The ephedra family of plants, most notably species Ephedra sinica (Ma Huang), contains non-alkaloid and alkaloid compounds, ephedrine one of the latter. It is a stimulant to the nervous system which, in combination with caffeine, appears to cause weight loss. So it has been widely used for weight loss and performance enhancement. But it also increases air flow to the lungs (good for performance) and constricts the blood vessels (very bad for performance and health in general). Side effects can range from the mildly adverse headache to the potentially deadly heart attack. 
Ephedra Products Claims
Nearly every over-the-counter ephedra product on the market hits you with at least three of the following claims:
- MASSIVE Fat-Burner!
- LOADS of energy to power through your workout!
- Suppresses your appetite to CRUSH those cravings!
- Targets your metabolism and pops it into OVERDRIVE!
Just how credible—and true/false—are those claims? And is there any downside?
Ephedra Products Ingredients
As we’ll explain further in a moment, Ephedra sinica and its component alkaloids are a controversial subject when it comes to supplements. Particularly ephedrine, the one alkaloid which does seem to have weight-loss benefits, but also a lot of potential hazard surrounding it. So much so that natural ephedrine is banned by the FDA.
Supplement manufacturers quickly found their way around the ban, though, producing ephedra extract by simply removing the suspect ephedrine.  And while natural ephedrine is still considered a banned substance, synthetic ephedrine is not, and is now sold and marketed as ephedrine HCL. So if you purchase an over-the-counter weight loss or performance-enhancing supplement , it likely contains the synthetic version or ephedra without the ephedrine alkaloids. 
Currently available ephedra supplements contain concentrations from 10 to 150 milligrams. The supplements are often combined with caffeine, green tea extract and/or “proprietary” formulas like the best-selling ephedra diet pills, Schwartz Labs’ Green Stinger.  Its formula, called TriENRG, is essentially 400 mg of caffeine per dose combined with kola nut, guarana and yerba extracts, all of which are commonly found in diet pills.
In looking over the ten most popular ephedra supplements on EphedraWarehouse.com, almost all of them contain the basics: caffeine (9/10 use synthetic powder), ephedra extract in varying amounts, and green tea extract. The other most popular ingredients are yohimbe and willow bark extract (this is aspirin, essentially—and it’s a blood thinner, so be careful if you take anticoagulants like warfarin as a prescription). More individual formula ingredients include everything from ginseng and ginger to peppermint and black pepper. 
NOTE: Keep in mind that not only is ephedra itself a stimulant, but the FDA’s recommended maximum daily intake of caffeine is 400mg. That’s daily.  If you’re caffeine sensitive be extra careful, as the combination of stimulants can have your heart racing or doing other strange mambos. It’s always best to let your doctor know, and pay close attention to side effects until you know how an ephedra supplement is going to affect you. Also, stick to water and decaf on your workout days.
The Science (or Lack Thereof) Behind Ephedra Products—and the Controversy
Let’s start with the proven scientific evidence, taken from the Mayo Clinic website’s “report card” on ephedra: 
- For weight loss: Grade B (good scientific evidence, further research needed)
- For athletic performance enhancement: Grade C (unclear scientific evidence, much further research needed)
- Over-the-counter Ephedra also received C grades for effectiveness in treating nasal allergies, asthma, low blood pressure, respiratory infections, and sexual arousal in women.
It’s commonly understood that ephedra was banned by the US Food and Drug Administration (FDA) in 2004. Subsequent legal challenges by supplement manufacturers were shut down and the ban remained.
What’s not commonly understood is it was specifically the ephedra alkaloid ephedrine that was banned. Too-high amounts in supplements, and alleged abuse by athletes and others, resulted in a study by the FDA. As a result of that investigation, the FDA first proposed in 1997 to ban ephedra supplements containing more than 8 milligrams of ephedra, with dosage specifications of no more than 24mg daily with a limited consumption period of one week.  and proposed strict labeling on all ephedra products describing the health risks, including heart attack and stroke. 
But ephedra was very popular with the general public, and the industry fought back with a public relations effort to counter FDA claims of the dangers of ephedrine.
In 2000, the FDA requested an independent review of adverse-event reports relating to ephedra, and several studies were published in the New England Journal of Medicine and other scientific journals.  Then two collegiate and three professional (one semipro) sports deaths—all involving ephedra or ephedra-related products—put the controversy on the map and under a spotlight: 
- 2001, Northwestern University football safety Rashadi Wheeler
- 2001, Florida State linebacker Devaughn Darling
- 2001, NFL Minnesota Vikings offensive tackle Korey Stringer
- 2001, former University of Utah tight end, playing in the US Inside Football Semipro League, Curt Jones 
- 2003, Baltimore Orioles baseball pitcher Steve Belcher in 2003
Wheeler and Rashadi both had ephedra in their systems when they died, Stringer had ingested a supplement before collapsing during a workout, Jones had a pre-existing heart condition which was exacerbated by his use of supplements, and the medical examiner who performed Belcher’s autopsy cited ephedra intake as a “significant element” in his death. 
The controversy grew. At the time, Metabolife was the largest and most popular of ephedra supplements and had not provided the FDA (as ordered by the U.S. Department of Justice) with approximately 14,000 complaints by users of its ephedra supplements about bad side effects and other concerns. A criminal investigation was launched,  and ultimately the company owner was sent to federal prison for failing to provide those to the government. 
Meanwhile, numerous studies were conducted to determine ephedra’s effectiveness and potential hazards. Of those, arguably the most significant commissioned by the federal health department was published in March 2003 in the Journal of the American Medical Association.  This extensive study concluded that
Ephedrine and ephedra promote modest short-term weight loss (≈0.9 kg/mo more than placebo) in clinical trials. There are no data regarding long-term weight loss, and evidence to support use of ephedra for athletic performance is insufficient. Use of ephedra or ephedrine and caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations.  (emphasis added)
In any event, the FDA ban was instituted in 2004 and, as mentioned, fought off legal challenges. But keep in mind, it’s the natural ephedrine alkaloid that was and is banned, not the ephedra plant or extracts from the non-alkaloids. 
Word on the Street About Ephedra Products
Schwartz Labs’ Green Stinger has more than 100 reviews and earned a four-star rating. 
Lipodrene with Ephedra—a popular supplement by manufacturer Hi-Tech containing 25 mg of ephedra—has 150 five-star reviews and a voluminous caution label (albeit in tiny print) about side effects and the possibility of heart attack or stroke, and warning people to not consume any additional caffeine products while taking Lipodrene. There’s even a boldface, all-caps advisory: “TO REPORT ADVERSE EFFECTS CALL FDA’s MEDWATCH AT 800-332-1088.” EphedraWarehouse .com advises people to consult their doctor “to ask your doctor if Lipodrene is right for you” and tells people to “thoroughly review Lipodrene's label.” 
And speaking of EphedraWarehouse .com, it’s a good place to look for reviews. There, one can purchase myriad ephedra “diet pills” with varying degrees of potency—from 10 mg up to 150 mg. Remember, daily values for ephedra extracts have not been evaluated or clearly determined; only FDA guidance is available. Appropriate warnings are also clear, indicating when a particular supplement is not recommended for beginners new to ephedra use.
Supplement names offer a clue: Hellfire EPH, for example. This supplement, containing 150 mg of ephedra, advertises that users will “feel the heat of the hottest diet and energy aid available.” Reviews for Hellfire are, well, hot: overall, more than 300 five-star reviews on the Ephedra Warehouse site. Each review on the site included—refreshingly, as some sites can offer rather dubious reviews—a reviewer name, occupation, date and location. The comments were, for the most part, glowing: Hellfire delivers energy and helps with appetite suppression and, ultimately some weight loss. 
That said, we went to another site selling performance-enhancing and weight loss supplements, A1Supplements.com, and found that Hellfire scored an average 4.5 stars from 22 reviews, again saying it provided a welcome boost. 
But one review caught our attention:
If You Want to Feel your Heart Explode—“JHI” posted in April of 2017. “I've taken multiple fat burners before but I must say while these definitely give you the energy you need they also kind of make you feel like you're about to have a heart attack. Not for the supplement newbies, know your body and your doses.” 
Other ephedra supplements like Stimamine and Diablo ECA Fire Caps each contain 50 mg of ephedra and are similarly well-reviewed. But we noted that not all supplements come with the appropriate warnings above “not for beginners.” Stimamine does, though, and it’s a very good warning that you’d be wise to heed for all ephedra supplements:
Warning: Designed for Customers with Experience Taking Ephedra Products for Weight Loss. Stimamine Black is the most intense version of the Stimamine line. It is for experienced customers only. If you have gotten the jitters and shakes from other products, this may not be for you. Choose Stimamine Black if, and only if, you are a battle hardened supplement veteran and most diet pills can’t keep up with you. Stimamine Black will be the pill that finally pushes you past your limits. 
So, consumers are warned that high doses of ephedra can be dangerous, deadly even.
The Bottom Line
Are over-the-counter Ephedra Products worth a try?
Problematic (at best). Use with caution and under strict medical supervision.The review describing someone feeling as if they were about to have a heart attack is a huge red flag. And there's this: ephedra is banned in most professional sports nationally and internationally, and is outlawed by the World Anti-Doping Agency and the Olympics: “any pharmacological substance…with no current approval by any governmental regulatory health authority for human therapeutic use…is prohibited at all times.” 
The overall science and reviews seem to indicate over-the-counter ephedra supplements can be useful when used cautiously. Still, as even ephedra manufacturers advise, it’s important you talk to your doctor before using ephedra. Your life may literally depend on it.
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