A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study

Abstract

Dietary therapy may be beneficial in alleviating symptoms of chronic fatigue syndrome (CFS), a disorder that is characterized by extreme fatigue and other symptoms, but the cause of which remains unclear. The aim of this study was to evaluate the protective effect of a botanical product containing cistanche (Cistanche tubulosa [Schenk] Wight) and ginkgo (Ginkgo biloba L.) extracts on adults with CFS in a randomized, double-blind, placebo-controlled clinical trial. A total of 190 subjects (35–60 years old, non-obese) with CFS were randomized to receive one tablet of a low dose (120-mg ginkgo and 300-mg cistanche), a high dose (180-mg ginkgo and 450-mg cistanche) or a placebo once daily for 60 days. Blood samples and responses on the Chalder fatigue scale (CFQ 11), the World Health Organization's quality of life questionnaire (WHOQOL), and the sexual life quality questionnaire (SLQQ) were collected at baseline and post-intervention. CFS symptoms of impaired memory or concentration, physical fatigue, unrefreshing sleep, and post-exertional malaise were significantly improved (p < 0.001) in both of the treatment groups. The botanical intervention significantly decreased physical and mental fatigue scores of CFQ 11 and improved WHOQOL and SLQQ scores of the subjects (p < 0.01). Levels of blood ammonia and lactic acid in the treatment groups were significantly lower than those of the placebo group (low-dose: p < 0.05; high-dose: p < 0.01). In addition, the change in lactic acid concentration was negatively associated with the severity of CFS symptoms (p = 0.0108) and was correlated with the change in total physical fatigue score of the CFQ (p = 0.0302). Considering the trivial effect size, the results may lack clinical significance. In conclusion, this botanical product showed promising effects in ameliorating the symptoms of CFS. Clinical trials with improved assessment tools, an expanded sample size, and an extended follow-up period are warranted to further validate the findings.Clinical Trial Registration:https://clinicaltrials.gov/, identifier: NCT02807649.

Is there a role for traditional and complementary medicines in managing chronic fatigue? a systematic review of randomized controlled trials

“…Fifty-nine trials reported the history of participants with CFS, out of them, twenty-six trials only reported the range of participants’ history ( Wang, 2014 ; Liu Y. et al, 2015 ; Liu A. et al, 2015 ; Gao and Pang, 2015 ; Li and Cao, 2015 ; Wang et al, 2015 ; Gao and Pang, 2016 ; Huang et al, 2016 ; Huang et al, 2017 ; Wei et al, 2017 ; Ou et al, 2018 ; Wu et al, 2018 ; Liu et al, 2019b ; Liu et al, 2019c ; Ding, 2019 ; Joung et al, 2019 ; Li et al, 2019 ; Lin et al, 2019 ; Ma et al, 2019 ; Kan et al, 2021 ; Liu et al, 2021 ; Shin et al, 2021 ). Twenty-two trials reported the range of participants’ history with mean history and standard deviation in the test and control groups ( Xu D. et al, 2013 ; Xu Z. et al, 2013 ; Zhao et al, 2013 ; Liu et al, 2014 ; Guo and Guo, 2015 ; Li, 2015 ; Wu et al, 2016 ; Yang and Liang, 2016 ; Wang, 2017 ; Du, 2018 ; Li et al, 2018 ; Liu and Cai, 2018 ; Liu Y. et al, 2019 ; Hu, 2019 ; Mao, 2020 ; Sheng, 2020 ; Chen, 2021 ; Guo and Huang, 2022 ; Huang et al, 2022 ; Zhou et al, 2022 ).…”

“…A total of 44 participants withdrew from ten trials ( Zhao et al, 2013 ; Huang et al, 2016 ; Huang et al, 2017 ; Joung et al, 2019 ; Huang et al, 2020 ; Sung et al, 2020 ; Kan et al, 2021 ; Li et al, 2022 ; Ma et al, 2022 ; Wu et al, 2022 ), none of which exceeded 10% of the sample size in each trial, participant withdrew before intervention started in two trials, the rest dropped out during treatment, and only one trial reported specific reasons, details as shown in Supplementary Table S8 , but did not report the reasons for dropout.…”

Exploration of the Pharmacological Mechanism of Bufei Nashen Pill in Treating Chronic Obstructive Pulmonary Disease Using Network Pharmacology Integrated Molecular Docking

“…28 HJ has a long history with many chemical components with anticancer, antiaging, antidiabetes, and antifatigue properties. 29 RCR contains various bioactive compounds, such as phenylethanoid glycosides, flavonoids, lignin, and alkaloids, with potent antioxidant properties with the capability to improve mitochondrial function, 30,31 and displaying a range of functions, including antioxidant, antinociceptive, anti-inflammatory, and immunity. 32 Ting Li Zi can decrease lung qi to relieve dyspnea.…”

Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives

“…A recent RCT found that a botanical product containing cistanche and ginkgo extracts improved ME/CFS symptoms [195]. Ginkgo is an antioxidant that improves memory and cognitive deficits and alleviates psychological and physiological distress and fatigue in subjects with mental health disorders [196].…”

“…Cistanche is a popular dietary ingredient in Chinese traditional medicine shown to delay the onset of fatigue [197]. An RCT showed a significant improvement in memory, concentration, physical fatigue, unrefreshing sleep, and postexertional malaise (PEM) in both high-and low-dose cohorts [195]. Blood ammonia and lactic acid levels were lower in treated groups compared to healthy controls.…”