Ephedra is made from a low evergreen shrub with small scaly leaves, that was first used in China and India to treat colds, fevers, headaches, coughing, wheezing, and many other conditions. More recently, it was used in supplements that:
- Promote weight loss,
- Increased energy, and even
- Enhanced athletic ability
- Used commonly for training amongst athletes
Ephedra has shown to only have short term modest effects on weight loss and any possible athletic benefits are outweighed by the extreme adverse effects from toxicity.
Toxicity
Ephedra contains ephedrine, which is an amphetamine-like compound very similar to adrenaline. Ephedrine acts like pseudoephedrine, a sympathomimetic amine, so it has direct and indirect sympathomimetic activity. It can bind alpha and beta receptors directly and can indirectly inhibit neuronal norepinephrine reuptake and displace more norepinephrine from storage vesicles. Both of these activities increase the amount of norepinephrine in the synapse that can continue to bind more alpha and beta receptors. The stimulation of these receptors causes the variety of symptoms seen in toxicity. For example, binding of alpha-1 adrenergic receptors on the smooth muscle of blood vessels will increase vascular resistance, and systolic and diastolic pressure, while binding of beta-1 receptors increases cardiac chronotropy and inotropy.
Adverse Effects
Some symptoms of ephedra toxicity include:
- Anxiety,
- Dizziness,
- Dry mouth,
- Headache,
- Irritability,
- Nausea,
- Personality changes,
- Insomnia,
- Upset stomach, and
- Heart palpitations
In more extreme cases ephedra can cause:
- Heart attack,
- Seizure,
- Stroke, and
- Sudden death
Note that people with pre-existing conditions like diabetes, anorexia, bulimia, high blood pressure, heart conditions, anxiety, and other conditions are at greater risk for ephedra toxicity.
Safety
Due to the known toxicity and possible adverse effects the FDA banned the sale of dietary supplements containing ephedrine alkaloids, including ephedra in the United States in 2004 and it has also been banned in Canada. However, ephedra still has important use in the management and treatment of certain cases of hypotension.
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