Nature: acrid, warm

Enters: Lung, Bladder

Actions: Promotes sweating (opens the pores); relieves asthma; promotes urination; disperses/moves Lung Qi and encourages it to descend.

Indications:

• Wind-cold invasion: aversion to cold, no sweats, etc. – specifically Taiyang.
• Wind-cold in the Lung obstructs Qi: cough, asthma.
• Edema with exterior syndrome (heat or cold).
• For externally-contracted or internally-generated wheezing.
• Ma huang opens the pores, but does not supply the sweat (combine with Gui zhi, which reaches the heart, the mother of sweat).
• Beneficial for urinary retention due to Lung Qi deficiency, where the Lungs lack the energy to descend fluids to the bladder.
• To mitigate its diaphoretic function, combine with astringent herbs, Qi tonics, or cool herbs.
• Anti-viral (influenzas); bronchodilator; vasoconstrictor, raises blood pressure (mild but prolonged).
• Not for breathing problems due to failure of the kidneys to grasp Lung Qi.
• Traditionally prepared by decocting it first and removing the foam on the surface of the water before adding other ingredients.
• American species (Mormon Tea / Brigham Tea) may be decent, though weaker, substitutes.
MLT: Of the world’s ephedra species, Chinese has the most ephedrine and pseudoephedrine, especially between the joints of the stem. The best quality Ma huang has the joints removed.
PFGC: Shen Nung says it can break up masses and accumulations; it can reach the surface and also penetrate deeply into pockets of accumulated phlegm and coagulated blood, especially in combination with materials to eliminate masses and transform stasis
• By its entry into the Taiyang bladder, it can also enter the Shaoyin kidney and treat Shaoyin syndrome.
• Can treat pustules, skin ulcerations, stubborn skin disorders of the Yin (cold) type.
• The foam that collects on the water when Ma huang is cooked is too intense a diaphoretic and should be removed.
• People in cold areas with thick skin and muscles may need a larger dose to induce sweating.
DY: This is one of six medicinals which have been traditionally aged for the purpose of reducing secondary effects and reinforcing their therapeutic actions. Generally, the longer it is kept, the more efficient.
• The nodes of the stem (Ma huang jie) have an anti-diaphoretic action (like the root). For most effective diaphoresis, the knots should be removed.
• With Gui zhi to mutually reinforce each other’s floating and dispelling characteristics, to effectively open the pores, strongly promote perspiration, resolve the muscle layer, and scatter wind-cold of the excess type. Gui zhi communicates with the constructive division [Ying] where it moves fluids. It brings these fluids to the exterior where Ma huang pushes them outward forcefully. See Gui zhi in this category for specific indications of this combination.
CHA: (Karen S. Vaughan) Honey fried Ma huang: The high heat in frying releases the essential oils in the joints of the Ma huang which would otherwise prevent sweating. (Smashing the joints and allowing the oils to escape would have a similar effect, but without honey’s properties.) Honey frying makes Ma huang less warming (which may seem counterintuitive) because the oils are freed. (The Shang Han Lun suggests using node-free Ma huang to promote sweating.)
K&R: Sympathomimetic, diaphoretic, vasoconstrictor, bronchodilator, adrenal medulla stimulant, volumetric diuretic.
Wood, fire, metal, and water deficiency, water excess.
Also for cardiac disorders – hypotension, bradycardia.
FDA: Contraindicated in heart disease, hypertension, thyroid disease, diabetes mellitus, difficult urination with enlarged prostate, or with antidepressants
Yoga: Somalata: K-; P+; V+ (in excess)
• Powerful Kapha reducer; lymph cleanser.
• Rajasic – can overstimulate the adrenals and burn out the nerves.
IBIS: Affinities: respiratory tract, urinary tract.
• Actions: Sympathomimetic, Bronchodilator, Decongestant, Central stimulant, Hypertensive, Diuretic, Sudorific, Anti-rheumatic.
• [Western] dosage: Tincture : (1:4) 2.5 ml T.I.D.; Decoction of Dried herb : 600 mg – 1500 mg per cup, 3 cups per day; Maximum Recommended Doses: UK: (Schedule III restricted): 600 mg herb single dose. USA: (FDA recommended) 8 mg single dose, 24 mg total daily as ephedrine alkaloid. Commission E: 15-30 mg single dose as ephedra alkaloid up to max. 300 mg daily as ephedrine alkaloid. Children – Not recommended under 13 years. 2 mg alkaloid /Kg body weight maximum dose.
• Internal: Asthma, hay fever, urticaria, hives, emphysema, nocturnal eneuresis, narcolepsy, febrifuge, rheumatism, myasthenia gravis, edema, rheumatic conditions.
• External: Allergic skin irritations, insect bites and stings.
• Specific Indications: Allergic rhinitis, congestion due to sinusitis, coryza or asthma.
Pharmacology:
• Ephedra is indirectly sympathomimetic, causing epinephrine release and thus non specific adrenergic receptor agonism. Ephedrine is predominantly alpha adrenergic, pseudoephedrine is predominantly beta adrenergic (Mills, 1991). Ephedrine is well absorbed by the oral route, crosses the blood brain barrier easily, and has a half life much longer than epinephrine being resistant to MAO and COMT degradation; excretion is urinary. The whole herb is not identical to isolated ephedrine because of the pharmacodynamics of pseudoephedrine and other components; in addition there are pharmacokinetic differences between the whole herb and isolated ephedrine (Mills, 1991; White, 1997; Gurley, 1998).
• Alpha and beta adrenomimetic effects: peripheral vasoconstriction, skeletal muscle vasodilation, positive inotropism, potentially hypertensive, sudorific, tachycardic, bronchodilator, mydriatic, urogenital tract stimulant and relaxant, decreases visceral muscle motility, increases viceral sphincter tone lipolytic, thermogenetic, hyperglycemic, diuretic.
• Central stimulation: Increases arousal and wakefulness.
• Motor end plate actions: Ephedrine modulates skeletal muscle motor end plate activity in rat models of myasthenia gravis (Sieb, 1993., Molenaar, 1993)
• Complement inhibition: Aqueous extracts of Ephedra inhibit complement activation at C2 and C9 (Ling, 1995).
• Inhibition of 3’5’cAMP Phosphodiesterase: Whole Ephedra extracts inhibit PDE in vitro, but isolated ephedrine did not inhibit PDE. (Nikaido, 1990, 1992).
• Reports of Ephedra whole herb toxicity in therapeutic dose ranges are absent from the medical literature. Numerous references to ephedrine (isolated alkaloid) toxicity exist. Ma Huang OTC supplements are often cited in toxicity reports without analysis of dose or alkaloid content. Ephedra is not used as an isolated herb or supplement by clinical herbalists of Western or Traditional Chinese schools, but is always used in combination with other herbs.
• Excessive consumption of ephedrine causes typical side effects of sympathetic hyperstimulation including headaches, nausea, dizziness, vomiting, palpitations, tachycardia, insomnia, tremor, anxiety. These effects are less noticable in consumption of the whole herb, and it has been suggested that the other constituents may modify the effects of the ephedrine alkaloids (Mills, 1991) .
• Nephrolithiasis has recently been associated with both ephedrine and Ma Huang usage (Powell,1998) .
• Contraindicated in hypertension due to vasoconstrictive and inotropic actions. Hypertensive effects of ephedrine in whole herb modulated by pseudoephedrine beta adrenergic effects causing muscle bed vasodilation.
• Contraindicated in hyperthyroidism: due to sympathetic induced increase in metabolic rate.
• Contraindicated in anxiety states: due to central stimulatory effects.
• Contraindicated in pregnancy: due to uterine stimulatory action of ephedrine and potential mutagenicity of byproducts.
• Contraindicated in Benign Prostatic Hypertrophy: due to net adrenergic effects on bladder causing urinary retention.
Drug interactions:
• Sympathomimetic effects could interact with MAOI therapy to cause potentially harmful elevation of catecholamine levels.
• Increased norepinephrine levels may reduce effectiveness of beta-blocker therapy.
• Ephedrine containing preparations are banned by Olympic and other sporting authorities.
Notes:
• Related Species: E. sinica is the principal herb of commerce; the related species E. equisitina, E. intermedia, E. distachya, E. geradiana all contain ephedra alkaloids, in varying distribution profiles (Zhang,1989). Several species of Ephedra are native to the South Western USA, including E. nevadensis, E. viridis. These species, commonly known as Mormon Tea or Mexican Tea have either insignificant traces or no detectable alkaloids (Moore, 1993).
• Traditional Chinese Medicinal Uses: Ma Huang has been used for over 5000 years in China. Ma Huang is never given alone in Chinese medicine, but always used in formulae combined with other herbs that modulate its stimulant effects without altering its actions on the lungs and kidneys. The crude herb may also be treated before use (by boiling in water or cooking with honey) to change its characteristics. Its principal uses in TCM are to disperse external wind, and aid movement of Lung qi. It is also taken for chills, fevers and coughs, and in combination with Rehemannia glutinosa as a kidney yin deficiency tonic. In Chinese medicine, the root is also used – its therapeutic effects being almost opposite to the stem e.g. hypotensive as opposed to hypertensive (Hikono,1983).
• Ephedra and its alkaloids have gained widespread popularity among the sports and body-building communities for weight reduction. The combination of ephedrine with caffeine (E.C.), and of both with aspirin (E.C.A.) is used by body builders in combination with caloric restriction to “cut” fat. This practice and popular OTC “weight loss” and “natural speed” products, based either on Ephedra herb or more usually on isolated ephedrine alkaloids have attracted considerable bad press in recent years. The FDA responded by issuing ultra-conservative dosage guidelines for Ephedra herbal products, expressed in terms of total ephedrine alkaloid maximum recommended doses. (Since then, this herb and its derivatives have been essentially banned, due to their use in the manufacture of crystal methamphetamine. Even pseudoephedrine products are now controlled.) The retail and MLM market is still replete with products purporting to be legal or natural speed and “natural” weight loss agents that contain variable amounts of Ephedra alkaloids or synthetic ephedrine and which will likely continue to be subject to consumer abuse and potential adverse reactions.

Dose: 3-9g