Ephedra
Background
Ephedra
is an evergreen shrub-like plant native to central Asia, and Mongolia;
it also grows in the southwestern United States.
People have used ephedra for centuries in China for colds, fever, flu,
headaches, asthma, nasal congestion, and wheezing.
The
U.S. Food and Drug Administration (FDA) banned the sale of dietary
supplements containing ephedrine alkaloids (compounds found in some
ephedra species) in the United States in 2004. It was an ingredient in
some dietary supplements marketed for weight loss, increased energy,
and enhanced athletic performance.
The dried stems and leaves of the ephedra plant have been used to
create capsules, tablets, extracts, and teas.
How Much Do We Know?
A
large amount of research led to ephedrine alkaloids becoming main oral
asthma medications in the 1940s and 1950s. Ephedra also has been used
as a weight-loss agent and energy enhancer for athletic performance.
However, the increasing number of reported adverse events caused the
FDA to ban dietary supplements that contain
ephedrine alkaloids.
What Have We Learned?
According
to the FDA, there is little evidence of ephedra’s effectiveness, except
for short-term weight loss. However, the increased risk of heart
problems and stroke outweighs any benefits.
What Do We Know About Safety?
The
FDA banned the U.S. sale of dietary supplements containing ephedrine
alkaloids. It found that these supplements had an unreasonable risk of
injury or illness—particularly cardiovascular complications—and a risk
of death. The ban does not apply to traditional Chinese
herbal remedies.
Using ephedra may worsen many health
conditions such as heart disease and kidney disease. Ephedra has been
associated with stroke. It also may contribute to increased blood
sugar levels.
Ephedra may intensify or cause seizures in people with
seizure disorders.
Taking
ephedra may also cause anxiety, dizziness, difficulty urinating, dry
mouth, headache, irritation of the stomach, nausea, psychosis,
restlessness, sleep problems, and tremors. Some of these side effects
may be associated with long-term use of ephedra.
Women who are pregnant or breastfeeding and children should avoid
taking ephedra.
Ephedra use may lead to serious health problems when used with other
dietary supplements or medicines.
Combining ephedra with caffeine increases the risk of potentially
serious side effects.
Keep in Mind
Tell
all your health care providers about any complementary or integrative
health approaches you use. Give them a full picture of what you do to
manage your health. This will help ensure coordinated and
safe care.
Key References
- Ephedra.
In: Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded
Commission E Monographs. Newton,
MA: Integrative Medicine Communications; 2000:110-117.
- Ephedra.
Natural Medicines Web site. Accessed at
naturalmedicines.therapeuticresearch.com on April 1, 2015.
- Fleming
RM. Safety
of ephedra and related anorexic medications. Expert Opinion on Drug Safety. 2008;7(6):749-759.
- Kim
EJ, Chen Y, Huang JQ, et al. Evidence-based
toxicity evaluation and scheduling of Chinese herbal medicines. Journal of Ethnopharmacology. 2013;146(1):40-61.
- Lee
MR. The
history of ephedra (ma-huang). Journal of the Royal College of
Physicians of Edinburgh. 2011;41(1):78-84.
- Manore
MM. Dietary
supplements for improving body composition and reducing body weight:
where is the evidence? International Journal of Sport
Nutrition and Exercise Metabolism. 2012;22(2):139-154.
- Rasmussen
CB, Glisson JK, Minor DS. Dietary
supplements and hypertension: Potential benefits and precautions. Journal of Clinical Hypertension. 2012;14(7):467-471.
- Thurn
AL, Betz JM. Ephedra. In: Coates P, Betz JM, Blackman MR, et al., eds. Encyclopedia of Dietary
Supplements. 2nd edition.
New York, NY: Informa Healthcare; 2010:250-255.
- U.S.
Food and Drug Administration. Final
rule declaring dietary supplements containing ephedrine alkaloids
adulterated because they present an unreasonable risk. Federal Register. 2004;69(28):6788-6854.
- Yen
M, Ewald MB. Toxicity
of weight loss agents. Journal of Medical Toxicology. 2012;8(2):145-152.
-NIH
