"Lose weight fast", "thermogenic fat burner", "rapid weight loss", these are just a few of the guarantees that manufacturer's are using to promote the now widely used and highly controversial dietary supplements containing ma haung (ephedra). Sounds great; a simple way to stimulate weight loss and increase energy, can this really work or are these companies suggesting the impossible?

Ma Huang, or ephedra sinica, is an ancient Chinese herb indigenous to temperate climates, in northwestern India, Pakistan, Mongolia and China, usually on sandy seashores. The plant dates back to 5,000 years ago as a medicinal agent for asthma and hay fever, quite possibly making it the world's oldest medicine (Gurley, Gardner, White et al., 1998). In 1923, scientists discovered that the plant has two active ingredients: ephedrine (EPH), and pseudoephedrine (PSE); the central nervous system stimulants. Ephedrine is a sympathomimetic alkaloid agonists that causes cardiac stimulation and vasoconstriction, which may produce short term increases in blood pressure and heart rate, insomnia, vertigo, madras's, and nervousness. Pseudoephedrine, also an agonist, enhances bro

· Reduce dosage if undesirable side-effects occur, and discontinue use entirely if they persist. This includes, but is not limited to, headache, nervousness, sleeplessness, anxiety, nausea, and prostate or urinary problems.

· Remember that ephedra works best when taken on an empty stomach. The best time to take it is one hour before meals. Ephedra can also cause nausea in some people with taken with food.

In conclusion, herbal dietary supplements, especially those containing ephedra, have taken the American health care system by storm. These products are raising enormous worries in the medical community due to the growing problem of toxicities associated with ma huang. Can it be believed that these so-called natural supplements are safe alternatives or enhancements for energy and weight loss? Until proposed regulatory restrictions on botanical ephedra are enforced, moderation and caution should be stressed when using any dietary supplements containing ma huang.

· Ephedra should not be used during pregnancy or lactation or by individuals with high blood pressure or those suffering from blood sugar, thyroid, or prostate problems or with glaucoma. Do not take if currently taking or have recently taken MAO inhibitor drugs. If taking prescription drugs check with your doctor before taking ephedra.

· To prevent interference with sleep, don't take ephedra too late in the day. This is particularly true when caffeine is also used.

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