Ephedra

Ephedra sinica

Ephedra (ma huang), together with its principal alkaloid ephedrine, was perhaps the first of the Chinese herbal remedies to see significant use in Western medicine. Known in China for more than 5,000 years, the green stems of various Ephedra species, particularly E. sinica Stapf, E. equisetina Bunge, and others of the family Ephedraceae, were employed there,  and E. gerardiana Wall. was used in India for the treatment of bronchial asthma and related conditions.

The active constituent, ephedrine, was isolated by a Japanese chemist, N. Nagai, in 1887. However, it was not until 1924 when K. K. Chen and his mentor C. P. Schmidt, working at Peking Union Medical College, began to publish a series of papers on its pharmacological properties that physicians in this country began to appreciate the utility of the drug. Ephedrine became widely used as a nasal decongestant, a central nervous system stimulant, and a treatment for bronchial asthma. Other alkaloids, pseudoephedrine, norephedrine, norpseudoephedrine, etc., with similar but not identical properties, were subsequently found in various Ephedra species.

Studies on the herb revealed that the approximately forty species of Ephedra could be divided into several geographic types which seem to vary qualitatively and quantitatively in their alkaloid content. The significant finding regarding these types is that the North and Central American types all appear to be alkaloid free. Thus, any activity attributed to these species must result from compounds other than ephedrine or its derivatives. For that reason, species such as E. nevadensis (see Mormon tea) are not considered to be in this group of ephedra plants and are discussed elsewhere. It should be noted that Ephedra species are often extremely difficult to distinguish from one another, even for the specialist.

Ephedra is a potent and useful herb for relieving the constriction and congestion associated with bronchial asthma. Ephedra is an effective nasal decongestant and is used in the treatment of various allergic disorders in adults. Ephedra acts as a strong central nervous system stimulant, but despite the claims of some advocates,  there is no substantial clinical evidence that it is either a safe or effective promoter of weight loss in obese persons or an enhancer of athletic performance. Unfortunately, ephedra and its contained ephedrine also increase both systolic and diastolic blood pressure. They also increase the heart rate and may cause palpitations as well as nervousness, headache, insomnia, and dizziness. Although the herb may be a very useful one in the treatment of various asthmatic and congestive conditions, the side effects indicated render its indiscriminate use highly inadvisable, particularly in persons suffering from heart conditions, hypertension, diabetes, or thyroid disease.

Because ephedrine can serve as precursor for the illegal synthesis of methamphetamine or "speed," a common drug of abuse, several states have passed laws regulating the sale of the alkaloid or products containing it. Although various species of ephedra contain 0.5 to 2.5 percent of an alkaloid mixture, some 30 to 90 percent of which is ephedrine, it must be emphasized that the herb is no longer the principal source of commercial ephedrine. That compound is produced today by chemical synthesis involving the reductive condensation of L-1-phenyl-1-acetylcarbinol with methylamine. This yields the desired isomer L-ephedrine, which is identical in all respects to the alkaloid obtained from ephedra.  In view of the difficulties involved in extracting the relatively small concentrations of ephedrine from ephedra, and the fact that the plant serves only as a minor source of the alkaloid anyway, restricting availability of the herb on this basis, although certainly well-intended, seems an excessive measure. The fact that ephedra is commonly abused by consuming excessive amounts for its psychotropic effects is a far better reason for restricting its sale to adults only and limiting the dosage and duration of consumption.

Other names

• Desert Tea
• Ma Huang

Parts used

Stems, root.

Uses

Historical uses - Traditionally, Zen monks used ephedra to promote calm concentration during meditation.
Chinese herb - In China, ephedra is popular for chills and fevers, coughs, and wheezing, and in combination with rehmannia is given to treat kidney yin deficiency.
Current Western uses - Ephedra is used principally in current Western herbal medicine as a treatment for asthma and hay fever, and for the acute onset of colds and flu. Ephedra also helps to raise blood pressure, cool fevers, and alleviate rheumatism.

Habitat & cultivation

Native to northern China and Inner Mongolia, ephedra often grows in desert areas. Ephedra is propagated from seed in autumn or by root division in autumn or spring and needs well-drained soil. The stems are gathered throughout the year and dried.

Research

Active constituents - Most of the active constituents mimic the effect of adrenaline within the body, increasing alertness. Ephedrine, extracted originally from ephedra, was first synthesized in 1927 and was used as a decongestant and antiasthmatic. It is still commonly used in conventional medicine for its decongestant properties.
Whole herb - The whole plant contains many compounds- some active, some inert -which in combination seem to act synergistically. The whole plant can be used at a much lower dosage than isolated constituents and it has significant therapeutic effects -including dilating the bronchial airways and increasing blood flow to the skin. Unlike ephedrine, the whole plant rarely gives rise to side effects.

Constituents

Ephedra contains alkaloids (inc. ephedrine), saponins, volatile oil.

How much to take

The crude powdered stems of ephedra (with less than 1 % ephedrine) are employed at a dose of 1-4 grams per day in tea form. Tinctures of 1-4 ml three times per day can be taken. Over-the-counter drugs containing ephedrine can be safely used by adults at a dose of 12.5-25 mg every four hours. Adults should take no more than 150 mg every twenty-four hours. Pseudoephedrine is typically recommended at a dose of 60 mg every six hours.

Side effects

Ephedra has a long history of safe use at the recommended amount. However, abuse of the drug-especially for weight loss--can lead to amphetamine-like side effects, including elevated blood pressure, muscle disturbances, insomnia, dry mouth, heart palpitations, nervousness, and even death due to heart failure. Anyone with high blood pressure, heart conditions, diabetes, glaucoma, thyroid disease, and those taking MAO-inhibiting antidepressants should consult with a physician before using any type of product with ephedra. Pseudoephedrine can cause drowsiness and should be used with caution if driving or operating machinery. Ephedra-based products should be avoided during pregnancy and lactation and used with caution in children under the age of six years.

Applications

TWIGS:

TINCTURE - Prescribed for asthma, hay fever, or severe chills. Combined with cowslip root and thyme tinctures for bronchial asthma, emphysema, whooping cough, and other severe chest conditions. Recommended dose up to 1 ml three times a day.

DECOCTION - Prescribed for common  colds, coughs, asthma, and hay fever.

ROOT:

DECOCTION - The Chinese use the decoction where yin or qi (energy) weakness leads to uncontrolled sweating.

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