Ephedrine: Uses, Side Effects, & Controversy

Disclaimer: Ephedrine is a controversial drug banned by the FDA. This article is not an endorsement for the drug and is meant for review purposes only.

Athletes worldwide have taken ephedrine to lose body fat and get more energy. There had been a popular trend going around called ECA stacking, where ephedrine is combined with aspirin and caffeine to boost its efficacy.

Due to its lipolytic, thermogenic, and stimulating effects, ephedrine is meant to ward off fatigue and promote a lean body composition. However, these benefits come at a price. After all, there’s a reason why the FDA banned all supplements containing this drug back in 2004. 

Ephedrine pills can still be used for medical purposes. Some dieters and athletes purchase them from the black market, which further increases the risks involved. There is a risk of getting incorrect or harmful versions when procuring drugs from such a source.

This drug is meant to work by stimulating the nervous system, leading to greater energy and mental focus. It has also been known to exhibit strong thermogenic effects and increases fat burning. In an earlier study, subjects who took ephedrine burned 3.6% more calories over 24 hours compared to the placebo group. 

But how does ephedrine work? Most importantly, is it worth the risk? Keep reading to find out more! 

What Is Ephedrine?

Ephedrine is a naturally occurring compound derived from the ephedra plant, also known as ma huang. 

From a scientific perspective, it’s an adrenergic receptor agonist with anti-hypotensive, thermogenic, and bronchodilatory activities. It also acts as a nervous system stimulant — just like caffeine. 

Medically, this compound is prescribed for the treatment of asthma, low blood pressure, nasal congestion, and other common ailments. It works by stimulating alfa-, beta1-, and beta2- adrenergic receptors, explains a 2013 review published in Natural Products. 

The FDA banned ephedra-based diet pills, but ephedrine sulfate for medical purposes is still available for purchase. This drug is administered intravenously to help increase blood pressure before anesthesia. 

Athletes naturally must consider using it to boost their metabolism and speed up fat loss. There are claims that ephedrine can help with that, but it may not be the safest option. 

How Does Ephedrine Work?

When used as a fat burner, this compound increases the release of noradrenaline or norepinephrine. As a result, heart rate and blood pressure go up. At the same time, a person’s body begins to break down fat for energy. 

Norepinephrine also affects the brain, leading to enhanced mental alertness. The same hormone is released during the fight-or-flight response, which kicks in following acute stress.

Elevated norepinephrine levels are associated with greater energy, increased attention, and improved memory. However, if one’s body produces too much of this hormone, they may experience jitters, anxiety, muscle cramps, restlessness, impaired concentration, and poor sleep. 

Norepinephrine also stimulates the release of glucose for fuel and increases blood flow to skeletal muscles. Furthermore, it accelerates the production of ketone bodies through ketogenesis. 

It has been said that ephedrine can help people on the keto diet enter ketosis faster. It may also help ease the symptoms of the so-called keto flu by increasing ketone body production from fatty acids, but again, there are safer ways to achieve these effects.

Ephedrine also has several pharmacological actions, reports Pathway Medicine. 

The drug contracts the smooth muscle in blood vessels, dilates the airways, and reduces fatigue. Its physiological effects are similar to those of epinephrine but tend to last longer. 

Using Ephedrine to Burn Fat? 

Clinical evidence supports the use of ephedrine for fat loss. This drug doesn’t directly burn fat, but it increases metabolism and fat oxidation.

In a 2007 study, subjects who took ephedrine with either caffeine or pioglitazone, a diabetes drug, lost 4.6 to 6% of their body fat within three months. Their triglyceride levels decreased too. 

As mentioned earlier, ephedrine is often used along with caffeine. 

These compounds work synergistically and may accelerate fat loss. When combined, they may suppress appetite and prevent the decline in good cholesterol associated with weight loss, according to an older but relevant study published in Obesity Research. 

More recent research shows that caffeine and ephedrine may cause significant reductions in fat mass. According to the study authors, ephedrine pills can help lose about two pounds per month when used for up to six months.

Obese subjects who took these supplements had a 5.9% decrease in body weight and a 9.6% reduction in body fat. The results were even more impressive when leptin was added to the mix. 

In clinical trials, supplements containing ephedrine and caffeine caused a major decrease in body weight without affecting lean mass. This combo is said to help preserve muscle and keep energy up while on a diet. 

Many users also report increased feelings of fullness when taking ephedrine. Its effects vary from one person to another and tend to diminish over time. Those struggling with hunger and cravings should consider trying these appetite suppressants. 

Beware that ephedrine alone isn’t enough to help someone get leaner. 

At the end of the day, it’s an athlete’s overall diet and training routine that matters most. This supplement may slightly boost metabolism, but it won’t counteract the effects of sitting all day or eating junk. 

Using Ephedrine to Regain Energy and Improve Focus 

Ephedrine is also claimed to aid in weight loss by increasing energy levels. It’s no secret that dieting often leads to low energy, fatigue, and weakness. That’s why many athletes take BCAAs and other sports supplements when cutting.

Due to its energizing effects, this drug supposedly makes it easier to stick to workouts while on a diet. It may also lift a person’s mood and boost alertness, helping them stay focused in the gym. 

Some studies suggest that ephedrine may improve muscular strength, aerobic performance, reaction time, and physical endurance. Unfortunately, there isn’t enough evidence to confirm these claims. 

Ephedrine pills may increase fat oxidation and resting VO2 (oxygen consumption) in healthy individuals, but not during exercise, states a 2001 review published in the Journal of Athletic Training. 

Furthermore, these supplements failed to improve physical endurance, strength, power, speed, and other aspects of sports performance in clinical studies. 

As the researchers note, combining ephedrine with caffeine may indeed benefit athletes. When used together, these compounds can increase the time to exhaustion, elevate heart rate, and decrease perceived exertion. 

However, most studies are either small or inconclusive, according to the Journal of Athletic Training. Additionally, severe adverse effects were commonly reported during these investigations. 

A better choice is Old School Labs’ Real Keto Pre-Workout, our ketogenic energy-boosting formula. Think of it as the antidote to keto fatigue. 

The unique combination of minerals, amino acids, creatine monohydrate, and adaptogens that allegedly helps restore energy and stamina while improving mental focus. Some also claim to feel stronger overall and get longer-lasting pumps without the need for carb loading. Plus, it’s much safer than ephedrine.

Using Ephedrine to Improve Body Composition

As discussed earlier, there are claims that ephedrine preserves lean mass and enhances a body’s ability to burn fat for fuel. When used as part of a balanced diet and training program, it may help improve body composition. If one combines it with caffeine, the benefits are even greater. 

A 2017 review featured in the Journal of Korean Medicine investigated 16 clinical trials assessing the efficacy and safety of ephedrine for fat loss. Researchers also looked at the effects of ma-huang. Both compounds significantly reduced fat mass and body weight in obese individuals. 

Furthermore, a 2012 study published in Diabetologia has found that ephedrine increased brown fat activity in men to a greater extent than placebo. This effect was only observed in lean men and not in those who were obese. 

Brown fat increases metabolism and can make it easier to lose weight. Compared to white adipose tissue, it requires more energy to sustain itself and hence stimulates thermogenesis. The above findings show that brown adipose tissue can be pharmaceutically activated in humans through the use of ephedrine. 

Dangers of Ephedrine

Like most diet pills, ephedrine has its share of side effects. Most clinical trials didn’t report any deaths or other serious adverse events, such as strokes or seizures, according to the National Institutes of Health (NIH). 

Subjects who used ephedrine alone or in combination with caffeine experienced mild symptoms like:

• Mood swings
• Anxiety
• Nausea and vomiting
• Rapid heartbeat

According to the Journal of Athletic Training, ephedrine side effects vary among individuals and are not dose-dependent. The FDA has received over 1,000 reports describing adverse reactions, including but not limited to: 

• Insomnia
• Restlessness
• Tremors
• High blood pressure
• Hepatitis
• Seizures
• Psychosis
• Stroke 

These statements contradict those made by the NIH. All in all, it’s hard to tell whether these side effects were due to ephedrine or a combination of ephedrine and other drugs. Additionally, heart disease, diabetes, and other underlying conditions may increase the risk of adverse reactions. 

Other potential side effects may include headaches, blurred vision, pounding in the ears, chest pain, flushing, painful urination, and shortness of breath. However, these reactions are not common.

Ephedrine Drug Interactions 

Ephedrine increases epinephrine levels, which in turn raises blood pressure and heart rate. This supplement may cancel out the effects of drugs that lower blood pressure. When combined with painkillers, it may increase the odds of having a heart attack. 

Many dieters and athletes take ephedrine with aspirin and other compounds without being aware of the risks involved. A 2009 report describes the case of three teenagers who developed neurological abnormalities and movement disorders after using an intravenous mixture of aspirin, ephedrine, and potassium permanganate.  

The FDA warns that ephedrine sulfate, an injectable form of the drug, may interact with monoamine oxidase inhibitors and other medications affecting blood pressure. 

It may also cause adverse reactions when combined with any of the following substances:

• Cardiac glycosides
• Theophylline
• Guanethidine
• Alfa- and beta-adrenergic antagonists
• Quinidine
• Oxytocin and oxytocic drugs 
• Atropine

Theophylline, an asthma medication, may cause insomnia, nausea, and mood changes when used along with ephedrine. If someone taking oxytocin, they should refrain from using ephedrine during treatment as it may increase their risk of stroke. 

Ephedrine Dosage

The side effects of ephedrine don’t depend on the dosage, but people are more likely to experience adverse events as they increase the dosage. 

Generally, the dosage for ephedrine in an ECA stack is 20 to 24 milligrams thrice a day. When deciding to take ephedrine alone, users usually do not exceed 20 to 50 milligrams three times a day. 

For people still looking to try ephedrine, it’s typical to first make sure the diet is in check and start with a small dose of 5 to 10 milligrams to see how their body reacts. They increase the dosage gradually and only if needed. 

People also consider combining it with caffeine to increase its potency. And everyone should avoid these compounds altogether if they’re sensitive to stimulants. 

Risk Versus Benefits

Ephedrine pills have been promoted in the U.S. since the ’80. Their beneficial effects, which range from fat loss to greater energy and improved cognition, are well-documented. But is it worth the risk?

According to the NIH and other sources, ephedrine is unlikely to cause severe adverse reactions. 

However, it may not be safe for those with underlying cardiovascular problems, like high blood pressure, tachycardia, or heart disease. In most studies, even healthy people reported mild-to-moderate side effects. 

Our advice is to look for safer alternatives to ephedrine. 

The Real Keto Fat Burner, for example, is produced in an FDA-certified facility and has none of the side effects associated with this drug. It’s ideal for those who are the keto diet, featuring a synergistic “super-stack” of nutrients that recharge energy and speed up fat loss. 

What’s your take on ephedrine? Have you ever used it or do you prefer the safer options? We’re looking forward to hearing back from you, so go ahead and share your thoughts below!