Ephedra (Ma Huang)

Hell-bent on cutting calories and fat from your diet? So is most of the country. Americans spend an unbelievable 33 billion dollars each year on weight-reduction products and services, including diet foods, products and programs. In this relentless pursuit to slim down, chances are you've stumbled upon something called ephedra - an herb purported to be a "natural" weight loss aid.

How It Works

The active ingredient in ephedra is ephedrine, an alkaloid salt that acts as a sympathetic nerve stimulant. Traditionally, Chinese herbalists used ephedra, or ma huang, for respiratory infections as well as certain kinds of asthma, eczema, hay fever, narcolepsy, and edema. Ephedra is rarely used today to treat such ailments due to its unpleasant side effects, which include rapid heartbeat, high blood pressure, agitation, insomnia, nausea, and loss of appetite. However, other compounds have been isolated from ephedra. One compound is pseudoephedrine - a major ingredient in over-the-counter decongestants like Sudafed. Unlike its counterpart ephedrine, pseudoephedrine has a less stimulating effect on the heart and blood pressure.

Due its suppressive effect on appetite, ephedra has found its niche among weight loss supplements. Researchers believe that ephedra exerts a fat-burning effect by facilitating the release and blocking the re-uptake of the neurotransmitter norepinephrine, thereby causing an increase in both metabolic rate and lipolysis (the liberation of free fatty acids from fat cells).

Potential Side Effects

Although ephedra is known to generate some weight loss, it is a far cry from that elusive magic bullet. In fact, most health care professionals do not recommend it due to its dangerous side effects. The FDA is now investigating ephedrine-containing supplements after receiving 330 reports of adverse reactions. It's especially concerned about products that combine ephedrine with caffeine, as in kola nut or guarana. Reactions include irregular heartbeat, dizziness, heart attack, and stroke. There have been 12 reports of death.

As with any supplement, talk to your healthcare provider. Since ephedra has such serious side effects, it should be taken under medical supervision - especially those with enlargement of the prostate, high blood pressure, heart, liver or kidney disease, diabetes, glaucoma or hyperthyroidism as serious complications may occur.

Herb-Drug Interactions

So, as you can see ephedra is one herb you want to steer clear of - especially if you take monoamine-oxidase inhibitors (MAO inhibitors) such as Nardil (phenelzine) since the combination may cause severely high blood pressure. (This goes for Sudafed and MAO inhibitors as well). Ephedra is also contraindicated with most cardiac medications.

Principal Author:

Stefanie Perelman, M.S., R.D., holds a B.A. in journalism from the University of Wisconsin-Madison and a master's in clinical dietetics from New York University. A registered dietitian, she presently works at Montefiore Medical Center in the Bronx and is available for private consultation.

Nutrition Editor

Donna Tinnerello MS, RD, CD/N is registered dietitian with more than 10 years experience in HIV and nutrition. She works in lower Manhattan at Cabrini Medical Center, the community and in private practice. Her subspecialties are cardiovascular, renal, gastrointestinal disease, diabetes and weight loss. Donna is available for private consultation by referral only.