Ephedrine (ma huang) — Uses and risks?

Hey Alice,

Is there any danger to taking ephedra (ma huang) for weight loss?

Dear Reader, 

It's great that you're asking questions about these types of substances! Ephedra, also known by its traditional Chinese name, ma huang, is a substance that comes from the naturally occurring herb Ephedra sinica and has been used in traditional Chinese medicine (TCM) for thousands of years. Some studies found that ephedra had short-term benefits on weight loss and athletic performance enhancement; however, no studies examined the effects of ephedra on weight loss in the long run. Not only that, but ephedra supplements also became associated with side effects such as heart attacks, strokes, anxiety, personality changes, and even sudden deaths. These reported cases of side effects and deaths led the Food and Drug Administration (FDA) to prohibit the sale of dietary supplements containing ephedra and its ingredients in the United States in 2004. However, this ban doesn’t extend to teas or traditional Chinese herbal treatments.  

The main active ingredient in ephedra, ephedrine, is an amphetamine-like chemical that mimics the effects of adrenaline. In fact, ephedra was used in TCM for treating asthma, bronchitis, and other respiratory illnesses for thousands of years. Ephedrine can be synthesized to make medications such as pseudoephedrine to treat cold and flu symptoms. Ephedra alkaloids, however, are derived from the Ephedra sinica herb itself. These alkaloids, when combined with caffeine and other stimulants, were marketed as weight-loss supplements and energy boosters. However, no studies examined the long-term effects of ephedra use on weight loss or the possible interactions that ephedra could have with other medications. 

In May 2004, the United States Food and Drug Administration (FDA) made any products containing ephedrine illegal for over-the-counter sales. Over 800 serious cases of side effects were reported in relation to use of ephedra, including heart attacks, strokes, and seizures. Several deaths were also reported in conjunction ephedra use, including a well-known baseball player in the US. Ephedra was even banned by the Olympics and several other athletic organizations before the ban by the FDA. If you live outside of the US and are interested in using ephedra, speaking with a health care provider who is experienced in the use of TCM may help you better understand if it's right for you or get answers to additional questions about its use.

It may also be helpful to reflect on the reasons a person may want to use ephedra for weight loss in the first place. Is it to help achieve certain results faster? Is there pressure to look a particular way? Are there hopes this may be a more effective method than others? Reader, you never indicated whether you’re asking about ephedra for you or for someone else in your life. In either situation, it may be helpful to encourage reflection on the motivations for weight loss before seeking out weight loss substances. This type of reflection may help to determine what types of actions may best help to meet those goals. Thanks for asking and take care! 

Last updated May 21, 2021
Originally published May 21, 1998

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