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China is a major manufacturer of ephedrine and
pseudoephedrine and is one of the world’s
primary exporters of both chemicals. China owns
and operates ephedra farms, where ephedra grass
(ephedra sinica) is cultivated under strict government
control. The active alkaloids, pseudoephedrine
and ephedrine, are chemically extracted from the
plant material and processed for pharmaceutical
purposes. These chemicals are then sold domestically
and internationally. China and India are the major
producers of these chemicals when extracted from
the ephedra plant.
Source: DEA, March 2002
In low doses, ephedrine and pseudoephedrine
act as nasal decongestants. Ephedrine and pseudoephedrine
are ingredients in many over-the-counter asthma
medications and are also key components in illegal
methamphetamine manufacturing. In high doses,
the stimulant effects of these drugs can raise
blood pressure and many studies have linked ephedra
use to heart attacks, strokes, seizures, psychosis,
insomnia and heatstroke. Those people suffering
from kidney disease, liver disease, diabetes,
glaucoma, heart disease or high blood pressure,
thyroid disease, emphysema or chronic bronchitis,
have an enlarged prostate, are pregnant or nursing,
or are taking an MAOI are advised NOT to take
products containing ephedrine and pseudoephedrine.
A recent study, published in the Annals of Internal
Medicine and based on information collected by
the American Association of Poison Control Centers
concluded:
* In 2001, U.S.
poison control centers reported 1,178 adverse
reactions to ephedra dietary supplements.
* Products containing
ephedra accounted for 64% of all adverse reactions
to herbs in the United States, yet these products
represented only 0.82% of herbal product sales.
The relative risks for an adverse reaction in
persons using ephedra compared with other herbs
were extremely high. Even with an extreme high
estimate for ephedra's share of the total herbal
market (13.5%), the relative risks for adverse
reactions among ephedra users were still 10- to
40-fold greater than the risk among users of other
herbal products.
Source: "The Relative Safety of Ephedra Compared
with Other Herbal Products," Stephen Bent,
MD; Thomas N. Tiedt, PhD; Michelle C. Odden, BS;
and Michael G. Shlipak, MD, MPH; Annals of Internal
Medicine. 2003;138:000-000.
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