MACA plus Pygeum by Wonder Laboratories

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Age-related testosterone deficiency. It is unclear if oral maca is beneficial for age-related testosterone deficiency. Details: A moderate-size clinical study in eugonadal males age 65 years on average with symptoms related to late-onset hypogonadism shows that taking maca 1.66 grams three times daily for 12 weeks improves physical, sexual, and psychological symptom scores when compared with placebo. However, maca did not lead to a significant difference in testosterone levels between groups (112012). The interpretation of these findings is limited by the use of patient-reported outcomes.
• Amenorrhea. Although there has been interest in using oral maca for amenorrhea, there is insufficient reliable information about the clinical effects of maca for this purpose.
• Anemia of chronic disease. Although there has been interest in using oral maca for anemia of chronic disease, there is insufficient reliable information about the clinical effects of maca for this purpose.
• Antidepressant-induced sexual dysfunction. It is unclear if oral maca is beneficial in patients with sexual dysfunction due to antidepressants. Details: Preliminary clinical research shows that taking maca 1.5 grams twice daily for 12 weeks modestly increases remission rates in females experiencing antidepressant-induced sexual dysfunction (90278).
• Athletic performance. It is unclear if oral maca is beneficial for athletic performance. Details: A small clinical study in male elite athletes shows that taking maca 2500 mg twice daily for 8 weeks may improve some measures of physical performance, including grip strength, power, or agility, when compared to baseline (112014). However, the interpretation of this study is limited by the lack of a control group, inconsistent results among the various types of athletes included in the study, and unreported habitual activities, such as diet, that may confound results.
• Chronic fatigue syndrome (CFS). Although there has been interest in using oral maca for CFS, there is insufficient reliable information about the clinical effects of maca for this purpose.
• Depression. Although there has been interest in using oral maca for depression, there is insufficient reliable information about the clinical effects of maca for this purpose.
• Fatigue. Although there has been interest in using oral maca for fatigue, there is insufficient reliable information about the clinical effects of maca for this purpose.
• Leukemia. Although there has been interest in using oral maca for leukemia, there is insufficient reliable information about the clinical effects of maca for this purpose.
• Male infertility. It is unclear if oral maca is beneficial for male infertility. Details: Clinical research shows that taking a specific maca product (Maca Gelatinizada La Molina, Laboratorios Hersil) 1.5-3 grams daily for 4 months increases semen volume, sperm count, and sperm motility in healthy males aged 22-44 years (18289). Conversely, a meta-analysis of 2 small clinical studies in males with infertility shows that taking 2-2.8 grams of maca daily for 12-16 weeks does not improve the concentration of semen when compared with placebo (112011). However, the interpretation of this finding is limited by the heterogeneity of the included studies.
• Memory. Although there has been interest in using oral maca for memory, there is insufficient reliable information about the clinical effects of maca for this purpose.
• Osteoporosis. Although there has been interest in using oral maca for osteoporosis, there is insufficient reliable information about the clinical effects of maca for this purpose.
• Postmenopausal conditions. It is unclear if oral maca is beneficial for postmenopausal conditions. Details: Two small clinical trials show that taking powdered maca (Maca Power, Incan Food, Healthychoices) 3.3 or 3.5 grams daily as a single dose or in two divided doses for 6 weeks modestly reduces anxiety, depression, and sexual dysfunction when compared with placebo (90606,99792). However, these changes are generally small and of questionable clinical significance (90606).
• Sexual desire. It is unclear if oral maca improves male sexual desire; it has not been evaluated for female sexual desire. Details: Preliminary clinical research shows that taking a specific maca product (Maca Gelatinizada La Molina, Laboratorios Hersil), 1.5-3 grams daily in three divided doses for 12 weeks can increase subjective feelings of sexual desire in healthy males aged 21 to 57 years (9928).
• Tuberculosis. Although there has been interest in using oral maca for tuberculosis, there is insufficient reliable information about the clinical effects of maca for this purpose. More evidence is needed to rate maca for these uses.

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LIKELY EFFECTIVE

• Benign prostatic hyperplasia (BPH). Most clinical research shows that taking oral pygeum reduces the frequency and severity of BPH symptoms in adults. However, it is unclear how pygeum compares with the standard prescription medications. Details: Meta-analyses of randomized clinical trials show that adults with BPH who take oral pygeum 75-200 mg daily for 60-90 days are about twice as likely to have improvement in BPH symptoms as those taking placebo. Taking pygeum also increases peak urine flow by 23% and reduces residual urine volume by 24% in patients with BPH (10425,10426). Preliminary clinical research also shows that once daily dosing is as effective as twice daily dosing (6368). Pygeum has also been evaluated in combination with other ingredients. One small study shows that taking a specific combination product (ProstateEZE Max, Caruso's Natural Health) containing pygeum, pumpkin seed oil, Epilobium parviflorum, lycopene, and saw palmetto as 1 capsule daily for 3 months decreases daytime urinary frequency by an additional 16% and nighttime urinary frequency by an additional 32% when compared with placebo (92164). In another clinical trial, taking a combination of pygeum and stinging nettle for 6 months did not improve BPH symptoms when compared with placebo; however, the study may have been inadequately powered to detect a difference between groups (70219).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Alzheimer disease. Although there has been interest in using oral pygeum for Alzheimer disease, there is insufficient reliable information about the clinical effects of pygeum for this purpose.

  
  Malaria. Although there has been interest in using oral pygeum for malaria, there is insufficient reliable information about the clinical effects of pygeum for this purpose.

  
  Psychosis. Although there has been interest in using oral pygeum for psychosis, there is insufficient reliable information about the clinical effects of pygeum for this purpose.

  
  Sexual desire. Although there has been interest in using oral pygeum for sexual desire, there is insufficient reliable information about the clinical effects of pygeum for this purpose.

  
  More evidence is needed to rate pygeum for these uses.

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LIKELY SAFE ...when maca is consumed in food amounts (9926).

POSSIBLY SAFE ...when used orally and appropriately, short term. Maca appears to be safe in doses up to 3 grams daily for 4 months (9928,10218,18289,90278,108603).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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LIKELY SAFE ...when used orally and appropriately. Pygeum 75-200 mg daily has been used safely in clinical trials for up to 12 months (3903,6368,10425,10426).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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General ...Orally, no adverse effects have been reported with the medicinal use of maca. However, a thorough evaluation of safety outcomes has not been conducted.

Gastrointestinal ...Consumption of fresh, uncooked maca may cause stomach pain (40231).

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General ...Orally, pygeum is generally well tolerated.

Gastrointestinal ...Orally, pygeum has been associated with nausea and abdominal pain in some clinical research. However, the rate of these events were similar to placebo (10425,10426,70238).

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