Image for Ephedra () / ma huang
Ephedra (Ephedra sinica) / ma huang
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Amp II, amsania, brigham tea, budshur, cao Ma huang (Chinese), cathine, chewa, Chinese ephedra, Chinese joint fir, D-pseudoephedrine, desert herb, desert tea, dextro-rotatory, EPH 833, Ephedra altissima, Ephedra americana, Ephedra anti-syphilitica, Ephedra distacha, Ephedra distachya, Ephedra equisetina (Mongolian Ephedra), Ephedra fasciculate, Ephedra geradiana, Ephedra helvetica, Ephedra intermedia (intermediate ephedra), Ephedra likiangensis, Ephedra major, Ephedra minuta, Ephedra monosperma, Ephedra nevadensis, Ephedra przewalskii, Ephedra sinica, Ephedra shennungiana, Ephedra trifurca, Ephedra viridis, Ephedra vulgaris, Ephedraceae (family), ephedra alkaloids, Ephedra distachya, Ephedra intermedia, Ephedra nebrodensis, Ephedra przewalskii, Ephedra regeliana, Ephedra sinica, Ephedra soup medicines, ephedrae herba, ephedrine, ephedrine alkaloids, ephedrine hydrochloride, ephedrine sulphate, ephedroid, epicatechin, epitonin, European ephedra, Gnetales, herba ephedrae, horsetail, hum, huma, Indian joint fir, intermediate ephedra, isoephedrine, joint fir, khama, L-ephedrine, levorotatory ephedrine, mahoàng, máhuáng, "Mao" (Chinese), mao-kon, mahuuanggen, methylephedine, methylephedrine, methylpseudoephedine, Mexican tea, môc tac ma hoàng, Mongolian ephedra, Mormon tea, mu-tsei-ma-huang, muzei mu huang, natural ecstasy, neuropeptide Y, norephedrine, norpseudoephedrine, O-coumaric acid beta-D-glucopyranoside (nebrodenside B), O-coumaric acid glucoside, phok, popotillo, pseudoephedrine, quinoline, san-ma-huang, sea grape, shrubby, soma, song tuê ma hoàng, squaw tea, synephrine, tannins, teamster's tea, trun aa hoàng, tsao-ma-huang, tutgantha, yellow astringent, yellow horse, zhong Ma huang.
  • Note: There are approximately 40 species of ephedra.

Background

  • 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.
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Evidence

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Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

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Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

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Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.