Ephedra: A beneficial and controversial herb

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Healing plant wards off colds

The Medicine Hunter, Chris Kilham, checks out the New York Botanical Garden in search of ephedra. It’s used in medicines to alleviate colds, sinus congestion and flu

One of the great medicines of all time, ephedra (Ephedra sinica) has been in use for as long as 5,000 years. Known as Ma Huang in traditional Chinese Medicine, ephedra is native to Central Asia. The evergreen shrub has been used in traditional medicine to alleviate colds, bronchial and sinus congestion, flu, headaches and asthma.

The plant naturally contains two alkaloids known as ephedrine and pseudoephedrine, as well as smaller amounts of related alkaloids. Pseudoephedrine is the sole active ingredient in the popular decongestant drugs Sudafed and Actifed. Ephedrine and pseudoephedrine are active compounds in over 700 over-the-counter drugs sold in the United States today. Ephedra the plant is listed in the pharmacopeias of several countries, and its compounds are listed drugs in the official compendia of many nations.

Ephedra viridis, a species found in the American southwest, is known as Mormon tea, Brigham’s tea, Squaw tea, Whorehouse tea and Cowboy tea. This species also contains the alkaloids ephedra, pseudoephedrine and related compounds, though in lower concentration than the Asian species. Used traditionally by Paiute, Kawaiisu and other native tribal groups, the plant received its name ‘Mormon tea’ due to its use as a stimulant beverage by people of the Mormon faith.  Mormons avoid caffeine in all forms but nonetheless embrace the stimulating properties of ephedra. Native people historically used the tea to treat colds, fever, headaches, and bowel and stomach disorders. Mormons learned the use of this plant from people of southwestern regional tribes. The name ‘Whorehouse tea’ refers to the drinking of the tea in the former well-known brothel Katie’s Place in Elko, Nevada during the gold rush of the 1900s.

Used in quantities of 8 milligrams of total alkaloids or less, ephedra is a highly beneficial decongestant and is reliable for relieving congestion due to seasonal allergies. Its popularity is justified by its rapid effectiveness. During a cold, ephedra-based preparations can quickly open up blocked breathing passageways.

When used in greater concentrations, ephedra can cause problems – such as a rapid heart rate. Ephedra and extracts of the plant became popular as recreational stimulants and sports-enhancing agents in the late 1980s, and additionally as thermogenic diet aids in the 1990s. The use of ephedra for calorie-burning and appetite-suppressing diet purposes spawned a lucrative supplement industry with sales in the $100 million per year.

Employed sometimes in very large amounts, use of the herb led to numerous reported cases of adverse cardiovascular and nervous system problems – and even deaths. This overuse of ephedra for non-traditional purposes affirmed the age-old adage that the difference between a medicine and a poison is the dose.

In 2004, the Food and Drug Administration (FDA) banned the sale of ephedra-containing dietary supplements in order to stem the tide of adverse reactions. This action was hotly disputed by companies in the dietary supplement industry, for whom ephedra supplements had been immensely profitable best-sellers. In 2005 the ban was briefly overturned by a Utah District court judge, but in 2006 it was reinstated by the 10th U.S Circuit Court of Appeals. This put an end to the wrangling over ephedra’s legal status.

The ban on the sale of dietary supplements containing ephedra remains in effect today. Additionally, ephedra alkaloids are banned by the USADA, the hyper-vigilant U.S. Anti-Doping Agency. Detection of ephedra derivatives will disqualify competitive athletes in many fields of sports.

Though ephedra has been embattled due to its wholly improper use in large quantities, its moderate use remains highly popular and very safe. In the U.S., billions of dollars-worth of ephedra-based remedies sell in drug stores, and there is no indication that this will be curtailed. Effective and time-tested, ephedra remains one of nature’s highly valuable medicines.