Ephedra
by Phillip Treadwell, PharmD

Ephedra, or Ma Huang, is a popular herb in the United States. It is often touted as a weight loss aid and as a method to improve alertness. There are some important problems with this plant that can make Ephedra a dangerous, and potentially deadly, product. We will look at some of these issues so that you can make an informed decision about this product.

The major active constituent in ephedra is ephedrine. Ephedrine is a stimulant that is similar in many ways to amphetamines. It causes the blood levels of catecholamines (adrenaline, etc.) to increase which leads to increases in heart rate, blood pressure and sweating, and decreased appetite and enhanced alertness. Ma Huang can cause weight loss if combined with other agents, and can improve neurologic testing scores.

Products that contain ephedra include: Metabolife 356® and copycats of this product, Herba Fuel®, and many herbal products for the common cold and weight loss, among others. It is also available as a single ingredient preparation from many herbal manufacturers. The dosages available in these products can vary widely, so caution must be exercised when selecting a product.

Problems exist with ephedra in that it can cause irregular heartbeats, which can lead to death. So far, dozens of deaths have been reported to the Food and Drug Administration associated with ephedra. Young, healthy athletes have died from using this product, so nobody is immune. It can also cause anxiety, chest pain, insomnia, dizziness, headaches and many other side effects. Many drug interactions and lab test abnormalities are also possible. Herbals are not regulated as stringently as are medicines, and can contain adulterants and unpredictable levels of the active ingredients.

I hope this information will help you in making an informed decision about ephedra. Herbs, in general, are not to be treated lightly, but should only be used when you have good information to guide your use of these products. Please talk to your physician, pharmacist, or another herbal expert if you have any questions.