A practical guide for nutritional and traditional health care.
The ephedra - ma huang in the Chinese system of medicine - is a plant which is valued as a herbal remedy. The plant's principal alkaloid compound ephedrine and various other derivatives of the plant saw substantial use in the western system of medicine early on, and it may be one of the first Chinese herbal remedies to do so. The use of the plant as an herbal remedy in China goes 5,000 years back, traditionally the green stems of many different varieties of the ephedra species, specifically the E. sinica spp., the E. equisetina spp., and related plants in the Ephedraceae family, were and are used in herbal medications. The traditional use of the species is not limited to China, for example, traditionally in India, the E. gerardiana spp. was extensively used in the herbal treatment of bronchial asthma and in treating other related disorders affecting the respiratory system.
The compound known as ephedrine is the major chemical constituent of the plant. N. Nagai, a Japanese chemist, isolated this compound from the plant in the year 1887. Its pharmacological properties were discovered and documented only in the year 1924 at Peking union medical college, where K. K. Chen and his mentor C. P. Schmidt, published a series of papers. From that time, the utility of this compound in medicine began to be recognized by many physicians in this country and it began to be used worldwide. The compound ephedrine saw wide initial use as a nasal decongestant, it was also used as a stimulant for the central nervous system, and it also saw widespread use in the treatment of bronchial asthma and related congestion problems in the respiratory system. As other ephedra species began to be identified and analyzed, alkaloids related to the ephedrine, such as pseudo ephedrine, the norephedrine, and norpseudoephedrine among others were identified, these alkaloids have identical or related abilities, and were subsequently utilized in herbal remedies.
There are approximately at least forty species of Ephedra, according to the scientific studies conducted on the herb, all of which can be divided into several geographic types or sub-species. The main difference between these geographic types is a qualitatively and quantitatively in the content of various alkaloid compounds. The North and Central American varieties of the plant appear to be free of alkaloids, which is a very significant finding with respect the plant species taken as a whole. Compounds other than ephedrine and its derivatives are therefore assumed to be responsible for the herbal and beneficial aspects of these American species. The E. nevadensis species-discussed under Mormon tea is not included in a discussion of the various ephedra plants for this reason-mainly due to the difference in the alkaloid content. At the same time, even a specialist has some difficulty distinguishing between the various species of Ephedra, as the plants are often morphologically very hard to distinguish from one another and require careful examination.
Many states in the US have passed laws that regulate the sale and use of the alkaloid ephedrine - this is because the chemical can act as a precursor compound during the illegal synthesis of methamphetamine or "speed," a very common abused drug. Some of these laws regulate even the sale of any products which contain ephedrine and hence take into account many herbal medications made from the Ephedra spp. of plants. Ephedra is not regarded as the primary or the main commercial source of the alkaloid ephedrine anymore as the alkaloid can now be synthesized in the laboratory, the alkaloid content of different species of ephedra can be 0.5 to 2.5 percent of alkaloid mixture in the full plant extract, with the ephedrine making up 30 to 90 percent of all alkaloids in the plant. Ephedrine for commercial use is synthesized in the lab and produced in large quantities during chemical synthesis which involves the reductive condensation of a chemical called L-1-phenyl-1-acetylcarbinol with another chemical compound methylamine - this is how all commercial ephedrine is manufactured these days. The product of this chemical synthesis is an isomer of ephedrine called L-ephedrine, which is identical to the alkaloid found in the ephedra species of plants. While the restrictions on the sale of the ephedrine seems like a reasonable measure considering the potential for abuse, in the light of the difficulty in extracting the relatively small amounts of ephedrine from the plant - the species being only a minor source of the alkaloid, the regulatory measures seem to be excessive as the herb is often hard to find for legitimate users and herbalist due to stringent regulations. As a matter of fact, the ephedra plants are also subject to potential abuse, and some people do consume large amounts of the herb solely for its psychotropic effects, in this respect controlled and restricting its sale to responsible adults and putting a limitation on the dosages and duration of dosage seem to be reasonable measure which can be taken by the regulatory authorities.
The promotion of mental calmness and concentration during the meditation period of Zen monks was traditionally aided by doses of the ephedra plant.
The remedy made from the ephedra also sees widespread and popular use in the herbal medicine of China, the ephedra based remedies are very popular for the treatment of various chills and fevers, in the treatment of coughs, and to treat wheezing in patients, this remedy is often used in combination with another herb called the rehmannia for the treatment of kidney yin deficiency in patients.
Disorders like the asthma and seasonal hay fever, and some acute onset diseases such as colds and flu are the conditions currently being treating using herbal remedies made from the ephedra in the Western world. Some distinct effect of the herbal remedies based on the ephedra include an ability to raise blood pressure, these remedies are also known to cool down elevated body temperatures during fevers, and they also help in alleviating conditions such as chronic rheumatism in different individuals.
Nasal congestion can be effectively cleared by the herbal remedies made from the ephedra. For this reason, the herbal remedy is utilized in the treatment of many different allergic disorders in affected adult patients - these typically include disorders in the respiratory system and congestion. The most effective role of the ephedra is as a strong stimulant of the central nervous system and is used in this role. However, the absence of substantial clinical evidence negates its role in weight loss, even though the plant has many supporters in this regard - no evidence supports either the safety or the effectiveness of the ephedra as an inducer of weight loss in obesity affected patients and its role as an enhancer or booster of athletic performance is also open to question. Both the systolic and diastolic blood pressure is increased by the ephedra mainly due to the ephedrine content - this is not a pleasant effect and an undesired side effect during the treatment of many disorders. For example, the ephedrine content may bring on palpitations as well as nervousness, as one of its first effects is to increase the heart beat rate, the herb is also known to bring on a headache, it can induce insomnia and sleeplessness, and even dizziness in the short term. While different congestive disorders and asthmatic conditions can be treated effectively using this herbal medication, some of the side effects which can appear make this remedy very inadvisable for uncontrolled use in patients, this is true especially of individual patients who suffer from heart conditions of different types, those suffering from hypertension, and individual affected by metabolic disorders such as diabetes, or by other glandular diseases such as thyroid disease particularly when they are affected by these diseases in the long term.
Other medical uses
Habitat and cultivation
The ephedra is a an endemic species of east Asia, and grows native in parts of northern China as well as Inner Mongolia, in addition, some ephedra species are also found in isolated populations in the desert areas within Asia. Autumn is the season during which the ephedra is propagated, using the stored seeds, the plant is also propagated by the root division method and this is done during the autumn or the spring, for optimal growth the plant requires well-drained soils and a good supply of water. Harvesting of the ephedra stems is done throughout much of the year, during which the plant is dried and stored for future processing.
The main action of the majority of the alkaloid compounds found in the ephedra plant is that they mimic the action of the fight or flight hormone called adrenaline within the human body, as a result the herbal remedies made from the plant increases the level of alertness and quickens reactions in the person. The initial synthesis of the ephedrine was done in the year 1927, when the compound was extracted from the ephedra; the main and initial use of the extracted compound was as a decongestant and an anti-asthmatic to ward off allergenic reactions in the body of affected patients. As far as the decongestant properties of the alkaloid are concerned, ephedrine is still in common usage, even now in the conventional medical system to treat internal congestion disorders in patients.
Both active as well as inert chemical compounds are found in the extracts of the whole plant, these chemical compounds act synergistically in combination and benefit patients in different ways. Significant benefits can accrue from using the whole plant as a remedy and at a much lower dosage instead of the isolated constituents from the plant, therapeutic benefits of the whole plant on the body include the dilation of the bronchial airways and other respiratory air passages, the blood flow to the skin is increased at the same time. The benefit of using the whole plant lies in the fact that side effects are rare during treatment unlike treatments with isolated ephedrine alone.
The ephedra plant can be taken in many forms, dosages differ, the dosage for the crude powdered stems of the ephedra are normally taken at doses of one to four grams every day in the form of an herbal tea as the total ephedrine content is only about one percent. Doses of one to four ml taken thrice daily are the normal dosage regimen for the herbal ephedra tincture. The safe adult dosages for all of the over the counter herbal medications with ephedrine as the main constituent are doses of about 12.5 to 25 mg once, every four hours daily during the treatment period. At any rate, during a twenty four hour period, dosage of the medication in adults must not exceed 150 mg during any period of the treatment regimen. Doses of sixty mg pseudo-ephedrine once every six hours is the typical recommended dose during any treatment.
Side effects and cautions
Whenever it has been used in the suggested doses, the safety record of ephedra has been good and the herbal remedy is not known to bring on any major side effects if taken within limits. Amphetamine like induced side effects have been known to occur in abusers, especially if the herbal medication was taken in large amounts for the express purpose of quick weight loss, some of these physical effects are the elevation in the blood pressure of the person, persistent muscular disturbances, sleeplessness and insomnia, the presence of persistent dry mouth, the appearance of heart palpitations, persistent nervousness, and at times heart failure sometimes resulting in the death of the person. For these reasons, it is suggested that a physician must be consulted by someone with problems like a high blood pressure, chronic heart conditions, metabolic disorders such as diabetes, problems like glaucoma, glandular thyroid disease before using any of the herbal products containing ephedra, a physician must also be consulted before using ephedra by all patients already on a regimen of the MAO-inhibiting anti-depressants. Caution is also advised when using the compound pseudoephedrine especially by someone intending to drive or operating machinery, as the medication is known to induce drowsiness and can impair mental alertness in the person. Pregnant women must avoid taking any ephedra based products during the term of pregnancy and till lactation is completed. Children younger than six years of age must also not be given ephedra based products without medical assent.