The Abuse of Ma Huang (Ephedra sinica)

By

Jeffrey S. Hoard

 

I have used Ma Huang (Ephedra sinica) for years. I find it is very effective when used – in conjunction with other herbs and for a specific and very short period of time – for respiratory problems. It saddens me to contemplate that the FDA may now actually be considering banning this herb because of its misuse and abuse by the massive Pharmaceutical/Supplement Industry as a weight-loss and/or sports enhancement product.

I’m sure I am not the only one to notice that when used properly and in very small amounts, the herb does exactly what we expect it to do. That is, to open and relax the bronchial area and to lessen excess mucus in cases of respiratory irritation or infection. It does not exhibit the side effects noted when using larger amounts, although it does certainly make you feel better. The speed effect associated with Ma Huang is, I believe, an indication in and of itself of an overdose of the herb. Even the esteemed conservative pharmacist, Varro Tyler recommends a dose of the herb which I find to be two to three times stronger than anything I (a rather large male-type person) would ever take!

Following the untimely death of Baltimore Orioles pitcher Steve Bechler during Spring Training recently and the news that he had a weight problem and was taking a weight-loss product containing ephedrine, the FDA has stepped up it’s efforts to control that chemical and by extension the herb Ma Huang.

An additional problem facing the continued availability of Ma Huang is that ephedrine is a precursor for the synthesis of methamphetamine. It would be safe to say, however, that all of the ephedrine used in such illegal drug production derives from synthetic ephedrine, created by and for the Pharmaceutical/Supplement Industry. There is no evidence that the herb itself is being used in this way. Indeed, it would not seem to be feasible to use natural extractions for illegal drug manufacturing, because of the small amount of alkaloids – about 2 – 4% – found in the plant.

So what is happening is that those of us who use the herb responsibly, in small amounts and for the right reasons may very well be deprived of its benefit by those who sell and use the herb in a dangerous and irresponsible manner. None of us should be very happy about this!

The FDA recently proposed a warning label for all Ephedra-containing dietary supplements. This is a good idea. The proposed label warns about the risks of serious adverse events, including heart attack, seizure, stroke, and death; cautions that the risk can increase with the dose, with strenuous exercise, and with other stimulants such as caffeine; specifies certain groups (such as women who are pregnant or breast feeding) who should never use these products; and lists other conditions, such as diseases and the use of certain medications, that rule out the use of ephedrine alkaloids.

Cheryl’s Herbs already includes the following warning for Ephedra sinica:

Avoid during pregnancy, nursing, anorexia, bulimia, glaucoma, anxiety, impaired circulation of the cerebrum, adenoma of prostate with residual urine accumulation, pheochromocytoma (a usually benign tumor of the adrenal medulla or the sympathetic nervous system in which the affected cells secrete increased amounts of epinephrine or norepinephrine) and thyrotoxicosis (a condition resulting from excessive concentrations of thyroid hormones in the body, as in hyperthyroidism). Not recommended for excessive or long-term use. In higher dosage side effects can be drastic increase in blood pressure, cardiac arrhythmia, development of dependency. Warning: Seek advice from a health care practitioner prior to use if you are pregnant or nursing, or if you have high blood pressure, heart or thyroid disease, diabetes, difficulty in urination due to prostate enlargement, or if taking a MAO inhibitor or any other prescription drug. Reduce or discontinue use if nervousness, tremor, irritability, headaches, sleeplessness, disturbances of urination, excessive rapid heart rate, loss of appetite or nausea occur. Not intended for use by persons under 18 years of age. Keep out of the reach of children.

 

It is one of the longest warnings in our catalog. It demonstrates our desire to provide as much safety information as possible so that our customers can make informed choices regarding their use of herbs. We believe responsible herbalists everywhere feel the same.

The Ephedra genus of the phylum Gnetophyta is a perennial, dioecious shrub that reaches from 1.5 to 4 feet tall. The species E. sinica is found mostly in the desert regions of China and Mongolia. It has been used in China for more than 5,000 years for the treatment of bronchial asthma and related conditions. An early written reference to its use can be found in a Chinese herb compilation called Shen Nong Ben Cao Jing which dates back to the first century A.D. There are over 40 different species of Ephedra. Local specie variants have been similarly used in Afghanistan, Australia, Central America, Europe, India and North America.

Besides ephedrine, there are several other alkaloids contained in Ma Huang in significant amounts: norephedrine, pseudoephedrine and norpseudoephedrine among others. Several have been synthesized and are commonly (and indiscriminately) used in over-the-counter cold preparations. Herbalists, of course reject the notion that synthesized isomers convey the same information as interaction with the whole of the plant in its natural state. Some day that may be possible, but that day is not today.

At Cheryl’s Herbs, we recommend against ephedrine pharmaceutical supplements for weight loss or sports performance. We do, however, feel that the use of the herb Ma Huang as described above and used by those who find no contraindications which apply to them, is safe and effective. We would ask those of you who are using ephedrine products for weight loss or sports performance to cease immediately! This may be the only hope we have of seeing the continued availability of this useful and long-used herb for those who truly need it.

March 13, 2002

 

References:

 

Blumenthal, Mark, et al., The Complete German Commission E Monographs, The American Botanical Council, Austin, TX, 1998.

Fox, Maggie. Baseball Player's Death Re-ignites Ephedra Debate. Reuters Health, Wednesday, February 19, 2003

The Herb Research Foundation: Herb Information Greenpaper: HERBAL STIMULANTS. April 20, 1995. http://www.ibiblio.org/herbs/stimulant.html

Mcguffin, Michael, et al., Botanical Safety Handbook, CRC Press, Boca Raton, 1997.

Peterson, Scott. Ephedra: Asking for Trouble? SIUC College of Science March, 2, 2001. 

Tyler, Varro E., PhD. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Pharmaceutical Products Press, 1994.

Weil, Andrew, M.D. Natural Health, Natural Medicine. Houghton Mifflin, 1995, 1998.

 

 

UPDATE: 1/8/06

Unfortunately, at this time, we are still unable to provide ma huang. You should know that it is the insurance liability providers who make it impossible for us to reasonably do so.

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