Why is ephedra harmful

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Key References. Natural Medicines website. Accessed at naturalmedicines. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis.

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Measure content performance. Develop and improve products. List of Partners vendors. Ephedra Ephedra sinica is an herb with a long history of use in traditional Chinese medicine for asthma, bronchitis, allergies, and cold and flu symptoms. It is also known as Ma huang. During the s, ephedra became popular outside of traditional Chinese medicine for weight loss and to enhance sports performance.

Its popularity continued to grow, and it was found in many nutritional supplements marketed for weight loss and performance enhancement. However, the U. The primary active ingredients in ephedra are the alkaloids ephedrine and pseudoephedrine. Both increase heart rate, constrict blood vessels, dilate bronchial tubes, and have thermogenic properties to increase body heat and metabolic rate. These alkaloids have been linked to stroke , seizures, psychosis, and death.

Dietary supplements containing any amount of ephedrine or pseudoephedrine are banned in the United States, however, some supplement companies have removed these alkaloids from ephedra and reformulated their products. In Canada, ephedra is authorized by Health Canada for use only as a nasal decongestant. Nutritional supplements with ephedra may not also contain stimulants, such as caffeine, which may heighten the effect of ephedra and increase its dangerous side effect.

Canadian products containing ephedra also may not imply claims of weight loss, appetite suppression, body-building effects, or increased energy. The once popular stimulant was used for weight loss, sports performance, and asthma and other respiratory problems. The plant ephedra ma huang contains multiple chemical compounds, but the most notable is ephedrine. This molecule impacts several bodily processes and was used as a popular dietary supplement ingredient prior to being banned in several countries.

Much of the studies examining the effects of ephedra on weight loss occurred between the s and early s — before supplements containing ephedrine were banned. Although multiple components of ephedra may impact your body, the most notable effects are likely due to ephedrine.

Several studies showed that ephedrine increases resting metabolic rate — the number of calories your body burns at rest — which may be due to an increase in the number of calories burned by your muscles 4 , 6. Ephedrine can also boost the fat-burning process in your body 7 , 8. One study found that the number of calories burned over 24 hours was 3.

Another study observed that when obese individuals went on a very-low-calorie diet, their metabolic rate dropped. However, this was partially prevented by taking ephedrine 9. In addition to the short-term changes in metabolism, some studies show that ephedrine can promote weight and fat loss over longer time periods.

In five studies of ephedrine compared to a placebo, ephedrine led to weight loss of 3 pounds 1. However, long-term data on the usefulness of ephedrine for weight loss is lacking Additionally, many ephedrine studies examine the combination of ephedrine and caffeine rather than ephedrine alone Ephedrine, a major component of ephedra, can increase the number of calories your body burns. Research has shown this results in greater weight and fat loss over weeks to months, though long-term studies are limited.

Many studies examining the weight loss effects of ephedrine have combined this ingredient with caffeine. The combination of ephedrine and caffeine appears to exert greater effects on your body than either ingredient alone 12 , For example, ephedrine plus caffeine increases metabolic rate more than ephedrine alone Some research has even reported that caffeine and ephedrine individually had no effects on weight loss, while the combination of the two did produce weight loss Over 12 weeks, ingesting a combination of ephedra and caffeine 3 times per day led to a reduction of 7.

Thus we analyzed only studies of products containing ephedrine or ephedrine plus caffeine, seven studies in all. No two studies were judged similar enough in design to combine their results: Measures of athletic performance varied widely from one study to another.

As a result, our conclusions regarding the effects of ephedrine on athletic performance are based on a nonquantitative synthesis of the research rather than on meta-analysis. In addition, no study looked at long-term changes in performance. Our analysis found that one-time use of ephedrinecontaining products seems to enhance immediate physical performance, but only when taken in combination with caffeine.

These results, too, must be interpreted with caution. The studies assessed performance immediately after a single dose; none of the studies examined the type of chronic, long-term use typical of consumers of these products. What's more, the study participants,all young, fit males,may not be typical of the average consumer.

To assess the safety of ephedra- and ephedrine-containing products, we reviewed four sources for reports of adverse events. First, we reviewed the clinical trials included in our analyses of weight loss and athletic performance, most of which reported adverse events for both treatment and placebo groups.

The trials contained no reports of very serious adverse events such as death and cardiovascular events. This is not surprising, considering that the occurrence of such events is likely to be quite rare less than one in a thousand users and the clinical trials included only a few thousand people. However, we found a two- to threefold increase in the occurrence of nausea, vomiting, anxiety, autonomic hyperactivity, and palpitations, and a trend toward an increase in headaches.

We also reviewed descriptions of medical cases published in peer-reviewed journals. This review identified 70 reports of adverse events, including heart attacks, strokes, and serious psychiatric problems. We then obtained all adverse-event reports submitted to the FDA prior to September that were associated with the use of ephedraor ephedrine-containing products and for which records existed: more than 1, adverse-event reports on ephedra and on products containing ephedrine.

Finally, we analyzed more than 18, adverse-event reports received by one of the largest U. These reports had been turned over to the FDA at the request of the U. Deptartment of Justice. Based on the available evidence, these reports were classified as "sentinel events," "possible sentinel events," or lacking in sufficient evidence see Table 1.

NOTE: The hour requirement was applied to reports of psychiatric events because these events are believed to result from prolonged use. The majority of the adverse-event reports lacked sufficient information to demonstrate a connection between the event and use of ephedra or ephedrine.

Of particular concern is that half the sentinel events occurred in apparently healthy people under the age of The studies we reviewed suggest that ephedra- and ephedrine-containing products may be modestly effective in promoting weight loss, but the evidence on enhancing athletic performance is not definitive.