Do Ephedra Diet Pills Really Work? Review, Results & Ratings
Do ephedra diet pills really work to promote weight loss? Research shows that ephedra supplements can increase weight loss when used appropriately, but they also pose a significant risk of side effects.
When it comes to diet pills with Ephedra, it’s important to take the time to understand what they are, whether they’re safe, and if they can help you achieve the goals and results you’re looking for.
Ephedra is known by dozens of names and nicknames around the world, depending on geographical origin. One of the most common is Chinese Ma Huang. It’s also known as:
- Joint Fir
- Yellow Horse
- Sea Grape
- Mongolian/Pakistani Ephedra
- Herbal Ecstasy
- Teamsters Tea, Mormon Tea, Squaw Tea, Cowboy Tea
The ephedra plant comes from the plant family Ephedraceae, and is indigenous to mainly southeastern Asia and India, but it also grows throughout the world, and in certain hot and dry portions of the United States. Species vary depending on geographical origin.
Ephedra Diet Pills
Among the most common species, potential users of ephedra diet pills will find:
- Ephedra sinica (Ma Huang)
- Ephedra viridis (Mormon tea) – there is some confusion regarding the species listed on a number of websites on ephedrine diet pills, and the National Institutes of Health define Mormon tea as belonging to the Ephedra nevadensis (American ephedra) species.
- Ephedra vulgaris aka Teamster’s Tea can be found in some homeopathic remedies
Each species of the ephedra plant may be slightly different in regard to its potency, effects, and side effects. Those looking for diet pills with ephedra should always pay attention to the species of ephedra mentioned on the label of ingredients because of that difference in potency.
For example, the sinica species of ephedra is known to be one of the most potent, with a majority of its active compounds found in the stem of the plant, while the American ephedra species (viridis/nevadensis) being the least potent, containing very little ephedrine or other alkaloids. 
Mechanism of Action
Ephedra has long been used in Chinese medicine practices to treat a number of conditions that have to do with the lungs such as asthma, allergies, colds, bronchospasms, pneumonia, and so forth.
In regard to its use by Western consumers, it’s mainly noted for its stimulative properties that back in the 1970s and 1980s became known as an effective weight loss supplement.
Ephedra itself contains two primary alkaloids that are known to trigger the stimulative and fat-burning effects that the diet pill supplements are known for: ephedrine and pseudoephedrine. Other components of ephedra are also stimulative:
- Norephedrine (phenylpropanolamine)
- Methylephedrine (ephedrine derivative)
- Norpseudoephedrine (cathine)
Ephedrine is described as an alpha (α) and beta (β) adrenergic agonist or trigger that may also influence the release of norepinephrine. It’s mainly used in bronchodilator medications and scenarios, but does have a distinct effect on stimulating the central nervous system.
Ephedrine has gradually grown in disfavor, at least in some medical treatments due to the development of safer and more specifically selective agonists. 
Scientific evidence regarding the overall efficacy and longevity of ephedra to promote energy-enhancing and weight-loss results is relatively lacking. A few small studies have been conducted on the benefits of ephedra pills, but results can be confusing because other components in combination with the ephedra product are often used by individuals seeking accelerated weight loss, such as caffeine.
What to Expect from Diet Pills with Ephedra in Regard to Weight Loss
When taken in pill form, ephedra has been used by people around the world to lose weight, in addition to its energy-boosting reputation for improving athletic performance. In regard to weight loss, some studies have reported moderate benefits in regard to weight loss, although long-term weight loss management is not addressed.
The National Institutes of Health released a fact sheet that states that while dietary supplements or diet pills with ephedra (often including caffeine) can promote “modest” or “significant” increase in weight loss within a six-month period of time, long-term results are lacking. 
In addition to looking for scientific evidence, a number of individuals interested in ephedra pills look to comments and feedback left by users of a variety of dietary supplements containing ephedra.
In many cases, users of diet pills with ephedra typically lose one to two kg per month, but the same results can be achieved with an adequate and nutritious diet combined with appropriate levels and intensity of exercise.
However, because of the surge in popularity of ephedra diet pills in the 1970s and especially the 1980s, some very small studies on thermogenesis back then claimed an obese woman who took approximately 20 mg of ephedrine three times daily (and without changing diet) averaged a 1 pound per week loss. Consumers will find such claims throughout the Internet, but should always apply caution in regard to their own goals.
An obese individual (man or woman) will tend to lose greater amounts of weight, and at a faster rate, than a person who is already lean and needs to lose only a few pounds. Some of these sites claimed that an individual can lose significant amounts of fat without diet or exercise, but studies have shown that diet is a vital for not only weight loss, but weight-loss maintenance.
In one study (1997), 43 obese adults (41 of them women) were given 20 mg ephedrine and 200 mg caffeine three times a day in combination with eight weeks of a low-energy diet. They followed this with 17 weeks of a conventional diet. The study determined that their initial weight loss following the just over six-month long study averaged 12.6 kg (roughly 27 pounds), which rounds out to about one pound a week. 
As noted however, the same can be achieved with diet and exercise, without the added risk of potential side effects associated with combinations or sensitivity to ephedra products or caffeine.
A boost in results can be achieved with ephedra products that also contain caffeine, known as an ECA product or “stack” designating a combination of ephedrine, caffeine, and aspirin. Because many are sensitive to the effects of aspirin, herbal substitutes such as White Willow Bark (an herbal analgesic) are often found in such products.
Some animal studies (obese rats) have reported that ephedrine can increase glycoprotein lipase activity, but this was in conjunction with theophylline.  Theophylline is a component found in a number of the drugs that treat respiratory conditions and is known as a bronchodilator. Bronchodilators are often used (and misused) by athletes to increase oxygen intake, which can contribute to enhance activity, effort, endurance, and metabolism.
However, no studies have been conducted that explore the durability or ability of individuals in most studies for their ability to sustain weight loss over a six-month period.
Another study attempted to rate the efficacy of ephedra as well as ephedrine components in dietary weight loss supplements marketed to boost or enhance athletic performance and weight loss. Again, such usage produced relatively modest and short-term weight loss in clinical trials.
Insufficient evidence has not determined the efficacy of ephedra usage for enhanced athletic performance or capability. However, one report did note that combinations of ephedra/ephedrine, as well as caffeine, were linked to increased risk of heart palpitations, gastrointestinal issues, autonomic functions, as well as some effects on the psyche. 
Individuals interested in purchasing ephedra pills of any kind or milligram strength should be aware that results also depend on diet, caloric intake, lifestyle, and exercise (type, duration, intensity).
Weight loss results may also depend on other ingredients found in popular ephedra diet pills, including Bitter Orange extract (Citrus aurantium), also known as p-synephrine. Because of the differences in ability or limitations of p-synephrine to act as an adrenergic receptor, studies have found it difficult, if not impossible, to compare their results in small animals and extrapolate to potential results in humans. 
Bitter Orange extract and its major proto-alkaloid, p-synephrine, are found in a number of over-the-counter weight-loss supplements and coupled with ephedra, may promote some weight-loss benefits.
Both ephedrine and pseudoephedrine are capable of stimulating (directly as well as indirectly) the sympathetic nervous system. They’re defined as non-selective alpha (α) and beta (β) receptor agonists. An agonist is something that triggers a reaction or activity in the body.
Because these components affect the sympathetic nervous system, they can influence the functions of the heart, the nervous system, respiratory rate, and other actions over which we have no control.
Adding caffeine to ephedra pills can also increase what is known as resting energy expenditure (RPE), although this aspect of its mechanism of action is not particularly beneficial in promoting actual weight loss.
Even so, ephedra may trigger thermogenesis (which relates to breakdown of fat) but is typically limited to very small and short-term weight loss. Ephedrine has been noted to trigger release of catecholamines, which also excite or stimulate the central nervous system.
Catecholamines, including norepinephrine, are defined as neurotransmitters responsible for transmitting signals throughout the central nervous system. They can also influence endocrine functions, motor control, and cognitive and emotional responses. 
For many, this equates to a burst of energy. Others only feel sensations of jitteriness.
Where Can You Buy Ephedra Diet Pills?
Purchasing ephedra diet pills is not difficult today, despite often confusing legalities regarding use of the component. For example, in the United States, ephedra extract found in nutritional and dietary supplements, dietary formularies and herbal remedies used in traditional Chinese medicine is considered legal.
It’s the ephedra alkaloids that have been banned by the Food and Drug Administration since 2004. Those alkaloids include ephedrine and pseudoephedrine.
In other countries around the world, such as Canada, the ephedra extract is not allowed to be put into nutritional supplements, although ephedrine and other alkaloids can. It’s for this reason that many consumers are confused as to what’s legal and what isn’t.
Note: The majority of sporting organizations around the world, including the International Olympic Committee, have banned usage of any stimulative product like ephedra/ephedrine. Regardless of whether the herb or any of its components are legal to purchase in a specific country, athletes, amateurs as well as professionals, should be aware of the distinction.
Ephedra diet pills are readily available from a number of online sports nutrition stores as well as online “auction” or store venues such as Amazon or eBay. When looking for fat-burning or weight loss pills in traditional brick-and-mortar stores, it’s important that consumers carefully read the labels for list of ingredients.
Different manufacturers of ephedra diet pills may use different parts of the ephedra plant or different species of the plant for their products. Milligram strength can vary greatly among online availability of diet pills with ephedra.
Among the most popular ephedra/ephedrine products used by consumers today, milligrams strength can differ greatly. For example:
- Green Stinger, manufactured by Schwartz Labs (contain 27 mg per ephedra extract)
- Hellfire, manufactured by Innovative Laboratories (this brand claims their product contains 150 mg of ephedra extract (leaves, composed in their registered Thermo-Z Brand)
Ephedra pills are available in a variety of milligram strengths depending on where you buy. Some contain as little as 10 mg per capsule while others contain 50 mg, 65 mg, or even higher, as noted above.
The extract strain or potency depends on which part of the ephedra plant and which species has been used. The leaves of the ephedra plant are less potent than the stem. The American ephedra (viridis or Mormon tea) contains the least amount of ephedra and its alkaloids within the more potent Chinese Ma Huang (Ephedra sinica) utilizes portions of the stem.
Cost of ephedra diet pills will also vary depending on manufacturer, brand, and the number of capsules found in the product.
Average cost of a bottle of diet pills with ephedra hovers around $35 on sale. Most list prices average $60, but finding sales of ephedra pills online is not difficult. Simply type in “ephedra diet pills” into your browser search bar and you’ll find dozens of products to choose from.
The U.S. Food and Drug Administration banned ephedra products in December 2003, with the law going into effect in Spring 2004. Ever since then, debate has continued regarding not only its legal status, but safety considerations.
In 2005, the FDA ban on ephedra was challenged by the dietary supplement industrial complex, without success.
Before purchasing ephedra from any source, be aware of the legalities in your state, province, or country. In addition, be aware of regulations proposed by customs officials for the receipt of such products through general mail services, travel, and shipments between countries.
Instructions for Use
Instructions for use differ widely among manufacturers of ephedra diet pills, mainly due to different milligram strength of the ephedra/ephedra alkaloids found in the product, as well as other components including caffeine, amino acids, herbal stimulants, and so forth.
It is recommended that individuals start at the lowest dosage to see how the body reacts to it. Some are more sensitive to the stimulative effects of ephedra/ephedrine than others.
For obese individuals looking to reduce weight, a number of products are popular. For example:
- Metabolize 356 contains 12 mg of ephedra and 40 mg Guarana. Instructions for use recommend one capsule three times daily.
- Ephedra 90 mg (with 192 mg of caffeine) is to be used once daily.
- Ephedra 60 mg (with kola nut and willow bark) to be used once daily.
In general, usage of ephedra in a single dose should not exceed 15 to 20 mg (ephedra alkaloids). Some take between 45 and 60 mg a day, but again, individual reactions as well as increased risk of potential side effects are applicable.
Always follow label instructions and avoid taking higher than recommended dosages. Doing so increases the risk of potential side effects.
Usage instructions as well as doses will also depend on the form that the ephedra and whether its alkaloids are present. For example, powdered ephedra or powdered alkaloids may be more potent than crushed leaves, such as those that are used to make Ma Huang tea.
Product labels are not always genuine, and there are concerns that some ephedra diet pills contain “mysterious” ingredients that are not found on the label. In addition, different species of the ephedra plant can be more potent than others, which can have a very real effect not only in regard to benefits and results, but also side effects and adverse reactions.
Safety Issues with Ephedra Pills
While it is natural to be more concerned about the benefits and possible results to be gained from usage of ephedra diet pills, it is important to also be aware of safety considerations. Some of the side effects associated with ephedra pills are not limited to those who are sensitive to the product.
Common side effects associated with ephedra pills include but are not limited to:
- Increased sense of thirst
- Nausea (take with food to reduce potential for upset stomach)
- Dry mouth
- “Brain fog”
It’s also important to be aware of interactions of ephedra/ephedrine with over-the-counter herbs as well as other supplements, including those that contain caffeine – especially large amounts of caffeine.
Panax ginseng may also negatively interact with ephedra in regard to cardiovascular function. Ephedra may have an influence on the QT intervals of heart rhythm, triggering arrhythmias or irregular heartbeat.
Use caution with ephedra diet pills, especially if you’re taking any kind of anti-convulsant or a drug treating seizure issues. Diabetics should also employ caution, as some of the chemical components of ephedra do have the potential to alter blood glucose levels and therefore can interfere with the efficacy of diabetic medications, including insulin.
Those on heart medications should consult with a physician prior to using ephedra diet pills, as well as those on anti-depressants and anti-anxiety medications.
The stimulative effects found in the ephedra alkaloids (ephedrine and pseudoephedrine) can affect blood pressure, heart rate, and the ability of not only the heart to contract, but the blood vessels in the arms and legs to dilate or constrict.
Combining ephedra or ephedra alkaloids with caffeine can trigger tachycardia or faster than normal heart rate even in young and otherwise healthy individuals. Tachycardia that lasts for more than a few minutes can be especially dangerous to cardiovascular health as well as function and should not be ignored.
The ephedra alkaloids have also been associated with possible increased risk of heart attacks, or irritation of the lining of the heart caused by vasoconstriction or tightening of the arteries. This can contribute to arrhythmias or irregular heart rhythms such as palpitations, an alternating faster or slower heartbeat, and ventricular arrhythmias.
While rare, ephedra usage, because of its similarity in action to other adrenergic drugs – especially at higher milligram strength and dosage – has been linked to cerebral hemorrhage due to its effect on blood pressure (hypertension).
In the event that usage of ephedra pills triggers unusual or abnormal reactions in your body that don’t go away within a short period of time, consult with a physician. This is especially true if those side effects are affecting cardiovascular function or cognitive ability or psychologic behaviors.
In spite of the potential dangers, the benefits of ephedra diet pills and the beliefs of those who use them continue to make them among the most popular over-the-counter supplements used. Ephedrine does stimulate the central nervous system, which in turn, can promote better athletic performance, but these benefits are short-term and duration.
Use of diet pills with ephedra may very well help an individual achieve faster weight loss, but not much more than can be achieved through diet and exercise. It will have more of an effect on someone who needs to lose a few pounds over someone who needs to lose twenty pounds or more.
Bottom line: Use ephedra diet pills with caution and avoid the temptation to take higher than recommended dosages based on label instructions for use.
- Caveney S, Charlet DA, Freitag H, Maier-Stolte M, Starratt AN. New Observations on the secondary chemistry of world Ephedra (Ephedraceae). Am J Bot. 2001 Jul;88(7):1199-208.
- Drugbank. Ephedrine.
- National Institutes of Health. Office of Dietary Supplements. Ephedra and Ephedrine Alkaloids for Weight Loss and Athletic Performance.
- Toubro S, Astrup A. Randomised comparison of diets for maintaining obese subjects’ weight after major weight loss: ad lib, low fat, high carbohydrate diet v fixed energy intake. BMJ. 1997 Jan 4;314(7073):29-34.
- Malecka-Tendera E. Effect of ephedrine and theophylline on weight loss, resting energy expenditure and lipoprotein lipase activity in obese over-fed rats. Int J Obes Relat Metab Disord. 1993 Jun;17(6):343-7.
- Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, Rhodes SL, Jungviq L, Gagné J. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA 2003 Mar 26;289(12):1537-45. Epub 2003 Mar 10.
- Stohs SJ. Safety, Efficacy, and Mechanistic Studies Regarding Citrus aurantium (Bitter Orange) Extract and p-Synephrine. Phytother Res. 2017 Jul 28. doi: 10.1002/ptr.5879. [Epub ahead of print]
- Kobayashi K. Role of catecholamine signaling in brain and nervous system functions: new insights from mouse molecular genetic study. J Investig Dermatol Symp Proc. 2001 Nov;6(1):115-21.