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Ephedra (Ephedra sinica, E. intermedia, E. equisetina)

Sometimes called the world's oldest medicine, this herb has been used in China to treat colds and asthma since 3000 B.C.  It's still considered an effective remedy for bronchial disorders, but concerns about safety have made ephedra controversial in recent years.

What it is?

Also known by its Chinese name, ma huang, ephedra is made form the dried stems of Ephedra sinica, a shrub native to the desert regions of Asia.  However, preparations from species such as E. intermedia or E. equisetina may also be effective.  A synthetic version of ephedra's active ingredients is widely used in both prescription and over-the-counter drugs, including many cold, allergy, asthma, weight-loss and energy-boosting formulas.

Unfortunately, ephedra has been abused in recent years, when some people began taking very high doses of the herb as a recreational stimulant – leading to heart attacks, strokes, and at least 28 deaths in the US.  As a result, the drug was almost banned in the US in 1996.  Although the ban wasn't imposed, a warning label may become compulsory.  In Australia, ephedra is available only on prescription (from holistic medical practitioners); in New Zealand, it can be sold only by pharmacists.

What it does?

Ephedra's primary active ingredients, the chemicals ephedrine and pseudoephedrine, have two major effects: they stimulate the central nervous system and they open the airways.  Ephedra's stimulant effect is stronger than that of caffeine, but less potent than that of amphetamines or the natural adrenal hormone epinephrine (adrenaline), which prepares the body to deal with stressful situations (the 'fight-or-flight' response).

Ephedra makes the heart beat faster, increases blood pressure, speeds up the metabolism and acts as a diuretic.  But throughout its long history, its main use has been as a bronchodilator, to treat the bronchial and nasal congestion of asthma, allergies, colds and sinus infections.  In the 1920s, US drug companies began extracting active ingredients from the herb and using low doses in asthma and cold medicines – a practice still common in many countries.

Major Benefits

Ephedra dilates the small airways in the lungs (the bronchioles), which helps to relieve congestion and coughing due to seasonal allergies or to mild asthma.  It also helps to alleviate respiratory symptoms caused by colds, flu and sinus infections.

Additional Benefits

Although ephedra may make the body burn kilo joules quickly and suppress appetitie, studies of this herb as a weight-loss aid have been contradictory.  For those in otherwise good health, it may be safe and effective in prescribed doses.

More controversial is the claim that ephedra enhances athletic performance by boosting energy.  Not only is there no scientific basis for this theory, but it has had tragic consequences.  A number of athletes have become seriously ill – and several have died – after taking large doses of products containing ephedra.  The herb is currently listed as a banned substance by the International Olympic Committee.

Common Uses

  • Eases the congestion and labored breathing caused by allergies or asthma.
  • Relieves pressure and congestion in sinus infections (sinusitis).
  • May aid weight loss.


  • Capsule.
  • Tablet.
  • Tincture.
  • Dried herb/tea.


  • Ephedra can cause blood pressure to soar.  You must be monitored by your doctor, especially if you have high blood pressure, heart disease or heart rhythm disorders, or if you take MAO inhibitors for depression.
  • Ephedra can elevate blood sugar.  People with diabetes should use it with caution.
  • Be sure to tell your doctor if you have thyroid disease or difficulty in urinating caused by prostate problems, or if you're pregnant or breast-feeding.
  • Reminder:  If you have a medical condition, talk to your doctor before taking supplements.

How to take it?


It's essential to follow your doctor's advice.  Most standardized extracts supply about 5.5-6.5% ephedrine (also known as 'ephedra alkaloids').  It's usual to begin with a low daily dose, such as 100 mg of ephedra (about 6 mg of ephedrine).  If side effects aren't a problem, the dose can be increased, but shouldn't exceed 130 mg of ephedra (about 8 mg of ephedrine) three times a day.

Your doctor may also prescribed ephedra as a tea or tincture.  The usual dose for a tea is one or two cups a day, made by pouring 1 cup of very hot water over 1 teaspoon of dried ephedra (along with other herbs if recommended) and steeping for 10-15 minutes.  As a tincture, the usual dose is 1/4 to 1 teaspoon of ephedra tincture (up to 8 mg of ephedrine) taken in a glass of water up to three times daily – but follow your doctor's instructions precisely.

Guidelines for use:

Take only on your doctor’s advice, especially if you have heart disease, diabetes or other medical problems.  Never exceed the prescribed dose.  This herb can be taken long term for certain conditions, such as chronic asthma, but should be used only as needed – up to seven days at a time – to minimize the risk of side effects.  Avoid taking ephedra with caffeine, which can cause excessive stimulation.  If you find it interferes with sleep, tell your doctor, who will probably advise you to omit your evening dose.

Possible side effects

The higher the dose and the longer you take ephedra, the greater the incidence of such common side effects as nervousness, insomnia, heart palpitations and vertigo.  Less often, there may be dizziness, tingling, nausea and vomiting, loss of appetite, muscle cramps, headache, and difficult or painful urination.  Extremely serious side effects include high blood pressure, stroke, seizures and with very high doses, hallucinations and psychosis.

Shopping Hints

  • Your doctor will monitor your heart rate (pulse) and blood pressure when you're taking ephedra.  If your resting heart rate seems faster than usual, or your blood pressure is above normal, you'll be advised to stop using the herb.
  • Don't take ephedra with over-the-counter cold remedies or with other remedies or with other formulas containing ephedrine or pseudoephedrine.  This will double your dose, raising the likelihood of side effects.

Latest Findings

  • Be sure that you're using preparations made from an effective ephedra species, such as E. sinica.  Many North American species, such as E. nevadensis (commonly called Mormon tea, because the first Mormons to reach the arid lands of Utah used this native plant in a piney-tasting tonic), have few active ingredients.

Did you know?

Legend has it that Genghis Khan's sentries, threatened with beheading if they fell asleep while on duty, drank a tea brewed from ephedra to stay awake.  A cup of ephedra tea delivers about 10 mg of the active ingredient ephedrine.