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EPHEDRA: FRIEND OR FOE?

Chinese ephedra (Ephedra sinica), also known as desert herb or Ma Huang, is a plant with a PR problem. Ephedra is a powerful herb which grows mainly in Mongolia and the bordering regions of China. It has been used in Chinese medicine for at least 5,000 years. It is the herb from which scientists have extracted ephedrine, one of the most effective treatments known for the symptoms of asthma, allergies, and sinus problems.

The Chinese employed ephedra for many uses, including the treatment of asthma and as a natural decongestant and antihistamine. Herbalists in the West have also discovered these benefits and ephedra has become a popular ingredient in herbal combinations for the respiratory system. Since it also has a thermogenic effect (increases basal metabolic rate, slightly raising body temperature and causing calories to be burned at a faster rate), it has also proven to be an effective aid for weight loss. An added bonus for those who use the herb for weight management is its appetite-suppressing effect.

The active ingredients in ephedra are naturally occurring ephedra alkaloids, the most important one being ephedrine. Because it has a stimulating effect, many believe that it contains caffeine. The truth is, the herb ephedra by itself contains no caffeine.

It is ephedra's stimulating and thermogenic effect that is responsible for the herb's PR (Public Relations) problem. One of the side-effects of thermogenesis is a slight increase in pulse rate and an elevation of blood pressure. Ephedra is therefore not recommended for individuals with high blood pressure, heart problems or hyperthyroidism. It may also cause problems for people with insomnia and for those who suffer from panic attacks. Reputable manufacturers who market products containing ephedra will put a warning on the label stating this contraindication. However, there have been a few unfortunate cases where this warning was either absent, or ignored, resulting in a serious complication such as a cardiovascular accident.

Another problem for ephedra is that a few young people have taken large amounts of the herb, often mixed with other stimulants, in order to get a "high." Invariably in such cases the ephedra is taken in combination with other drugs, such as caffeine and pseudoephedrine, and in some cases it has been combined with illegal substances such as methamphetamines. This has occasionally resulted in cardiovascular accidents and even a few deaths. In such cases, the question to ask is whether these accidents resulted from the herb, or from the drugs. It is certain that they resulted from misuse or abuse.

To make matters worse, many herbal manufacturers spike their ephedra-containing weight loss products with caffeine. This is often done by adding herbs that contain caffeine, such as guarana seeds or cola nuts. Caffeine by itself can elevate blood pressure and cause heart palpitations. When combined with ephedra this potential is increased. Most health professionals strongly recommend that ephedra products should not contain caffeine.

Despite these unfortunate events, ephedra has an excellent safety record considering the large number of people who have used the herb. (To keep our perspective, remember that 20,000 Americans are hospitalized each year from taking aspirin.) Medical research has shown that there are many health risks associated with being even moderately overweight, including heart disease, arthritis, and diabetes. Obesity (defined as 30 pounds or more over your ideal body weight) is considered a major health problem in the U.S. According to the Center for Disease Control, obesity is an epidemic resulting in 300,000 deaths each year. A risk to benefit analysis of ephedra will clearly indicate that its potential benefits for weight loss far outweigh its potential to do harm, especially when taken in a prudent manner.

Due to a few highly-publicized incidents, a public perception of danger has ensued and political groups in two states have managed to get ephedra banned. One such state, Ohio, has since taken a more objective look at the data and has decided to lift its ban. One other state, Nebraska, still has a ban on the herb.

Millions of people, including this writer, have benefited from ephedra for allergy and sinus problems, for asthma, and as a weight management aid. The record shows that when used properly the herb is as safe or safer than many over-the-counter medications including aspirin. Ephedra has a 5,000 year record of safety, something that no drug can lay claim to. Hopefully, Nebraska will follow Ohio's lead and lift their ban on ephedra and it will be available, without a prescription, for those who desire a safe and natural alternative for the health conditions for which it is indicated.

Important things to consider when selecting and using ephedra products:

Don't use ephedra products that contain caffeine. This includes those that contain guarana and cola (or kola) nuts. Choose an ephedra product that uses the whole herb, not just the extracted ingredient ephedrine. The whole herb contains other ingredients that work synergisticly with the naturally-occurring ephedrine, increasing its effectiveness and decreasing its potential for undesirable side-effects. When taking prescription drugs or being treated for a health condition, check with your health professional before using ephedra. Reduce dosage if undesirable side-effects occur, and discontinue use entirely if they persist. This includes, but is not limited to, headache, nervousness, sleeplessness, anxiety, nausea, and prostate or urinary problems. Remember that ephedra works best when taken on an empty stomach. The best time to take it is one hour before meals. Ephedra can also cause nausea in some people when taken with food. To prevent interference with sleep, don't take ephedra too late in the day. This is particularly true when caffeine is also used. The maximum safe dosage of ephedra is 100 mg of ephedra alkaloids, or ephedrine, per day. This may vary depending on body size. Ephedra should never be taken on a continual basis. It is best to take it for no longer than a month at a time. After a break of a week or two its use can be resumed. Never take ephedra for longer than three months without taking a break. Continuous use can cause adrenal exhaustion and the herb can lose its effectiveness.

Disclaimer: These statements have not been evaluatedby the Food and Drug Administration. This information is notintended to diagnose, treat, cure or prevent any disease, and is foreducational purposes only. If you are taking anymedication or are under treatment for any disease, pleaseconsult your health care professional about potential interactionsor other possible complications before taking any of theseproducts. If you are pregnant or lactating, please consult withyour health care professional before taking any medication ordietary supplements.

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