Ephedra dietary supplement review

Ephedra dietary supplement, also known by its chinese name ma huang and has been banned since April 2004 for an outbreak of related adverse effects. An adverse effects list is very long and beyond the scope of this review but includes reports of heart attacks, strokes, psychosis, muscle deterioration, insomnia, personality changes, death, heart palpitations, racy heart rate, increased blood pressure and many more. 

People used the ephedra dietary supplement mainly for weight loss and obesity along with its ability to enhance athletic performance. Other common uses are for allergies, runny nose, nasal congestion, asthma and bronchitis. It can help with the common cold, flu, swine flu, fever, chills, headache, joint and bone pain and as a diuretic. 

There is evidence to support that those who takes greater than 32mg of the ephedra dietary supplement per day might have more than triple the risk of hemorrhagic stroke, including subarachnoid hemorrhage and intracerebral hemorrhage. This is referring to blood pouring out of your brain profusely due to ephedra use. 

The supplement industry claimed that ephedra was only unsafe when used inappropriately or with excessive dose. There have been reports of serious adverse events in plenty of patients with no known pre-existing medical condition. In most cases, these occur when it is combined with another stimulant such as caffeine. 

There also exists reports of serious adverse events when ephedra is used alone. There is no safe dose or reason to be taking ephedra. Severe life-threatening or debilitating effects have even occurred from short term use at low doses ranging from 20-60 mg of ephedra alkaloids per day. 

Effectiveness of the ephedra dietary supplement

Studies have shown that ephedra does seem to promote weight loss, a total of 1.98 pounds per month for up to 6 months. It is unknown if the weight returns upon cessation or if the weight loss is sustained beyond discontinuation. 

Additionally, caffeine, when combined with ephedra can produce additional weight loss according to studies (See references below). 

Another combination that has shown modest weight loss is the use of ephedra with cola nut and willow bark. This was seen in overweight and obese people. 

Ephedra 90mg in combination with caffeine from cola nut 192mg per day for 6 months seems to cause a modest weight reduction of 11.66 pounds in people with a body mass index between 25 and 40. 

The ephedra/cola nut combo along with a fat intake of 30 percent of calories with modest exercise, seems to reduce body fat, decrease bad cholesterol (LDL) and increase good cholesterol (HDL).

Even in young healthy people, ephedra with caffeine can increase heart rate and blood pressure significantly. Ephedra should be avoided completely. 

Picture of ephedra sinica the species of ma huang. 

› Ephedra Dietary Supplement


1. Doyle H, Kargin M. Herbal stimulant containing ephedrine has also caused psychosis. BMJ 1996;313:756 

2. FDA. Proposed rule: dietary supplements containing ephedrine alkaloids. Available at www.verity.fda.gov (Accessed 25 Jan 2000).

3. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833-8. 

4. Jacobs KM, Hirsch KA. Psychiatric complications of Ma-huang. Psychosomatics 2000;41:58-62.

5. Morgenstern LB, Viscoli CM, Kernan WN, et al. Use of Ephedra-containing products and risk for hemorrhagic stroke. Neurology 2003;60:132-5.

6. Walton R, Manos GH. Psychosis related to ephedra-containing herbal supplement use. South Med J 2003;96:718-20.

7. Shekelle PG, Hardy ML, Mortan S, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003;289:1537-45.

8. Anon. Ephedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects. Evid Rep Technol Assess (Summ) 2003;76:1-4. 

9. Coffey CS, Steiner D, Baker BA, et al. A randomized double-blind placebo-controlled clinical trial of a product containing ephedrine, caffeine and other ingredients from herbal sources for treatment of overweight and obesity in the absence of lifestyle treatment. Int J Obes Relat Metab Disord 2004;28:1411-9.

10. Boozer CN, Daly PA, Homel P, et al. Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Int J Obes Relat Metab Disord 2002;26:593-604.

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