Efficacy

In the February 2003 RAND report "Ephedra and Ephedrine for Weight Loss and Athletic Performance Enchancement: Clinical Efficacy and Side Effects", limited evidence supporting health benefits was shown from ephedra use. This report reviewed the majority of recent clinical studies on the safety and efficacy of ephedra. The researchers found a modest but relatively consistent effect of short-term weight loss from ephedrine or ephedra-caffeine combination products. None of the studies, though, included treatment for more than 4 - 6 months or any follow-up after cessation of product use. Thus, no evidence on long-term weight loss is available. In addition, no evidence proved that ephedra enhanced athletic performance and very little evidence for this claim was shown for ephedrine.

The Ephedra Working Group presented their report to the National Advisory Council for Complementary and Alternative Medicine on February 26, 2003. Their report was based on the RAND review and new publications since the preparation of that review. The following is a synopsis of the report:

Efficacy for weight loss

• Few trials of ephedra have been conducted. But, the evidence suggests that short-term use of ephedrine, ephedrine with caffeine, or ephedra-containing supplements is associated with short-term weight loss of approximately 2 pounds per month, compared to placebo.
  
• No evidence exists as to the dose-response relationship.
  
• No evidence from controlled trials exists as to whether continued use of ephedra would result in long-term weight loss.
  

Efficacy for athletic performance enhancement

• No clinical trials of ephedra for athletic performance enhancement exist.
  
• Limited replication of findings with regard to ephedrine exist, with virtually all reported trials having emanated from a single laboratory.
  
• Virtually all trials of ephedrine have been conducted on a small number of very fit young men, limiting the generalizability of the findings.
  
• The available data support a modest effect of ephedrine with caffeine on short-term indicators of athletic performance enhancement, such as time to exhaustion, increase in performance time, and power output.