A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study. — CFSMEATLAS
A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study.
Kan, Juntao, Cheng, Junrui, Hu, Chun et al. · Frontiers in nutrition · 2021 · DOI
Quick Summary
Researchers tested whether a supplement containing two plant extracts (cistanche and ginkgo) could help adults with ME/CFS. Over 60 days, people taking the supplement reported improvements in fatigue, memory, sleep quality, and ability to exercise compared to those taking a placebo. The treatment also lowered certain chemicals in the blood (ammonia and lactic acid) that may be linked to fatigue.
Why It Matters
ME/CFS lacks proven pharmacological treatments, making exploration of botanical interventions potentially valuable. The finding of reduced blood ammonia and lactic acid coupled with symptom improvement suggests a possible mechanistic link to metabolic dysfunction, which could inform future research into disease pathophysiology.
Observed Findings
Both treatment groups reported significant improvements in memory/concentration, physical fatigue, unrefreshing sleep, and post-exertional malaise compared to placebo (p<0.001)
Blood ammonia and lactic acid levels were significantly lower in treatment groups versus placebo
CFQ-11 physical and mental fatigue scores decreased in treatment groups (p<0.01)
WHOQOL and SLQQL quality-of-life scores improved in treatment groups (p<0.01)
Change in lactic acid concentration was negatively associated with CFS symptom severity (p=0.0108)
Inferred Conclusions
The botanical product showed promise in ameliorating multiple ME/CFS symptoms
Reductions in blood ammonia and lactic acid may contribute to symptom improvement, suggesting a possible metabolic mechanism
Higher doses did not consistently outperform lower doses, suggesting dose optimization is needed
Larger, longer trials with improved methodologies are necessary to validate clinical utility
Remaining Questions
What is the mechanism by which cistanche and ginkgo reduce ammonia and lactic acid, and does this directly cause symptom improvement or represent correlation?
What This Study Does Not Prove
This study does not prove cistanche and ginkgo are a reliable or clinically meaningful treatment for ME/CFS—the authors themselves noted trivial effect sizes that may lack real clinical relevance. The mechanism linking reduced blood ammonia/lactic acid to symptom improvement remains speculative and requires validation. The results cannot be generalized beyond the study population (non-obese, ages 35-60).