Ephedra/Ma-Huang

Plant Part Used

Stem

Introduction

 

Warning:
Not intended for use by anyone under the age of 18. Do not use this product if you are pregnant or nursing. Consult a health care professional before using this product if you have heart disease, thyroid disease, diabetes, high blood pressure, psychiatric condition, difficulty in urinating, prostate enlargement, or seizure disorder, if you are using a monoamine oxidase inhibitor (MAOI) or any other prescription drug, or you are using an over-the-counter drug containing ephedrine, pseudoephedrine or phenylpropanolamine (ingredients found in certain allergy, asthma, cold/cough and weight control products).

Exceeding recommended serving will not improve results and may cause serious adverse health effects.

Discontinue use and call a health care professional immediately if you experience rapid heartbeat, dizziness, severe headache, shortness of breath, or similar symptoms. (1)

 

Ephedra has been used traditionally for thousands of years in China to treat respiratory disorders, colds, congestion, and more. Today, ephedra supplements are under scrutiny due in part to the irresponsible use of ephedra products by some people and also due to the inappropriate advertising of ephedra products as a recreational stimulant by some manufacturers. In fact, several State Boards of Pharmacy have either impending action or have acted against the sale of ephedra and ephedra-containing products.

While the potential for abuse of ephedra is great, when used responsibly, it can be considered useful and safe. It may be of particular benefit in weight loss, asthma, and allergies. To insure the quality of the ephedra product, purchase dietary supplements that are manufactured by reputable companies.

Interactions and Depletions

Interactions

Dosage Info

Dosage Range

Dosages recommended by manufacturers and those typically used in clinical studies range from 8-25mg ephedra alkaloids per dose, no more than 4 times a day.

Tea: Made with 1 to 4 gm, 3 times daily. (2)

Tincture (1:1): medium single dose 5 gm. (3)

Extract: 1 to 3 ml, 3 times daily. (4)

Tincture (1:4): 6 to 8 ml, 3 times daily. (5)

Most Common Dosage

25mg ephedra alkaloids, 3 to 4 times per day.

American Herbal Products Association (AHPA) recommended dosage: do not exceed 25mg, 4 times per day.

Tea: Made with 1 gm, 3 times daily.

Tincture (1:1): medium single dose 5 gm.

Extract: 1 ml, 3 times daily.

Tincture (1:4): 6 ml, 3 times daily.

Standardization

[span class=doc]Standardization represents the complete body of information and controls that serve to enhance the batch to batch consistency of a botanical product, including but not limited to the presence of a marker compound at a defined level or within a defined range.[/span]

The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 6 to 8% total ephedra alkaloids.

Reported Uses

Ephedra has numerous biological effects including constriction of the circulatory system, dilation of the respiratory system, stimulation of the heart accompanied by an increased pulse rate, (6) increased blood pressure, and more. These effects may cause the body to use energy at an increased rate while simultaneously suppressing the appetite. (7) , (8) Based on these functions, it is not only easy to see why ephedra may have applications in both weight loss and weight management, but also why it is important to use ephedra responsibly to avoid adverse effects. (9)

Because ephedra dilates the respiratory system, it may also have applications in the treatment of asthma. In fact, studies suggest that the use of ephedra in concert with pharmaceutical bronchodilators may be effective in asthma management. (10) , (11) Ephedra may also decrease sinus congestion in a manner similar to many common decongestants. (12)

Toxicities & Precautions

Introduction

[span class=alert]Be sure to tell your pharmacist, doctor, or other health care providers about any dietary supplements you are taking. There may be a potential for interactions or side effects.[/span]

General

In recommended dosages, ephedra has a long history of being safe. However, if abused, taken in high dosages, or taken with pre-existing cardiovascular diseases, ephedra will not improve results and may contribute to adverse events. (13) There are several deaths reported from overdosage of ephedra. (14) , (15)

There is one report of hepatitis associated with the use of ephedra. (16)

Individuals with pre-existing healthcare problems should only use ephedra-containing products under the supervision of a physician.

Health Conditions

If you have a kidney disorder, glaucoma, high blood pressure, heart disease, thyroid disease, diabetes, psychiatric disorders, difficulty urinating, enlarged prostate or seizure disorders talk to your doctor before taking this dietary supplement. (17) , (18) , (19) , (20) , (21) , (22)

Side Effects

Side effects are possible with any dietary supplement. This dietary supplement may cause heart palpitations, extreme nervousness, sweating, severe headache, dizziness, shortness of breath, enlarged pupils and elevated body temperature. (23) Tell your doctor if these side effects become severe or do not go away.

Pregnancy/ Breast Feeding

This dietary supplement should not be used if you are pregnant or breast-feeding an infant.

Age Limitations

This dietary supplement should not be used by anyone under 18 years of age unless recommended by a physician.

References

  1. American Herbal Products Association. Current Trade Recommendations, AHPA Code of Ethics and Business Conduct. Silver Spring, MD: American Herbal Products Association; Mar1994.
  2. PDR for Herbal Medicines, 2nd ed. Montvale, NJ: Medical Economics Company; 2000:489.
  3. PDR for Herbal Medicines, 2nd ed. Montvale, NJ: Medical Economics Company; 2000:489.
  4. PDR for Herbal Medicines, 2nd ed. Montvale, NJ: Medical Economics Company; 2000:489.
  5. PDR for Herbal Medicines, 2nd ed. Montvale, NJ: Medical Economics Company; 2000:489.
  6. View Abstract: Haller CA, Jacob P 3rd, Benowitz NL. Pharmacology of ephedra alkaloids and caffeine after single-dose dietary supplement use. Clin Pharmacol Ther. Jun2002;71(6):421-32.
  7. View Abstract: Ramsey JJ, et al. Energy expenditure, body composition, and glucose metabolism in lean and obese rhesus monkeys treated with ephedrine and caffeine. Am J Clin Nutr. Jul1998;68(1):42-51.
  8. View Abstract: Boozer CN, Daly PA, Homel P, et al. Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Int J Obes Relat Metab Disord. May2002;26(5):593-604.
  9. View Abstract: Haller CA, Benowitz NL. Adverse Cardiovascular and Central Nervous System Events Associated with Dietary Supplements Containing Ephedra Alkaloids. N Engl J Med. Dec2000;343(25):1833-8.
  10. Direkwattanachai C, et al. Sustained release theophylline and ephedrine therapy in chronic asthma. J Med Assoc Thai. Oct1986;69(Suppl 2):31-7.
  11. View Abstract: Owen S, et al. A controlled trial of an oral bronchodilator preparation ('Franol') in asthma. Pharmatherapeutica. 1988;5(4):240-5.
  12. View Abstract: Kalix P. The pharmacology of psychoactive alkaloids from ephedra and catha. J Ethnopharmacol. Apr1991;32(1-3):201-8.
  13. View Abstract: Haller CA, Benowitz NL. Adverse Cardiovascular and Central Nervous System Events Associated with Dietary Supplements Containing Ephedra Alkaloids. N Engl J Med. Dec2000;343(25):1833-8.
  14. Thoeharides TC. Sudden death of a healthy college student related to ephedrine toxicity from a ma huang-containing drink. J Clin Psychopharmacol. Oct1997;17(5):437-9.
  15. View Abstract: Gurley BJ, et al. Ephedrine pharmacokinetics after the ingestion of nutritional supplements containing Ephedra sinica (ma huang). Ther Drug Monit. Aug1998;20(4):439-45.
  16. View Abstract: Nadir A, et al. Acute hepatitis associated with the use of a Chinese herbal product, ma-huang. Am J Gastroenterol. Jul1996;91(7):1436-8.
  17. LaValle JB, et al. Natural Therapeutics Pocket Guide. Hudson, OH: LexiComp, Inc; 2000:429-430.
  18. View Abstract: Powell T, et al. Ma-huang strikes again: ephedrine nephrolithiasis. Am J Kidney Dis. Jul1998;32(1):153-9.
  19. View Abstract: Zaacks SM, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol. 1999;37(4):485-9.
  20. Jacobs KM, et al. Psychiatric complications of Ma-huang. Psychosomatics. Jan2000;41(1):58-62.
  21. Capwell RR. Ephedrine-induced mania from an herbal diet supplement. Am J Psychiatry. Apr1995;152(4):647.
  22. View Abstract: Harada M, et al. Contribution of alkaloid fraction to pressor and hyperglycemic effect of crude Ephedra extract in dogs. J Pharmacobiodyn. Sep1981;4(9):691-9.
  23. PDR for Herbal Medicines, 2nd ed. Montvale, NJ: Medical Economics Company; 2000:489.