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| EVIDENCE FOR EFFICACY (HUMAN DATA) |
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Clinical Trials
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A dietary supplement containing herbal caffeine (70mg/dose) and ephedra (24 mg/dose) increased resting metabolic rate in 12 healthy subjects, by 8% and promoted more weight and fat loss than placebo, and was well tolerated.
Greenway 2004
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Investigations on the effects of ephedra alkaloids(EA) in 13 patients with autonomic impairment revealed that EA increased blood pressure significantly in individuals with impaired baroreflex function & Concomitant ingestion of EA & water produced a greater increase in blood pressure.
Jordan 2004
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[An acute clinical trial evaluating the cardiovascular effects of an herbal ephedra-caffeine weight loss product in healthy overweight adults.]
Kalman 2004
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The ephedra- & caffeine-containing dietary supplement Metabolife 356 increased the mean maximal QTc interval & systolic blood pressure in 15 healthy volunteers. With anecdotal reports of cardiovascular and cerebrovascular adverse events, further research with this formulation is warranted.
McBride 2004
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A study on prevalent use of dietary supplements among people who exercise at a commercial gym reveals that multivitamin/minerals (45%) protein shakes/bars (42.3%),vitamin C (34.7 %), and vitamin E (23.4%) were commonly consumed and Ephedra was consumed by 28 % at least once per wk.
Morrison 2004
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[Effect of a multicomponent, ephedra-containing dietary supplement (Metabolife 356) on Holter monitoring and hemostatic parameters in healthy volunteers.]
Gardner 2003
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The botanical dietary supplement use in peri- & postmenopausal women between the ages of 40 and 60 years revealed that black cohosh, garlic, red clover, kava, valerian, evening primrose, & ephedra were used by less than 15% of respondents among 500 female outpatients.
Mahady 2003
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Ephedrine & ephedra promote modest short-term weight loss (approximately 0.9 kg/mo more than placebo) in clinical trials & it was found that use of ephedra or ephedrine & caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, & heart palpitations.
Shekelle 2003
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In this 6-month placebo-controlled, randomized trial, herbal ephedra/caffeine (90/192 mg/day) promoted body weight and body fat reduction and improved blood lipids without significant adverse events.
Boozer 2002
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Serious cardiovascular toxicity has been reported in people taking dietary supplements that contain Ephedra. In this clinical trial, plasma clearance and elimination half-lives for ephedrine and pseudoephedrine were comparable to published values reported for drug formulations.
Haller 2002
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Ingestion of the commercial herbal ephedrine and caffeine weight loss supplement in twenty-seven healthy overweight adults, over a 14-day period, did not produce any noticeable cardiovascular side effects.
Kalman 2002
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Ingestion of a combination of caffeine (C) and ephedrine (E) prolongs time to exhaustion during high-intensity aerobic exercise. This clinical trial showed improvement in anaerobic exercise performance as a result of both stimulation of the CNS by E and skeletal muscle by C.
Bell 2001
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A multistate survey of use of nonprescription weight loss products revealed that seven percent of 14,679 adults (18 years or older) have reported overall use of nonprescription weight loss product, out of which 2% and 1% reported use of phenylpropanolamine, and ephedra product respectively.
Blanck 2001
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A randomized controlled clinical trial of the use of a herbal mixture of Ma Huang and Guarana showed effective promotion of short-term weight and fat loss. Safety with long-term use requires further investigation.
Boozer 2001
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Tracheitis Plaster (TP) which consisted of ephedra, almond, earthworm, white mustard seed, etc, is a highly effective transcutaneous absorbent with promising long-term effect in 59 patients with chronic bronchitis and could regulate the immune function.[Article in Chinese].
Huo 2001
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An 80% dose of a caffeine/ephedrine mixture had none of the nausea of the full dose. Times to exhaustion for cycle ergometer by 12 healthy men for caffeine/ephedrine (mg/kg) of 5/1.0=27.1, 4/0.8=28.2, placebo=17.0 minutes
Bell 2000
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In this clinical trial peak oxygen consumption was measured for 45 minutes after taking two herbal dietary supplement capsules orally, each containing the equivalent of 10 mg of caffeine and 5 mg of ephedrine.It increased oxygen consumption when taken according to the package directions.
Greenway 2000
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In this pilot study of a caffeine/ephedrine mixture taken by obese adolescents, relative body weight decreased, adverse events were negligible, withdrawal symptoms were mild, transient and their frequency/severity were not different between the placebo and active groups.
Molnar 2000
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3.2 km run times were 5% shorter in 9 men taking 375 mg caffeine plus 75 mg ephedrine
Bell 1999
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Caffeine/ephedrine was most cost-effective of three treatments in reducing weight, cardiac risk and LDL cholesterol. Loss of 6%-10% of body weight reduced pharmacy costs $122.64/month for insulin, and $61.07/month for hyperlipidemia treatment
Greenway 1999
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Contingent negative variation (brain function test) was decreased by oral Mao-to (Ma Huang Tang) and Keishi-to (Gui Zhi Tang) and was increased by Shimbu-to (Zhen Wu Tang) and Shimotsu-to (Si Wu Tang)
Xu 1999
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Pharmacokinetics of three commercially available ma huang products were similar to synthetic ephedrine HCl (25-mg) in a randomized, crossover study with 10 people
Gurley 1998
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Letigen (20 mg ephedrine + 200 mg caffeine) for 6 weeks reduced weight by 4 kg and systolic blood pressure by 4-5 mmHg in a study with 136 patients
Svendsen 1998
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Of 601 asthma patients interviewed, herbal self-treatment was reported by 46 (8%); coffee or black tea by 36 (6%), epinephrine or ephedrine OTC by 36 (6%), and any of the three by 98 (16%)
Blanc 1997
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Rhinitis and asthma severity were reduced and expiratory flow rates improved by loratadine (5 mg) plus pseudoephedrine (120 mg) in a trial with 193 patients
Corren 1997
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Increase in heart rate but variable effects on blood pressure by 4 capsules of powdered ma-huang (19.4 mg ephedrine; 4.9 mg pseudoephedrine; 1.2 mg methylephedrine) in 12 healthy adults. Pharmacokinetics were similar to 20 mg ephedrine tablet
White 1997
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Hemodynamic responses to 0.1 or 0.2 mg/kg i.v. ephedrine in 110 pediatric patients anesthetized with halothane, nitrous oxide, and oxygen
Taguchi 1996
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Chronic allergic rhinitis is reduced in those using a 1% ephedrine-saline nasal wash once every 48 hours for 4 weeks compared to placebo in a study with 118 patients
Shaikh 1995
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PaO2 was increased from 187 to 205 by ephedrine (0.15 mg/kg) or from 209 to 248 by phenylephrine (2 micrograms/kg) in a study with 30 patients under general anesthesia with enflurane, fentanyl and oxygen [Article in Japanese]
Tanaka 1994
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Analgesic effect of morphine is enhanced by ephedrine in study with 32 people and 240 mice
Tekol 1994
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Resting energy expenditure in obese adolescents was increased by ephedrine and aminophylline, 7.1 and 6.4%, but effect declined in a week
Molnar 1993
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Postoperative nausea and vomiting were reduced by droperidol (0.05 mg/kg) and metoclopramide (0.15 mg/kg) but not by ephedrine (1 mg/kg) in a study with 100 pediatric patients
Liu 1992
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Immune response was improved by Ma-Xin-Shi-Gan tang (Ephedra, Semen Armeniacae Amarum, Glycyrrhizae and Gypsum) in 64 children with respiratory tract infection [Article in Chinese]
Yue 1990
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Pharmacologic action and clinical use of herbal Ephedrae [Article in Chinese]
Liu 1989
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Anaesthetic complications of Shock Wave Lithotripsy, mainly cardiovascular, were reduced by minimal concentrations of general anaesthetic agents, or epidural anaesthesia supplemented with ephedrine in a study with 100 patients
Frank 1985
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Observational Studies/Case Reports
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Drugs and dietary supplements including ephedrine, ephedra, caffeine, anabolic steroids, human growth hormone, erythropoietin, darbepoetin, androstenedione, have proven performance-enhancing effects in athletes. However, due to adverse effects many of them are banned by various organizations.
Ambrose 2004
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5 patients with ischemic infarctions associated with use of over the counter products containing ephedra were evaluated for over 2 years & found that Ephedrine, like other sympathomimetic agents, predisposes patients to both ischemic & hemorrhagic strokes.
Chen 2004
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[5 young patients with cryptogenic stroke who used an ephedra-containing compound in a time window prior to suffering a stroke.]
Cohen 2004
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Ephedra alkaloids and brief relapse in EMDR-treated obsessive compulsive
disorder.
Corrigan 2004
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The combined ingestion of caffeine and ephedrine has been observed to increase blood glucose and lactate concentrations during exercise, and are quite effective in decreasing the rating of perceived exertion hence become most popular ergogenic aids.
Magkos 2004
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An objective causality assessment probability scale revealed that an adverse drug reaction was possible between cardiomyopathy and ephedra use in 2 patients who are 19-years and 21 years old individuals and the first one died with in 5 weeks.
Naik 2004
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A case study of exercise-induced syncope in a healthy 22-year-old woman that occurred 1 hour after she took second dose of Xenadrine EFX, an ephedra-free weight-loss supplement revealed "ephedra free" formulations marketed for weightloss & performance enhancement contain sympathomimetic substances.
Nasir 2004
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Consumers are becoming more aware of the serious adverse effects secondary to products containing ingredients such as Ma huang and ephedra, and adverse reports involving other ingredients such as bitter orange or synephrine, found in bitter orange are increasing.
Nykamp 2004
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3 case studies aimed at discovering the molecular targets responsible for psychoactive drug actions of Hypericum perforatum, Salvia divinorum, & Ephedra sinica were screened at the "receptorome" (that portion of the proteome encoding receptors) & their actions are presented.
Roth 2004
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[Coronary dissection and thrombosis after ingestion of ephedra.]
Sola 2004
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Neuropsychological deficits of a 36 year-old U.S. Army male pilot following an anoxic event as a function of cardiac arrest was reported after taking an over-the-counter supplement that included an herb called Ma Huang on the day of his cardiac arrest.
Baggett 2003
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[The irony of herbal hepatitis: Ma-Huang-induced hepatotoxicity associated with compound heterozygosity for hereditary hemochromatosis.]
Bajaj 2003
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The emergence of a 21-year-old woman?s acute manic symptoms with psychosis coincided with her use of two supplements containing ma-huang which has potential adverse psychiatric effects.
Boerth 2003
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[Vasospasm-induced stroke in a varsity athlete secondary to ephedrine ingestion.]
Foxford 2003
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A case of nonpigmenting solitary fixed drug eruption appearing on the right thigh of a 31-year-old woman in Japan was described and the causative drug was determined as ma huang (Ephedra Hebra), mainly containing pseudoephedrine & ephedrine.
Matsumoto 2003
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3 patients who developed priapism following the use of either cocaine or formulations containing ephedrine has been reported and an experimental study on isolated rabbit penile cavernosal tissue strips revealed Ephedrine and cocaine caused contractions that persisted for several hours.
Munarriz 2003
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A highly trained, heat-acclimatized infantry soldier who suffered from exertional heatstroke during a 12-mile road march shortly after taking an ephedra-based supplement was reported.
Oh 2003
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[JAMA patient page. Ephedra and ephedrine.]
Torpy 2003
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4 cases associated with ephedra-containing herbal products have been reviewed and three additional cases were reported who developed persistent psychosis that required psychopharmaceutical management.
Walton 2003
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Two recent French case studies report severe poisonings from ephedra containing herbal supplements(one with "ripped Fuel" for losing weight and the other with "Energy pills" in a body builder). In France, dietary supplements are not subject to control under "la Direction Generale de la Sante".
Arditti 2002
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A study of a case of a young user of Thermadrene (SportPharma USA, Inc, Concord, Calif), an herbal remedy for weight loss revealed that Thermadrene can cause serious complications such as ischemic stroke.
Kaberi-Otarod 2002
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A 25-year-old male with myocardial infarction after receiving a diet pill containing ephedra has been temporally correlated to ephedra and a possible role for the coronary microcirculation has been suggested to cause coronary artery spasm, hypercoagulable states, or oxygen demand imbalance.
Rezkalla 2002
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This is a case report of a reservist who presented for a physical examination with hypertension. It was discovered that the reservist was unknowingly taking large doses of Ephedra sinica, or ma huang, a Chinese herbal supplement, for body-building.
Wettach et al
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[NEJM study detailing the causative link between ephedra-containing supplements and adverse cardiovascular and neurovascular events.]
Wolf 2002
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This review of the literature in Medline relative to the use of caffeine and ephedrine in the treatment of obesity concludes that caffeine and ephedrine are equivalent in weight loss to Diethylpropion to dexfenfluramine and that they have a long history of safe, non-prescription use.
Greenway 2001
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Urine toxicology for a 22-year-old man hospitalized for seizure-like activity was negative for salicylates, acetaminophen, alcohol, and drugs of abuse. Medical history indicated recent ingestion of a dietary supplement containing ephedra alkaloids and caffeine, to which the seizure was attributed.
Kockler 2001
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A short-lasting episode of acute psychosis in a 32-year-old male which followed the consumption of alcohol, caffeine and 'vigueur fit' tablets containing ephedra alkaloids is reported.
Tormey 2001
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Half of the standard dose of Mao-bushi-saishin-to (containing ephedra) was prescribed for 7 days to one elderly patient with fever and positive C-reactive protein (CRP) levels suffering from drug resistant Pseudomonas aeruginosa. The patient's fever and CRP level returned to normal levels.
Kamei 2000
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Bradycardia/asystole after spinal anaesthesia treated with prompt administration of atropine and ephedrine
Lovstad 2000
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Blood pressure, heart rate, stroke volume, cardiac output, cardiacindex were increased and total peripheral resistance was decreased by Mao-to (Ma Huang Tang) in 7 healthy men
Xu 1999
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Due to temporal course of disease & propensity to induce vasculitis, Ephedra seen as cause of hypersensitivity myocarditis in a 39-year-old male with hypertension & 1-month history of progressive dyspnea on exertion & who took Ephedra(Herbalife) along with other vitamin supplements.
Zaacks 1999
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Ephedrine in the treatment of congenital myasthenic syndrome.
Felice 1996
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Among 57 patients with narcolepsy, ephedrine was used by 46% (usually with phenmetrazine), amphetamines in 26.3%, phenmetrazine in 82.5% and mazindol in 19.3% [Article in Czech]
Sonka 1996
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Increase in energy expenditure (thermogenesis) by ephedrine is half blocked by nadolol indicating beta 3-adrenoceptor involvement, in a study with nine healthy men
Liu 1995
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Bolus doses of ephedrine are often used by anaesthesiologists for intraoperative hypotension. In healthy men 0.1 mg/kg increased cardiac index, systolic and mean arterial blood pressure, expired minute volume, oxygen uptake and CO2 excretion
Radstrom 1995
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Improper use of oral steroids, overuse of ephedrine preparations and supportive measures and under use of inhalers, oxygen therapy, peak flow meter and patient education by 106 general practitioners of Punjab
Bedi 1994
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During pregnancy drugs should be minimized but in case of anaphylaxis, epinephrine and ephedrine are drugs of choice
Di Lorenzo 1994
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Ephedrine is sometimes used for bronchodilation to prevent anaphylaxis
Wittbrodt 1994
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The bronchodilating effect of ephedrine tablets in bronchial asthma [Article in Danish]
Faurschou 1993
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Urine nitrogen was lowered by L-(-)-Ephedrine (50 mg three times a day) in obese subjects on a very-low-calorie-diet
Pasquali 1992
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Inhaled epinephrine followed in 15 minutes by a theophylline-ephedrine tablet had earlier onset, longer duration, greater peak effect and patient preference over metaproterenol in a study with 12 patients
Pinnas 1991
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Ephedra juice is used as the drink of longevity given even to the new born. This is an Aryan custom mentioned in Rigveda. Tracing the history of this leads to identifying Soma = Ephedra sinica, "the plant with yellow stalks"
Mahdihassan 1989
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Ephedrine, a sympathomimetic agent with alpha-1, beta-1 and beta-2 agonistic activity, infused into 11 mechanically ventilated patients increased systolic blood pressure, urine flow rate and clearance of para-aminohippuric acid, inulin and sodium
Westman 1988
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Red substances predominate in alchemy: red ochre and cinnabar as minerals, ephedra bearing red berries and pomegranate and peach as vegetable products
Mahdihassan 1984
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Ephedra or the soma plant as an energizer-cum-euphoriant use for rejuvenation by Aryan nomad hunters
Mahdihassan 1981
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Ethnopharmacology of sacred psychoactive plants used by the Indians of Mexico.
Diaz 1977
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Management of respiratory allergy by nonallergists. 2. Asthma.
Seebohm 1973
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Traditional and Folk Use
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Neutraceutical supplements like ephedra, androstenedione, & creatine, remain unregulated by Food & Drug Administration and have serious issues with quality and side effects. An understanding of these products is essential for sports medicine practitioner to provide sound, safe advice to the athlete.
Tokish 2004
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The literature on Ephedra with regard to traditional uses, botany, chemistry, analytics, pharmacological effects and health risks have been reviewed.
Abourashed 2003
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Psychoanaleptic (stimulant) plants that possess activity on the CNS and those utilized by human beings to reduce body weight [Ephedra spp., Paullinia spp., Catha edulis Forssk.] and plants used to improve general health conditions were scrutinized.
Carlini 2003
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[The relative safety of ephedra compared with other herbal products.]
Dickinson 2003
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[The need for regulation of dietary supplements--lessons from ephedra.]
Fontanarosa 2003
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[The relative safety of ephedra compared with other herbal products.]
Kalman 2003
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[The relative safety of ephedra compared with other herbal products.]
Kingston 2003
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[The relative safety of ephedra compared with other herbal products.]
Whitaker 2003
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[Ephedra and ephedrine: modest short-term weight loss, at a price.]
Worley 2003
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[Safety and efficacy of ephedra and ephedrine for enhancement of athletic performance, thermogenesis and the treatment of obesity.]
Shekelle 2002
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[Dietary supplements containing ephedra alkaloids.]
Hutchins 2001
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[Dietary supplements containing ephedra alkaloids.]
Traub 2001
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A review of selected herbals and human exercise performance showed that Ma huang, ephedrine, and related alkaloids have not benefited physical performance except when combined with caffeine.
Bucci 2000
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A study on efficacy and safety of herbal stimulants and sedatives in sleep disorders revealed that ephedra, and its constituent ephedrine, are used in both stimulant and weight loss preparations, sometimes with caffeine but safety concerns, have arisen with this practice.
Gyllenhaal 2000
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Chiang Chung-Ching (142-212 AD) used the appearance of rashes in diagnosis, treated infections with anthelmintics and asthma with ephedra
Chan 1994
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Plants found in the Neanderthal grave of a Shanidar IV individual (Iraq) include Achillea, Centaurea solstitialis, Senecio, Muscari, Ephedra altissima, Althea
Lietava 1992
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Early remedies for chronic bronchitis included garlic, pepper, cinnamon and turpentine. Later therapies emphasized coffee, ipecac and potassium nitrate. Modern bronchodilators derived from traditional folk remedies: ephedrine, atropine and theophylline
Ziment 1991
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Adverse Effects & Toxicity
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The ephedrine derivatives norephedrine and pseudoephedrine are used in ENT as decongestants because of their vasoconstrictive properties. They expose patients to serious cardiovascular risks and Ephedra which is used in appetite suppressant mixtures has a negative risk-benefit ratio.
[No authors listed] 2004
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A review revealed that 16 complementary & alternative medicinal agents including angelica, ephedra, gingko, grape seed extract,licorice root, St. John's wort etc. used for treatment of asthma, allergy, & immunologic conditions, are associated with significant adverse effects.
Bielory 2004
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The demographic, pathologic, and toxicological profiles of 127 decedents who were positive for ephedrine alkaloids revealed that norephedrine plays no role in ephedrine toxicity as revealed in a review of the autopsies in Medical Examiner's jurisdiction.
Blechman 2004
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[More evidence supporting the ban of ephedra dietary supplements.]
Chavez 2004
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The effects of the Few Gs (feverfew, ginkgo biloba, garlic, ginseng, & ginger), valerian, kava, St.John's wort, ephedra (Ma huang or metabolite), & Echinacea have been reviewed in the study of dietary supplements in primary care, since botanicals can affect surgical outcomes & follow-up.
Ciocon 2004
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Based upon the well-known pharmacology of ephedrine alkaloids, the peer-reviewed scientific literature on the effects of ephedrine alkaloids & the adverse events reported to have occurred in individuals, the FDA declared dietary supplements containing ephedrine alkaloids adulterated.
FDA 2004
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[Beyond ephedra. Why the FDA's ban may lead users to look for other weight-loss stimulants.]
Gupta 2004
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[Ephedra products from the Internet: dangerous herb] [Article in German].
Kaulen 2004
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The review of supplemental products used for weight loss revealed that Ephedra has been shown to be effective in promoting weight loss, especially when combined with caffeine, but it has a high adverse effect risk profile.
Lenz 2004
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A study on safety concerns regarding ephedrine-type alkaloidal dietary supplements revealed that Weight loss & athletic performance appear to be only modestly improved, for short durations, with large numbers of adverse event reports & studies examining over-the-counter use are also only minimal.
Miller 2004
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[FDA issues alert on ephedra supplements in the USA.]
Nelson 2004
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[Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance.]
Pipe 2004
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A systematic review of 11 dietary supplements in body weight reduction provided some encouraging data but no evidence beyond a reasonable doubt that any specific dietary supplement is effective except Ephedra sinica & ephedrine-containing supplements with an increased risk of adverse events.
Pittler 2004
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The sale of dietary supplements containing ephedra (ephedrine alkaloids) was banned by Food & Drug Administration with effect from April 12, 2004 due to concerns over their cardiovascular effects, including increased blood pressure and irregular heart rhythm.
Rados 2004
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[Regarding the cardiovascular effects of an herbal ephedra-caffeine weight loss product.]
Rawson 2004
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As a natural substance with an easily perceived and desirable (i.e. weight-loss) pharmacological effect, ephedra is susceptible to a variety of adulterants, both economic & efficacious. But the reports of adverse events submitted to FDA raise concern about the risk associated with ephedra.
Soni 2004
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Literature on potential risks of commonly used herbal medications in dental patients, like Ginkgo Biloba, St.John's Wort, Ginseng, Echinacea, Saw Palmetto,Garlic, Kava & Ephedra reviewed as herbal medicines have become an increasingly common form of alternative therapy.[Article in Hebrew].
Zlotogorski Hurvitz 2004
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Products containing ephedra accounted for 64% of all adverse reactions to herbs in the US and its use is associated with a greatly increased risk for adverse reactions compared with other herbs hence its use should be restricted.
Bent 2003
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A review of literature has revealed that ephedra alkaloids have received recent attention for their wide use by athletes and their potential serious side effects, despite the lack of evidence regarding any ergogenic or performance benefit.
Bohn 2003
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[Ephedra supplement may have contributed to sportsman's death.]
Charatan 2003
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A review of abnormal laboratory test results & toxic effects due to use of herbal medicines revealed that use of ma huang (an ephedra-containing herbal product), Chan Su and comfrey may cause death.
Dasgupta 2003
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The recent evidence regarding the serious or potentially serious cardiovascular adverse effects of herbal medicines include aconite, ephedra and licorice which have been summarized.
Ernst 2003
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[American Society for Clinical Pharmacology and Therapeutics position statement on the public health risks of ephedra.]
Hollister 2003
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[Use of Ephedra-containing products and risk for hemorrhagic stroke.]
Karch 2003
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[The relative safety of ephedra compared with other herbal products.]
Kimmel 2003
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The study of herbal therapy use in a pediatric emergency department population revealed that the most dangerous potential herbal and prescription medication combination reported was ephedra and albuterol in an adolescent with asthma.
Lanski 2003
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[False-positive RIA for methamphetamine following ingestion of an Ephedra-derived herbal product.]
Levisky 2003
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Public health officials caution against ephedra use. Health officials caution consumers against using dietary supplements containing ephedra. The stimulant can have dangerous effects on the nervous system and heart.
Meadows 2003
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The study of use of ephedra-containing products and risk for hemorrhagic stroke revealed that it is not associated with increased risk for hemorrhagic stroke, except possibly at higher doses.
Morgenstern 2003
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[Regulation of ephedra in the United States.]
Motoo 2003
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Ephedra, because of its imminent danger when used for weight reduction and athletic enhancement, sale of ephedrine containing dietary supplements was prohibited by FDA as over-the-counter (OTC) medications. Pharmacist's vigilance is needed to avoid sale of such agents as OTC medication.
Newton 2003
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A review of the potential risks associated with ephedra use revealed that ephedra may be associated with adverse events including heart attack, stroke, seizure, and death.
Schulman 2003
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[Ephedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects.]
Shekelle 2003
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A review has revealed that Ephedra products are used as a slimming aid, performance enhancer (sports), stimulant during long working hours but it produce restlessness, agitation, tachycardia and palpitations. [Article in Dutch].
van Riel 2003
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[Medicine. Ephedra--scientific evidence versus money/politics.]
Wolfe 2003
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In the study of supplement use in the adolescent athlete, creatine, anabolic steroids, androstenedione, caffeine, ephedrine-type alkaloids etc., are reviewed and reported that adolescents may be at particular risk when using anabolic steroids and caffeine-ephedra combinations.
DesJardins 2002
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[Adverse events associated with supplements containing ephedra alkaloids.]
Geiger 2002
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Case reports, and researched data on five of the most popular performance-enhancing supplements of the professional athlete, including androstenedione, creatine, chromium, ephedra, and protein & amino acid supplements were reviewed and all were found to have potentially harmful side effects.
Lawrence 2002
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Citrus aurantium is to be considered as a thermogenic, weight-reduction replacement for ephedra as adverse reactions of ephedra is leading to its gradual withdrawal from use by many despite the perceived consequences of obesity.
Preuss 2002
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A review of the FDA Adverse Reaction Monitoring System, which included clinical records, investigative reports, and autopsy reports related to ma huang use. The main outcome measurements were stroke, myocardial infarction, and sudden death.
Samenuk 2002
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[Voluntary recall of ephedra products not enough, MD says.]
Sibbald 2002
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The adverse reactions associated with Ephedra-containing weight-loss products comprised mainly palpitations, stress, headache, insomnia, stroke, heart attacks, cardiac arrhythmias, seizures and psychotic disorders. [Article in Dutch].
van der Hooft 2002
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A case has been reported in which a patient with schizophrenia began using Metabolife, an herbal preparation containing ephedra, for weight reduction and subsequently developed an exacerbation of his psychosis with superimposed delirium.
Verduin 2002
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A Medline search and review of the literature was performed and found that many herbal medicines are relevant in dermatologic surgery, including ephedra, which may potentiate the side effects of epinephrine.
Chang 2001
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[Ephedra is linked to CNS, cardiovascular risks.]
Chase 2001
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Anecdotal, uncontrolled observations suggest that herbal stimulants containing ephedrine (ephedra or ma huang) and caffeine can exacerbate seizures in people with epilepsy, especially when taken in combination.
Spinella 2001
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Hyperthermia resulted from l-ephedrine 40 mg/kg i.p. in rats Ephedrine causes less depletion of dopamine in the caudate/putamen than d-amphetamine
Bowyer 2000
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Dietary Supplements alerts, public meetings and proposed regulations concerning ephedrine alkaloids.
FDA
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These findings indicate the use of dietary supplements that contain ephedra alkaloids may pose a health risk to some persons.
Haller 2000
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Hypersensitivity myocarditis with ephedra use.
Kurt 2000
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Experimental results found; (1) cytotoxicity of all ma-huang extracts could not be totally accounted for by their ephedrine contents (2) grinding significantly enhanced the toxicity of the extracts (3) toxic principles of ma-huang extracts may act on neuronal cells.
Lee 2000
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Ischaemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for body building.
Vahedi 2000
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Case of suicide by 50 Letigen tablets 200 mg caffeine and 20 mg ephedrine with severe toxic manifestations from the heart, CNS, muscles, liver and kidneys leading to cardiac arrest
Hedetoft 1999
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Comments on "ma huang toxicity" letter by Dr. Theoharides.
Karch 1999
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Borage, calamus, coltsfoot, comfrey, life root, sassafras, chaparral, germander, licorice, and ma huang have been identified as unsafe
Klepser 1999
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Psychosis associated with pseudoephedrine and dextromethorphan.
Soutullo 1999
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Ma huang, St. John's wort and kava are examples of readily available psychotropic herbs with the potential for negative effects
Tinsley 1999
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Case of a man with hypertension who had been taking pravastatin (used for angina and cholesterol), furosemide (diuretic) and Ma Huang 1-3 tablets twice daily for 3 months
Zaacks 1999
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Case of blood pressure at 220/110 mmHg and ventricular dysrhythmias after ingesting 4 capsules of herbal ecstacy (caffeine + ephedrine). Treatment with lidocaine and sodium nitroprusside resolved the symptoms in 9 h
Zahn 1999
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Nonpigmenting fixed exanthema induced by pseudoephedrine.
Anibarro 1998
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Ephedrine nephrolithiasis associated with chronic ephedrine abuse
Blau 1998
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A study on influence of processing methods on alkaloid, toxicity and effect of Strychnos nux-vomica L. revealed that the product processed with Ephedra sinica can reduce toxicity and promote curative effect. [Article in Chinese]
Chen 1998
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Use of herbal products and symptoms of bipolar disorder.
Emmanuel 1998
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Most of 36 dedicated female athletes who reported prolonged ephedrine use had experienced at least some adverse effects and seven (19%) displayed frank ephedrine dependence at the time of the interview
Gruber 1998
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Renal tubular secretion of ranitidine is inhibited by trimethoprim, but not by amantadine, pseudoephedrine or triamterene
Nation 1998
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Nephrolithiasis in a patient using an energy supplement, Ma-Huang extract. The Herring kidney stone database shows this is an endemic complication of ephedrine with hundreds of previous episodes
Powell 1998
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Case of suicide by severe ephedrine intoxication
Backer 1997
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"All but death, can be adjusted". Ma Huang (ephedrine) adversities.
Mack 1997
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Sudden death of a healthy college student related to ephedrine toxicity from a ma huang-containing drink.
Theoharides 1997
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500 adverse events in people who took supplements containing ephedrine and associated alkaloids (pseudoephedrine, norephedrine and N-methyl ephedrine) in Texas 12/93-9/95
anon 1996
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From the Centers for Disease Control and Prevention. Adverse events associated with ephedrine-containing products--Texas, December 1993-September 1995.
anon 1996
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The FDA warns of the dangers of ephedrine.
Chase 1996
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Dangerously revved. Ephedrine misuse poses health hazards.
Jones 1996
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Case of acute hepatitis associated with the use of ma-huang which may have contained some other ingredient or contaminant or was misidentified
Nadir 1996
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