Kuchta, Kenny, Cameron, Silke · Frontiers in pharmacology · 2020 · DOI
This review examines herbal medicines used in Japan and Russia to treat cachexia—a condition of muscle loss, weight loss, and fatigue. The researchers found that three traditional plant-based preparations (Hochuekkito, Juzentaihoto, and Rikkunshito) showed promise in clinical studies for reducing fatigue, increasing weight, and improving overall health in patients with cancer, COPD, dementia, and chronic fatigue syndrome. Since no approved medications currently exist for cachexia in Western medicine, the authors suggest these herbal treatments deserve further research and potential use in Europe and North America.
Post-exertional malaise and unintentional weight loss are significant problems in ME/CFS, and cachexia-like symptoms including fatigue and weakness are core disease features. This review identifies herbal approaches with documented clinical efficacy in fatigue and weight management in chronic illness, providing ME/CFS patients and researchers with evidence-based alternatives to explore given the current absence of approved pharmacotherapies. The mechanistic insights into inflammatory pathway modulation may be particularly relevant to ME/CFS pathophysiology.
This review does not establish efficacy of these herbal preparations specifically in ME/CFS populations—the included studies primarily involved cancer, COPD, dementia, and one small chronic fatigue syndrome trial. The heterogeneity of conditions, outcome measures, and study designs prevents definitive conclusions about which preparation is most effective or optimal dosing for any specific disease. Correlation between herbal treatment and improved outcomes does not prove causation, and publication bias toward positive results may inflate apparent effectiveness.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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