The Common Ground ~ The POWER of EPHEDRA

Just prior to the arrival of the New Year, the FDA initiated a ban on controversial over-the-counter (OTC) ephreda-based dietary supplements such as ephedra, Ma huang, Sida cordifolia, and pinellia citing unreasonable risk of stroke and heart-attack. In recent years ephedra has become more casually available to the broader public in supplements marketed for weight loss, athletic performance and energy amplification. But alas the herb proved to be too powerful a substance for cavalier use, or misuse, as is evidenced by the wide-ranging inventory of its wounded, some fatally…

the POWER of EPHEDRA

Ephedra sinica, commonly known as Mormon tea, comes from a cone-bearing shrub indigenous to China, where it is known to Chinese doctors as Ma huang. In the 1920s, western pharmacologists synthesized pseudephedrine from ephedra’s primary compound, ephedrine, and classified it as a drug. Since then it has been widely used to treat acute breathing difficulties and nasal congestion due to cold, flu, allergies, asthma and sinusitis. The focus of the FDA’s ban, however, centers on the high ratio of adverse effects attributed to the herb’s more recent and pervasive use in long term weight loss, body building, and energy boosting formulas.

Analyzing current statistics, FDA researchers found that ephedra was disproportionately responsible for 64% of all adverse reactions reported from use, although ephedra products account for less than 1% of all herbal supplements sold. The overwhelming majority of these serious reactions were associated with OTC weight loss and athletic performance products, rather than decongestants or traditionally based preparations.

The abuse and misuse of ephedra products is a fairly recent phenomenon. With the advent of the herb’s use (often in risky combination with caffeine) in diet, energy, and physical conditioning supplements, its exploitation among certain communities has risen sharply. Baltimore Orioles pitching prospect Steve Bechler popularized concern when his death last year from heat stroke was additionally attributed to his use of ephedra supplements.

The use of ephedra can promote weight loss and increase energy and endurance due to its action on the elements of the nervous system that regulate unconscious functions such as digestion and blood pressure. Ephedrine indirectly stimulates the sympathetic and central nervous systems increasing metabolism and elevating both blood pressure and heart rate. This translates to more calories burned, improved alertness, and increased blood flow to the muscles (and in excess, an adrenaline-like high or a bad case of the jitters). Ephedra does function as an effective bronchial dilator and is therefore used to treat acute conditions of the respiratory tract such as asthma attacks, bronchiospasms and pleurisy.

Not surprisingly, ephedra (Ma huang) has long remained one of the most important medicinal herbs in its native Chinese pharmacopoeia. The highly regarded therapeutic use of Ma huang as a remedy for asthma, colds and flu dates back to 2,000 year old classical Chinese medical texts with oral traditions dating back more than 5,000 years. Fortunately, ephedra’s traditional uses will continue to be available to the American public via the FDA’s exemption for qualified practitioners of traditional Chinese medicine, namely licensed, certified and/or registered acupuncturists, naturopathic physicians and herbalists.

"[Ephedra] is a very respected herb, one of the first, if not the first, herb you learn in Chinese medical school," notes Suzanne Friedman, director of the Traditional Chinese Medicine and Medical Qigong Clinic in San Francisco. "When misused for weight loss or to keep people awake or energized… it could lead to serious health problems." A position statement on ephedra from the Illinois State Acupuncture Association (AAOM) further clarifies that Ma huang is not and has never been used in Oriental medicine for weight loss, athletic performance or energy augmentation. Used in small controlled doses, and typically for short periods of time, the herb is invaluable for treating many serious illnesses, most notably acute asthma. Furthermore, Ma huang is rarely used alone, but rather is combined with other botanicals, many of which reverse the inherent stimulant actions of ephedra’s potent alkaloids. In comparison to traditional formulations, the dietary and performance supplements provoking the current ban contain extremely high doses of Ma huang and/or ephedrine, and they are often dangerously combined with other stimulants such as caffeine.

Let this current ban on ephedra serve as a compelling reminder of the power of herbal medicines and our need to take whatever we put in our bodies seriously. To lend further perspective to this issue, it is also beneficial to extend this word of warning to prescribed pharmaceuticals: the Journal of the American Medical Association (JAMA), April 18, 1998, published a report from the University of Toronto, wherein researchers examined 39 rigorous studies and found that adverse drug events kill about 106,000 U.S. hospital patients per year and cause 2.2 million serious, but non-fatal, medical problems, when prescribed in accordance with the FDA's dosage guidelines. Adverse drug events from pharmaceuticals rank as the fourth leading cause of death in the U.S.