How to treat chronic fatigue with maca

Chronic fatigue syndrome (CFS/ME) is a multi-faceted condition with an array of non-localised symptoms that can often be seemingly unrelated. Before beginning any treatment plan we highly recommend you read our  understanding chronic fatigue review and treating chronic fatigue review so you can understand the role of maca within the big picture of recovery to full health. No one supplement can cure chronic fatigue but creating a holistic recovery plan based on the known pathophysiology of CFS can assist you to reach your health potential.

Step 1:

Take 1-1.5 tsp per day of Seleno Health Maca for Women or Maca for Men with breakfast or lunch. Minimum suggested treatment time is 6-12 weeks. Beyond this you may continue to consume maca daily and do not require taking a break from treatment if you are receiving positive benefits. For recipe ideas of how to include maca in your daily routine download our recipe booklet here or watch our recipe channel here.

Treating with maca for women

Treating with maca for men

Step 2:

Take 1 additional sachet of Seleno Health Atomised Red Maca or Black Maca on days when symptoms are worse. Align the colour of the Maca to the symptoms shown below in Table 1. Dissolve the powder into water, a tea, juice, smoothie or other drink.

Maca for PMS
Maca for libido

Take Red Maca to manage acute:

  • Exhaustion
  • Anxiety
  • Palpitations
  • Mood Swings
  • Sugar Cravings
  • Excessive Sweating
  • Pensiveness
  • Tinnitus
  • Achy Bones and Lower Back
  • Poor Sleep
  • Poor Immunity

Take Black Maca to manage acute:

  • Tiredness
  • Depression
  • Lack of Motivation
  • Pain
  • Muscular Tension
  • Headaches and Migraine
  • Brain Fog
  • Frustration
  • Muscle Weakness
  • Shortness of Breath
  • Poor motor neuron function

Gut healing comprehensive chronic fatigue support pack

An all in one treatment pack for improving endocrine function, liver function and to heal and reduce chronic gut inflammation. 2 months of supplemental support.

Maca for treating chronic fatigue

Chronic fatigue syndrome (CFS), a devastating and poorly understood disorder, is estimated to affect millions of people worldwide.

Nearly 90% of CFS cases remain undiagnosed due to the complex nature of the syndrome1,2,3. Symptoms of CFS are broad and non-specific, meaning diagnosis is generally made by excluding other possible diseases. Symptoms can be debilitating as they persist over extended periods and can include the following4:

  • Feelings of extreme fatigue
  • Post exertional malaise (PEM) – tiredness with exertion
  • Inability to perform normal activities
  • Muscle pain and joint pain
  • Headaches and migraines
  • Gastrointestinal issues
  • Swollen glands
  • Trouble sleeping
  • Trouble concentrating (brain fog)
  • Food sensitivities

There are several comorbidities patients with CFS also suffer. Commonly, fibromyalgia is found in individuals with CFS5. Fibromyalgia affects 2-8% of the population and is characterised by widespread pain and stiffness throughout the body, fatigue, headaches, and sleep problems1,6. Other comorbidities often associated with CFS include5:

  • Irritable bowel syndrome (IBS)
  • Chronic pelvic pain
  • Multiple chemical sensitivities
  • Temporomandibular disorder

The causes and risk factors associated with CFS are not fully understood. CFS is thought to be triggered by a combination of several factors in genetically predisposed individuals4. Suspected risk factors and triggers for CFS symptoms include1,4,7:

  • Infection
  • Stress
  • Metabolic disturbances
  • Dysregulated immune system
  • Autoimmunity

Several, or all, of the above risk factors, may be involved in initiating the inflammatory processes that are associated with CFS. Recent research has begun to shed more light on the progression of the condition with a consensus now pointing towards the involvement of the microbiome and inflammatory cascade (read more here).

In summary, studies of patients with chronic fatigue have proposed that a source of primary inflammation initiates an imbalance of the gut microbiota and eventually leads to increased gut permeability (leaky gut) and dysbiosis.7a A leaky gut allows toxins and bacteria to leave the intestine and enter the blood and lymphatic vessels, maintaining a chronic inflammatory environment that can trigger autoimmunity and immune dysfunction. Finally, the continual dysregulation of the immune system perpetuates dysregulation of the hypothalamus-pituitary-adrenal axis (HPA) in the brain via the inflammatory cascade. This in-turn affects the energy production pathways and normal mitochondrial function (Scheme 1)

Scheme 1. The inflammatory processes leading to dysfunction of energy production.

The HPA axis is a complex set of hormonal interactions that produces cortisol and manages the body’s natural response to stressors. Cortisol plays critical roles throughout the body during stress, including the initiation or modulation of the immune response. During an infection, pro-inflammatory signalling molecules called cytokines are released by immune cells. Cytokines signal to surrounding cells that there is a threat that needs to be eradicated (Scheme 2). TNF-α and Interleukins (IL) are two types of cytokines commonly released in an inflammatory environment. TNF-α is a key mediator of inflammation released during a wide range of immune threats and therefore is a therapeutic target with many current pharmaceutical approaches. Dysregulation of the TNF-α cytokine is associated with autoimmunity, where the body attacks its healthy cells. Interleukins are a large group of cytokines released during an inflammatory event and possess both pro- and anti-inflammatory properties.

Cytokines such as TNF-α can stimulate the HPA axis and enhance cortisol levels, which in turn inhibit further production of cytokines8. This type of feedback loop is critical to return the immune system to homeostasis and prevent tissue damage caused by an aberrant response. In the setting of continual leaky gut and chronic inflammation, enhanced and prolonged cytokine production would be an ongoing issue. In this dysregulated environment, continued TNF-α production might perpetuate the HPA cycle and continually produce cortisol (Scheme 2). It is known that following chronic production of cortisol, cortisol dysfunction occurs due to several mechanisms9. Cortisol dysfunction could then lead to unchecked cytokine production. Prolonged cytokine production can also weaken the intestinal barrier, which would exacerbate the primary leaky gut issue and ultimately, the associated symptoms10. These processes are known as the downward spiral to chronic inflammation and are prominent in the case of chronic fatigue.

Scheme 2. The inflammatory processes related to the gut and increased cytokine signalling in CFS.

Importantly, it has been shown that cytokines such as TNF-α and IL-2 are significantly higher in patients with CFS compared to control patients11. Hypocortisolism (adrenal fatigue), or the insufficient production of cortisol, was also associated with CFS in adolescent patients12. Overall, a balance of both the immune system and HPA axis is needed for the ability of 1) the immune system to respond appropriately to an infection/immune challenge and 2) the immune response to return to a level of homeostasis to keep the body in a healthy equilibrium.

In the proposed model of events that lead to CFS symptoms, long-term dysregulation of the HPA axis results in malfunctions in metabolic pathways. Mitochondrial dysfunction and metabolism defects, in turn, lead to enhanced oxidative stress13. Oxidative stress occurs when a cell produces more damaging reactive oxygen species (ROS) than its antioxidant system can block. This imbalance and resultant oxidative stress contribute to the pathology of CFS, in particular the symptoms of post-exertional malaise (PEM)13.

Currently, there is no cure for CFS, and treatment involves only treating the symptoms1. Unfortunately for some, treating the symptoms does not provide sufficient relief. There is a desperate need for treatment options that can repair the underlying issues of dysregulation, rather than mask the symptoms alone.

Maca is a medicinal root vegetable that grows above 4000m in the Andes of Peru. Traditionally maca is taken in Peru at all stages of life to build strength and resilience to stress and to balance endocrine function. The Inca believe that maca is a sacred feminine plant spirit that grows in the most extreme conditions (4000m + in altitude) and endures such extreme climatic stresses but thrives under them. She (la maca – feminine) is the food of your brain and her gift to you when you respect her is all her strength and resilience to stress. Furthermore her different colours have different properties and are used long-term or acutely to return balance to an out of balanced nervous system.

Red maca is believed to nourish the internal and black the external. In additional to daily consumption of boiled maca roots, the shamans and healers will look at your body’s constitution and see what energies are lacking before using red and black maca in high doses to treat symptoms via maceration of the roots. In essence, they will see which symptoms are dominant on any given day and treat with the colour that corresponds to return balance to the body. These ancient principals are the foundations of treating all chronic inflammatory conditions.

Properties of maca

The three colours of maca used traditionally to manage chronic health problems in Peru

How Maca can assist chronic fatigue

Clinically, maca has demonstrated properties that could treat both some of the symptoms that impact individuals with CFS and more importantly, some of the underlying defects that lead to the symptoms. As mentioned above, patients with CFS also had higher levels of pro-inflammatory cytokines and hypocortisolism11,12. In one study, maca treatment was able to regulate components of the HPA axis14. Another study showed that maca treatment was able to suppress production of inflammatory cytokines including TNF-α and IL-2, as well as recruit immune cells that are known to suppress immune responses15.

Maca contains macamides which are commonly known as fatty acid amides, or oleamides16-18. These fatty acid derivatives affect anti-inflammation through many different pathways. In a laboratory model of paw swelling, oleamides inhibited the production of TNF-α, IL-1ß, and IL6, thereby reducing paw swelling19. The same model showed an oleamide-induced reduction of reactive oxygen species (ROS) and a decrease in the expression of COX220. Non-steroidal anti-inflammatory drugs (NSAIDs) similarly inhibit COX2 function. Oleamides also acted in an anti-inflammatory capacity by suppressing ROS and ultimately protecting against sepsis-induced intestinal injury in rats21.

Phytosterols22 also contribute to the anti-inflammatory properties of maca. For example, stigmasterol suppresses TNF-alpha and reduces macrophage recruitment23, and beta-sitosterol is proposed as a chemo-preventative drug for colon carcinogenesis24. Other extractions from maca reduce fatigue by reducing muscle damage in mice25,26.

Maca has long been believed to improve low energy, which is one of the main symptoms of CFS. Faulty metabolism is thought to exacerbate the symptoms of CFS, which could explain the low energy levels and brain fog associated with the disorder. Studies suggest that maca can improve mitochondrial function and metabolism27-29. Furthermore, studies have shown a role for maca in improving cognitive function and physical endurance in rodents28, 30-32. Several studies have demonstrated the efficacy of maca in treating memory impairment and depression in a laboratory setting14, 33-35.

Altogether, these studies suggest the possibility that maca could be a feasible complimentary treatment option for the millions of patients suffering from CFS. Treatment with maca of both symptoms (low energy, depression, cognitive impairment) as well as underlying dysregulated mechanisms (oxidative stress, pro-inflammatory cytokine production, HPA axis dysregulation) that cause the symptoms would immensely benefit CFS patients.

Note: There is no upper limit with maca and everybody is different, so it is important to find your ideal dose that is right for your body, for some this may be less than the recommended for others it may be more. If you experience positive health benefits then we suggest you continue treatment at that ideal dosage. The material provided on this website is for information purposes only. It is not intended to replace medical advice or be a treatment for any medical condition. Users should consult a health professional if you have any concerns about your health, are starting any health or nutritional related treatment, or for any questions you may have regarding your own or any other party’s medical condition. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.

Bibliography

1. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). CDC: Centers for Disease Control and Prevention [cited 2019; Available from: https://tools.cdc.gov/medialibrary/index.aspx#/media/id/332483.
2. Jason, L., S. Torres-Harding, and M.G. Njoku, The Face of CFS in the U.S. The CIFIDS Chronicle, 2006: p. 16-21. https://www.researchgate.net/publication/236995875_The_Face_of_CFS_in_the_US
3. Solomon, L. and W.C. Reeves, Factors influencing the diagnosis of chronic fatigue syndrome. Arch Intern Med, 2004. 164(20): p. 2241-5. https://www.ncbi.nlm.nih.gov/pubmed/15534161
4. Chronic fatigue syndrome NIH: Genetic and Rare Diseases Information Center 2016; Available from: https://rarediseases.info.nih.gov/diseases/7121/chronic-fatigue-syndrome.
5. Aaron, L.A., et al., Comorbid clinical conditions in chronic fatigue: a co-twin control study. Journal of general internal medicine, 2001. 16(1): p. 24-31. https://www.ncbi.nlm.nih.gov/pubmed/11251747
6. Clauw, D.J., Fibromyalgia: a clinical review. Jama, 2014. 311(15): p. 1547-55. https://www.ncbi.nlm.nih.gov/pubmed/24737367
7. Sotzny, F., et al., Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an autoimmune disease. Autoimmun Rev, 2018. 17(6): p. 601-609. https://www.ncbi.nlm.nih.gov/pubmed/29635081
7a. Giloteaux L., Goodrich J.K., Walters W.A., Levine S.M., Ley R.E., Hanson M.R. et al. (2016) Reduced diversity and altered composition of the gut microbiome in individuals with myalgic encephalomyelitis/chronic fatigue syndrome. Microbiome 4, 953–959.
https://www.ncbi.nlm.nih.gov/pubmed/27338587
8. Malek, H., et al., Dynamics of the HPA axis and inflammatory cytokines: Insights from mathematical modeling. Comput Biol Med, 2015. 67: p. 1-12. https://www.ncbi.nlm.nih.gov/pubmed/26476562
9. Hannibal, K.E. and M.D. Bishop, Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Physical therapy, 2014. 94(12): p. 1816-1825. https://www.ncbi.nlm.nih.gov/pubmed/25035267
10. Rea, K., T.G. Dinan, and J.F. Cryan, The microbiome: A key regulator of stress and neuroinflammation. Neurobiology of stress, 2016. 4: p. 23-33. https://www.ncbi.nlm.nih.gov/pubmed/27981187
11. Strawbridge, R., et al., Inflammatory proteins are altered in chronic fatigue syndrome—A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 2019. 107: p. 69-83. https://www.ncbi.nlm.nih.gov/pubmed/31465778
12. Nijhof, S.L., et al., The role of hypocortisolism in chronic fatigue syndrome. Psychoneuroendocrinology, 2014. 42: p. 199-206. https://www.ncbi.nlm.nih.gov/pubmed/24636516
13. Blomberg J et al. Infection Elicited Autoimmunity and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An Explanatory Model. Front Immunol. 2018 Feb 15;9:229.
https://www.ncbi.nlm.nih.gov/pubmed/29497420
13a. Lee, J.-S., et al., Oxidative Stress is a Convincing Contributor to Idiopathic Chronic Fatigue. Scientific reports, 2018. 8(1): p. 12890-12890. https://www.ncbi.nlm.nih.gov/pubmed/30150620
14. Ai, Z., et al., Antidepressant-like behavioral, anatomical, and biochemical effects of petroleum ether extract from maca (Lepidium meyenii) in mice exposed to chronic unpredictable mild stress. Journal of medicinal food, 2014. 17(5): p. 535-542. https://www.ncbi.nlm.nih.gov/pubmed/24730393
15. Zheng, W., et al., Lepidium meyenii Walp Exhibits Anti-Inflammatory Activity against ConA-Induced Acute Hepatitis. Mediators Inflamm, 2018. 2018: p. 8982756. https://www.ncbi.nlm.nih.gov/pubmed/30647537
16. Muhammad, I., et al., Constituents of Lepidium meyenii ‘maca’. Phytochemistry, 2002. 59(1): p. 105-10.
17. McCollom, M.M., et al., Analysis of macamides in samples of Maca (Lepidium meyenii) by HPLC-UV-MS/MS. Phytochem Anal, 2005. 16(6): p. 463-9. https://www.ncbi.nlm.nih.gov/pubmed/16315492
18. Zhao, J., et al., New alkamides from maca (Lepidium meyenii). J Agric Food Chem, 2005. 53(3): p. 690-3. https://www.ncbi.nlm.nih.gov/pubmed/15686421

19. Moon, S.M., et al., Oleamide suppresses inflammatory responses in LPS-induced RAW264.7 murine macrophages and alleviates paw edema in a carrageenan-induced inflammatory rat model. Int Immunopharmacol, 2018. 56: p. 179-185. https://www.ncbi.nlm.nih.gov/pubmed/29414648
20. Oh, Y.T., et al., Oleamide suppresses lipopolysaccharide-induced expression of iNOS and COX-2 through inhibition of NF-kappaB activation in BV2 murine microglial cells. Neurosci Lett, 2010. 474(3): p. 148-153. https://www.ncbi.nlm.nih.gov/pubmed/20298753
21. Zou, Z., et al., Cx43 Inhibition Attenuates Sepsis-Induced Intestinal Injury via Downregulating ROS Transfer and the Activation of the JNK1/Sirt1/FoxO3a Signaling Pathway. Mediators of inflammation, 2019. 2019: p. 7854389-7854389. https://www.ncbi.nlm.nih.gov/pubmed/30948926
22. Zheng, B.L., et al., Effect of a lipidic extract from lepidium meyenii on sexual behavior in mice and rats. Urology, 2000. 55(4): p. 598-602. https://www.ncbi.nlm.nih.gov/pubmed/10736519
23. Kangsamaksin, T., et al., Lupeol and stigmasterol suppress tumor angiogenesis and inhibit cholangiocarcinoma growth in mice via downregulation of tumor necrosis factor-α. PloS one, 2017. 12(12): p. e0189628-e0189628. https://www.ncbi.nlm.nih.gov/pubmed/29232409
24. Baskar, A.A., et al., beta-sitosterol prevents lipid peroxidation and improves antioxidant status and histoarchitecture in rats with 1,2-dimethylhydrazine-induced colon cancer. J Med Food, 2012. 15(4): p. 335-43. https://www.ncbi.nlm.nih.gov/pubmed/22353013
25. Zheng, Y., et al., Two macamide extracts relieve physical fatigue by attenuating muscle damage in mice. J Sci Food Agric, 2019. 99(3): p. 1405-1412. https://www.ncbi.nlm.nih.gov/pubmed/30120787
26. Li, J., et al., Anti-fatigue activity of polysaccharide fractions from Lepidium meyenii Walp. (maca). Int J Biol Macromol, 2017. 95: p. 1305-1311. https://www.ncbi.nlm.nih.gov/pubmed/27840217
27. Vecera, R., et al., The influence of maca (Lepidium meyenii) on antioxidant status, lipid and glucose metabolism in rat. Plant Foods Hum Nutr, 2007. 62(2): p. 59-63. https://www.ncbi.nlm.nih.gov/pubmed/17333395
28. Guo, S.-S., et al., Preservation of Cognitive Function by Lepidium meyenii (Maca) Is Associated with Improvement of Mitochondrial Activity and Upregulation of Autophagy-Related Proteins in Middle-Aged Mouse Cortex. Evidence-Based Complementary and Alternative Medicine, 2016. 2016: p. 9. https://www.ncbi.nlm.nih.gov/pubmed/27648102
29. Sandoval, M., et al., Antioxidant activity of the cruciferous vegetable Maca (Lepidium meyenii). Food Chemistry, 2002. 79(2): p. 207-213. http://www.sciencedirect.com/science/article/pii/S0308814602001334
30. Shin, S., et al., Gelatinized and fermented powders of Lepidium meyenii (Maca) improve physical stamina and epididymal sperm counts in male mice. J. Emb. Trans, 2008. 23: p. 283-289. https://www.researchgate.net/publication/291889082_Gelatinized_and_fermented_powders_of_Lepidium_meyenii_Maca_improve_physical_stamina_and_epididymal_sperm_counts_in_male_mice
31. Choi, E.H., et al., Supplementation of standardized lipid-soluble extract from maca (Lepidium meyenii) increases swimming endurance capacity in rats. Journal of Functional Foods, 2012. 4(2): p. 568-573. http://www.sciencedirect.com/science/article/pii/S1756464612000436
32. Lin Zheng, B., et al., Effect of Aqueous Extract from Lepidium meyenii on Mouse Behavior in Forced Swimming Test. 2001. p. 258-268.
33. Rubio, J., et al., Effect of three different cultivars of Lepidium meyenii (Maca) on learning and depression in ovariectomized mice. BMC complementary and alternative medicine, 2006. 6: p. 23-23. https://www.ncbi.nlm.nih.gov/pubmed/16796734

34. Rubio, J., et al., Aqueous and hydroalcoholic extracts of Black Maca (Lepidium meyenii) improve scopolamine-induced memory impairment in mice. Food Chem Toxicol, 2007. 45(10): p. 1882-90. https://www.ncbi.nlm.nih.gov/pubmed/17543435
35. Rubio, J., et al., Aqueous Extract of Black Maca (Lepidium meyenii) on Memory Impairment Induced by Ovariectomy in Mice. Evidence-based complementary and alternative medicine : eCAM, 2011. 2011: p. 253958-253958. https://www.ncbi.nlm.nih.gov/pubmed/18955369

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Treating With Maca