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Ephedra

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What other names is Ephedra known by?

Alcaloïde d'Éphédrine, Belcho, Cao Mahuang, Desert Herb, Efedra, Éphédra, Éphédra Américain, Éphédra Chinoise, Ephedra distachya, Ephedra equisetina, Éphédra Européen, Ephedra gerardiana, Ephedra intermedia, Ephedra shennungiana, Ephedra sinensis, Ephedra sinica, Ephedra Sinisa, Ephedra vulgaris, Ephedrae Herba, Éphèdre, Ephedrine, Éphédrine, Ephedrine Alkaloid, Épitonin, Herbal Ecstasy, Joint Fir, Ma Huang, Ma-Huang, Mahuang, Mahuanggen (ma huang root), Muzei Mahuang, Popotillo, Raisin de Mer, Sea Grape, Teamster's Tea, Thé de Désert, Yellow Astringent, Yellow Horse, Zhong Mahuang.

What is Ephedra?

Ephedra is an herb. Usually, the branches and tops are used to make medicine, but the root or whole plant can also be used. Ephedra is banned in the U.S. due to safety concerns.

Mormon tea and ephedra are often confused. Mormon tea or American ephedra comes from Ephedra nevadensis, and ephedra or ma huang comes primarily from Ephedra sinica. Mormon tea lacks the chemicals (notably ephedrine) that give ephedra its effects and potentially serious side effects.

Ephedra is used for weight loss and obesity and to enhance athletic performance. It is also used for allergies and hay fever; nasal congestion; and respiratory tract conditions such as bronchospasm, asthma, and bronchitis. It is also used for colds, flu, swine flu, fever, chills, headache, inability to sweat, joint and bone pain, and as a "water pill" to increase urine flow in people who retain fluids.

There has been a lot of debate about the safety of ephedra and legal wrangling over its status. In June 1997, the FDA proposed restrictions on the ephedrine content of dietary supplements, new warning labels for products that contain the active ingredients in ephedra, and a ban on combination products containing ephedra and other natural stimulants, such as guarana and cola nut, both of which contain significant amounts of caffeine. These proposals were dropped after the link between ephedra use and serious adverse effects was challenged by the General Accounting Office (GAO) and the dietary supplement industry. According to the Dietary Supplement Health and Education Act of 1994, FDA must prove a supplement is unsafe before it can be withdrawn from the market. The FDA reviewed numerous adverse event reports involving ephedra-containing products, with 140 of the reports receiving in-depth clinical review by FDA and outside experts. Findings from experts outside the FDA support the FDA's initial finding that ephedra is likely the cause of many of the events noted in the reports.

On December 30, 2003, the FDA announced the ban of ephedra products in the U.S., effective April 2004. In April 2005, the dietary supplement industry successfully challenged the FDA ban on ephedra. A year after the ban on ephedra began, a federal judge in Utah struck down the FDA's action saying that FDA didn't prove that low doses of ephedra are harmful. In August 2006, an appeals court reversed the Utah judge's decision and upheld the FDA's ban of ephedra-containing dietary supplements.

Ephedra use is banned by the National Collegiate Athletic Association, International Olympic Committee, and National Football League.

Ephedra is sometimes marketed as a recreational drug "herbal ecstasy." The FDA has announced that ephedra products marketed as recreational drugs are unapproved and that misbranded drugs can be taken by the authorities.

Is Ephedra effective?

There is some scientific evidence that ephedra can help asthma, bronchitis, bronchospasm, and other breathing problems. But large and possibly unsafe doses are needed. Using ephedra for these conditions is not worth the risk, since there are many safer alternative treatments.

Ephedra is often promoted for weight loss, but it is not safe or effective for this use.

There isn't enough information to know if ephedra is effective for the other conditions people use it for, including: improving athletic performance, allergies, nasal congestion, colds, flu, fever and many more.

Possibly Effective for...

  • Obesity. Ephedra can produce modest weight loss when used with exercise and a low-fat diet, but it can cause serious side effects, even in healthy people who follow product dosage directions. Taking ephedra seems to produce weight loss of approximately 0.9 kg (about 2 pounds) per month for up to 6 months. It is not known if weight loss continues beyond this time frame or if weight returns after ephedra is discontinued.
    Caffeine may provide additional weight loss. The combination of ephedra, cola nut, and willow bark may also cause modest weight loss in overweight and obese people. Early research suggests that a specific combination product containing ephedra, guarana, and 17 other vitamins, minerals, and supplements (Metabolife 356) might help reduce weight by approximately 2.7 kg (about 6 pounds) over 8 weeks when used with a low-fat diet and exercise. Taking 90 mg of ephedra in combination with caffeine from 192 mg of cola nut per day for six months seems to cause a modest weight reduction (5.3 kg or about 12 pounds) in overweight people with a body mass index (BMI) between 25 and 40. This combination, along with limiting fat intake to 30 percent of calories and moderate exercise, also seems to reduce body fat, lower "bad" low-density lipoprotein (LDL) cholesterol, and raise "good" high-density lipoprotein (HDL) cholesterol. However, even in carefully screened and monitored otherwise healthy adults, ephedra combinations can cause small changes in blood pressure and heart rate. There are serious concerns about the safety of these products since they combine significant amounts of the stimulants ephedra and caffeine and are often taken without monitoring for harmful side effects.

Possibly Ineffective for...

  • Exercise performance. Some research suggests that taking ephedra with caffeine is no more effective than taking caffeine alone for improve exercise performance.

Insufficient Evidence to Rate Effectiveness for...

  • Allergies.
  • Asthma and other breathing disorders.
  • Nasal congestion.
  • Colds.
  • Flu.
  • Fever.
  • Other conditions.
More evidence is needed to rate the effectiveness of ephedra for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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