Ephedra Dangers Taught in Traditional Herbal Training

The Chinese medicine herb, ephedra (ma huang), has been misused by the supplement industry and misunderstood by both the press and biomedical community. The February 17th death of Orioles pitcher Steve Bechler brought national attention to both the risks of inappropriate ephedra usage and the dangers of an under-regulated supplement industry.

The use of ephedra for energy, athletic performance, or weight loss is not traditional. Chinese Medicine employs ephedra for asthma, coughing, wheezing, and the common cold. Ephedra played an essential part in the first systematic chinese herbal text, “On Cold Damage,” written around 200 A.D. by Zhang Zhong-Jing.

Ephedra‚s dangers are well-documented in the traditional Chinese medical literature. According to Dan Bensky’s “Chinese Herbal Medicine: Materia Medica,” a standard academic textbook, ephedra may raise blood pressure or cause restlessness and tremors.

Like most Chinese herbs, ephedra is always prescribed within an herbal formula. The combination of herbs typical to chinese medicine allows gentler herbs to moderate harsher ones. Even so, Bensky’s “Formulas & Strategies,” says that the classic formula, “Ephedra Decoction” is contraindicated for weak patients with copious urination, patients prone to bleeding, and should be used with caution in cases of high blood pressure. These texts are studied by all chinese herbal students. The herbal combinations marketed by supplement companies are not traditional formulas.

Herbalists trained and licensed to prescribe chinese herbs such as ephedra usually attend 3-4 years of Traditional Chinese medicine college, graduate with a Masters degree, and pass minimum competency exams for licensing. Profiles of colleges that teach Chinese medicine are available from the Council of Colleges of Acupuncture and Oriental Medicine (www.ccaom.org/ or 301-313-0868).

Licensure that ensures competency in chinese herbs is regulated nationally by the National Certification Commission for Acupuncture and Oriental Medicine (www.nccaom.org/ or 703-548-9004).

Each state has its own laws regarding the prescription of herbs. Some individual states have their own competency tests with even higher standards. For example, in California, both herbal and acupuncture competency are tested before an acupuncture license is awarded. See the California Acupuncture Board at http://www.acupuncture.ca.gov/index.html or 916-263-2680.