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This week’s article will address the recent concern in the news with Ephedra. However, there are other substances on the market which could get confused with Ephedra.

My purpose here is to share with you the facts behind these items which will give you more information to make better health decisions.

The first section will discuss the substances and common uses and the next section will discuss other options these.

First off to clarify these items Ephedrine and Pseudoephedrine are closely related drugs. Whereas, Ephedra is an herb; and is the plant from which ephedrine was originally isolated. Ephedra—also called ma huang—is used in many herbal products, including supplements promoted for weight loss.

It is important to note that just because something is an herb does not mean it should not be used with caution and know that is does have a pharmacological effect on the body. Herbs are quite powerful.

I have been using herbs in my office for nearly twelve years and have spent hundreds of hours in the study of their use.

The most common reaction to this drug is insomnia and nervousness. Also, included are Dizziness, headache, lightheadedness, heartburn, loss of appetite, altered taste sensation, restlessness, anxiety, nervousness, trembling or sweating, increased blood pressure, chest pain, palpitations, vomiting or breathing difficulties may also occur and should be immediately reported.

Precautions: Tell your doctor if you have heart disease, high blood pressure, an overactive thyroid gland, epilepsy or diabetes. Tell your doctor if you ever had a bad reaction to bitolterol, ephedrine, epinephrine, metaproterenol, phenylephrine, phenylpropanolamine, pseudoephedrine, or terbutaline. Many nonprescription products contain these drugs (e.g., diet pills and medication for colds and asthma), so check the labels carefully. Do not take any of these medications without consulting your doctor (even if you never had a problem taking them before). Do not allow anyone else to take this medication. Before you use this drug, tell your doctor if you are pregnant or breast-feeding. This drug should not be used unless clearly needed if you are pregnant. For information on Medic Alert(TM) call 1-800-854-1166. In Canada call 1-800-668-1507.

Additionally this drug will interact with Ephedra and can be quite hazardous.

Pseudoephedrine

Generically this is known as Pseudoephedrine HCl. This drug is most often used for relief from nasal or sinus congestion caused by allergies or the common cold, or ear congestion caused by inflammation or infection.

Ephedra is a shrub-like plant found in desert regions throughout the world. It is distributed from northern China to Inner Mongolia. The dried green stems of the three Asian species (Ephedra sinica, E. intermedia, E. equisetina) are used medicinally. The North American species of Ephedra, sometimes called Desert Tea or Mormon Tea, does not appear to contain the active ingredients of its Asian counterparts.

Historical or traditional use: The Chinese have used Ephedra medicinally for over 5,000 years. Ephedra is listed as one of the original 365 herbs from the classical first century A.D. text on Chinese herbalism by Shen Nong. Ephedra’s traditional medicinal uses include the alleviation of sweating, lung and bronchial constriction, and water retention. Coughing, shortness of breath, the common cold, and fevers without sweat are all indications for its use. While its active constituent, ephedrine, was isolated in 1887, the herb did not become popular with U.S. physicians until 1924 for its bronchodilating and decongesting properties.

Active constituents: Ephedra’s main active medicinal ingredients are the alkaloids ephedrine and pseudoephedrine. The stem contains 1–3% total alkaloids, with ephedrine accounting for 30–90% of this total, depending on the plant species. Both ephedrine and its synthetic counterparts stimulate the central nervous system, dilate the bronchial tubes, elevate blood pressure, and increase heart rate. A synthetic form of pseudoephedrine is a popular over-the-counter remedy for relief of nasal congestion. Little research has been done on the whole plant (compared to its isolated alkaloids) for any condition.

How much is usually taken? The crude powdered stems of Ephedra (with less than 1% ephedrine) are used at 1.5–6 grams per day, taken as a tea. The crude herb can also be taken in capsule or tablet form, at 500–1,000 mg of Ephedra two to three times daily. Tinctures of 1–4 ml three times per day can be taken. Alternatively, standardized extracts supplying 12–25 mg of total alkaloids (calculated as ephedrine) per capsule or tablet may be taken two to three times daily. This form may be preferable for monitoring total daily intake of ephedrine.

CAUTION: I do not recommend taking this or any other similar herbs without the assistance of health care provider.

Ephedra has a long history of safe use at the recommended amounts. However, abuse of Ephedra (and particularly ephedrine)—especially for weight loss or as a recreational drug—can lead to amphetamine-like side effects, including elevated blood pressure, rapid heart beat, nervousness, irritability, headache, urination disturbances, vomiting, muscle disturbances, insomnia, dry mouth, heart palpitations, and even death due to heart failure. One study has shown that a single application of Ephedra caused mild elevation of heart rate but did not consistently affect blood pressure in otherwise healthy adults. When taken at higher levels, Ephedra can cause drastic increases in blood pressure, as well as cardiac arrhythmias. Ephedrine is considered potentially habit-forming, though it is unclear if the whole herb Ephedra is likely to have the same effect. Long-term (months or more) overdose of Ephedra or ephedrine can potentially cause kidney stones composed of ephedrine, though this is rare. A review of 140 reports of heart and nervous-system emergencies concluded that one-third of the adverse health reports were “definitely or probably related” to Ephedra and another one-third “possibly related.”9 All of the cases cited were people taking Ephedra together with either caffeine and/or drugs with known cardiovascular side effects, such as theophylline and phenylpropanolamine.

Anyone with high blood pressure, heart conditions, diabetes, glaucoma, hyperthyroidism, anxiety or restlessness, impaired circulation to the brain, benign prostatic hyperplasia with residual urine accumulation, pheochromocytoma (primary adrenal tumor), and those taking MAO-inhibiting antidepressants, digtoxin, or guanethidine should consult with a physician before using any type of product containing Ephedra. Pseudoephedrine can cause drowsiness and should be used with caution if driving or operating machinery. Ephedra-based products should be avoided during pregnancy and breast-feeding and should not be used in children.

The conditions listed in this article can all be handled with methods that are much safer than the substances listed herein. Every person is as unique on the inside as he or she is on the outside.

The primary use for Ephedra was for weight loss. Our weight loss program has an paralleled track record and will not only insure healthy weight loss but will also help you to change your habits and keep the weight off for good.

Dr. Bradley Shapero
Premier Health Care - A rapidly expanding state of the art health care facility helping
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