Ephedra (ma huang)

What is ephedra? What is it used for?

Ephedra is an herbaceous twig. There are about 40 species of ephedra, the most well-known of which is ma huang, which is produced in the Hebei, Shanxi, and Gansu provinces of China. The parts of the plants used consist of its stems and twigs.

They are collected in the beginning of autumn, dried in a shaded area and cut into pieces. Ephedra stems may be used either raw or after being baked with honey, or pounded into a fine powder.

In traditional Chinese medicine, ephedra is considered pungent, bitter and warm, and is associated with the Lung and Urinary Bladder meridians. It has been used to treat wind-cold types of exterior syndromes such as chills, fevers, headaches and stuffy nose. Some practitioners have used ephedra to treat coughs and asthma, and to promote urination. Ephedra is usually not taken alone, but in conjunction with other herbs, such as cinnamon, apricot seed and gypsum.

How much ephedra should I take?

The typical dosage of ephedra is between 1.5 and 10 grams, with the dosage taken depending on the condition being treated. It is usually incorporated with other herbs as part of a larger formula. Raw ephedra is used to induce sweating, while stir-baked ephedra is typically used to relieve asthma.

What forms of ephedra are available?

Until April 2004, ephedra was available in a variety of forms, including pills, capsules and tablets. It was also sold as a component of several herbal formulas and many weight-loss formulas.

What can happen if I take too much ephedra? Are there any interactions I should be aware of? What precautions should I take?

Ephedra causes heavy sweating, and should be used with extreme caution in deficient conditions or asthma and cough due to failure of the kidneys. Long-term use of ephedra, or overuse, can raise the blood pressure and weaken the body.

When taken in the proper dosage, combined with other herbs, and used under the care of a licensed acupuncturist or doctor of Oriental medicine, ephedra is considered quite safe. The American Herbal Products Association gave it class 2B, 2C and 2D ratings meaning that it should not be taken by women who are pregnant or breastfeeding, and that it is contraindicated for a wide range of conditions, including anorexia, bulimia and glaucoma. In the United States, however, the herb has been marketed as a major component of weight-loss pills and formulas, and in the past decade, it became a favorite among people trying to shed extra weight or enhance athletic performance. As a result, in April 2004, it was banned by the Food and Drug Administration, and is no longer available in the United States.

References

• Blumenthal M, Goldberg A, Brinckmann J (eds.) Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications, 2000, pp. 110-117.
• McGuffin M, Hobbs C, Upton R (eds.) American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997, pp. 45-46.
• Editorial Committee of Chinese Materia Medica. State Drug Administration of China. Chinese Materia Medica. Shanghai: Science and Technology Press, 1998.
• Final Rule Declaring Dietary Supplements Containing Ephedrine Alkaloids Adulterated Because They Present an Unreasonable Risk. Food and Drug Administration 21 CFR Part 119, Docket no. 1995N-0304. Published in the Federal Register, Feb. 11, 2004.
• Statement of the American Herbal Products Association on FDA's announcement of a ban on ephedra. American Herbal Products press release, Dec. 31, 2003.