Ephedra: Not a Weight Loss Panacea

Ephedra (ma huang) is both a stimulant and a thermogenic (generates heat). Its biological effects are due to ephedrine and pseudoephedrine content. These compounds stimulate the brain, increase heart rate, constrict blood vessels (and increase blood pressure). Their thermogenic properties cause an increase in metabolism, evidenced by an increase in body heat.

Ma huang herb has been used in traditional Chinese medicine to treat asthma (it expands the bronchial tubes, making breathing easier) and other illnesses. The alkaloids ephedrine and pseudoephedrine are the active constituents of the herb.

It has been used for weight loss, sometimes in combination with aspirin and caffeine. Some studies have shown that when taken in a regulated and supervised environment it is effective for marginal short-term weight loss. However, several reports have documented a large number of adverse problems attributed to unregulated doses.

Studies of supplements containing the substance have also found significant discrepancies between the labeled dose and the actual amount in the products. Significant variations in ephedrine alkaloid levels have been seen even from lot to lot within the same brand.

Side effects of it may include severe skin reactions, irritability, nervousness, dizziness, trembling, headache, insomnia, profuse perspiration, dehydration, itchy scalp and skin, vomiting, hyperthermia, irregular heartbeat, seizures, heart attack, stroke, or death.

Ephedrine is also considered a performance-enhancing drug and is prohibited in most competitive sports. It is listed as a banned substance by both the International Olympic Committee and the World Anti-Doping Agency. The National Football League banned players from using it as a dietary supplement in 2001, after the death of Minnesota Vikings offensive tackle Korey Stringer. The supplement was found in Stringer's locker and lawyers for the team contend that it contributed to his death.

It is also banned by the National Basketball Association. Nonetheless, it is believed to still be widely used by athletes around the world.

A review of adverse reactions, published in the New England Journal of Medicine in 2000, found a number of cases of sudden cardiac death or severe disability resulting from its use. Many of these occurred in young adults using it in the labeled dosages.

Subsequently, the makers of Metabolife, the best-selling brand of a ephedra supplement, were compelled by the Department of Justice in 2002 to turn over reports of over 13,000 ephedra-related adverse events, ranging from insomnia to death, which the company had previously withheld from the FDA.

Escalating concerns regarding the safety of supplements containing the substance led the FDA, in 2004, to ban their sale in the United States. This ban was challenged by supplement manufacturers and initially overturned, but ultimately upheld.

The sale of ephedra-containing dietary supplements remains illegal in the United States.

References and further information can be found here . . .

The New England Journal of Medicine


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