Maca (Lepidium meyenii), coming to a health food store near you!

In accordance with my ongoing efforts to keep my patients and readers on the cutting edge of health and medicine, let me present Maca (Lepidium meyenii ), a plant grown high in the Andes mountains for over 2000 years. I only recently heard of it, and believe there is enough preliminary information to add it to the "one to watch" category.

Of course, the Peruvians would say it's been used medicinally for at least hundreds of years, for conditions related to male fertility and female menstual irregularities. It's also been used in Peru as a "vitality boosting" medicine, in atheletes to boost performance, and in people with depression or fatigue. In the last 5-10 yrs there has been a growing global interest in the plant for its medicinal properties, so much so that now you can find it at Whole Foods and many other natural markets.

So far the scientific evidence has been limited, finding only small effects on male libido, as well as in sperm quality, without affecting testosterone levels.  Studies in humans have looked at doses of 1500 and 3000mg daily and found no significant adverse effects. As always, it's a good idea to discuss any new medicine, plant or not, with your physician. Patients at risk for bleeding, or with hormone-senstivie cancers should be cautious when considering its use.

So is this a "natural Viagra"? Should everyone be using Maca? To help guide patients interested in using it, I've looked to Dr. Oz, who recommends the supplement to boost energy. I've also read Dr. Weil's take, and he feels there is insufficient evidence to supoprt using Maca medicinally at this time.

What about Dr. Blackman, you ask? While I do think the evidence is still too scant to make strong conclusions, I have recommended this to a few patients looking to conceive, and with fatigue. As I told them, it should be taken with food because it can cause heartburn. It may also cause insomnia, so pay attention to your sleep quality and if affected, cut back or stop completely.

For more info, please review the Bottom Line Monograph from NaturalStandard.com.

Evidence for Supplements

If you are looking for ideas on where to start with supplements, either for general health or for a specific problem, this website from and David McCandless and Andy Perkins, presents the best available evidence for a wide variety of herbs and nutritional supplements.

Using Pubmed and the Cochrane Collaboration databases, two widely used sources for cataloging and reviewing the biomedical literature, they've identified high quality studies that looked at the use of health supplements. Then they created a spreadsheet which gives "quality of evidence" and "popularity" scores to each supplement, as well as tags for specific conditions. Pretty simple, and very powerful.

Pregnancy and depression, new news.

I promise I'll have posts from other sources, but the New York Times just reported on a study done at Stanford in which women with depression who were pregnant saw significantly greater benefit from symptom-targeted acupuncture than from "generic" acupuncture or massage. Moreover, the amount of benefit these women received from the specific acupuncture was about the same as has been shown for antidepressant medications.

This is important because women who are taking antidepressants and become pregnant often face a difficult choice between continuing on an antidepressant, and taking a risk of harming the fetus, or of stopping the medication and suffering a relapse of their symptoms. (For more information, see the Mayo Clinic summary of risks/benefits of antidepressants during pregnancy.) This research suggests that focused acupuncture might be a great alternative.

It's also worth noting that the massage had a pretty good effect on the subjects' depression symptoms, so one might consider a combination of both anti-depression acupuncture and massage for depression in pregnancy.

Finally, I want to put in a plug for Jeannie Bianchi LAc, an excellent Chinese medicine and acupuncture practitioner whom I have been working with at the Noe Valley Clinic. She does a lot of work with pregnancy and post-partum care, and I've been learning a lot from her. If you are in the SF bay area and are looking for a good acupuncturist, she is great!