As with all drugs, the dangers of side and adverse effects of Ephedra is an ever prevailing threat and is found to be higher in individuals who suffer from ailments like heart disease, seizures, stroke, transient ischemic attacks, high blood pressure, heart-related disorders, thyroid disease, glaucoma, anxiety, glaucoma, diabetes (both type I and type II); renal disease or calculi; mental illness, benign prostatic hyperplasia (enlargement of prostate); cerebral insufficiency and individuals suffering from such conditions are recommended to avoid Ephedra, as also people who are allergic to Ephedra, ephedrine, or pseudoephedrine.

Side effects of Ephedra include nausea, headache, dizziness, stomach irritation and/or diarrhea, psychosis, renal lithiasis (kidney stones), tremors, dryness of mouth, irregular heart rhythms, tachycardia, heart damage, anxiety, high blood pressure, restlessness; nervousness; sleeping disorders, loss of appetite, flushing, diaphoresis (excessive sweating), polyuria (increased urination).

Excessive or continued intake of Ephedra has also resulted in strokes, seizures, psychosis, and even death. Because Ephedra increases metabolism and influences the body’s ability to lose heat, it has been known to increase the risk of heat stroke also.

Ephedra should be strictly taken on the recommendation of doctors and should be avoided at least two weeks before and after any kind of surgery. Pregnant or nursing women, children, and as it is known to result in loss of appetite, people with anorexia nervosa or bulimia should abstain from the use of Ephedra at all costs.

Ephedrine is listed in the banned category by a number of sports associations, the International Olympic Committee, the National Basketball Association, the World Anti-Doping Agency, and the U.S. National Football League to name a few, the last one following the death of Minnesota Vikings offensive tackle Korey Stringer. Ephedra was found in his locker and it was concluded that it was responsible for his untimely demise. But, despite all the prohibition, Ephedra still is widely used by sportspersons all over the country; in fact, a survey conducted some years ago of university hockey players concluded that almost 50 percent confessed using Ephedra at one time or the other.

The FDA launched a Meta-analysis for the safety and efficacy of Ephedra which was done by the RAND Corporation. This was done in response to multiple demands for the regulation of the drug. The findings were that while Ephedra promoted modest short-term weight loss, there was little or no evidence of its efficacy for long-term benefits, either for weight loss or increase in performance at the cost of mild-to-severe psychiatric, gastrointestinal, and autonomic side effects. About the same time, the Annals of Internal Medicine conducted an independent study which found evidence that the use of Ephedra increased the chances of adversely affecting health between 100 to 700 times as compared to the other supplements found in the market such as Ginkgo Biloba and Kava. The evidence thus collected resulted in the FDA recommendations on December 30, 2003, to stop use of Ephedra, and finally on April 12, 2004, issued a final ruling banning the sale of Ephedra and ephedra-containing dietary supplements with the US Secretary of Health and Human Services, Tommy Thompson, stating, “These products pose unacceptable health risks, and any consumers who are still using them should stop immediately.”

The sale of Ephedra and ephedra-containing dietary supplements remains illegal in the United States.