The FDA removed ephedra, also known as Ma-huang from the market in April 2004, claiming that it was responsible for dozens of deaths.

The ban on ephedra didn't affect the sale of over-the-counter cold medications such as decongestants which often contain ephedrine in synthetic form.

Judge Campbell states that drug agencies had failed to prove that ephedra at low doses was dangerous, and that it lacked the authority to ban the substance without such proof. She called for the FDA to lift the ban on ephedra.

The US ban on ephedra was lifted, among other things the court clarified that the FDA must follow the 1994 Dietary Supplement Health and Education Act (DSHEA), and can not treat dietary supplements like drugs or medical devices.

According to the court low doses of ephedra do not pose significant or unreasonable risk by a preponderance of the evidence. Companies that sell ephedra based products are allowed to resume selling whole herb ephedra products with no more than 10mg of naturally occurring ephedrine alkaloids.