Ephedra

Encyclopedia of Alternative Medicine, Apr 06, 2001 by Beth Kapes

Ephedra, also known as Ma Huang, is an herb utilized by Chinese medicine for over 2,500 years due to its ability to remedy symptoms of asthma and upper respiratory infections. A member of the Ephedracae family of herbs (Ephedra sinica), ephedra is native to northern China and Inner Mongolia where it thrives in desert areas as a jointed, barkless plant with branches that bear few leaves and tiny yellow-green flowers that bloom in summer. While varieties of ephedra grow throughout the world, the United States version flourishes in the dry southwest.

Ephedra became popular to Mormon settlers in the early 1800s as a stimulant consumed in the form of tea in place of the coffee and black tea from which they abstained, giving the plant one of its many names, Mormon Tea. Other folk names that have resulted over time include Desert Tea, Desert Herb, and Squaw Tea. The herbal drink was named Whorehouse Tea after it was served in brothels during the 1800s due to unproven beliefs that it cured gonorrhea and syphilis.

The medicinal herb Ma Huang is made of the dried, young branchlets of ephedra. Harvested in the autumn, ephedra is reproduced from seed or by root division and the stems are dried in the sun throughout the year for production. The herb should be stored away from light. Ephedra gains its strength primarily from the alkaloid ephedrine, pseudephedrine, and norpseudephedrine. These active ingredients produce central nervous system stimulation. Other key components of ephedra include:

• tannin, an acidic substance found in the bark
• saponin, originating in the roots
• flavone, the chemical from which natural colors of many plants originate
• volatile oil

A bitter-tasting herb that has been relied upon by the Chinese throughout centuries to heal ailments from fevers and chills, to nasal and chest congestion, ephedra also maintains its prominence as a strong stimulant. Contrary to its reputation, Zen monks used the herb to promote calm concentration during meditation. However, larger amounts can make a person jittery. Today, ephedra is used in the United States as an herbal medicine to treat asthma and hay fever, and the beginnings of colds and flu. The herb is also used to raise blood pressure, cool fevers, and ease the pain of rheumatism.

While ephedrine was used in various decongestant and bronchodilator products in the United States beginning in the late 1920s through the 1940s, its potential for causing dangerous side effects led to the creation of a chemical substitute. Scientists created the equally effective, but safer, pseudephedrine that remains the active ingredient in many over-the-counter (OTC) products such as Sudafed. Primatene Mist, an OTC that contains ephedrine, is used regularly to treat asthma.

The body responds to ephedra as one of its key ingredients, ephedrine, opens bronchial passages which activates the heart and raises blood pressure while increasing metabolism. Due to its stimulating effect on the nervous system, many weight loss and energy products contain ephedra. Ephedrine increases basal metabolic rate (BMR), causing the body to burn calories faster. Dieters use ephedra-based products because they suppress the appetite and stimulate metabolism. While these diet products prove to be effective, their results are rarely permanent, and long-term use can be quite harmful. Chinese sources only recommended its use for acute situations.

As an "energy" product, ephedra increases alertness and perception. The use of ephedra in this way dates back to bodyguards of Genghis Khan, who, legend has it, fearful of being beheaded if they fell asleep on duty, consumed tea containing ephedra to stay alert. Caffeine products, such as coffee, tea, chocolate, and cola drinks, enhance the effect of energy products containing ephedra. Additional medicinal uses of ephedra include the promotion of menstruation, the decreased desire for cigarettes, and the promotion of uterine contractions. Ma Huang is also known for its ability to increase sexual sensation.

Some controversy surrounds the extended use of ephedra. It is recommended that products containing ephedra be taken only for short periods of time. Tachyphylaxis, or becoming immune to a drug's effectiveness due to overuse, and dependence on the drug may develop when taken consistently over time. Both ephedrine and Ma Huang are considered doping substances. In April 1996, the United States Food and Drug Administration (FDA) issued a warning on dietary supplements containing ephedra that were labeling themselves as safe substitutes for "street drugs," such as the illegal drug ecstasy. The FDA stated that these products could have "potentially dangerous effects on the nervous system and heart."

Ephedra is classified as a dietary supplement, and unlike pharmaceutical companies that must follow strict rules regarding safety, efficacy and quality set by the FDA, manufacturers of supplements are not held to these guidelines. In 1994, the regulation of herbal medicine-type products in the United States changed with the passage of the Dietary Supplement Health and Education Act (DSHEA). At this time, herbal products were reclassified, along with vitamins and minerals, as dietary supplements. When classified in this grouping that falls somewhere between food and over-the-counter drugs, herbal supplement manufacturers were then able to begin making "structure-function" claims for a product on its label if there is scientific evidence supporting these claims. When appropriate, supplement manufacturers are allowed to use three types of claims: nutrient-content claims, disease claims, and nutrition support claims. These claims are made to guide the buyers of supplements, but supplement manufacturers may use the claims without FDA authorization, and are not required by law to conduct scientific studies on their products. In March 1999, the placement of a "Supplement Facts" panel became a requirement on the labels of most dietary supplements.