Ephedra: Stimulating questions about ephedra
by Paul Bergner
Medical Herbalism 10-31-96 8(3): 3
We thought we’d pose some questions on ephedra, used so successfully by Chanchal Cabrera in the treatment of allergies in the case study on page one. The FDA is currently reviewing the regulatory status of ephedra, and the herbal industry is responding in a variety of ways. Here is what we consider to be medical facts:
Ephedra may cause significant health problems if taken during pregnancy or lactation, heart or thyroid disease, high blood pressure, diabetes, or if taking a variety of prescription drugs. Most of these conditions — early pregnancy, heart disease, thyroid disease, high blood pressure, and diabetes — are common “silent” conditions, undiagnosed and unknown to the individual. Most hypertension remains undiagnosed. If herbal products containing ephedra are sold to the general public for reducing weight or boosting energy, they will be consumed by people who are obese and/or fatigued — and many of these groups, especially, with silent conditions. Fatalities and serious injury will continue to occur, just as they do at present. Warning labels are of no use in undiagnosed conditions.
Ephedra now unfortunately also has a reputation as a drug of abuse. As a drug, its action is similar to the amphetamines, at about one-fifth the strength. When taken in sufficient excess, it causes amphetamine psychosis. During the “drug-revolution” of the sixties, street wisdom was that “speed kills.” It’s a bad drug. And so is ephedra. Why should either amphetamines or ephedra be available over-the-counter?
So that leaves the problem of how to
protect the public from a potentially deadly drug, from unscrupuluous
companies that push it for inappropriate use, and still make ephedra
available to responsible herbalists. We emphasize “responsible” here,
because all herbalists do not necessarily know the proper use of the
drug. We have in hand a case study in which the patient spent three
months in the hospital with adrenal exhaustion after ephedra abuse
under the care of an “herbalist” who continued to prescribe it in
progressively larger doses while misinterpreting the emerging toxic
effects as “cleansing” reactions. The biggest question: who will will
protect us from irresponsible herbalists?