We know that ephedras have been used at least for 5000 years in China, probably elsewhere. Beverage made with the ephedra plant have been referred to under many names, e.g., yellow river, mormon tea, and whorehouse tea. Ancient Chinese physicians prescribed ephedra tea and pills for the common cold, coughs, asthma, headaches, and hay fever. Ephedra comforts asthma patients by acting as a bronchial dilator. Honey is often added to the ephedra.

The stimulants, or uppers, ephedrine and pseudoephedrine, are the two widely used alkaloids of ma huang. All the alkaloids are less potent than adrenaline, yet more effective than caffeine. Caffeine--contained in coffee, tea, cocoa, chocolate, yerba mate, and cola drinks--when combined with ma huang enhances the performance of ma huang, and the results are insomnia, irritability, and nervousness.

Many herbalists agree that the intact ma huang stem is much safer to use for medicinal purposes than its alkaloid extracts. As an example, pure ephedrine raises blood pressure, whereas ephedra stems reduces it. Comparing the alkaloid pseudoephedrine with the entire plant, the entire plant causes fewer heart symptoms. When comparing alkaloid to alkaloid for commercial cold preparations, pseudoephedrine is less risky than ephedrine.

Ma huang and its alkaloids have various medicinal uses. Ma huang acts as a bronchial dilator to dry up the sinuses. Pseudoephedrine HCL, an isomer of ephedrine, is claimed to have a longer bronchial dilating effect than ephedrine. This use is especially helpful in treating hay fever, allergies, and asthma. Bronchial dilation also aids in decongesting the chest from the cold and flu.

Ma huang stimulates the nervous system to enhance mood, reduce fatigue, and to make a person alert enough to smell their coffee in the morning. Ma huang also has the ability to increase energy and endurance; it does this through increase of blood flow to the muscles, resulting in an increase of oxygen and nutrient supply to the muscles. Ephedrine also increases basal metabolic rate (BMR), so that the body is spurred to burn calories faster, and so ephedrine is part of the thermogenic process that can result in substantial weight loss. In thermogenesis, white fat stores are mobilized into the bloodstream, where they are carried to the brown fat to be burned up and dissipated as heat.

In April 2004, the U.S. Food and Drug Administration (FDA) banned the sale of ephedra in the United States. A federal court later restricted the ban to products containing high daily doses of ephedra, and the FDA is considering how to conduct safety studies ordered by the court.