Ephedra: Herbal Medications, What Does Not Work

Ephedra (Ephedra species) is also known as ma huang in Chinese medicine, and in the United States as Mormon tea (actually a different species with little or no ephedrine or pseudoephedrine). This twiggy herb has proven valuable in treating colds, asthma, and cough, and in combination with caffeine, it has also been shown to produce greater weight loss than can be achieved with caloric restriction alone.

Active constituents of ephedra are the alkaloids ephedrine and pseudoephedrine. These potent substances increase blood pressure and heart rate, and pose dangers for people with heart disease, high blood pressure, thyroid problems, or enlarged prostate, and for pregnant and lactating women.

Some 1.5 million pills and tablets containing ephedrine and pseudoephedrine are reportedly taken every day in the United States in cold, hay fever, sinus remedies, and diet aids.

In recent years ephedrine developed a reputation as a recreational drug, and began to be packaged in products with such names as Herbal Ecstacy (sic), which supposedly produced safe and pleasurable stimulation. Abuse of these products, as well as some of the more conventional preparations, has resulted in hundreds of reports of adverse reactions, and the FDA has reportedly received notice of fifteen deaths. Most of these cases involved excessive doses.

In response to reports of toxic reactions, the FDA is currently considering banning any products that contain more than 8 mg of ephedrine. This is probably an excessively low limit, since many of the OTC cold and hay fever remedies contain upwards of 30 mg. Some states have suspended the OTC status of ephedrine- and pseudoephedrine-containing drugs, making them available only by prescription. Herb industry spokespeople consider the attempts to control ephedra somewhat overzealous. They point out that whereas some eight hundred adverse reactions per year may have been reported for ephedra, users of acetaminophen, a common aspirin substitute, experience as many as fifty thousand toxic reactions a year. However, this statement is somewhat misleading given the much greater prevalence of the use of acetaminophen than ephedra at the present time.

A major study is presently being conducted at Harvard and Vanderbilt Universities in which seventy-five people will take 90 mg a day of ephedrine alkaloids along with caffeine to determine whether they lose weight, and also to monitor for harmful effects.

Ephedra is probably safe, especially as a whole plant, in modest doses for people who do not have the medical conditions that contraindicate its use.

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From THE BEST ALTERNATIVE MEDICINE: WHAT WORKS? WHAT DOES NOT? by Dr. Kenneth R. Pelletier.
Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.
Reprinted by permission of Simon & Schuster, Inc., New York, New York.

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Unless otherwise indicated, Dr. Kenneth R. Pelletier. All Rights Reserved.
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