Maca Root Powder

NYBC recently decided to stock this form of the traditional botanical, which has a long history of use and some newer research as well to support its use. Below is our take on MACA (excerpted from our catalog description).

Read more, and purchase from the buyers’ co-op, at

MACA ROOT POWDER

Royal Maca (Whole World Botanicals) Each bottle, 180 maca root gelatinized capsules. Each capsule, 500 mg Royal Maca Root Extract along with 2.49 mcg of selenium. This is certified organic by BIO LATINA in Lima, Peru, which so far as we have reviewed here at NYBC appears to be a legitimate certification institution for organic products from this region.

Whole World Botanicals obtains its root from a farm in the high Central Sierra of Peru. Maca, from the root of Lepidium peruvianum / meyenii, has a nutty, malty flavor and is used in traditional medicine to address hormonal imbalances in both women and men. Consider it for managing PMS or menopausal symptoms, for low energy related to hypothyroidism (low function) and may help improve bone strength. Men also use it for libido, erectile function, mood, mental clarity, focus and energy (especially over age 40).

This product is a fair trade product, according to the manufacturer, however it is not labeled as such (yet).

Suggested use varies. For men, 2-6 capsules every day or every other day. For women, if young and peri-menopausal, 2 caps daily. If needed, increase to 3 caps per day in the second month. For women who are not menstruating, 2-3 caps per day for hot flashes is suggested. Evaluate after 5 days and increase by 1-2 caps per day every five days until symptoms are 80% better. Do NOT take with estrogen or estrogenic herbs (may increase hot flash symptoms!). Also do not take with estrogen or if you have any hormone-related cancer.

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Supplements for Depression: Updated Info Sheet from NYBC

We’ve updated our info sheet on Supplements for Depression, reflecting some additional supporting evidence that has accumulated for these applications, plus new references. See www.newyorkbuyersclub.org for detailed product information.

In recent years there’s been a lot of well-designed scientific research about the effectiveness of dietary supplements for depression. The supplements studied have ranged from the herb St. John’s Wort, which has a long tradition of use, to molecules like SAMe, L-Tryptophan, and 5-HTP, which play a role in the body’s production of neurotransmitters (such as serotonin) connected with mood and cognitive function. Other developments in depression research involve the steroid DHEA and fish oil.

DHEA (Dehydroepiandrosterone). In a study sponsored by the National Institute of Mental Health, DHEA was found to be an effective therapy for mild to moderate or severe midlife depression, on a par with some prescription drug treatments. Moreover, the NIMH research showed that taking DHEA promoted both a significant lifting of depressive symptoms and an improvement in sexual functioning. (On the other hand, inhibition of sexual function remains one of the chief troublesome side effects of prescription anti-depressants). Note that dosing recommendations vary for men versus women, and DHEA is not recommended for those diagnosed with prostate problems or cancer.

SAMe (S-adenosyl-l-methionine). First studied by Italian researchers in the 1950s, SAMe is produced naturally in the body from the amino acid methionine. Supplementing with SAMe increases concentrations of the neurotransmitters serotonin and L-dopamine, which are related to mood. Several studies show SAMe having an anti-depressant effect comparable to that of some prescription drugs. A dose of 400-800mg/day has been studied for mild to moderate depression, and 800-1600mg/day for the moderate to severe condition. As of 2007, SAMe was being compared with the prescription drug Lexapro® in a 5-year NIH-funded study. SAMe generally has fewer side effects than prescription anti-depressants. However, it should be avoided in people with bipolar disorder, and should be used cautiously with other anti-depressants, because the combination may push serotonin levels too high. Taking a B-complex vitamin while using SAMe can counter build up of homocysteine, which is associated with heart disease. (It’s best to take them separately.) SAMe also supports joint health and liver function, so may have positive effects for overall health if taken over the long term.

St. John’s Wort is a widely used herb with clinically demonstrated (multiple, well-controlled studies, mostly in Europe) anti-depressant effects for mild to moderate depression – generally without the side effects of prescription antidepressants. High doses of the herb may cause a sensitivity to light (phototoxicity), so avoid direct sunlight or sunbathing while using. Do not take St. John’s Wort with 5-HTP, serotonin re-uptake inhibitors (like Prozac), or with protease inhibitors, as it my affect beneficial liver enzymes. St. John’s Wort may also have activity against Epstein-Barr and herpes infections.

L-Tryptophan and 5-HTP (5-hydroxy L-tryptophan): These closely-related supplements are converted in the body to serotonin and to melatonin. (Specifically, L-Tryptophan converts to 5-HTP, which then converts to serotonin or melatonin.) Their use as antidepressants has been studied, and they have also been found to aid sleep and suppress appetite. (To minimize appetite suppression, try taking the supplement an hour before bedtime.) Mild gastrointestinal side effects have been reported with both. For best absorption, take with water or juice, and separately from protein-containing foods and dietary supplements. Although L-Tryptophan and 5-HTP are close relatives, people may respond somewhat differently to them. Thus, if encountering unwanted side effects or lack of effect from one, it may still be worthwhile to try the other.
The suggested dosage for 5-HTP is wide, ranging from 50 and 500 mg daily. It can be used together with other anti-depressants, in which case an effective dose could be quite low. The best approach is to start at the low end of the range and increase as needed. Like 5-HTP, L-Tryptophan has been used in combination with other anti-depressants, and has also been employed with lithium for bipolar disorder. An added benefit: 5-HTP may also decrease symptoms of fibromyalgia and migraine headaches.

Fish Oil. Epidemiological studies have suggested that populations that eat fish regularly have low rates of depression. More recently, research has found fish oil supplements (omega-3 fatty acids being the significant component) of benefit in treating depression and bipolar disorder. It’s also worth noting that fish oil can be taken with other anti-depressants as an adjunct therapy. Doses found effective in treating depression are quite high, 3 to 9 grams per day, so be aware of potential problems related to the supplement’s blood-thinning properties. Added benefit: as has been widely reported, fish oil can have a beneficial impact on cholesterol regulation and in supporting cardiovascular health.

References:
Christian R. Dolder, “Depression,” in Natural Products: A Case-Based Approach for Health Care Professionals, ed. Karen Shapiro, published by the American Pharmacists Association, Washington, DC (2006), pp. 97-114.
Shaheen E Lakhan and Karen F Vieira. “Nutritional therapies for mental disorders” in Nutrition Journal (2008), 7:2doi:10.1186/1475-2891-7-2. Accessed 10/7/2009 at http://www.nutritionj.com/content/7/1/2
Schmidt PJ, et al. “Dehydroepiandrosterone Monotherapy in Midlife-Onset Major and Minor Depression,” Archives of General Psychiatry (February 2005): Vol. 62, No. 2, pp. 154–62.
Hyla Cass, “Prescriptions for Depression,” in Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition. Basic Health Publications (2007), pp. 113-128.

L-Arginine for sexual function: background and references from Natural Products: A Case-Based Approach for Healthcare Professionals (2006: American Pharmacists’ Association)

The excellent reference work Natural Products: A Case-Based Approach for Healthcare Professionals, Karen Shapiro, ed., published  by the American Pharmacists’ Association in 2006, provides background and references to the scientific literature on the use of L-arginine for erectile dysfunction.

L-arginine, an amino acid required for the synthesis of nitric oxide, has been studied for erectile dysfunction with a dosage of 5g (= 5 x 1000mg) per day. It was also a component in a study of women with decreased libido; dosage in that study was 2.5g (= 2.5 x 1000mg) per day. L-arginine was found to be “well-tolerated” in general, though it has hypotensive (or blood pressure-lowering) effects and should not be used following heart attack.

Citation: “Erectile Dysfunction,” pp. 51-62, in Natural Products: A Case-Based Approach for Healthcare Professionals, Karen Shapiro, ed., (Washington, DC: American Pharmacists’ Association, 2006).

DHEA and depression

Here are citations for two well-designed recent studies on DHEA and depression. The first was undertaken by the NIH/National Institute of Mental Health and used DHEA as the sole therapy with a group of men and women aged 45 to 65 who were experiencing major or minor midlife-onset depression. The researchers concluded that DHEA was an effective treatment for this group. Note: a further item of interest is that DHEA therapy was also found to be associated with improvement in sexual function. (Contrast with certain prescription anti-depressants, which shall remain nameless!)
The second study, by Judith Rabkin et al. at Columbia Univ., focused on people with HIV and examined DHEA as a therapy for non-major depression, especially among a group that was not in the best physical health. The finding: DHEA was an effective and useful therapy under these conditions.
For more information on DHEA, including recommendations for use, see the NYBC
description of

DHEA – Douglas Laboratories

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Source: Arch Gen Psychiatry. 2005 Feb;62(2):154-62.

Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression.

Authors: Schmidt PJ, Daly RC, Bloch M, Smith MJ, Danaceau MA, St Clair LS, Murphy JH, Haq N, Rubinow DR. Behavioral Endocrinology Branch, National Institute of Mental Health, Rockville, MD CONTEXT: Alternative and over-the-counter medicines have become increasingly popular choices for many patients who prefer not to take traditional antidepressants. The adrenal androgen and neurosteroid dehydroepiandrosterone (DHEA) is available as over-the-counter hormonal therapy and previously has been reported to have antidepressant-like effects. OBJECTIVE: To evaluate the efficacy of DHEA as a monotherapy treatment for midlife-onset depression. DESIGN: A double-blind, randomized, placebo-controlled, crossover treatment study was performed from January 4, 1996, through August 31, 2002.S ettings The National Institute of Mental Health Midlife Outpatient Clinic in the National Institutes of Health Clinical Center, Bethesda, Md.Patients Men (n = 23) and women (n = 23) aged 45 to 65 years with midlife-onset major or minor depression participated in this study. None of the subjects received concurrent antidepressant medications.Intervention Six weeks of DHEA therapy, 90 mg/d for 3 weeks and 450 mg/d for 3 weeks, and 6 weeks of placebo. MAIN OUTCOME MEASURES: The 17-Item Hamilton Depression Rating Scale and Center for Epidemiologic Studies Depression Scale. Additional measures included the Derogatis Interview for Sexual Functioning. Results were analyzed by means of repeated-measures analysis of variance and post hoc Bonferroni t tests. RESULTS: Six weeks of DHEA administration was associated with a significant improvement in the 17-Item Hamilton Depression Rating Scale and the Center for Epidemiologic Studies Depression Scale ratings compared with both baseline (P<.01) and 6 weeks of placebo treatment (P<.01). A 50% or greater reduction in baseline Hamilton Depression Rating Scale scores was observed in 23 subjects after DHEA and in 13 subjects after placebo treatments. Six weeks of DHEA treatment also was associated with significant improvements in Derogatis Interview for Sexual Functioning scores relative to baseline and placebo conditions.CONCLUSION: We find DHEA to be an effective treatment for midlife-onset major and minor depression.

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Source: American Journal of Psychiatry. 2006 Jan;163(1):59-66.

Placebo-controlled trial of dehydroepiandrosterone (DHEA) for treatment of nonmajor depression in patients with HIV/AIDS

Authors: Rabkin JG, McElhiney MC, Rabkin R, McGrath PJ, Ferrando SJ.
New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York

OBJECTIVE: Subsyndromal major depressive disorder is common among HIV-positive adults. This study was designed to assess the efficacy of dehydroepiandrosterone (DHEA) as a potential treatment. METHOD: One hundred forty-five patients with subsyndromal depression or dysthymia were randomly assigned to receive either DHEA or placebo; 90% (69 of 77) of the DHEA patients and 94% (64 of 68) of the placebo patients completed the 8-week trial. The primary measure of efficacy was a Clinical Global Impression improvement rating of 1 or 2 (much or very much improved) plus a final Hamilton Depression Rating Scale score <or=8. Outcome was assessed by using intent-to-treat analysis, followed by completer analysis. Safety was assessed by queries about side effects at every study visit plus measures of CD4 cell count and HIV RNA viral load at baseline and week 8. DHEA dosing was flexible (100-400 mg/day). RESULTS: On the basis of clinicians’ ratings, DHEA was superior in the intent-to-treat analysis, where the response rate was 56% (43 of 77) for the DHEA group versus 31% (21 of 68) for the placebo group. In the completer analysis, the response rate was 62% (43 of 69) for the DHEA group, compared to 33% (21 of 64) for the placebo patients. The number needed to treat was 4 on the basis of intent-to-treat data and 3.4 on the basis of completer data. Few adverse events were reported in either treatment group, and no significant changes in CD4 cell count or HIV RNA viral load were observed in either group.

CONCLUSIONS: Nonmajor but persistent depression is common in patients with HIV/AIDS, and DHEA appears to be a useful treatment that is superior to placebo in reducing depressive symptoms. The low attrition rate in this group of physically ill patients, together with requests for extended open-label treatment, reflect high acceptance of this readily available intervention.