Ephedra (Ephedra sinica, Ephedra intermedia, Ephedra equisetina)

Parts used and where grown: Ephedra is a shrub-like plant found in desert regions throughout the world. It is distributed from Northern China to Inner Mongolia. The dried green stems of the three Asian species (E. sinica, intermedia, equisetina) are the plant parts employed medicinally. The North American species of ephedra does not appear to contain the active ingredients of its Asian counterparts.

• asthma

• congestion

• cough

• chronic obstructive pulmonary disease

• weight loss and obesity

Historical or traditional use: The Chinese have used ephedra medicinally for over 5,000 years. Ephedra is listed as one of the original 365 herbs from the classical first century A.D. text on Chinese herbalism by Shen Nong.¹ Ephedra’s traditional medicinal uses include the alleviation of sweating, lung and bronchial constriction, and water retention. Coughing, shortness of breath, the common cold, and fevers without sweat are all indications for its use. While the active constituent, ephedrine, was isolated in 1887, it was not until 1924 that the herb became popular with physicians in the U.S. for its bronchodilating and decongesting properties.²

Active constituents: Ephedra’s active medicinal ingredients are the alkaloids ephedrine and pseudoephedrine. The stem contains 1-3% total alkaloids, with ephedrine accounting for 30-90% of this total, depending on the plant species employed.³ Both ephedrine and its synthetic counterparts stimulate the central nervous system, dilate the bronchial tubes, elevate blood pressure, and increase heart rate. Pseudoephedrine (the synthetic form) is a popular over-the-counter remedy for relief of nasal congestion.

How much should I take? The crude powdered stems of ephedra (with less than 1% ephedrine) are employed at a dose of 1-4 grams per day in tea form. Tinctures of 1-4 ml three times per day can be taken. Over-the-counter drugs containing ephedrine can be safely used by adults at a dose of 12.5-25 mg every four hours. Adults should take no more than 150 mg every twenty-four hours. Pseudoephedrine is typically recommended at a dose of 60 mg every six hours.

Are there any side effects or interactions? Ephedra has a long history of safe use at the recommended amount. However, abuse of the drug—especially for weight loss—can lead to amphetamine-like side effects, including elevated blood pressure, muscle disturbances, insomnia, dry mouth, heart palpitations, nervousness, and even death due to heart failure.

Anyone with high blood pressure, heart conditions, diabetes, glaucoma, thyroid disease, and those taking MAO-inhibiting antidepressants should consult with a physician before using any type of product with ephedra. Pseudoephedrine can cause drowsiness and should be used with caution if driving or operating machinery. Ephedra-based products should be avoided during pregnancy and lactation and used with caution in children under the age of six years.

Special United Kingdom Considerations: Ephedra is either not available or may require a prescription. Please check with your nutritionally oriented physician.

1. Foster S. Herbs for Your Health. Loveland, CO: Interweave Press, 1996, 37-8.
2. Tyler, VE. The Honest Herbal, 3d ed. Binghamton, NY: Pharmaceutical Products Press,1993, 119-21.
3. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics,2d ed. New York: John Wiley & Sons, 1996, 227-29.