Toxic Topics - Ephedra

Ephedra, also referred to as "ma huang", is an herb found in many diet supplements and muscle enhancement products. The FDA has reported nearly 1,200 adverse health effects, including almost 50 deaths, of consumers taking Ephedra, and has launched an investigation.

Those who have suffered strokes, heart attacks and other major injuries by taking Ephedra may be entitled to compensation.

What Are The Dangers Of Ephedra? Side effects of ephedra include:

  • Nervousness
  • Dizziness
  • Tremor
  • Elevated blood pressure
  • Accelerated heart rate (tachycardia)
  • Headache
  • Gastrointestinal distress
  • Chest pain
  • Myocardial infarction
  • Hepatitis
  • Stroke
  • Seizures
  • Psychosis
  • Death

Ephedra (herbal)

Drug names

As OTC herbal, "approved medical uses" does not apply

Approved medical usage

Hypertension, palpitations, vasoconstriction; habit-forming and/or addictive.

Adverse effects

Many, Metabolife being the leader.


Crisis of hypertension with coronary artery vasoconstriction resulting in death; or hemorrhagic stroke in brain

Patient presentation

$13 million verdict in Alaska, Feb 7 2001

Litigation status

Contents of Ephedra vary, typically including

Norpseudoephedrine = Cathine (NPSE)
Norephedrine = phenylpropanolamine (NEPH)
Pseudoephedrine (PSE)
Ephedrine (EPH)

Other names for Ephedra:

Sea grape
yellow horse
country mallow
squaw tea
Mormon tea

The Ephedra components cause vasoconstriction plus increased cardiac output.  This can cause increased metabolic demands in the heart coupled with reduced blood supply to the heart; and can result in bursting of arteries in the brain as a result of hypertension.  Periods of physical exertion by athletes are therefore obviously makes for a particularly vulnerable situation.

Although not particularly euphoric, Ephedra components are likely to be habit-forming if ingested orally, and addictive if smoked.  This dangerous trend has been identified already by FDA.  A significant problem is that there may be major variations in the strength of the different Ephedra components, and "doping" - illegal addition of synthetic chemicals such as ephedrine - is known to occur. 

Some herbal cigarettes containing Ephedra are marketed as a legal alternative to marijuana. Known side-effects of ephedrine include:

dizziness, confusion, or fainting spells
increased sweating
irregular heartbeat, palpitations, or chest pain
pain or difficulty passing urine
rapid or troubled breathing
difficulty sleeping
dry mouth
loss of appetite

The surgeon general of the US Air Force has said that risks outweigh the benefits of Ephedra.

Much incompetent advice is given in the lay press, including statements that Ephedra components are judged safe in cold medicines.  Possibly proponents of Ephedra safety confuse ephedrine with pseudoephedrine and consider PPA as having been a component of cold medicines.  Ephedrine is used in injectable form in the operating room to sustain patients whose cardiac output and blood pressure are dropping, but that is the only medically recognized use of the drug.

Public Citizen has protested very loudly that Ephedra should be withdrawn from the market immediately, condemning the FDA decision to call for more study.  This public interest group had filed a petition September 5, 2001, for banning Ephedra from sale.

Drug interactions:  Caffeine can potentiate the toxic effects of Ephedra.  Any psychoactive drugs that affect dopamine, norepinephrine, or serotonin can potentially have serious actions in amplifying Ephedra toxicity.  These include antidepressants and other diet drugs, and street drugs such as amphetamine, cocaine, ecstasy (MDMA), methamphetamine, "ice", "crack", "crystal", "speed".  Death will be preceded by sweating palms and erratic heartbeat.

Update 13 Feb 2003:  Ephedra and Ephedra-containing products account for 64% of all Adverse Reactions to Herbs in the United States.  Yet these products account for less than 1% of herbal product sales. The relative risks for an Adverse Reaction in persons using Ephedra compared with other herbs were over 100.  These are the conclusions of a publication in the Annals of Internal Medicine, a prestigious journal put out by the American College of Physicians.

Stephen Bent, Thomas N. Tiedt, Michelle C. Odden, Michael G. Shlipak
The Relative Safety of Ephedra Compared with Other Herbal Products
Annals of Internal Medicine 3 (?) ??-??, 2003.

If you believe you have been injured by Ephedra please contact us at


Copyright© 2011 Toxic Discovery , Web Design Acker Design