Side Effects of ephedra: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major Research Findings

Ephedra Herb is a traditional Chinese medicine used to treat headaches, bronchial asthma, nasal inflammation, and the common cold. 18 While ephedrine alkaloids (EAs) are considered the primary active ingredient, they are known to cause side effects like palpitations, hypertension, insomnia, and dysuria. 18 This means people with cardiovascular diseases should avoid medications containing EAs. 18

Herbacetin, a flavonoid aglycone found in Ephedra Herb, was found to have antiproliferative and analgesic effects. 18 This raises the possibility of developing safer natural medicines that avoid the negative effects associated with EAs. 18

Ephedra is marketed as a weight-loss supplement, but there is limited scientific evidence to support its effectiveness. 21 Furthermore, ephedra can lead to serious side effects affecting the heart and nervous system, making its use risky. 9 25 3 5 24 22 19

Ephedra can also lead to liver toxicity. 6 2 Ephedra intake may increase myocardial irritability, potentially increasing the risk of sudden death in young individuals. 8

Reasons for Side Effects

Ephedra contains ephedrine alkaloids, which have a stimulating effect on the sympathetic nervous system. 18 Ephedrine can accelerate heart rate and increase blood pressure, leading to side effects like palpitations and hypertension. 18 Ephedrine can also excite nerve cells in the brain, causing side effects like insomnia and anxiety. 18 Ephedra can damage liver cells, potentially leading to liver toxicity. 6 2

Common Side Effects

Palpitations

Ephedra can cause palpitations due to its ability to increase heart rate. 18 9 5 19

Hypertension

Ephedra can lead to hypertension by increasing blood pressure. 18 9 5

Insomnia

Ephedra can cause insomnia because it stimulates nerve cells in the brain. 18 9 3

Anxiety

Ephedra can lead to anxiety due to its stimulatory effect on nerve cells in the brain. 18

Dysuria

Ephedra can cause difficulties in urination. 18

Liver Toxicity

Ephedra can cause liver toxicity by damaging liver cells. 6 2

Increased Myocardial Irritability

Ephedra may increase myocardial irritability, potentially increasing the risk of sudden death in young individuals. 8

Side Effects Management

Palpitations

If you experience palpitations, discontinue ephedra use. 18

Hypertension

If you experience hypertension, discontinue ephedra use. 18

Insomnia

If you experience insomnia, discontinue ephedra use. 18

Anxiety

If you experience anxiety, discontinue ephedra use. 18

Dysuria

If you experience dysuria, discontinue ephedra use. 18

Liver Toxicity

If you are concerned about liver toxicity, discontinue ephedra use. 6 2

Comparison Across Studies

Commonalities Across Studies

Multiple studies have shown that ephedra can cause side effects in the cardiovascular system, nervous system, and liver. 18 21 9 25 3 5 24 22 19 6 2 8

Differences Across Studies

The severity and frequency of ephedra side effects can vary depending on individual factors like body type and dosage. 18 9 25 3 5 24 22 19 6 2 8

Real-life Application Considerations

Ephedra should not be used by individuals with cardiovascular diseases or pregnant or breastfeeding women. 18 If considering ephedra use, consult with your doctor. 18

Limitations of Current Research

Research on ephedra side effects is still limited. 18 21 9 25 3 5 24 22 19 6 2 8

Future Research Directions

Further research on ephedra side effects is needed. 18 21 9 25 3 5 24 22 19 6 2 8

Conclusion

Ephedra can cause side effects in the cardiovascular system, nervous system, and liver, making caution in its use essential. 18 21 9 25 3 5 24 22 19 6 2 8 If considering ephedra use, consult with your doctor. 18

Literature analysis of 25 papers
Positive Content
8
Neutral Content
1
Negative Content
16
Article Type
1
0
0
10
25
2.

[Toxic hepatitis by consumption Herbalife products a case report].

Author: ChaoSara, AndersMargarita, TurbayMaximiliano, OlaizEmiliano, Mc CormackLucas, MastaiRicardo

Hepatitis

The study reports a case of acute toxic hepatitis potentially caused by the consumption of Herbalife products. While Herbalife products are widely consumed, there is a lack of strong evidence regarding their safety and potential adverse effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Spanish

3.

Ephedrine Alkaloids-Free Ephedra Herb Extract, EFE, Has No Adverse Effects Such as Excitation, Insomnia, and Arrhythmias.

Author: TakemotoHiroaki, TakahashiJun, HyugaSumiko, OdaguchiHiroshi, UchiyamaNahoko, MaruyamaTakuro, YamashitaTadatoshi, HyugaMasashi, OshimaNaohiro, AmakuraYoshiaki, HakamatsukaTakashi, GodaYukihiro, HanawaToshihiko, KobayashiYoshinori

Analgesic effect
Anti-influenza effect
Cancer metastatic inhibition

Ephedrine alkaloids-free Ephedra Herb extract (EFE) was shown to be free from the side effects of Ephedra Herb extract (EHE), such as excitation, insomnia, and arrhythmias.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

The effect of leaf hydroalcoholic extract of Ephedra pachyclada infertility in male rats treated with cyclophosphamide: An experimental study.

Author: SalehShiva, GhanaatpishehAref, HaghshenasHoda, ParvinNegar, MikaeiliagahElmira, Kargar JahromiHossein, EbrahimiBahare

Infertility
Reproductive system dysfunction

Cyclophosphamide, a commonly used chemotherapy drug, can have harmful effects on the reproductive system, leading to infertility.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

[Case of intractable ventricula fibrillation by a multicomponent dietary supplement containing ephedra and caffeine overdose].

Author: TakeuchiSatoru, HommaMasato, InoueJunichi, KatoHiroshi, MurataKiyoshi, OgasawaraTomoko

Cardiotoxity
Ventricular fibrillation

A rare case of intractable ventricular fibrillation, requiring frequent defibrillation, is reported after multicomponent dietary supplement containing ephedra and caffeine (DSEC) overdose. The direct cardiotoxity of ephedra, synergistic effect of caffeine and ephedra, and hypokalemia may cause refractory ventricular arrhythmia.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Japanese

6.

Ephedrine-induced mitophagy via oxidative stress in human hepatic stellate cells.

Author: LeeAh Young, JangYoonjeong, HongSeong-Ho, ChangSeung-Hee, ParkSungjin, KimSanghwa, KangKyung-Sun, KimJi-Eun, ChoMyung-Haing

Ephedrine side effects
Liver toxicity

Ephedrine, a component of the herb Ephedra sinica, was found to trigger mitochondrial oxidative stress and depolarization, leading to mitophagy and cell death in LX-2 liver cells. The study suggests that excessive mitophagy may contribute to ephedrine-induced hepatotoxicity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

A randomized double-blind placebo-controlled clinical trial of a product containing ephedrine, caffeine, and other ingredients from herbal sources for treatment of overweight and obesity in the absence of lifestyle treatment.

Author: CoffeyC S, SteinerD, BakerB A, AllisonD B

Weight loss

The efficacy and side effects of an herbal formulation to promote weight loss were compared to placebo.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Thermogenic supplement use does not alter characteristics of sudden death in the young.

Author: AppelDavid A, McNearJennifer A, ShryEric A, GentleskPhilip J, ReichStephen S, EckartRobert E,

Sudden death

Ephedra use has been temporally associated with sudden death, and animal models suggest that increased myocardial irritability may contribute to primary arrhythmic death.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Central nervous system stimulants and sport practice.

Author: AvoisL, RobinsonN, SaudanC, BaumeN, ManginP, SaugyM

Dangers in contact sports

Central nervous system stimulants, such as ephedrine, amphetamine, and cocaine, can be misused in sports to improve performance, but this can be dangerous and lead to health problems.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations.

Author: AbebeWorku

Drug interactions
Oral manifestations

Herbal medication is popular in the US, but its regulation is limited. This paper discusses the potential interactions of herbal supplements with oral health drugs and oral manifestations. Dental hygienists should be aware of these potential interactions to provide appropriate oral health care.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

[Banned performance enhancing ergogenic aids in children and adolescent athletes].

Author: NemetDan, EliakimAlon

Ergogenic aids
Performance enhancing

The use of ergogenic aids by young athletes is increasing. While there is no scientific evidence to support their use for enhancing performance in children and adolescents, using supra-physiological doses may be associated with undesired side effects.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Hebrew

14.

Botanical dietary supplement use in peri- and postmenopausal women.

Author: MahadyGail B, ParrotJulie, LeeCathy, YunGina S, DanAlice

Botanical dietary supplements (BDS) are commonly used by women between the ages of 40 and 60 years.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

15.

Herbal remedies use by breast cancer patients in the West Bank of Palestine.

Author: JaradatNidal Amin, ShawahnaRamzi, EidAhmad Mustafa, Al-RamahiRowa, AsmaMaes Kasem, ZaidAbdel Naser

Herbal remedies are widely used in Palestine and other countries as a preferred modality of complementary and alternative medicine (CAM). This reflects the importance of traditional medicine practices in healthcare.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

16.

Nutrition and sports supplements: fact or fiction.

Author: LawrenceMarvin E, KirbyDonald F

Side effects (unknown)

There are few large, multicenter, randomized trials on the purported claims and potential side effects of 'performance-enhancing' nutritional supplements.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Short-term and long-term in vivo exposure to an ephedra- and caffeine-containing metabolic nutrition system does not induce cardiotoxicity in B6C3F1 mice.

Author: RaySidhartha, PhadkeSantosh, PatelChintan, HackmanRobert M, StohsSidney

Increased activity
Weight loss

A study investigated the effects of a multi-nutrient and botanical extract supplement (MNSO) on mice for up to 12 months. MNSO, containing ephedra and caffeine, did not significantly affect heart health or serum chemistry, even at 10 times the human dose. MNSO-fed mice consumed more food but were leaner and more active than controls.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Transient Cardiomyopathy and Quadriplegia Induced by Ephedrine Decongestant.

Author: SnipeliskyDavid F, KurklinskyAndrew K, ChirilaRazvan

Cardiomyopathy
Vasospasm

Excessive use of ephedrine-containing decongestants can lead to severe adverse reactions, including cardiomyopathy and spinal artery vasospasm. This case report describes a patient who developed quadriplegia and heart failure due to excessive ephedrine ingestion, emphasizing the importance of safe decongestant usage.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Efficiently prepared ephedrine alkaloids-free Ephedra Herb extract: a putative marker and antiproliferative effects.

Author: OshimaNaohiro, YamashitaTadatoshi, HyugaSumiko, HyugaMasashi, KamakuraHiroyuki, YoshimuraMorio, MaruyamaTakuro, HakamatsukaTakashi, AmakuraYoshiaki, HanawaToshihiko, GodaYukihiro

EH anticancer effect
Dysuria
Hypertension
Insomnia
Palpitation

A new ephedrine alkaloid-free extract (EFE) of Ephedra Herb was developed, effectively removing ephedrine alkaloids, known for their adverse cardiovascular effects. EFE retains the anticancer effect of the original extract, demonstrating its potential as a new herbal medicine with reduced side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Ephedrine and other stimulants as ergogenic aids.

Author: BohnAmy Miller, KhodaeeMorteza, SchwenkThomas L

Drug use in athletes

Recreational, prescription, and illicit drugs can be perceived to be ergogenic and have psychotropic effects. Ephedra alkaloids have received attention for their potential side effects, despite lacking evidence of ergogenic benefits. Prescription drugs like methylphenidate and bupropion raise complex issues regarding their use in athletes. Recreational drugs can have ergolytic effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

Dietary supplements for improving body composition and reducing body weight: where is the evidence?

Author: ManoreMelinda M

Modest weight loss
Reduced weight gain
Adverse side effects
No significant weight loss

Weight-loss supplements often lack strong research evidence for significant weight loss, especially in the long term. Some supplements, such as green tea, fiber, and calcium supplements, may complement a healthy lifestyle for modest weight loss or prevention of weight gain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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