Is Ephedra Safe?

We know the herb works. The biggest-selling class of diet pills uses the herb ephedra (Ephedra sinica) because it contains ephedrine, an amphetaminelike molecule, and an herbal caffeine source. But is it safe? Ephedra has taken many hits in the past for its notorious side effects, but new research suggests that the still-popular herb may not be as bad as was previously thought.

Conducted under medical supervision, numerous studies with synthetic ephedrine-and-caffeine (E + C) products have shown the combination to be safe for periods up to one year. The majority of the synthetic studies were done with a 1:10 ratio of ephedrine to caffeine.

But don't assume that herbal E + C mixtures enjoy the safety history of synthetic E + C mixtures. The herbal combinations contain herbal-source ephedrine and an herbal-source caffeine that also contain other chemicals. Only in the past year have longer-term safety and efficacy studies with herbal E + C mixtures been published. Of the available controlled studies done on herbal E + C products, however, the side effects appear to be mild.

A prudent first-time user of herbal E + C products should start with a small dose (5 or 10 mg of ephedrine alkaloids plus 50 or 100 mg of caffeine) taken once daily for a few days, and then slowly increase the dose. Some individuals may manifest modest-to-severe adverse reactions. Use these products wisely and read the warning statement on the label.

Nutrition and exercise biochemist Anthony Almada, MS, has collaborated on more than 45 university-based studies. He is cofounder of Experimental and Applied Sciences (EAS) and founder and chief scientific officer of IMAGINutrition.