Talk:Ephedra (medicine)

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Why does this page exist? Merge suggestion[edit]

This is a USA-specific article about legislation and health concerns in USA, concerning a chemical compound known as Ephedrine. It is specifically not about the plant Ephedra although the page bears that name (misleading). Why have a page on Ephedrine titled Ephedra ? - these two are not the same!

Additionally, it is misleading to have a USA-centric page dealing with USA-specific information, and not being labelled as such. AFAIK, the English-language Wikipedia is not an American Wikipedia, but an international one. USA-specific standards on various matters are often just that; USA-specific. I suggest merging this page with Ephedrine#United States. clsc (talk) 18:50, 18 December 2016 (UTC)[reply]

Ephedra was never banned! (Only ephedrine alkaloids were -- See Reference #10)[edit]

The fact is that ephedra was never banned by the FDA or anyone else. In the ephedra wikipedia article, reference #12 is titled

12. ^ a b FDA Statement on 10th Circuit Court's ruling to uphold ban of ephedra That title is false and misleading. If you actually click on that reference and read it, the word "ephedra" never appears anywhere on the page. It refers to "ephedrine alkaloids."

As I tried to point out in my attempt to edit the ephedra article (that was removed by an overzealous editor), reference #10 is the actual text of the FDA ban on ephedrine alkaloids:

10. ^ a b FDA Final Rule Banning Dietary Supplements With Ephedrine Alkaloids Becomes Effective. Accessed from FDA website 7 Feb 2007.

That reference links to: http://www.fda.gov/bbs/topics/NEWS/2004/NEW01050.html which is the actual text (on the FDA's website) of the ban.

Thank goodness the overzealout editor that mercillessly butchered my corrections of fact didn't remove reference #10 (that I added) that contains the actual text of the FDA's ban on ephedrine alkaloids.

As written, the ephedra article still has many absolutely false statements, mostly confusing ephedra with ephedrine alkaloids, and therefore does a great dis-service to consumers who have a right to know that ephedra is legally available.

Being new to Wikipedia, I don't know how to persuade the anonymous editor(s), who apparently never bothered to read the FDA ban I cited when they demolished my edits.

Moreover, the fact is that only dietary supplements containing ephedrine alkaloids have been banned. In other words, all other ephedra-based products, including even prescription pills that contain ephedrine alkaloids, have always been and still are 100% legal.

What do I need to do to get this corrected? I've already provided absolute proof of my assertion by citing #10, the FDA's own text from their own website.

Ithe interest of full disclosure, I'd add this. The FDA did create some confusion in some text that appeared as commentary on their website that used the terms "ephedra", "ephedrine alkaloids," and even "ephedra alkaloids" interchangeably. At the time, that may have made some sense because then all ephedra-based dietary supplements contained ephedra alkaloids, which is no longer true, as I tried to point out. However, it should be noted that the commentary does not have the force of law (in other words, it's just talk), but the Final Ruling that I cited in reference #10 does.

Finally, in the interest of full disclosure, in my edits, I referred to a proprietary (product-oriented) website and was more or less accused of spamming. My intention in referring to that web page was that the author of that information, Todd Crowley is an attorney who has practiced regulatory law in cases involving the FDA and the FTC and is a nationally recognized expert on ephedra.

I would appreciate any help regarding how to get all the factual mis-statements corrected without having the corrections removed by an overzealous editor without reading the FDA citation. —Preceding unsigned comment added by Rubirich (talk • contribs)

I believe most of the terms of abuse in your post are directed at me. That being the case, let me aver that I have read the FDA statements, and in fact was the editor who added many of them to this article. As you note, the FDA (and virtually all other reputable sources) use the terms "ephedra" and "ephedrine alkaloids" interchangeably in the context of dietary supplements. This is because ephedrine alkaloids are the main and active component of ephedra supplements, producing the supplement's advertised effects.

I think the best way forward might be to provide reliable sources attesting to the sale of "legal" ephedra supplements. If you're in doubt as to what constitutes a reliable source, check our guidelines, bring a source here to the talk page, or ask at the reliable sources noticeboard. Since any "ephedra" supplement lacking ephedrine alkaloids would presumably have absolutely no effect of any sort, I'm not personally clear on what is being discussed here, but reliable sources should clear that up.

Finally, it's most useful if you can maintain a slightly more civil tone and avoid personally attacking other editors. If you'd like outside review, please peruse our dispute resolution pathway for advice on the existing mechanisms. MastCell Talk 23:51, 31 October 2008 (UTC)[reply]

As I pointed out, the only FDA "statement" that has the force of law is the Final Ruling cited as reference #10, which clearly states that ephedrine alkaloids are the subject of the ban. There is no mention whatsoever of ephedra anywhere in the ban. Despite various informal discussions of the fact that consideration was given to banning ephedra, nowhere is there any documention that ephedra has ever been banned, because it was never banned, as I previously pointed out.

The fact that in its informal discussions, the FDA used the terms ephedra and ephedrine alkaloids interchangeably, doesn't alter the fact that the FDA was careful in writing its Final Ruling (the official ban which I cited in Reference #10) to restrict the language to the specific term "ephedrine alkaloids."

Moreover, Reference #12 is inaccurately titled with a reference to a ban on ephedra, despite the fact that the term ephedra appears no where within the material referred to, so there is no basis for including the term "ephedra" in the reference title: "12. ^ a b FDA Statement on 10th Circuit Court's ruling to uphold ban of ephedra" In fact, within the cited text, the actual title is "FDA Statement on Tenth Circuit's Ruling to Uphold FDA Decision Banning Dietary Supplements Containing Ephedrine Alkaloids" and there is not one single mention of ephedra anywhere to be found within the text.

The editor's claim that "ephedrine alkaloids are the main and active component of ephedra supplements" is false and unsupported by any actual facts. Ephedra has other important ingredients. Moreover some ephedra supplements contain other important and active ingredients, such as green tea, quercetin, trimethylglycine, yohimbine, and octopamine, to name a few.

The editor's assention that 'Since any "ephedra" supplement lacking ephedrine alkaloids would presumably have absolutely no effect of any sort' is ludicrous and patently false. Clearly an ephedra supplement containing ephedra, green tea, quercetin, trimethylglycine, octopamine, and yohimbine, would have a slew of positive effects.

There is no need for further sources to verify that ephedra was never banned; and that the sale of ephedra is legal; The FDA ban itself is quite explicit on this point. Moreover, as I pointed out, even ephedra alkaloids in pill form remain legally available by prescription. The article is not very clear about the fact that only dietary supplements containing ephedrine alkaloids were ever banned.

Finally, the article fails to make clear that the lawsuit brought by the Nutraceutical Corporation was only brought because their product did contain ephedrine alkaloids. The articles implies that the lawsuit to reverse a ban on all ephedra-based products, which was never necessary since ephedra was never banned.

Consider this to be my attempt at informal resolution, which the Wikipedia rules require before I am entitled to pursue formal resolution. —Preceding unsigned comment added by Rubirich (talk • contribs) 15:17, 2 November 2008 (UTC)[reply]

The marketing claims genreally made by ephedra supplements - stimulant and weight-loss properties - are mediated by ephedrine alkaloids. An "ephedra" supplement which does not contain these alkaloids would not be expected to have any such effects, to the best of my knowledge. If I'm wrong, please provide a reliable source that I can use to educate myself.

The use of the term "ephedrine alkaloids" by the FDA was intended to broaden the scope of the rule - meaning that it applies not only to substances marketed under the name "ephedra", but to any supplement blend containing these substances even if marketed under a different name.

I'm not particularly impressed with this "attempt at informal resolution", since you have yet to provide anything resembling a reliable source on the topic of so-called "ephedrine-free ephedra". Do such sources exist? If there are reliable, independent sources indicating that the herbal industry is using this loophole to market "ephedra" supplements which lack the active ingredients, then perhaps it would be worthy of inclusion in an encyclopedia, but I'm not seeing such sources. MastCell Talk 21:02, 2 November 2008 (UTC)[reply]

Sources[edit]

In lieu of waiting for others to produce sources, I've collected a few on the topic of "ephedrine-free" ephedra. It appears that bitter orange was substituted for ephedra by the herbal industry when the adverse event reports started piling up and ephedra was banned. Bitter orange contains synephrine, a stimulant closely related to the ephedrine alkaloids and with the same type of side effects. Am I correct in understanding that "legal" ephedra refers to supplements containing bitter orange rather than ephedra? In any case, here are relevant sources:

  • Ephedra Facts: Ephedra in the market place ~~Ephedra —Preceding unsigned comment added by 96.239.90.70 (talk) 15:58, 2 April 2009 (UTC)[reply]
  • Medical News Today: Although their effectiveness remains unclear, many products containing bitter orange are being promoted as "Ephedra/ephedrine free," since the use of Ephedra has been restricted in Canada and prohibited in dietary supplements in the United States3 owing to adverse cardiovascular and cerebrovascular reactions.
  • USA Today: Law lets risky stimulants take ephedra's place
  • New York Daily News: Bitter Orange has the same effect as the stimulant ephedra and is already replacing the controversial substance in dietary supplements... Companies... market an "ephedrine-free" version [containing bitter orange]. It is a deceptive piece of advertising, according to Bill Gurley, a professor of pharmaceutical science at the University of Arkansas.
  • New York Times: Bitter orange peel was one often mentioned [as a replacement for banned ephedra], because it is the main ingredient in many products marketed as "ephedra free." Bitter orange peel, weight-loss specialists warn, may be as dangerous as ephedra.
  • L.A. Times: Years of bad publicity over health problems linked to ephedra led many supplement companies to develop alternative products that are marketed in health food stores, gyms and over the Internet as "ephedra-free." Among the most popular are herbal products containing bitter orange, which is chemically similar to ephedra.
  • San Diego Union-Tribune: Pressured by flagging sales, litigation and regulatory scrutiny, many leading ephedra companies had already dropped ephedra from their herbal mixes. Many substituted alternative herbs such as citrus aurantium, popularly known as bitter orange. Bill Gurley, a professor of pharmaceutical sciences at the University of Arkansas, said bitter orange is chemically similar to ephedra, and could pose similar health risks.
  • Fox News: Ephedra-free weight loss supplements aren't risk-free, a study in humans shows.
  • L.A. Times again
  • Science Daily: 'Ephedra-free' Dietary Supplements Pose Potential Health Risks.
  • National Center for Complemetary and Alternative Medicine: "Many herbal weight-loss products now use bitter orange peel in place of ephedra. However, bitter orange contains the chemical synephrine, which is similar to the main chemical in ephedra. The U.S. Food and Drug Administration banned ephedra because it raises blood pressure and is linked to heart attacks and strokes; it is unclear whether bitter orange has similar effects. There is currently little evidence that bitter orange is safer to use than ephedra."
  • PMID 16610576: Bitter orange is now being used as a stimulant in "ephedra-free" weight-loss supplements but was recently implicated in adverse cardiovascular sequelae.
  • PMID 15497209: Suspected adverse events from "ephedrine-free" supplements

Bottom line appears to be that the supplement industry has largely replaced ephedra with other stimulants, particularly bitter orange, and marketed these products as "legal" ephedra or "ephedrine-free". These products contain stimulants closely related to ephedra, though not covered under the FDA ban, and in the opinion of experts they are untested and possibly share the same serious risks as ephedra.

Thank you to the IP and Rubirich (talk · contribs) for bringing this aspect of ephedra to my attention; given the wealth of independent, reliable secondary sources, I now agree that the switch to untested non-ephedra stimulants, as a response to the FDA ban, warrants some mention here. MastCell Talk 05:17, 3 November 2008 (UTC)[reply]

Additionally: PMID 15819293 and PMID 18700609, ischemic stroke associated with "ephedrine-free" supplements. See also PMID 16164886, referenced above. PMID 17165643: ischemic colitis associated with ephedrine-free supplements. Point being that these are many of the same safety signals seen with ephedra. MastCell Talk 06:24, 3 November 2008 (UTC)[reply]
Additional refs on "ephedra-free" products: PMID 17126636, PMID 15657116. MastCell Talk 06:31, 3 November 2008 (UTC)[reply]

European/Asian Use[edit]

The article does not cite the European and Asian usage of ephedra. Was international use omitted because it does not fit the authors bias regarding ephedra?

The article itself is clearly one-sided and biased against ephedra, and a more balanced writeup that isn't anti-ephedra should be undertaken. A biased article is not a credible article! It is clear that the author/editor does not approve of ephedra, but one person's constructed opinion is not what this reader wanted in an epedra article. Truth, please! —Preceding unsigned comment added by 98.71.195.26 (talk) 07:19, 17 April 2009 (UTC)[reply]

I think that the lack of global perspective is a failing of the article as currently written. It focuses largely on ephedra as a dangerous and sometimes lethal dietary supplement in the US. That's certainly part of the story, and an important part. On the other hand, it would be useful to have some well-sourced material on the usage and regulation of ephedra elsewhere in the world. Do you know of any reliable sources covering those topics? If so, let's work them into the article. MastCell Talk 16:50, 17 April 2009 (UTC)[reply]

== heres another source for Ephdra alkoloids not mentioned in article ==Sida Cordia folia is also a source of Ephedra alkolods .Not just Ephedra sinenis etc. Maybe a mention of this plant? Also, its use in Ayuvedic Indian medicne?Thanks!JANUSROMA (talk) 00:15, 9 August 2009 (UTC)[reply]

Evidence supporting proper ephedra use as safe and effective[edit]

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=15356670&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=15292480&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11319627&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16552410&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=15730434&ordinalpos=137&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum (statistical test dubious?) —Preceding unsigned comment added by Chalupa987 (talk • contribs) 08:37, 5 September 2009 (UTC)[reply]

Ephedra is not banned[edit]

This article is extremely misleading. Ephedra is not banned. I just bought some today. Not to mention Ephedra Extract is still widely available in the US.

Proof: http://www.bmfhardcore.com/exn.html Dumaka (talk) 01:43, 11 December 2009 (UTC)[reply]

I was able to purchase is also at http://www.thatswholesale.com and at http://www.ephedrawholesale.com Why are my references for sites where to get ephedra get removed but the one from Dumaka do not? Any good reasons for it? 69.86.215.59 (talk) 21:57, 12 February 2010 (UTC)ecastacker[reply]

The FDA issued a rule prohibiting the sale of dietary supplements containing ephedra, as the sources in the article make clear. Regarding your link, please see our guidelines on reliable sources. The fact that one can buy something over the Internet is not proof of its legality, to say the least. MastCell Talk 06:47, 11 December 2009 (UTC)[reply]
Ephedrine alkaloids were banned not Ephedra. It's available in stores. I have a bottle from the GNC sitting on my desk as we speak. Your links are outdated and it should be update. Most of them date back 2 years ago. Ephedra Extract is still available in the US. This entire article is wrong. And by the way, the way you are promoting bitter orange in this article is just plain POV. But it doesn't even matter, this article can say anything it wants; that doesn't stop the fact that Ephedra is still being sold and is still available legally.Dumaka (talk) 11:39, 11 December 2009 (UTC)[reply]
Please, explain to me the difference between "ephedra" and "ephedrine alkaloids". Ephedrine alkaloids are the active constituents of ephedra, and are responsible for any biological effects that it has. If someone is selling "ephedra" that lacks ephedrine alkaloids, then either a) they have removed the active part of the herb, b) they are actually selling bitter orange or some other "ephedrine-free ephedra", or c) they are mistakenly or intentionally violating the ban on dietary supplements containing ephedrine alkaloids.

The point of the section on "legal ephedra" is to address exactly this sort of misconception. Such supplements do not actually contain ephedra - they contain other herbal stimulants which are not banned, such as bitter orange, but they are marketed with the word "ephedra" in the title because it moves product. MastCell Talk 18:25, 11 December 2009 (UTC)[reply]

re: Please, explain to me the difference between "ephedra" and "ephedrine alkaloids": I can do that, it's quite straightforward and simple: Ephedra is a plant (biology) and Ephedrine is a chemical (chemistry). clsc (talk) 19:10, 18 December 2016 (UTC)[reply]

Neandertal use[edit]

Homo Neandertalis (sp?) was one of the earliest users of Ephedra known to us now. It was found, among other plants commonly used for herbal remedies later, at a burial site at "Shanidar" which naturally predates the use by the Chinese. Since there is a brief explanation of its historical use, it might be worth mentioning this fact.--Senor Freebie (talk) 03:13, 11 December 2009 (UTC)[reply]

Ephedra is no longer banned. Will someone please correct the article?[edit]

I came to this article to learn about ephedra and was surprised to find inaccurate information.

Ephedra is no longer banned. I believe that was overturned. It is possible to buy ephedra at many online sites. (Just google "buy ephedra" to see.) It is also possible to buy the originating herb, ma huang. So the article is inaccurate by informing us that ephedra is (still) banned. I am new to Wikipedia as a poster, and I hope someone will correct that article. Maybe I will try to eventually.

Brygivrob (talk) 10:54, 24 December 2009 (UTC)brygivrob[reply]

No, the sale of dietary supplements containing ephedrine alkaloids remains illegal in the US. The ban was most recently challenged and upheld several years ago. If that's changed, it would certainly be newsworthy - please provide a reliable source indicating that the ban has been overturned. Just because something is advertised for sale on the Internet does not mean that it's legal. Alternately, a lot of products advertise themselves as "legal" ephedra; as our article makes clear, these do not contain ephedrine alkaloids, but rather other, less well-studied herbal stimulants like bitter orange. MastCell Talk 19:02, 24 December 2009 (UTC)[reply]
Hey Brygivrob, don't even bother. MastCell is on a campaign to keep people misinformed about Ephedra and to promote bitter orange. He somehow thinks that he OWNS this article, so any information added or deleted from it will be reverted by him instantly. It would be wise to just ignore this article. Dumaka (talk) 16:29, 29 December 2009 (UTC)[reply]
If you think I'm on a campaign to promote bitter orange, then I'm doing a spectacularly bad job of promotion. Or maybe you're mistaken about my motivations - that happens sometimes when you rely on ad hominem arguments. Anyhow, if you feel strongly that I'm being unreasonable, please take a look at Wikipedia's dispute resolution pathway. MastCell Talk 20:29, 29 December 2009 (UTC)[reply]


No, ephedrine alkaloids which is the natural form of ephedrine as opposed to the synthetic ephedrine hcl is not illegal. Ephedrine Alkaloids can be used in traditional Chinese and Ayurvedic medicine. There are 5 categories in the Controlled Substance Act passed by Congress and ephedrine is not listed. Something that is banned does not mean it is illegal. You can do an online search under "ephedra wholesale" and you can find the real ephedra, ma huang and sida cordifolia with the active ingredient Ephedrine Alkaloids being sold. Beware of companies selling fakes called Ephedra Extract, Ephedra Nevadensis or Ephedra Viridis. Those lack the Ephedrine Alkaloids and are useless. Parents ban their kids from being out in the street late at night but they sneak out anyways. If there was a curfew then it would be illegal to be out and violation could mean jail/fine or both. See the difference now? 69.86.215.59 (talk) 22:07, 12 February 2010 (UTC)ecastacker[reply]

International Journal of Obesity Studies[edit]

Universities well known Internationally in the field of nutrition have performed various studies. Normally, medical doctors have little training in the field of nutrition and prevention of disease. MD's certainly are very knowledgeable in dealing with the diseases.

In that regard, these scholarly sources should not be ignored by the amateur Wikipedia gate keepers and one would hope their viewpoint would be greatly considered along with their “professional” literature due to the obesity crisis. It is certainly unfortunate that readers get a one sided view of ephedra when it has been successfully used by millions of people for over 5,000 years with incidents not even remotely comparable to the side effects of many Pharmaceutical drugs. For example, here is one study by professionals: http://www.nature.com/ijo/journal/v30/n10/abs/0803283a.html.

Many of these professors set on the scientific and medical advisory boards of corporations that actually create helpful products in the wellness and nutrition industry and would strongly disagree with the contents of this article on ephedra.

It is indeed unfortunate that journalistic school children are controlling the minds of readers while educated professionals and their work are totally ignored. —Preceding unsigned comment added by 72.192.99.90 (talk) 02:50, 13 February 2010 (UTC)[reply]

One reference seems to give 404 not found error[edit]

The reference at item 5 or 6 or 7 or whatever that appears as follows:

^ "National Center for Complementary and Alternative Medicine Consumer Advisory on ephedra". 2004-10-01. Retrieved 2007-02-13.

when clicked, gives a NOT FOUND error on the target web server for that organization.

Can someone locate where that document has moved, then update the article text to fix this? Oldspammer (talk) 05:13, 19 May 2011 (UTC)[reply]

I found it I think: http://nccam.nih.gov/news/alerts/ephedra/consumeradvisory.htm
was that it? Oldspammer (talk) 05:28, 19 May 2011 (UTC)[reply]

5000 years[edit]

I've marked the 5000 years as unreliable because I would expect a history source, not a medical source for that claim. There appears to be some nuance that is being lost from the source as well. (they note a 3k gap between one emperor looking at it, and then it resurfacing much later). They cite some sources if someone wants to go a hunting. Otherwise I will soon. IRWolfie- (talk) 23:12, 10 April 2013 (UTC)[reply]

Ephedra[edit]

This is a truly amazing plant, it has such a great history! — Preceding unsigned comment added by 123.211.7.97 (talk) 03:24, 31 August 2014 (UTC)[reply]

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Requested move 4 November 2021[edit]

The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.

The result of the move request was: moved. I will move the page shortly after fixing the links. Regards, —usernamekiran • sign the guestbook • (talk) 10:15, 16 November 2021 (UTC)[reply]

Ephedra → Ephedra (medicine) – No clear primary topic, the plant genus and this article are about neck and neck in terms of pageviews [1]. Feel free to suggest a more appropriate disambiguator. Hemiauchenia (talk) 23:08, 4 November 2021 (UTC)[reply]

I've also created a dab at Ephedra (disambiguation) which can be moved. If somehow it's decided one of the two is primary, it can be deleted. ASUKITE 02:20, 13 November 2021 (UTC)[reply]
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
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