid originally used to relieve asthma symptoms by its bronchodilating action, meaning it dilates the bronchioles that supply the lungs with oxygen. Ephedrine can sharply raise blood pressure and heart rate, and it stimulates thermogenesis. Thermogenesis, or heat production, occurs with exercise, food consumption, and the use of certain substances. It is thought that ephedrine contributes to a thermogenic effect by causing the adrenal glands to dump epinephrine into the blood stream, leading to increased body temperature, and, therefore, expending more calories.

Ephedrine is also known by its traditional Chinese name, Ma huang, which is an evergreen plant derivative. It acts as a stimulant by supposedly boosting energy and helping with weight control, making ephedrine chemically similar to the stimulant drugs known as amphetamines. Ephedrine also accomplishes weight control partly by reducing appetite.

Any products containing ephedra were made illegal for over-the-counter sales by the U.S. Food and Drug Administration (FDA) on April 12, 2004. Prior to this date, ephedra was available legally in nutritional supplements, energizers, and dietary teas, as well as in herbal "ecstasy," which was the impetus for its controversy. The FDA banned ephedrine after it "...received an increasing number of reports of adverse reactions associated with ephedra use. These reported reactions vary from the milder adverse effects known to be associated with sympathomimetic stimulants (e.g., nervousness, dizziness, tremor, alterations in blood pressure, headache, gastrointestinal distress) to chest pain, myocardial infarction, hepatitis, stroke, seizures, psychosis, and death." Some 32 deaths were also attributed to this drug. Ephedrine has been taken off the shelves in some states because of these various complications.

However, as more research has been done concerning ephedrine, this controversy continues. On April, 13, 2005, a United States Federal District Court overruled the ban of ephedrine in over-the-counter products. The key point to this reversal is that ephedrine can only be sold in amounts of 10 mg or less to be sold legally. This dosage is much less than what was sold in prior dietary supplements. Also, if ephedrine was deemed illegal at the state level, as it was in New York and California, state law rules supreme over this Federal Court's decision.

Ephedrine's future on the U.S. dietary supplement market has yet to be definitively determined. In the meantime, ephedrine is in no way a miracle worker. Exercise and nutrition, as challenging as they are to decide, implement, and stick to, are still the most effective keys to weight loss. Similar to ephedrine, exercise causes body temperature to increase, which, in turn, expends calories. Also, each time you eat, your body temperature rises. Some of the calories simply get burned up as heat in their conversion for use. The thermic effect of food usually accounts for 10 percent of what we take in. For example, if you eat 2000 calories, then 200 are spent by the thermogenic effect of food alone.

Stick with the following exercise and nutrition recommendations if you're interested in weight management or loss:

• Eat breakfast — this jump starts your metabolism for the day.
• Eat five to six small instead of three large meals a day, to help keep metabolism high.
• Participate in regular aerobic exercise, which helps to reduce stored fat. This activity also allows your body to continue to expend calories at a high rate for a short amount of time after exercise.
• Participate in a weight lifting program to build more lean muscle mass since this will increase your basal metabolic rate (BMR), thereby expending calories even when you are not exercising.

If you need to take ephedrine for medical reasons, consult with your health care provider first to make sure you are not placing your health at risk. A reputable web resource for more information is the National Center for Complementary and Alternative Medicine of the National Institutes of Health (NIH).

For the details on the recent Federal Court ruling, you can visit the "Federal Court Overturns FDA Ban on Ephedrine-Containing Dietary Supplements" (PDF) article on the National and Nutritional Products Industry Center website.

Alice

Related Q&As

Are there dietary supplements that promote healthy living?

Metabolife

Metabolife

Do ''fat burners'' really work?