Natural Standard® Patient Monograph, Copyright © 2017 ( All Rights Reserved. Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.


In 2003, there was a death of a U.S. major league baseball pitcher which was thought to be related to ephedra. The U.S. Food and Drug Administration (FDA) has collected more than 800 reports of serious toxicity, including more than 22 deaths. On February 6, 2004, the FDA issued a rule prohibiting the sale of dietary supplements containing ephedrine alkaloids (ephedra). This rule was issued because supplements with ephedra present a serious risk of illness or injury.

In 2005 this rule was struck down in Utah but reversed again four months later. Ephedra is currently banned throughout the United States. It remains unclear whether ephedra will re-appear on the market, despite serious safety risks, including heart events or death.

Ephedra sinica, a species of ephedra (ma huang), contains ephedrine and pseudoephedrine. Ephedra has been found to stimulate the nervous system, increase airflow into the lungs and constrict blood vessels. In combination with caffeine, ephedra appears to cause weight loss. However, effects of ephedra or ephedrine monotherapy have been mixed. Ephedrine has been widely studied for asthma and low blood pressure. However, quality research of commercial supplements with ephedra is lacking.

Major safety concerns have been associated with ephedra or ephedrine use, including high blood pressure, increased heart rate, nervous system excitation, irregular heartbeat, heart attack, and stroke.

This evidence-based monograph was prepared by The Natural Standard Research Collaboration