Which groups of people (pregnant women, thyroid disease patients) need to avoid using maca extract?

Regarding the applicable and prohibited populations of Maca root extract, it is necessary to comprehensively analyze its active ingredient characteristics, clinical research evidence, and safety data. The following provides a detailed explanation from a scientific basis perspective:

1. Suitable population for taking maca root extract (based on health needs and individual differences)

1.   People who suffer from long-term fatigue and lack of energy

-Scientific basis: Macamide can regulate the hypothalamic pituitary axis function, promote the secretion of neurotransmitters such as dopamine and norepinephrine, and improve central fatigue status (Phytomedicine 2019 study showed that taking 3g/d maca extract continuously for 8 weeks can significantly improve fatigue scale scores).   

-Attention: It is necessary to distinguish between physiological fatigue and pathological conditions (such as anemia and hypothyroidism), and it is recommended to first investigate underlying diseases.   

2.   Sports and fitness population (improving endurance and recovery)

-Mechanism: Polysaccharides can promote muscle glycogen synthesis, and thiocyanate, a metabolite of glucosinolates, may enhance mitochondrial respiratory chain function (Journal of the International Society of Sports Nutrition, 2021 study shows that 500mg/d maca extract can prolong exhaustion exercise time by 12%).   

-Applicable scenarios: Suitable for medium to high-intensity trainers, requiring carbohydrate supplementation.   

3. Adult males with sexual dysfunction (non organic causes need to be identified)

-Clinical evidence: Alkaloids in black maca extract may improve erectile function by regulating the nitric oxide (NO) pathway (according to a 2020 Cochrane systematic review, taking 1.5-3g maca extract daily for 12 weeks can increase the International Erectile Function Index (IIEF) by 15-20%).   

-Limitations: The effect on organic ED (such as vascular and neurological) is limited, and medical attention is needed to determine the cause.   

4. Women with mild menopausal syndrome (relieve hot flashes and emotional fluctuations)

-Characteristics of action: Maca does not have estrogenic effects, but improves autonomic nervous system function by regulating serotonin receptors (5-HT1A) (Menopause 2018 study showed that 2.8g/d red maca extract can reduce the frequency of hot flashes by 34%).   

-Attention: Moderate to severe symptoms still require hormone replacement therapy and avoid alternative medical interventions.   

5.   Sub healthy population with weakened immunity (auxiliary regulation under non disease conditions)

-Experimental basis: The sterols in the extract can enhance the proliferation ability of T lymphocytes, and animal experiments have shown that it can increase macrophage phagocytic activity (Journal of Ethnopharmacology 2022 in vitro experiment).   

-Limitations: It cannot replace vaccines or drugs for the treatment of immunodeficiency diseases.   

2. Identify the population that needs to be prohibited from using maca root extract (based on safety risks)

(1)   Absolute taboo group

1. Pregnant women and women planning to conceive

-Risk mechanism: Macamide may affect uterine smooth muscle excitability (animal experiments have shown that high doses can increase uterine contraction frequency), and there is currently a lack of human early pregnancy safety data (FDA has not approved its use during pregnancy).   

-Clinical recommendation: Discontinue use from 3 months before pregnancy to avoid affecting fetal development through the placenta.   

2. Patients with thyroid diseases (hyperthyroidism, Hashimoto's thyroiditis, etc.)

-Core reason: Maca contains glucosinolates, and its metabolite thiocyanate can competitively inhibit thyroid uptake of iodine, which may exacerbate thyroid dysfunction (Thyroid 2017 case report shows that TSH levels in hyperthyroidism patients decrease by 18% after taking maca).   

-Alternative solution: If you need to supplement energy, you can choose plant extracts without sulfur-containing glycosides (such as ginseng and Rhodiola rosea).   

3.   Individuals allergic to cruciferous plants

-Cross reactivity: Maca belongs to the Brassicaceae family and has homologous allergenic proteins with radish, broccoli, etc. There have been case reports of urticaria and laryngeal edema after taking it (Allergy 2015 literature).   

(2)   Cautious user population (requires medical evaluation)

1.   Breastfeeding women

-Data gap: It is unclear whether maca ingredients are secreted through breast milk, and the American College of Obstetricians and Gynecologists (ACOG) recommends avoiding the use of non essential herbal supplements during lactation.   

2.   Minors (≤ 18 years old)

-Developmental risk: There is a lack of research on the long-term effects of its active ingredients on the endocrine system of adolescents, which may interfere with the secretion rhythm of growth hormone.   

3.   Patients with hypertension or cardiovascular disease

-Potential risk: Maca may mildly increase hypertension (according to a 2019 study in Hypertension Research, the high-dose group (4g/d) had a 5-7mmHg increase in systolic blood pressure), and should be taken with a 2-hour interval from antihypertensive medication.   

4.   Patients with depression or anxiety (those currently taking medication)

-Drug interactions: Maca may enhance the serotonergic effect, and co administration with SSRI antidepressants (such as fluoxetine) may cause serotonin syndrome (symptoms such as tremors and high fever).   

III. Core Precautions Before Taking

1.   Dose control  : The recommended daily dose of maca extract in health food is usually ≤ 3g (based on dry product), and exceeding 5g may increase the risk of adverse reactions;   

2.   Cycle limit  : It is recommended to take continuously for no more than 3 months to avoid long-term stimulation of the hypothalamic pituitary axis;   

3. Raw material traceability: Select products that have been tested by third-party testing to ensure that they do not contain pesticide residues (such as cypermethrin) and heavy metals (lead ≤ 0.5mg/kg);   

4.   Special case consultation  : diabetes patients should pay attention to the reducing sugar content in the extract (some processes may leave 3-5% glucose), and should stop using it 2 weeks before surgery to prevent bleeding risk.   

The above content is based on the safety assessment requirements of the "Catalogue of Health Food Raw Materials" and the European and American clinical guidelines. In practical applications, adjustments should be made according to individual health conditions to avoid equating health functions with disease treatment.