Is Ephedra Safe?: The Side Effects

Is Ephedra Safe?: The Side Effects

Time and time again we hear stories of weight loss supplements that promise drastic changes within short time periods- perfect for a short notice beach body- but beware that many of these are risky, have unverified claims about their ingredients, and some are not even legal.

There are lots of options out there, and one of the more talked about ingredients is Ephedra, but is Ephedra Safe? And what are the side effects of it?

In this article you will learn:

  • What is Ephedra
  • How does it work?
  • Why is it unsafe?
  • Is it legal?
  • Final word – Is it safe?
  • What safe alternatives are available?

What is Ephedra?

Native to Central Asia, Ephedra is a cone-bearing, evergreen plant- otherwise known as Ma-huang and Ephedra sinica. It has a long traditional as a medicinal plant and is documented to have been used in treatments of respiratory diseases throughout India and China [1].

The principal active compound is ephedrine alkaloids, or ‘ephedrine‘, however it contains a number of alkaloids including pseudoephedrine and phenylpropanolamine.

How does Ephedra work?

This drug is classed as a ‘sypathomimetic’ – it mimics an action on the nervous system similar to that of adrenaline. In fact, ephedrine is metabolized to norepinephrine – which explains the stimulant effect. This process is what forms phenylpropanolamine.

Due to its stimulant effect it increases metabolic rate- as such it has been marketed to promote weight loss or increase energy. It does this by dilating the airways and blood vessels, whilst at the same time increasing heart rate, pressure and contractile force [2]. It has also been used for nasal swelling and congestion.

Evidence suggests modest benefits to weight loss when Ephedra is combined with caffeine that can keep weight off for up to 6 months.

For example, a study by Astrup [3] enrolled 180 participants and administered either ephedrine (20mg), caffeine, or the combination of both. Results showed that ephedrine alone did not result in any significant weight loss, but when combined with caffeine saw weight loss of more than 36lbs over a 6 month period.

However, do these benefits outweigh the costs?

Key Point: Ephedra is a drug that works in a similar way to adrenaline. It may only work effectively when combined with caffeine, and it can still cause side effects.

Side effects

Ephedra was a popular weight loss drug from the 1980’s but soon began to gather complaints relating to side effects. Since then, a number of adverse effects have been reported.

If you’re wondering if ephedra is safe, this is what you need to now:

One category of supplements frequently associated with adverse events are those that contain ephedra alkaloids [4]. These include:

  • Severe allergic reactions
  • Tachycardia- irregular and rapid heart rate
  • Chest pain and Rapid breathing
  • Seizures
  • Dizziness and headaches
  • High temperature, sweating and flushed skin
  • Nausea, vomiting and stomach pain

But there are much more serious side effects you need to be aware of:

#Study 1: Haller et al [5]

In this study, a review of 140 reports of adverse effects involving dietary supplements containing ephedra alkaloids were collected for analysis.

Out of the reports, 10 resulted in death and 13 in permanent impairment. The remainder were made up cardiovascular symptoms (47%), neurological – strokes, seizures (18%). Some of these reactions occurred with extremely low doses of 12 – 36mg per day. 

#Study 2: Zaacks et al [6]

In this case study, a 39-year old male with high blood pressure was admitted at ER after complaints of breathing difficulties. Upon examination he was found to have myocarditis – a complication of the heart walls. He had been taking 1-3 tablets a day for a 3 month period.  

In total, products containing ephedra account for 64% of all adverse reactions to herbs in the United States, yet these products represented only 0.82% of herbal product sales [7].

Thats a pretty damning statistic, making the relative risks for adverse reactions among ephedra users 10- to 40-fold greater than the risk among users of other herbal products.

So what if you just aimed for really low doses?

Worryingly, a study by Gurley et al [4] reported that in a study of 20 ephedra-containing dietary supplements showed that alkaloid content often differed markedly from label claims and was inconsistent between two lots of some products.

It is a risky process as you just don’t know the content and can’t necessarily trust the labeling.

Key Point: Ephedra is not safe and should be avoided. It can cause several side effects such as allergies, tachycardia, chest pain, seizures, dizziness, nausea and more.

Is it legal?

No. Ephedra was banned on April 12, 2004 by the federal government [8]. It is illegal to purchase and also to distribute at the risk of criminal conviction.

In their report the FDA issued a final regulation declaring dietary supplements containing ephedrine alkaloids as they presented an unreasonable risk of illness or injury under the conditions of use.

Additionally they suggested that they were taking this action based upon the well-known pharmacology of ephedrine alkaloids, the peer-reviewed scientific literature on the effects of ephedrine alkaloids, and the adverse events reported to have occurred in individuals following consumption of dietary supplements containing ephedrine alkaloids”.

Additionally, it is also on the US Anti-Doping Agency (USADA) 2016 banned prohibited list [9] so should not be considered by anyone who competes under their competitive guidelines.

Final word – Is Ephedra Safe?

Ephedrine, the principal active compound from the Ephedra plant, is a weight loss drug that has been banned since 2004 by the FDA. Whilst its effects seem to work (mostly in combination with caffeine), the side effects far outweigh these benefits, with a number of serious side effects that occur, ultimately leading to death. The effects reported with this chemical are severe, with many users experiencing:

a.) Severe allergic reactions

b.) Tachycardia- irregular and rapid heart rate

c.) Seizures

d.) Nausea, vomiting and stomach pain and more.

This drug is not a safe long term weight loss plan, and as a dangerous, banned drug, it should be avoided.

Is there a safer alternative for fat loss?

Yes there is.

It’s important that you choose ingredients that are proven to work but also safe.

Instant Knockout is an industry-leading fat burner that helps you achieve your fat loss goals. It boosts your metabolism in a safe way. It uses ingredients such as cayenne pepper and green tea extract alongside a host of vitamins as well as many other nutrients.

It’s even been endorsed by multiple MMA fighterswho have seen benefits such as:

  • Increased Calorie Burning – Lose fat faster and safely
  • More Energy – Work harder for longer
  • Appetite Control – Reduce food cravings and stay on strict diets with minimal effort
  • Day-Long Fat Burning – Keep that metabolic fire high
  1. Rotblatt M, Ziment I.  Evidence-Based Herbal Medicine. Philadelphia: Hanley & Belfus; 2002.
  2. Hardman JG, Limbird LE. Hardman JG, Limbird LE Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 10th ed. New York: McGraw-Hill; 2001.
  3. Astrup A, Breum L, Toubro S. Pharmacological and clinical studies of ephedrine and other thermogenic agonists [review]. Obes Res 1995; 3 (Suppl 4): 537S–40S.
  4. Gurley, BJ et al. Content versus label claims in ephedra-containing dietary supplements. Am J Health-Syst Pharm; 57 May 15, 2000
  5. Haller, CA et al. Adverse Cardiovascular and Central Nervous System Events Associated with Dietary Supplements Containing Ephedra Alkaloids. N Engl J Med 2000; 343:1833-1838
  6. Zaacks, SM et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol. 1999; 37(4): 485-9.
  7. Bent, S et al. The Relative Safety of Ephedra Compared with Other Herbal Products. Annals of Internal Medicine. 2003; 138(6): 468-471
  8. The Food and Drug Administration (FDA). Final rule declaring dietary supplements containing ephedrine alkaloids adulterated because they present an unreasonable risk. Final rule. Fed Regist. 2004; 69(28): 6787-854.
  9. US Anti-Doping Agency (USADA). Athlete Guide to the 2016 Prohibited List. 2016.