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| Ephedra |
| Description: Ephedra (Ephedra sinica, Ephedra intermedia, Ephedra equisetina) has been used medicinally for over 5000 years to treat various lung and breathing conditions. Ephedra’s (or Ma Huang, as it is also known) main ingredient is ephedrine. Ephedrine stimulates the nervous system, dilates bronchial tubes, elevates blood pressure, and increases heart rate. Ephedra has received lots of press for being "natural ephedrine". This is one of the cases, however, where natural is not necessarily better than laboratory-made. The amount of ephedrine present in ephedra is highly variable. It can account for anywhere from 30 to 90% of the alkaloids in a given sample.1 The variability of dosage can cause many problems, as will be described below. Ephedra has gained popularity as a weight loss drug. It is not, however, a safe herb to use for this purpose. In most cases, the doses used for weight loss are far beyond the 150 mg per 24 hours safety limit that has been established. Higher doses cause many amphetamine-like side effects, ranging from mild things like dry mouth to severe problems including heart failure. Even a single dose of ephedra can raise heart rate;2 the result is multiplied when ephedra is used repeatedly. Too high a level of ephedra in the system can case many problems, including restlessness, anxiety, headaches, high blood pressure, and insomnia. Like other amphetamines, ephedra is addictive. When its use is discontinued, withdrawal symptoms – including cold sweats, mood swings, and heart palpitations – occur. In addition, when it is used as a weight loss drug, a common response to its removal from the system is binge eating. As a result, the weight is almost immediately gained back. Ephedra is taken again, and the downward spiral continues. Ephedra reacts badly with many medical conditions, including with high blood pressure, heart problems, glaucoma, hyperthyroidism, and diabetes. Not all of these are always listed on commercially-available ephedra compounds. The Food and Drug Administration has been investigating ephedra and ephedrine for several years. In 1983, they banned over-the-counter medications containing both ephedrine and caffeine due to reports of abuse. In 1988, Congress passed a law requiring that strict records about ephedrine powder sales be kept due to concern by the DEA that it was being used to make the illicit drug methamphetamine (ephedrine and methamphetamine are almost identical in chemical structure). In 1994, this law became stricter, and all products using ephedrine had to be tracked, since drug dealers were using them to create meth. In 1995, Congress attempted a ban of ephedrine. It failed. In 1997, the FDA stepped in again, proposing limitations on the amount of ephedrine that could be used in diet products. They have since been carefully watching the use of ephedrine and ephedra, and put out repeated warnings against the use of diet products containing either substance. It is probably a good indicator of the potential dangers of ephedra that the herb can only be dispensed under a prescription in the United Kingdom. Ephedra can help ease the bronchial tightness often associated with asthma.3,4 Extreme care should be taken with its use, however. It should not be taken in conjunction with or within four hours of over-the-counter ephedrine. Useful in treatment of: asthma. Recommended Dosage: Since there are other available asthma treatments, use of ephedra is not recommended. Contraindications: Should not be used by anyone with high blood pressure, heart problems, glaucoma, hyperthyroidism, or diabetes. Ephedra can cause many side effects including dry mouth, irregular heartbeat, sweating, and even death. It should only be used with care. References: 1Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996, 227–29. |
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