Speaking of ephedra (Ma Huang), an ancient Chinese herb with over 5,000-year history, you might have heard of it if you ever spent some time on locating an effective diet pill. These days weight loss pills with ephedra are expanding the market despite of all those considerable controversy out there. As a legal drug recorded in the “Chinese Pharmacopoeia”, clinically it is mainly used for common cold due to wind-cold, chest tightness, cough, wheezing, and so on. Its main ingredient is ephedrine (EPH), which is also one item listed in the pharmacopoeia and commonly used for the prevention of bronchial asthma and relief of mild asthma.
When you catch a cold, the nasal drops containing ephedrine hydrochloride can be of a great help on reducing nasal congestion and swelling, runny nose, and other cold symptoms. Thanks to its outstanding benefits on accelerating metabolism, losing weight, and increasing endurance, ephedrin becomes one of the most popular performance enhancers for athletes. Besides, it is also one desirable fat burning pills since it will burn off the fat while maintaining muscle. But I do have to say, ephedrine has obvious adverse reactions, especially damage to the heart. Others include heart palpitations, arrhythmias, myocardial infarction, elevated blood pressure, stroke, brain damage, or even death.
What is ephedra or Ma Huang?
Medicinally it refers to the herbaceous stems of Ephedra sinica Stapf, Ephedra intermedia Schrenk ex C.A.Mey, or Ephedra equisetina Bge., which is a plant in the family Ephedraceae. It is mainly produced in Xinjiang, Hebei, Shanxi, Inner Mongolia, Gansu and other places. It is usually collected during autumn. After the harvesting, it needs to remove the woody stems, residual root and impurities, and then cut into sections. It is usually used raw, stir-fried with honey, or smashed.
Ephedra plant is a perennial herb, 30 to 50 cm in height. Needle leaves, usually about 1 to 2 millimeters thick, grow upward directly. The color of leaf is always changing according to the seasonal variation – green in summer, yellow in autumn, withered and yellow in winter, and tender green mixed with pale yellow in the following spring. Ephedra fruit turns red and sweet when ripe. Since it is edible and with high nutritional value, people love to pick and eat it when the fruit season comes. But eating too much of it may lead to dizziness. After the fruits are rife enough to fall into the soil or sand, it will sprout and grow in the coming year.
Ephedra sinica stem contains 1% to 2% alkaloids, which consist of 40% to 90% l-Ephedrine, d-pseudoephedrine, and traces of lN-methyl ephedrine, dN-methyl-pseudoephedrine, l-Norephedrine, d-Demethyl-pseudoephedrine, and Ephedine. Besides, it still contains 6% of catechu tannin, volatile oils, flavonoids, organic acids, etc.; Ephedra equisetina contains 1.15% to 1.75% alkaloids, mainly ephedrine and pseudoephedrine. And it still contains tannins, flavonoid glycosides, dextrin, inulin, starch, pectin, cellulose, saccharides like glucose, oxalic acid, citric acid, malic acid, fumaric acid and other organic acids; Ephedra intermedia contains large amounts of ephedrine. Besides, it still contains tannins, flavonoid glycosides, dextrin, inulin, starch, pectin, cellulose, glucose, etc. The above-mentioned 3 species have similar chemical constituents. But in terms of alkaloid content, the highest one is ephedra equisetina, followed by ephedra sinica and ephedra intermedia.
Ephedra health benefits
Ephedrine and pseudoephedrine are the main active ingredient in many anti-tussive, anti-cold and intranasal compound preparations. Unlike its traditional use in China, this herb is extensively used for the purposes of weight loss, bodybuilding, and libido boost. Common brands include Stimerex with ephedra, Xenadrine with ephedra, Metabolife with ephedra, Lipodrene with ephedra, and so on. Besides of ephedra pills, you can also buy ephedra products such as ephedra tea, extract, supplements, etc. It is used as diet pills because it can induce perspiration, promote diuresis, and improve basal metabolic rate; it is used as stamina and sex enhancer because it can increase myocardial contractility, enhance cardiac output, and stimulate central nervous system. In addition, it is considered that the reason why it can help lose weight is based on its effect of suppressing appetite, which results in reduced calorie intake and thus burn off the fat for the energy needed.
Modern pharmacological actions of má huáng
1. Its volatile oil can induce sweating because ephedra alkaloids increases and speeds up people’s sweat gland secretion;
2. Its volatile oil has antipyretic effect;
3. Ephedrine and pseudoephedrine relieve bronchial smooth muscle spasm;
4. Pseudoephedrine has significant diuretic effect;
5. Ephedrine can stimulate the heart, constrict blood vessels, and increase blood pressure;
6. Ephedrine has obvious stimulant effect on central nervous system, which cause excitement, insomnia, and anxiety;
7. Its volatile oil has inhibition on influenza virus;
8. Its methanol extract has anti-inflammatory effects;
9. Its decoction inhibits pathogenic microorganisms.
Selected herbal remedies on herba ephedrae
The Chinese Pharmacopoeia says that it is acrid and slightly bitter in flavor and warm in nature. It covers meridians of lung and bladder. Prime functions are inducing perspiration to dispel cold, freeing lung to relieve asthma, and inducing diuresis for removing edema. Essential indications include common cold due to wind-cold, chest tightness, cough, and wind-water puffy swelling. Besides, the ephedra stir-fried with honey is able to moisten lung to arrest cough, which is mainly used for asthma or cough after the exterior syndrome has been cured. Recommended dosage is from 2 to 9 grams.
1. Ma Huang Tang from Shang Han Lun (On Cold Damage). It is combined with Gui Zhi (Cinnamon Twig), Xing Ren (Apricot Seed), and Gan Cao (Licorice Root) to cure wind-cold exterior excess accompanied with wheezing and cough.
2. San Ao Tang from Tai Ping Hui Min He Ji Ju Fang (Formulas of the Peaceful Benevolent Dispensary). It is matched with apricot and licorice to treat excess type dyspnea due to attack of exopathogenic wind-cold and obstructive lung qi.
3. Xiao Qing Long Tang from On Cold Damage. It is formulated with Xi Xin (Herba Asari), Gan Jiang (Dried Ginger Root), Ban Xia (Pinellia), etc. to get rid of cold phlegm, fluid retention, cough, asthma, and clear, thin mucus in the nose.
4. Ma Xing Gan Shi Tang from (On Cold Damage). It is joined with Shi Gao (Gypsum), apricot, and licorice for the treatment of excessive lung heat, high fever, and tachypnea.
5. Gan Cao Ma Huang Tang from Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabine). It is coupled with licorice to cure edema and dysuria accompanied with exterior syndrome.
6. Yue Bi Jiao Zhu Tang from Jin Gui Yao Lue. It is used together with gypsum, licorice, Sheng Jiang (Fresh Ginger), and Bai Zhu (White Atractylodes) to treat edema and dysuria.
Ephedra side effects
In April 2004, the U.S. Food and Drug Administration (FDA) has banned the sale of food containing ephedra alkaloids and decided more relevant products would be imposed greater controls in early 2006. However, the fancy use, marketing hype, and poor management of over-the-counter drugs, instead of ephedra, should be the one to take the blame since the combination of them can lead to public neglect and misunderstanding on the safety of ephedra and ephedrine. Since 2003, the adverse events caused by abusing ephedrine have been increasing since it is allowed to be used as a food additive. And most of them are cardiovascular and nervous system problems, including myocardial infarction, heart rhythm abnormalities, seizures, loss of consciousness, or even a death. All these mentioned adverse reactions are more serious than normal side effects of ephedrine used medicinally, which doesn’t make sense at all. But there is one thing worth noting here – among the severe or death cases some are women who have taking weight loss pills with ephedra for a long term, even up to 4 years.
Currently controversy still exists on the clinical safety of ephedra and ephedrine alkaloids. Traditional Chinese medicine (TCM) never uses Ma Huang herb for the mere purpose of losing weight or building muscle. For sure ephedrine can be used for loss of libido and delayed ejaculation clinically, which however doesn’t justify the abuse of it by healthy person. And this is against the basic spirit and principles of TCM. So, clinically the use and dosing of ephedra or ephedrine should be done strictly according to the guidance of a doctor.