Ephedraceae

Ephedra sinica

Ma huang · Chinese ephedra

Mixed Serious

Part used: aerial
Native range: Northern China and Mongolia
Morphology: A jointed, almost leafless shrub of dry country, with slender green stems that do the photosynthesis. A gymnosperm, so more closely related to conifers than to any flowering herb here.

What is in it

phenylalkylamine alkaloids ephedrine, pseudoephedrine

Evidence

Ephedrine itself is a well-characterised sympathomimetic drug with genuine effects. The herb as a weight-loss and performance supplement produced modest short-term weight change in trials alongside a clear excess of adverse cardiovascular and psychiatric events.

Safety

A genuine sympathomimetic. Associated with hypertension, arrhythmia, myocardial infarction, stroke, seizure and death, including in young healthy users. The US banned it as a supplement ingredient in 2004 after roughly 150 reported deaths and around 16,000 adverse event reports. Risk rises sharply with caffeine, with exertion and with heat.

Interactions: Serious with monoamine oxidase inhibitors; Additive with caffeine and other stimulants; Opposes antihypertensives

Regulatory: Banned as a dietary supplement in the US. In Australia ephedrine and pseudoephedrine are scheduled and the herb is not a permitted listed-medicine ingredient. Precursor controls apply in many countries.

How the traditions classify it

Chinese Warm, pungent and slightly bitter; entering the lung and bladder channels. Classically used to release the exterior and to settle wheezing, and traditionally paired to moderate it.

Three systems, rating the same plant. Where they disagree, none of them is correcting the others — they are separate frameworks that arrived at their categories independently.

Historical use

In the Chinese materia medica for around two thousand years, principally for cough and wheezing and in the early stages of feverish illness. Ephedrine was isolated in 1885 and re-isolated in the 1920s, entering Western medicine as a bronchodilator and decongestant.

Recorded as history and attributed where possible. Long use establishes that a plant was widely used, not that it worked, and not that it was safe.

Worth knowing

Ephedra is the argument against reading traditional use as a safety record, and the argument for reading it carefully, at the same time.

The Chinese tradition used it in specific formulas, for short courses, in acute illness, paired with other herbs intended to moderate it. The Western supplement industry sold concentrated extract to healthy people for weight loss and athletic performance, taken daily and alongside caffeine. Same plant, and the second use was the one that killed people.

Nomenclature verified against GBIF backbone taxonomy.