In the US, supplements containing ephedra have been banned since 2004 due to safety issues.

The Chinese herb ma huang is a member of a primitive family of plants that look like thin, branching, connected straws. A related species, Ephedra nevadensis, grows wild in the American Southwest and is widely calledMormon tea. However, only the Asian species of ephedra contains the active compounds ephedrine and pseudoephedrine.

Ma huang was traditionally used by Chinese herbalists during the early stages of respiratory infections and also for the short-term treatment of certain kinds of asthma, eczema, hay fever, narcolepsy, and edema.

Japanese chemists isolated ephedrine from ma huang at the turn of the century, and it soon became a primary treatment for asthma in the United States and abroad. Ephedra's other major ingredient, pseudoephedrine, became the decongestant Sudafed.

Although it can still be found in a few over-the-counter drugs for asthma and sinus congestion (in a safer form than the banned dietary supplements), physicians seldom prescribe ephedrine anymore. The problem is that ephedrine mimics the effects of adrenaline and causes symptoms such as rapid heartbeat, high blood pressure, agitation, insomnia, nausea, and loss of appetite. The newer asthma drugs are much safer and easier to tolerate.

Meaningful evidence suggests ephedrine/caffeine combinations can assist in weight loss.1-5,19,31Note: Due to safety risks, we strongly recommend that you seek physician's supervision before attempting to lose weight with ephedrine/caffeine combination therapy. We do not recommend using herbal sources of ephedrine, which are now banned, for weight loss at all. (See Safety Issues.)

One highly preliminary study has been used to claim that ephedrine is helpful for women with sexual dysfunction.20 However, this trial was very small, enrolled women without sexual problems, and only examined sexual responsiveness to visual stimuli; at this time, we do not recommend that women with sexual dysfunction use ephedra. Another study examined the possible benefits of ephedrine for treatment of female sexual dysfunction caused by antidepressants in the SSRIfamily (eg, Prozac).32 Ephedrine failed to prove more effective than placebo.

There is no meaningful evidence that ephedra enhances sports performance.29

Note: Individuals taking ephedra or ephedrine may test positive for methamphetamine (speed) on drug screening.21,33