Ephedra sinensis; Ephedra sinica; Ma huang

Note: Over-the-counter supplements containing ephedra were banned by the U.S. Food and Drug Administration (FDA) in May 2004. See below for additional information.

Ephedra (Ephedra sinica), also called ma huang, is an herb that has been used in Traditional Chinese Medicine (TCM) for more than 5,000 years, primarily to treat asthma, bronchitis, and hay fever. Ephedra is also prescribed for symptoms of cold and flu, including nasal congestion, cough, fever, and chills.

While ephedra is a naturally-occurring herb, its main active ingredient ephedrine can also be synthesized as a medication. Synthetic ephedrine compounds, such as pseudoephedrine, are widely used in over-the-counter cold remedies and are regulated as a drug. This is unlike the regulation of ephedrine alkaloids derived from the herb itself. These are regulated as dietary supplements.

Until May 2004, ephedra was sold commercially as an energy booster, weight-loss supplement, and athletic performance enhancer. Although some scientific evidence suggests that this herbal supplement may improve weight, the information overall regarding its effectiveness for weight loss, energy, or athletic performance has been inconclusive and controversial. In addition, ephedra-containing products sold for these purposes have been linked to many cases of stroke, heart arrhythmia (irregular heart rhythm), and even death. Several of these products also contain caffeine; the combination of ephedra with caffeine dramatically increases the chances of adverse side effects.

It is important to note that ephedrine-containing products are banned from amateur sporting events, and evidence of ephedra on drug testing will likely disqualify athletes from competition.

The FDA ban on this substance includes any dietary supplements that contain ephedra, ephedrine, norephedrine, ma huang, Sida cordifolia, or pinellia. This does not pertain to teas (which are regulated as a conventional food) or to traditional Chinese herbal remedies prescribed by a traditional Chinese physician.

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