A wee bit of personal experience with herbs that I would like to share.

[daodejing]

So if you were really concerned about the difference between ma huang and ephedrine, just look at the list of known ingredients. In your case with the toxicity they probably overdosed you because you had deficient lung qi. It should be noted that as far as the toxicity goes a solution of EPHEDRINE was used, and not an extract of ephedra stem aka ma huang.

[doc]

Yes, I am deficient in lung qi. This year has been proof of that. But I doubt it has anything to do with the properties of ephedra and how it interacts with my physiology.

As you so duly noted, ephedra contains not only ephedrine, but other compounds that are closely related, some of which also have sympathomimetic properties. A description of "Ma Huang" reveals the following:

A popular herb that has been used for over 5,000 years is Ma Huang, it was used by the ancient Chinese people as a decongestant, antihistamine, and to treat respiratory ailments such as asthma. Ephedrine consists of only 8% of the Herb on average and has been shown to contain powerful fat burning characteristics which can enhance thermogenesis, the body’s burning of fat for energy. A natural energizer, this is the reason why so many popular diet drugs today contain Ephedrine in some form.

The active ingredient in Ma Huang is ephedrine, which reduces the appetite while stimulating fat metabolism. It increases the basal metabolic rate, which allows your body to burn calories faster and more efficiently. By mobilizing stored fat and carbohydrate reserves, Ma Huang works to reduce your appetite and aids in helping you lose excess weight. It can also assist in helping you keep a clear mind, helpful when dieting.

Unless you are certain that the supplement you are taking is standardized for ephedrine content, there is no way to know for sure that you are getting a high quality 8% standardised supplement. Read package ingredients and labels carefully when buying this or any all natural supplement.

A "high quality" 8 % formulation. As if a higher concentration of ephedrine in the Ma Huang formulation is better for you.

Let's talk about ephedrine. It's a potent beta adrenergic drug that's used to resuscitate critically ill hypotensive patients. It's used not only in the ICU and the ER on emergent basis, but also routinely in the OR to counteract the hypotensive effects of anesthesia on volume depleted and cardiovascular impaired patients. It has similar effects to epinephrine, without as strong of a tachycardic effect. (Epinephrine injected intravenously can easily pop someone's heart rate over 160 to 180 and higher, beats per minute, standard five milligram doses of ephedrine usually raise one's heart rate over 100, and generally higher). Both drugs have a strong alpha vasoconstrictive effect, which causes an elevation in blood pressure.

The problem with vasoconstrictive drugs, of which Ephedrine is a potent one, is that causing generalized vasoconstriction increases afterload on the heart, which makes the heart work harder. It has to pump against more resistance. With the cardio-accelerator effects of ephedrine on top of that, the heart beats faster and stronger against more resistance, which is a veritable nightmare for someone with cardiac disease. It is for this reason, that ephedrine must be used cautiously. Also, in those people with previous hypertension, the addition of ephedra can worsen hypertension, leading to a hypertensive crisis, and increased risk of stroke.

Ephedrine has some beta adrenergic effects, which lead to bronchodilation, thus it's use in asthma in China. However, the cardiac and vascular effects are more pronounced, thus, it's use for bronchodilation is not common in the US, where we have better, more beta specific bronchodilatory drugs, that do not effect the cardiovascular system as much. As I've said before, usiing ephedrine to cure asthma is like using a shotgun to kill a fly. You'll cure the asthma, but you'll have many, many more side effects. The treatment is not specific enough to warrant using it. Far too many side effects.

Ephedra is used illegally to create methamphetamine, which, at least out west here, is a nightmare of a drug problem.

Of interest, is the dosage of Ma Huang used. Let's say, for number's sake, that the dosage is nine grams as you say, which is 9,000 milligrams. If a standard Ma Huang root is used, 8% of that is ephedrine, or, 720 milligrams. Now, granted, it's taken by mouth, which leads to a slower absorption. When the standard intravenous dose is 5 to 10 milligrams (granted, administering the drug directly into the bloodstream leads to rapid and potent effect), one can get a feel for how much ephedrine is taken by people using Ma Huang. You're talking about a lot of ephedrine.

[fanzi]

Sorry to jump in so late on this ephedra thing, I'm taking my time finding different parts of the forum. Ephedra contains what it contains, but when prescribed properly with other herbs in a formula, it's harsh effects are often moderated. Recently, when I was in Beijing at a pediatrics department of Dong Fang hospital, the doctor precribed ma huang to many children. 3 grams of Ma huang along with about twenty other herbs at higher doses. The formulas varied and were used to treat patients with bronchitis, tonsilitis, sore throat, and other acute upper respiratory complaints.

A major aspect of TCM is pattern diagnosis for the individual. It seems clear that the doc that gave you, Doc, the tea in China did a poor job. I have had many patients with upper respiratory problems and I haven't yet used Ma Huang. After my recent training in China, I may use it, with caution. I know other practitioners that only use the honey fried Ma Huang because the honey moderates the unpleasant cardiovascular effects of the herb. I don't understand the pharmacology of how that works, but it's common in TCM. The sweet and cloying nature of honey moderates the dispersing and moving nature of Ephedra. TCM explains the cardiovascular effects by saying that ephedra is warm and acrid and strongly opens up the chest and lungs. Honey keeps it from being too strong. (I'm not reccomending anyone just go ahead and try this, one needs to be properly trained and certified in TCM to do so).

With correct pattern diagnosis and appropriate herbal combining, Ma Huang can be an effective medication.

For the record, just as an example of appropriate Pattern diagnosis, I had one teacher who successfully treated hypertension with Ma Huang Tang (includes ephedra, apricot seed, cinnamon twig, and licorice). The diagnosis for those patients was Lung Qi Stagnation. The dispersing quality of Ma Huang released the stagnation and in turn lowered blood pressure. This is not common obviously but is a good example of pattern ID. Also, the practitioner was trained as an MD and was well aware of ephedra's effects and prescribes herbs carefully.

Also, in the recent FDA ban, Herbalists certified by the NCCAOM were excluded. We may still dispense ephedra according to the tenets of TCM. Board members of the AAOM (American Association of Oriental Medicine) recently met with the FDA to discuss the future of TCM herbal medicine. The results of those discussions are still out.

G

[daodejing]

Yup, we're allowed to prescribe it in a traditionally suitable manner, but banned from prescribing it for weight loss. Frankly it boggles my mind that people used the stuff to lose weight and for improved athletic performance. Its a powerful diaphoretic, and as such the worst thing you could do is take the stuff and go work out to the point where you perspire even more. Mmmmm yang collapse. Of course, its no more intelligent than a baseball player using amphetamines, ritalin, or adderall to improve their playing skills, and people do that in the MLB all the time.

Have I mentioned that behaviour altering pharmacueticals (anti-depressents, stimulants, and others) for children are more popular than they've ever been in the U.S. right now? That scares me. Doc, its time you went Godzilla on the drug companies.