Are All Ephedrine Supplements Banned?

Ephedrine is a drug derived from the plant ephedra, also called ma huang. It has been used for hundreds of years as both a stimulant and decongestant to treat lung problems and asthma. Athletes also use this as a way to improve athletic performance. In 2004, the U.S. Food and Drug Administration (FDA) banned the sale of supplements containing ephedrine after a number of deaths and cases of adverse effects related to their use were reported.

That said, ephedrine can be legally obtained for certain medical purposes where the benefits are believed to outweigh the risks.

Effectiveness of Ephedrine

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

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

Despite the widespread popularity of ephedrine in sports and diet supplements, studies have found that the benefits of their use are questionable or must be monitored closely:

• A study looked at the effects of taking ephedrine with caffeine on athletic performance. They found that although the subjects reported improved mood and enhanced alertness, there were no differences in athletic performance, including muscle strength, endurance or anaerobic power.
• A 2021 meta-analysis found that although those who took ephedrine-containing products lost more weight than those who didn't take the supplements, they also had an increased heart rate. Researchers concluded that ephedrine may be beneficial to obese patients, however close heart rate monitoring should be done by a doctor.
• 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.
  

Dangers of Ephedrine

Ephedrine 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. The deaths were not always associated with either high intake or overuse.

Among some of the more dangerous side effects associated with ephedra/ephedrine use are:

• Elevated blood pressure
• Heart attack
• Irregular or rapid heart rate
• Psychosis
• Seizure
• Stroke

Many products found containing caffeine and ephedra/ephedrine were not found to be effective for their intended purpose and were found to increase the rate and severity of the above side effects.

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 ephedrine even for these purposes is strictly regulated with drug control laws that vary from state to state. Many states will require merchants to obtain proof of identity and maintain records of all sales.

Can You Still Buy Ephedrine?

There are many sports supplements 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.

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. A 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.

Bottom Line

Supplements remain unregulated, so it is best to use them with caution, investigate your source, and interrogate health benefits claimed by manufacturers of the product. Their benefits to athletic performance have not been found in studies. They can help with weight loss, but can also increase your heart rate and should not be taken without a doctor's supervision. Consult with your doctor before taking ephedrine and related products and make sure you understand the legality of the drug in your state.