After the Food and Drug Administration (FDA) banned ephedra in 2004, thousands of manufacturers of diet and weight-loss drugs turned their attention to finding natural and synthetic alternatives that would mimic its effects. Many of the ingredients in these fat burners also pose a number of health risks, but some of them may still be safer than ephedra. Understanding how ephedra works in the body can help you determine if alternative supplements are right for you.

Ephedra and Its Effects, Good and Bad

Derived from the Chinese herb ma huang, ephedra contains the herbal form of ephedrine, an FDA-regulated drug. Ephedra has been used for thousands of years as a stimulant and allergy reliever. Many people have used ephedra to alleviate symptoms of allergies and asthma, since it can speed up circulation and increase adrenaline release. It can be taken in pill form or added to tea. Since it’s a stimulant, ephedra can temporarily raise the metabolic rate and potentially burn calories.

It’s this mechanism that made ephedra a popular dietary supplement for weight loss. Still, the herb and ephedrine-containing products posed many side effects. The New England Journal of Medicine reported approximately 54 deaths related to ephedrine use, and more than 140 ephedra-related incidents. The adverse side effects resulted in the FDA’s nationwide ban, and supplement manufacturers turned to other options.

Ephedra Imitators

A number of alternatives to ephedra are now available. The following are among the most popular.

• Bitter orange, also known as Citrus aurantium, is the leading ephedra alternative on the market and is a common ingredient in thermogenic formulas. Its active ingredient, synephrine, imitates many of the effects of ephedrine. Bitter orange can increase heart rate and blood pressure, potentially increasing the body’s metabolism. Most weight-loss supplements containing bitter orange also contain caffeine, vitamins, and minerals to enhance its effects. Not only is bitter orange a natural appetite suppressant, but it can also increase calorie burning. However, according to the U.S. Army Center for Health Promotion and Preventive Medicine, high doses of bitter orange are dangerous; they can cause serious interactions with other herbs and medications, and in children, can result in colic, convulsions, or death.


• Hoodia comes from the desert plant Hoodia gordonii and can help stimulate the metabolism and reduce the appetite. Read more about hoodia, including its potential hazards, here.


• Vasodrene is touted as a weight-loss solution and metabolic enhancer, containing a proprietary blend of Oxy-Phedra Complex HCL, yohimbe, and green tea extract. This nervous system stimulant also includes a high dose of caffeine.


• Green tea extract is commonly used in weight-loss aids as an energy enhancer. Green tea extract offers a natural form of caffeine, and can simulate ephedra’s metabolism-enhancing properties.

Who Should Not Take Ephedra Substitutes or Other Stimulants?

People who are pregnant, nursing, or have high blood pressure are not good candidates for any weight-loss supplement that affects the nervous system. Diabetics and people with a history of heart conditions may also find it difficult to manage their health when they take metabolism enhancers and other ephedra-like stimulants. Side effects have yet to be reviewed and published by the FDA, and there is limited research on the long-term health risks of most dietary aids. Understanding what will work best for your body may require consulting with a physician before use.

—Sabah Karimi