Ephedra (Ephedra sinica)
Ephedra Summary
Ephedra is commonly known by its Chinese name "Ma Huang" due to its popularity in Chinese medicine.
It has been used medicinally for at least 5000 years in China and has been used in surrounding Asian countries like India for a very long time as well.
The main components of ephedra are a class of chemicals known as alkaloids. These alkaloids are similar in structure and function to the hormone known as epinephrine (Adrenalin). They act as sympathomimetics, which increases heart rate, blood pressure, and promote the bronchioles (airway) to dilate. This allows more air into the lungs. This last action is the reason behind ephedras common use on asthma, and bronchitis-related conditions.
This herb is incredibly useful to a trained herbalist but is easily abused. This has lead to its banning in Australia for safety reasons. Overdose of ephedra can lead to dangerously high blood pressure which can lead to convulsions, coma, and death if not treated promptly. The problem is not in the herb itself, but the carelessness of dose.
Following a strict maximum dosage and paying close attention to how it affects your body individually will eliminate any risk of this happening.
What is Ephedra Used For?
Ephedra is not much used in Western herbal medicine — primarily due to some bad press around people abusing the plant for its ephedrine content. Ephedrine is a central nervous system stimulant. People use ephedra similar to other stimulant drugs like modafinil, Ritalin, or Adderall.
Ephedrine stimulates the sympathetic nervous system — activating the adrenergic receptors thought the cardiopulmonary system. One of the results of this stimulation is a feeling of euphoria, intense focus and concentration, and elevated energy levels. This has lead to a large number of people using the herb as a pre-workout, recreational drug, or to support study efforts. The unfortunate result of this is the same as any stimulant drug abuse — overburdened liver and adrenals and disorientation in the sleep-wake cycle.
The FDA banned the sale and use of ephedra in 2003.
The medicinal uses for ephedra involve the ephedrine content as well but in smaller, more controlled doses. The ability to interact with the central nervous system so reliably makes it a beneficial herb.
One of the most important applications of this is asthma. Ephedra stimulates the adrenergic system in the lungs, causing the bronchioles to dilate — allowing more air into the lungs.
More long term use of this herb isn't recommended, but for shorter bursts (2 weeks or less) ephedra is useful as a mild stimulant (in small doses) for supporting weight loss programs in combination with a nutritional analysis and diet plan.
Traditional Uses:
+ Western Herbal Medicine
One of the more recent uses of ephedra is as a weight loss supplement for its ability to stimulate the CNS and increase metabolism [9].
+ Traditional Chinese Medicine
The use of ephedra dates back thousands of years, especially in China where it has been used for at least 5000 years as medicine. Mention of this herb has been found in some of the Hindu Vedas as well [1, 2, 8].
In total, its traditional usage across Asia includes the treatment of asthma, nasal congestion, hypotension, urinary incontinence, [5].
Taste:
Acrid, pungent, slightly bitter [7, 21]
Energy:
Warm [7, 21]
Channels:
Lung and bladder [21]
Actions:
Promotes sweating to disperse cold, diffuses the lungs to relieve wheezing, promotes the flow of lung Qi, reduces swelling by increasing urination. [7, 21].
Indications:
Colds with wind-cold pattern (especially with lack of sweating), chest oppression, cough, wheezing due to excess, wind edema. [7].
Caution:
People who sweat easily (it's a strong diaphoretic), deficiency type asthma, weak constitution, hypertension, or heart disease [7]. Avoid large doses [21].
Botanical Information:
Ephedra is one of the oldest living plant species on earth. It's contained in the ancient family of plants — Gnetales. Compared to its two sister genera; Gnetum, and Welwitschia it's actually quite young.
Ephedra is estimated to have first appeared between 8 and 32 million years ago. Other members of the family are thought to have first appeared closer to 250 million years ago — placing it in the Cretaceous period. [26].
Each ephedra plant is either a male or a female (dioecious) [3].
Habitat Ecology, and Distribution:
Ephedra can be found growing on sandy shores in temperate climates in both the east and west hemispheres [3]. It's reportedly very adaptable — especially for a plant so morphological simple. This ability to adapt makes identification of this herb difficult at times [5, 7].
Habitat Ecology, and Distribution:
Ephedra can be found growing on sandy shores in temperate climates in both the east and west hemispheres [3]. It's reportedly very adaptable —, especially for a plant so morphological simple. This ability to adapt makes identification of this herb difficult at times [5, 7].
Harvesting Collection, and Preparation:
The best ephedra is reported to come from northern China, with the highest quality grown in Shanxi, Gansu, Shaanxi, and Qinghai provinces. Good quality ephedra can be identified as light green; dried, thick-stemmed with a solid cent. [7].
Pharmacology & Medical Research
+ Allergies
An anaphylactic reaction results from a systemic release of inflammatory mediators from the mast cells and basophils [20]. In modern emergency medicine, the immediate treatment for this is an intramuscular injection of epinephrine [20]. Epinephrine is a mixed alpha- and beta-adrenergic receptor agonist and works by alleviating allergen-induced inflammatory, and other physiological effects [21].
Ephedra contains alkaloids very similar in structure and function to epinephrine, with the most significant one likely being ephedrine. Similar to epinephrine, ephedrine possesses both alpha- and beta- adrenergic receptor agonist actions [24] and thus may sustain similar actions towards the anti-anaphylactic effects of the emergency medicine epinephrine.
The alpha adrenergic receptor agonist effects cause vasoconstriction of the blood vessels which then reduce systemic vasodilation and alleviate hypotension and possible hypotensive shock, as well as lowering erythema, urticaria, and angioedema [22].
The beta-adrenergic receptor agonist activity dilates bronchial airways, increases the force of myocardial contraction (positive inotropy), and increases heart rate. This results in a significant increase in cardiac output and can reduce the severity of Ig-E mediated reactions via mast cells. [23, 24].
Although the actions of ephedrine and epinephrine on the alpha and beta adrenergic receptors, the application is generally very different. It is impossible to inject ephedra intramuscularly without laboratory intervention, its use in the absence of epinephrine, or for milder anaphylactic reactions, may warrant ephedras use in an emergency setting. In minor incidents, ephedra appears to offer a valuable treatment, especially in the way of bronchial asthma as further indicated through its long traditional usage.
+ CNS Stimulant
The alkaloid component of ephedra has well known stimulating actions on the CNS through a binding to adrenergic receptors. [4].
+ Weight Loss
Ephedra is often used as a weight loss supplement for its ability to stimulate the CNS to stimulate metabolism. It has hypolipidemic and hypocholesterolemic, as well as hypoglycemic actions which go a long way in the prevention and treatment of obesity and its associated ramifications. [23-25]. There are some side effects with ephedra alkaloids; however, some of which can lead to serious events such as myocardial infarctions, cardiac arrhythmias, high blood pressure, and stroke [15, 16]. These reports have been debated, and the non-alkaloid content has also been found to be hypolipidemic through the prevention of free radical species generation, and recuperation of liver function during liver damage [17]. This action will have a much less pronounced effect on the reduction of weight specifically but addresses some of the commonly associated conditions with obesity such as hyperlipidemia and hypercholesterolemia. Currently, the primary treatment for these conditions involves statin medications, which themselves have a wide range of negative associations and side effects [18, 19].
The consensus at the time of this writing is that the long term usage, as is the case with weight loss programs, should be avoided with ephedra. Other herbs are available instead that will achieve this purpose in a much safer manner.
Clinical Applications Of Ephedra:
Ephedra is not recommended therapeutically. Experience is needed to use this herb safely.
Cautions & Safety: Ephedra
Contraindicated with cardiovascular conditions, thyroid disease, diabetes, or prostate enlargement [1].
May interact with cardiac glycosides or halothane to produce arrhythmias [1].
Guanethidine has been reported to enhance the sympathomimetic effects of ephedra [1].
Combination with monoamine oxidase inhibitors (MAOI's) can significantly increase the sympathomimetic actions of ephedrine, which can lead to fatal hypertension [1].
Be cautious of ephedra products adultered with synthetic alkaloids [5].
+ Contraindications
- Cardiovascular conditions
- Thyroid conditions
- Enlarged prostate
- Diabetes
- Pregnancy & lactation
- Not for use in children
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