Ephedra (Ma Huang)
Introduction: During the spring and summer, 2000, this herbal product became the focus of a dispute between the FDA and herbal industry officials. Based on reports that the FDA had compiled on its harmful effects, the agency wanted to impose dosages and to require warnings against the use of the product for extended periods of time. However, scientists from the herbal industry attributed the health problems that had occurred to underlying medical conditions, the use of multiple products, and excessive fasting and exercise (ephedra has been used as a weight-loss and bodybuilding aid) rather than on ephedra itself. The herbal industry scientists were supported by Congress's General Accounting Office which raised questions about the data that the FDA used stating that while ephedra may be harmful, the FDA did not have enough data to set dosages. (See The Wall Street Journal, April 3, 2000, page B18 and August 9, 2000, page B2. Note: Page numbers are based on the California edition of WSJ.)
Medicinal Parts: The young canes and the dried rhizome with roots.
Demonstrated Uses: This product has been used in Chinese herbal medicine for over 4,000 years for illnesses accompanied by fever, bronchial asthma, and joint symptoms (Leung & Foster, 1996; Morton, 1977). The German Commission E approved the use of this product for coughs and bronchitis. The World Health Organization found clinical evidence to support the following uses: Treatment of nasal congestion that results from hay fever, allergic rhinitis, common cold, and sinusitis as well as a bronchodilator in the treatment of bronchial asthma (WHO, 1999).
There is little clinical evidence that it is effective in weight loss or in enhancing athletic performance.
How it Works: The herb's main alkaloids are ephedrine and pseudoephedrine which act as a central nervous system stimulant.
Precautions: In 1994, the American Herbal products Association issued a warning for all ephedra products, "Seek advice from a healthcare practitioner prior to use if you are pregnant or nursing, or if you have high blood pressure, heart or thyroid disease, diabetes, difficulty in urination due to prostate enlargement, or if taking a MAO inhibitor or any other prescription drug. Reduce or discontinue use if nervousness, tremor, sleeplessness, loss of appetite, or nausea occur. Not intended for use by persons under 18 years of age. Keep out of the reach of children" (McGuffin, et al., 1997).
Daily Dosage: For adults, preparations corresponding to 15-30 mg total alkaloid, calculated as ephedrine, not to exceed 300 mg per day.
For children, preparations corresponding to 0.5 mg total alkaloid, calculated as ephedrine, per kg of body weight, not to exceed 2 mg per day per kg of body weight.
Storage: Protect this product from light.
Leung, A.Y. and Foster, S. (1996). Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd edition. New York: John Wiley & Sons, Inc.
McGuffin, M., Hobbs, C., Upton, R. and Goldberg, A. (1997). Botanical Safety Handbook (Product of the American Herbal Product Association). Boca Raton: CRC Press.
Morton, J.F. (1977). Major Medicinal Plants: Botany, Culture and Uses. Springfield, IL: Charles C. Thomas.
World Health Organization (WHO). (1999). WHO Monographs on Selected Medicinal Plants, Vol. 1. Geneva: World Health Organization.