Ephedra, also called ma huang, has been used in Traditional Chinese Medicine (TCM) for more than 5,000 years. Used in TCM primarily to treat asthma or bronchitis, 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, have been 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 a dietary supplements.

Ephedra had been 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. A number of these products also contain caffeine; the combination of ephedra with caffeine dramatically increases the chances of adverse side effects.

In addition, due to a large body of evidence to support the conclusion, the Food and Drug Administration (FDA) has banned the sale of ephedra-containing dietary supplements. This ban 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 traditional Chinese physician.

Ephedra can produce side effects such as irritability, restlessness, anxiety, insomnia, headaches, nausea, vomiting, and urinary problems. More serious side effects include high blood pressure, rapid and/or irregular heart beat, stroke, seizures, addiction, and even death. Use of ephedra should be discontinued and your healthcare professional contacted immediately if you experience any of these adverse effects.

Individuals with certain health conditions including anxiety, depression, high blood pressure, glaucoma, heart disease, prostate enlargement, difficulty urinating, seizure disorder, impaired circulation to the brain, psychiatric disorders, thyroid disorders, or diabetes should not take ephedra. Those taking medications for high blood pressure, or depression and women who are pregnant or breastfeeding, should avoid ephedra and ephedra alkaloids such as ephedrine.

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.