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Cistanche (herb)

Also known as: Cistanche tubulosa, Cistanche deserticola, Cistanche, Rou Cong Rong

Overview

Cistanche, primarily *Cistanche tubulosa* and *Cistanche deserticola*, is a parasitic desert plant widely used in Traditional Chinese Medicine (TCM). It is harvested for its stems, which are rich in bioactive compounds, particularly phenylethanoid glycosides (PhGs). Traditionally, Cistanche has been used to address "kidney-yang" deficiency, infertility, and neurodegenerative disorders. Modern research is exploring its potential antidepressant, cognitive-enhancing, immunomodulatory, and antitumor properties. The plant's pharmacological effects are largely attributed to its phenylethanoid glycoside content. While research shows promise, most studies are preclinical or small-scale clinical trials, highlighting the need for more robust, large-scale randomized controlled trials and meta-analyses to confirm its efficacy and safety.

Benefits

Cistanche exhibits several potential benefits supported by preclinical and limited clinical evidence. In rodent models, *Cistanche tubulosa* extract has shown significant antidepressant effects by improving depressive-like behaviors, restoring brain serotonin (5-HT) and brain-derived neurotrophic factor (BDNF) levels, and modulating gut microbiota composition. Animal studies also indicate cognitive improvement, including enhanced spatial learning and memory, and increased dopamine levels. Furthermore, phenylethanoid glycosides from *Cistanche tubulosa* have demonstrated antitumor activity by inhibiting hepatocellular carcinoma cell growth and enhancing immune cell proliferation in mouse models. Preliminary evidence suggests potential benefits for infertility and reproductive health with a favorable safety profile. However, more human studies are needed to validate these findings.

How it works

Cistanche's mechanism of action involves several biological pathways. It modulates neurotransmitters like serotonin and dopamine, and enhances neurotrophic factors such as BDNF in the brain, contributing to its antidepressant and cognitive-enhancing effects. The herb also regulates gut microbiota and the production of neuroactive metabolites like short-chain fatty acids (SCFAs), influencing the microbiota–gut–brain axis. Additionally, Cistanche induces apoptosis and cell cycle arrest in tumor cells via MAPK pathway activation and mitochondrial pathways. Its immunomodulatory effects are achieved by enhancing splenocyte proliferation and reducing apoptosis. These interactions span the central nervous, immune, and gastrointestinal systems, as well as oncological pathways.

Side effects

Cistanche generally exhibits a favorable safety profile based on traditional use and preclinical studies. Common side effects are not well-documented in human studies, and animal studies have reported no significant adverse effects at tested doses. Uncommon and rare side effects are also not reported in the available literature. However, caution is advised when combining Cistanche with antidepressants or chemotherapy agents due to potential pharmacodynamic interactions. Contraindications are not clearly established, and there is insufficient data to support its use during pregnancy or breastfeeding. Special population considerations are limited, but traditional use suggests caution in pregnant women. Further research is needed to comprehensively assess the safety profile in diverse populations and identify potential drug interactions.

Dosage

Due to limited human data, the minimum effective dose and optimal dosage ranges for Cistanche are not well-established. Animal studies have used doses scaled to body weight, with extracts equivalent to several hundred mg/kg. The maximum safe dose is also undefined, as no toxicity has been reported at studied doses in animals. For neuropsychiatric benefits, chronic administration appears necessary. Extracts standardized for phenylethanoid glycosides are commonly used in research. Specific absorption factors and required cofactors are currently unknown. Further research is needed to determine appropriate dosage guidelines for humans and to explore strategies for enhancing bioavailability.

FAQs

Is Cistanche safe for long-term use?

Traditional use and animal studies suggest safety, but long-term human data are lacking. More research is needed to confirm its safety profile with extended use.

Can it be used for depression?

Preclinical evidence supports antidepressant-like effects, but clinical trials are needed to validate its efficacy in treating depression in humans.

Does it improve memory?

Animal studies show cognitive benefits; however, human evidence is limited. Further research is necessary to determine its impact on memory in humans.

Is it effective against cancer?

In vitro and animal studies indicate antitumor potential, especially in liver cancer models, but clinical evidence is absent. More research is required.

How quickly do effects appear?

Effects in animal models require weeks of treatment. The onset of effects in humans is not well-defined and requires further investigation.

Research Sources

  • https://pubmed.ncbi.nlm.nih.gov/38718638/ – This systematic review and meta-analysis investigates the effects of Cistanche on male infertility. It concludes that Cistanche is a promising treatment for male infertility with a favorable safety profile compared to conventional drugs, but more high-quality trials are needed to confirm these findings.
  • https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2018.00967/full – This study on rats with chronic unpredictable stress showed that *Cistanche tubulosa* extract improved depressive behaviors and restored hippocampal 5-HT and BDNF levels. The research also linked gut microbiota changes to neurochemical improvements, supporting a microbiota–gut–brain axis mechanism.
  • https://onlinelibrary.wiley.com/doi/10.1155/2017/3925903 – An animal study demonstrated that *Cistanche* decoction reduced immobility in the tail suspension test and improved spatial memory in the Morris water maze. The study found that it downregulated monoamine oxidase activity and increased brain dopamine, indicating a neurochemical basis for antidepressant and cognitive effects.
  • https://www.mdpi.com/2072-6643/17/9/1501 – This systematic review summarizes the bioactive compounds and pharmacological effects of *Cistanche deserticola*, highlighting immune regulation, neuroprotection, and antioxidant activities. The review emphasizes the need for more rigorous clinical trials to confirm efficacy and safety in humans.
  • https://journals.sagepub.com/doi/abs/10.1177/15347354211013085 – An in vitro and mouse model study showed that phenylethanoid glycosides from *Cistanche tubulosa* induced apoptosis and cell cycle arrest in hepatocellular carcinoma cells, activated MAPK pathways, and enhanced immune cell proliferation. Combined with cisplatin, it improved antitumor efficacy and reduced chemotherapy side effects in mice.