Are All Ephedrine Supplements Banned?

Ban Extends to Most, But Not All, Over-the-Counter Products

Raw ephedra before processing.
Unprocessed ephedra stems are high in both ephedrine and pseudoephedrine. Imagemore Co Ltd./Getty Images

Ephedrine is a drug derived from the plant Ephedra equisetina. It has been used for hundreds of years as both a stimulant and decongestant.

Ephedrine has long been found in many diet pills and sports supplements and embraced by athletes and non-athletes alike for their reported benefits, including:

  • Increased weight and body fat loss
  • Improved athletic performance and endurance
  • Improved concentration

However, in 2004, the U.S. Food and Drug Administration (FDA) banned the sale of supplements containing ephedrine after a slew of deaths were reported following their use.

The FDA does allow for the sale of ephedra extracts so long as they do not contain any ephedrine. These products are commonly found in a number of popular sports supplements and appetite suppressants. Ephedra herbal teas are also allowed under current law.

Effectiveness of Ephedrine

Despite the widespread popularity of ephedrine in sports and diet supplements, studies released by the FDA have long since concluded that the benefits of their use are questionable. Among the findings:

  • While ephedrine can increase the likelihood of short-term weight loss, there is no evidence that it will offer any gains over the long term.
  • There is also no evidence that ephedrine improves athletic performance either by increasing strength, endurance, reaction time, anaerobic capacity, or recovery time after prolonged exercise.

Moreover, in their research, the FDA found that products containing caffeine and ephedra/ephedrine only increased the rate and severity of side effects.

Dangers of Ephedrine

Ephidrene is among the list of banned substances issued by the International Olympics Committee and practically every other major professional or amateur athletics association.

The dangers of ephedra were first reported in 2000 when a study published in the New England Journal of Medicine reported that a number of people had died of cardiac arrest after taking an ephedra-containing product.

Moreover, the deaths were not always associated with either high intake or overuse.

By 2003, more than 40 such deaths had been reported including that of Steve Bechler, a pitcher with the Baltimore Orioles. Among some of the more dangerous side effects associated with ephedra/ephedrine use are:

Legal and Non-Banned Uses

While ephedrine is banned in diet and sports supplements, it still is commonly used to treat allergic disorders such as bronchial asthma. It is also used in certain medical procedures involving anesthesia to prevent dangerous drops in blood pressure.

However, the use of these products is strictly regulated with drug control laws varying from state to state. Many states will require merchants to obtain proof of identity and maintain records of all sales.

As for the legal use of ephedra, there are many sports supplements today which are marketed as containing "safe ephedra extracts." In a great many cases, however, they are made with other plant-based substances, such as Caralluma fimbriata, and contain no ephedra at all. Read the labels closely whenever buying these products.

The one ephedrine-containing product that can be legally sold over the counter is the Chinese herbal medication known as Ma huang.

It is the raw, natural tea made from E. equisetina or E. sinica. This legislative loophole allows the tea to be sold without restriction so long as it is not marketed as an appetite suppressant or added to any other supplement of any sort.

Sources:

Manore, M. "Dietary supplements for improving body composition and reducing body weight: where is the evidence?" Int J Sports Nutr Exerc Met. 2012; 22(2):139-54.

National Center for Complementary and Integrative Health: National Institutes of Health. "Ephedra." Washington, D.C.; NCCIH Publication D336; updated September 2016.

U.S. Food and Drug Administration. "Evidence Report/Technology Assessment (Number 76): Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects." Silver Spring, Maryland; issue March 2004.

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