Ephedra

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The Chinese botanical ephedra, or ma-huang, is sold as a dietary supplement in the United States. Ephedra is the common name for three principal species: Ephedra sinica, Ephedra equisentina, and Ephedra intermedia. The active compounds in the plant's stem (about 1.32% by weight) are the phenylalanine-derived alkaloids ephedrine, pseudoephedrine, phenylpropanolamine (norephedrine), and cathine (norpseudoephedrine)[1].

A systematic review of 117 studies found that ephedra and ephedrine promoted modest short-term weight loss (approximately 0.9 kg/month more than with placebo) but increased the risk of psychiatric, autonomic, gastrointestinal, and cardiac complications by a factor of 2.2 to 3.6.[2]. An analysis of adverse reactions reported to poison control centers found that products containing ephedra accounted for 64% of all adverse reactions to herbs in the United States, yet these products represented only 0.82% of herbal product sales[3].

Notes

  1. National Institutes of Health, Ephedra and Ephedrine Alkaloids for Weight Loss and Athletic Performance, Office of Dietary Supplements
  2. Shekelle et al, Ephedra, JAMA March 26, 2003;289:1537-1545
  3. Bent et al, Ann Intern Med March 18, 2003;138:468-471