About Ephedra: The Controversy

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Few herbs have generated more controversy than ephedra. This ancient and unpretentious-looking plant (it resembles a stubby broom) contains a class of chemicals called alkaloids, which are among nature’s most potent and useful medicines. Morphine, quinine, and caffeine are other well-known alkaloids (look for the -ine suffix to identify an alkaloid), as is ephedrine, the key substance that gives ephedra its “kick”.

Before ephedra reached its current popularity in the United States, Chinese healers understood that ma-huang, the classical Chinese name for various Ephedra species, “releases the exterior and disperses cold” and “facilitates the movement of lung chi (or life’s energy) and controls wheezing,” according to D. Bensky and A. Gamble, authors of Chinese Herbal Medicine: Materia Medica (Eastland, 1993). The Chinese also used ephedra to treat asthma, colds, congestion, and coughs. They carefully controlled ephedra’s use, however, because they knew that ephedra could not only clear the bronchial passages, but also stimulate the central nervous system.

Such properties have made ephedra one of the top-selling herbs in the ­United States. Some estimates put sales of ephedra products at $750 million in 1995.

For some people, ephedra is truly a lifesaver, providing sufferers of chronic asthma and allergies with blessed relief when nothing else helps. For others, eph­edra has become a symbol of the irresponsible use of herbs and a reason to clamp down on the herb industry.

Insiders: A Century of Use

Ephedrine was first isolated from ephedra in 1887 by Japanese chemist N. Nagai. In 1924, K. Chen of the Eli Lily Company recognized it as a useful bronchodilator—it relaxes the bron­chial muscles so that airways can expand. Many drugs coming onto the market then contained ephedrine and became increasingly popular over time. The U.S. Food and Drug Administration (FDA) monograph for ephe­drine was published on September 9, 1976. It is still sold as an active ingredient in many well-known pharmaceuticals, such as Primatene and Sudafed, but the ephedrine in these drugs is now synthetically made and known as ephedrine hydrochloride or pseudoephedrine hydrochloride. How­­ever, people with certain health conditions, such as heart or thyroid disease, hypertension, and diabetes, shouldn’t use products containing ephedrine because it increases the heart rate and systolic and diastolic blood pressure.

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