Ephedra (Ma Huang): Good Or Bad?
Chester J. Zelasko, Ph.D. | January 3, 2001

Ephedra or ephedrine is the general name given to dietary supplements that contain ephedra alkaloids from the herb Ma Huang. Most often combined with caffeine, these products are used for weight loss and to increase energy. The controversy with ephedra-containing food supplements is whether the products are safe for general use by the public. The reason for the concern is the high number of adverse events reported to the U.S. Food and Drug Administration. Late in 2000, two reports were published within days of one another. The first, by Haller and Benowitz, was published in the New England Journal of Medicine and concluded that dietary supplements containing ephedra alkaloids may pose a health risk to some individuals. The adverse events range from nervous upset to sudden death.

Released for publication two days before the actual publication of the Haller article was a report from the Council for Responsible Nutrition compiled by the consulting firm Cantox Health Sciences International. In that publication, the research on the safety of ephedra-containing supplements was reviewed in order to determine an upper limit for ephedra use. The conclusion of the review article was that ephedra was safe when used at responsible doses with the notification of the person’s physician.

Two groups of scientists. One group says use it, the other says maybe you better not. So what are we to think about ephedra-containing products? The controversy will not be resolved any time soon. Many people can use it safely. Most people will experience negative side effects that range from nervousness to arrhythmias (abnormal heart rhythms) but no permanent damage. The problem is that some people have serious diseases with no symptoms—for example, they don’t know they have heart disease—and those are the people most at risk for serious reactions to these products, including sudden death.

Does ephedra work? Yes. Ephedra combined with caffeine helps curb appetite and raise metabolism. The result is weight loss, but there are no studies to support the use of ephedra for weight loss that remains lost—for most people, the weight returns when use is discontinued. Ephedra remains a quick fix which may cause more problems than it solves.

Should you use ephedra? That’s up to you. But this is what the research summarized in the Cantox report found: “Ephedrine should not be used by persons with heart disease, diabetes, glaucoma, hypertension, thyroid disease, circulatory problems, chronic anxiety/psychiatric problems, enlarged prostate, renal insufficiency, pregnancy, or by children, the elderly, and persons taking monamine oxidase inhibitors, (pharmaceuticals used for depression).” With that list, who is left? Only the healthiest obese persons seem to qualify.

Ephedra is a powerful central nervous system stimulant. And because it doesn’t lead to a long-term solution, it’s not as effective as the truly natural way to lose weight: eat less and exercise more.


  1. Haller, C., & Benowitz, N. (2000). Adverse Cardiovascular and Central Nervous System Events Associated with Dietary Supplements Containing Ephedra Alkaloids. New England Journal of Medicine, 343. 1833-1838.
  2. Cantox Health Sciences International. (2000). Safety Assessment and Determination of a Tolerable Upper Limit for Ephedra. Council for Responsible Nutrition, December 2000. (www.crnusa.org/pdfs/Cantoxreport.doc)
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