Ephedra sinica (often referred to as “ephedra” or “ma huang”) is a plant that contains several substances called “ephedrine alkaloids,” which include ephedrine and pseudoephedrine. Ephedra is neither safe nor legal as a dietary supplement. FDA concluded in 2004 that all dietary supplements containing ephedra alkaloids pose a risk of serious adverse health events (heart attack, stroke, and death), and FDA issued a final rule stating that dietary supplement products containing ephedrine alkaloids cannot be legally sold or marketed in the United States.
Why should consumers still be cautious, especially those in the military?
Ephedra and its alkaloids are still legal in some countries, and many dietary supplement products—usually supplements for weight loss—containing this dangerous ingredient are available from online retail websites. Some supplements contain “ephedra extracts” but do not contain ephedrine alkaloids, so these can be sold legally in the U.S. However, without laboratory testing, it is impossible to know whether a product that lists “ephedra,” “ephedra extract,” or the like on its label contains any ephedrine alkaloids. Military Service Members should be especially careful when considering any dietary supplement claiming to contain ephedra or its alkaloids, because they are on the OPSS list of DoD-prohibited substances.
For more detailed information, you can read the NIH fact sheet. For background information about ephedra’s legal status, read FDA's Guidance for Industry: Final Ruling Declaring Dietary Supplements Containing Ephedrine Alkaloids Adulterated...
Updated 11 January 2021