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Ephedra: Contraindications for Ma huang

by Paul Bergner

Medical Herbalism 4(3):10

Ma huang is a common constituent in over-the-counter herbal formulas, most often in allergy formulas and weight-loss formulas. Its main active component, ephedrine, is sometimes used by itself in pharmaceutical allergy preparations, and sometimes added to commercial herbal formulas which have official FDA over-the-counter approval status.

Michael Tierra OMD, Lac

Ma huang (Ephedra sinica) has somewhat different properties from the closely related American species. Chinese Ma huang contains significant amounts of ephedrine and pseudoephedrine which act like adrenaline in the body while the American species has none or much less.

Being a pungent, butter, warm-natured herb, it has definite stimulant properties making it contraindicated for individuals with hypertension, insomnia, involuntary sweating or cardiac asthma.

Ma huang’s outward directed, sharp, drying effect is ameliorated with the addition of small amounts of demulcents such as apricot seed and licorice in Chinese herbal medicine or with marshmallow, comfrey root or slippery elm in Western herbal medicine.

Roy Upton, Herbalist

I have seen one person pass out after one dose of a strong decoction. Another person’s face literally peeled as if it was sunburned after continued low dosages for thirty days. He was already subject to “deficient heat rising” and his redness gradually got worse as he kept taking the formula. Another person had been treated by an acupuncturist for asthma. He was given a mahuang formula. He immediately felt considerably better and purchased some mahuang on his own. He took a strong tea daily for three weeks. He woke in the morning and could not get out of bed because of severe lower back pain. He was picked up by an ambulance. It took him three days to recover in the hospital.

Paul Bergner

Ma huang is a stimulant and, although approved for commercial use, is subject to the same law as all stimulants: “what goes up must come down.” In oriental medicine, it is considered a “surface relieving” herb, meaning in part that it promotes sweating. People with “deficient” conditions (in the oriental sense), have a symptom picture of low energy, a tendency to dehydration, easy sweating, insomnia, and redness of the face and hands. Unless part of a specific Chinese formula that moderates its effects, mahuang is inappropriate for people with this picture, even those with allergies or other conditions for which it might normally be given.
 
Copyright 2001 Paul Bergner