The Sneezin' Season

Should you try ephedra for allergies?

Ephedra (Ephedra sinica) has a long history of use in Asia, North America, and western Europe for treating respiratory conditions such as asthma and hay fever. In a lab study, a Chinese herbal formula that contains ephedra as its main ingredient blocked the allergic response. Neither of the herb’s active ingredients—the alkaloids ephedrine and pseudoephedrine— inhibited histamine release from mast cells, which means that they work in other ways to stop an allergy attack. Both of these chemicals are similar in structure and action to the body’s epinephrine (adrenaline).

Synthetic epinephrine and similar drugs are used to halt serious allergic reactions because they open the airways and constrict the tiny blood vessels in the respiratory lining, which decreases the swelling. Synthetic pseudoephedrine is sold as Sudafed and as an ingredient in many hay fever, sinus, and cold remedies.

The problem with ephedra (and its pharmaceutical counterparts) is that it can raise heart rate and blood pressure, and cause jitteriness and insomnia. A recent report in the New England Journal of Medicine reviewed 140 reports of adverse reactions related to the use of ephedra. It found that one-third of these cases were likely caused by ephedra. These adverse reactions included heart palpitations, stroke, and seizures. Ten people died and thirteen had permanent disabilities. Most of these people took products designed to promote weight loss or increase energy, products that combine ephedra alkaloids with caffeine. Many of the people also were taking asthma or hay fever medicines that have similar actions. The authors speculated that these serious reactions “may be due to individual susceptibility, the additive stimulant effects of caffeine, the variability in the contents of pharmacologically active chemicals in the products, or preexisting medical conditions.”

Joseph Pizzorno, N.D., co-founder of Bastyr University, and author of Total Wellness (Prima, 1997) and other books, says, “I’m not concerned about toxicity when ephedra is used in moderation. Limited dosages are fine, and anything misused is dangerous.” But he also adds that he rarely uses ephedra alone.

His advice: Don’t take more than a total daily dosage of 50 mg of ephedra alkaloids, unless you’re doing so under the advice of a health-care professional skilled in herbal medicine. Don’t combine ephedra with caffeine, decongestants, asthma bronchodilators, or any other stimulant drugs. Finally, don’t take ephedra if you have high blood pressure, glaucoma, circulatory problems of the brain or heart, prostate disease, diabetes, anxiety, insomnia, or if you’re pregnant or nursing.