ECA stacks, which include a combination of ephedra, caffeine and aspirin, have been used as a tool to decrease body fat and lose weight. Ephedra, a very powerful stimulant, has health risks such as hypertension, heart palpitations, stroke, seizure and death. For this reason, the sale of ECA stacks and other dietary supplements containing ephedra have been restricted.
Not Your Everyday Stimulant
Ephedra is the most potent and controversial ingredient in ECA stacks. While caffeine and aspirin are common, everyday substances widely considered safe, ephedra is not. Ephedra, also known as ma huang, is an herbal stimulant derived from an evergreen shrub-like plant native to Central Asia and Mongolia. While different species of the ephedra plant exist, the species that contains the ephedrine alkaloid most commonly used in ephedra products is Ephedra sinica. Ephedra stimulates the central nervous system, which increases heart rate, constricts blood vessels and increases metabolism and body temperature. These characteristics, which are the same ones that promote weight loss, can also make this substance dangerous.
The FDA determined that ephedrine containing products pose an “unreasonable risk of illness or injury,” particularly to people with high blood pressure or heart disease. The agency has notified the public that all dietary supplements, including any ephedrine alkaloids, that have not been specifically approved by the FDA, are illegal to market in the United States. While the sale of over-the-counter ephedrine products was banned by the FDA in 2004, ephedrine is still a legal substance, approved for human consumption; though it is highly regulated.
According to the National Center for Complementary and Alternative Medicine, the FDA has received over 900 reports of ephedra toxicity between 1995 and 1997 (before ephedra was banned) with over 37 of those cases representing serious injuries including heart attack and stroke or death. NCCAM also notes that using ephedra along with caffeine makes for an even more dangerous cocktail, with an increased potential for side effects.
One 2000 article published in the “New England Journal of Medicine” reviewed 140 reports of side effects related to the use of ephedra. The researchers found that hypertension was the most common adverse effect with 17 reports, followed by heart palpitations with 13 reports, stroke with 10 reports and seizures with seven reports. Some sources, however, conclude that ECA stacks, when taken in modest doses, can be safe. One 1993 study published in the “International Journal of Obesity and Related Metabolic Disorders” found that ECA, in doses of ephedrine (75-150mg), caffeine (150mg) and aspirin (330mg), is well tolerated in healthy people, ''causing no significant change in heart rate or blood pressure.”
- FDA: Dietary Supplements Containing Ephedrine Alkaloids
- EROWID: Ephedrine
- NCCAM: Ephedra
- Journal of Pharmaceutical Sciences: Ephedrine-Type Alkaloid Content Of Nutritional Supplements Containingephedra Sinica (Ma-Huang) As Determined By High Performance Liquid Chromatography
- The New England Journal of Medicine: Adverse Cardiovascular and Central Nervous System Events Associated with Dietary Supplements Containing Ephedra Alkaloids
- International Journal of Obesity and Related Metabolic Disorders: Ephedrine, Caffeine And Aspirin: Safety And Efficacy For Treatment Of Human Obesity