Dangers Of Ephedra
By Pete Draovitch, MS, ATC, PT, CSCS

As recent tragic events have demonstrated, ephedra use in extreme weather can prove deadly. Exactly what is it about the two that causes the problem?

The active ingredient in Ephedra (also known as Ma Huang or Ephedra Sinica) is called Ephedrine. Ephedrine has been in common use by asthmatics as an effective bronchodilator. Unfortunately, it can have the undesired side effects of increased blood pressure, heart rate and body temperature.

The relevant factor regarding extreme weather is dehydration. Like ephedrine, dehydration increases heart rate and how hard the heart has to work. And, although dehydration does not increase body temperature directly, it significantly reduces the body's ability to cool itself through sweating. As little as 2.9% loss in body weight due to dehydration can impair physical performance, mental sharpness and muscular power and endurance (don't forget, the heart is a muscle). Finally, the tendency to dehydrate is increased if the person in question is overweight and/or unacclimated to the extreme weather.

Potential problems with ephedra use in extreme environments should now be apparent; heat illness, heat stroke, and even death brought on by high body temperature and/or heart failure.

Compounding the potential for problems, Ephedra's side effects become pronounced relatively quickly once use is started. The body has little time to counter-act these effects. An FDA commission studied records of 140 ephedra users between 1997-1999. The population standard by Haller & Benowitz (New England Journal of Medicine 343: 1833-8, 2000) was young and healthy and had only been on ephedra a few days. Results showed:

o   1/3 of complications were definitely or probably caused by ephedrine

o   Another 1/3 of the problems were possibly caused by ephedrine

Most athletes take ephedra to increase energy/decrease fatigue during training or to reduce fat mass by increasing resting metabolism and/or suppressing appetite. Since no significant body of research suggests ephedra will improve performance, are the side effects worth the risk?