Clinical effects of wasabi extract containing 6-MSITC on myalgic encephalomyelitis/chronic fatigue syndrome: an open-label trial 2022 Oka et al

Abstract

Background
Wasabi (Eutrema japonicum) is a common pungent spice used in Japan. 6-Methylsulfinylhexyl isothiocyanate (6-MSITC) found in the rhizome of wasabi has been shown to have anti-inflammatory and antioxidant effects, as well as improve neuroinflammation and memory. Therefore, we hypothesized that these effects would be beneficial for treating myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The present study was conducted to investigate the effectiveness of wasabi extract containing 6-MSITC on ME/CFS in an open-label trial.

Methods
Fifteen patients (3 males, 12 females, 20–58 years old) were orally administered wasabi extract (9.6 mg of 6-MSITC/day) for 12 weeks. The following parameters and test results were compared pre- and post-treatment: performance status (PS), self-rating questionnaires, pressure pain threshold (PPT) on the occiput, Trail Making test-A (TMT-A), and hemodynamic patterns determined by an active standing test.

Results
After treatment with 6-MSITC, PS improved significantly (p = 0.001). Although the scores on the 11-item Chalder Fatigue scale (CFS-11) and numerical rating scale (NRS) of fatigue did not show significant changes, subjective symptoms improved significantly, including headache frequency (4.1 to 3.0 times/week, p = 0.001) and myalgia (4.1 to 2.4 times/week, p = 0.019), NRS brain fog scores (5.7 to 4.5, p = 0.011), difficulty finding appropriate words (4.8 to 3.7, p = 0.015), photophobia (4.8 to 3.5, p = 0.008), and the Profile of Mood Status vigor score (46.9 to 50.0, p = 0.045). The PPT of the right occiput (17.3 to 21.3 kPa, p = 0.01) and TMT-A scores (53.0 to 38.1 s, p = 0.007) also changed, suggesting reduced pain sensitivity, and improved cognitive function, respectively. Orthostatic patterns determined by a standing test did not show remarkable changes. There were no serious adverse reactions.

Conclusion
This study suggests that 6-MSITC improves PS as well as subjective symptoms such as pain and cognitive dysfunction, and psychological vitality of patients with ME/CFS. It also improved cognitive performance and increased pain thresholds in these patients. 6-MSITC may be a promising therapeutic option especially for improving cognitive dysfunction associated with ME/CFS.

Open access, https://bpsmedicine.biomedcentral.com/articles/10.1186/s13030-022-00255-0

 

But was sushi administered along with the wasabi? Important!

Imagine the improvement if co-administered with high quality toro!

 

This is the evidence-based medicine model in a nutshell: literally anything can pass through it. That's why everything passes through it, because anything can, as long as the people involved want it to.

Whether it's yoga, CBT, exercise of any form, healing crystals, snorting freebased Brussels sprouts, afternoon tea, giving people $50, it makes zero difference in outcome: if the people involved want something to "work", it will. Eventually, there are infinite tries and no one cares about 99 misses if there's a single false hit.

This is the model they built, so that the stuff they like can pass through. Well, literally all pseudosciences can pass through. And they will, it's just a matter of time. The model has been perfected to the point where it means nothing at all anyway.

 

The Science Based Medicine critique requires that EBM use a 'prior plausibility' test - here it would necessary to show that ME/CFS involves inflammation or is quantifiably responsive to treatment with well established anti-inflamatory drugs, similarly for injestible antioxidants (whatever they are !) and then if warranted in combination anti-inflamatories and injestible antioxidants.

Only having established that there is a) something to treat, and b) that it is treatable would there be demonstrable plausibility to move toward a novel substance that would be tested for comparative impacts with well understood alternatives.

 

*Chucks the paper into the wastebasket*

 

The Chalder Fatigue Scale needs to be retired.

Poor study design is the backbone in psychology and psychiatry.

 

Made my evening

 

Reminds me of the tumeric craze for osteo-arthritis and whatever ails one.

Even my primary care doc said (he was just about out the door)"a lot of my patients swear that tumeric helps them."
Thanks, Dr. Anecdote.

Turns out that the gut doesn't absorb the tumeric. Very very little enters the bloodstream.

Spices have spiritual force and dragons live under the South China Sea.

 

Really? Is this medicine of the future? What's next? Deer antlers?

 

To be fair, at least this study included one semi-objective and one objective outcome measure.

The latter, hemodynamics measured during an active standing test, showed no effect.

It's harder to know what to make of the former, the Trail Making test-A, which showed significant improvement. However, that test is prone to inconsistent results in a fluctuating condition like ME where it may just measure how exhausted you happen to be at the time of taking the test. It consists of the numbers 1 to 25 randomly scattered over a page and you have to draw a line to connect them in order as quickly as possible.

All the other outcomes are self-reported and while some of them show modest improvements, which you'd expect from an open label set up, others show no improvement at all even under open label.

So all up and taken together with the small n the data do not support the conclusion that "6-MSITC may be a promising therapeutic option especially for improving cognitive dysfunction associated with ME/CFS".

Pity really, I rather like wasabi. Coincidentally my husband is out buying sushi for dinner tonight though I believe those little green sachets you get with takeaways contain very little real wasabi. Maybe I should work on my belief here and convince myself I'm eating real wasabi for real benefit, for the placebo effect

 

Free fulltext:

https://link.springer.com/article/10.1186/s13030-023-00287-0

• Ryota Nakajima,

• Masanobu Kanou,

• Masahiko Tokushima,

• Yoshitaka Iwama &

• Kei Yamana

Oral administration of 6-methylsulfinylhexyl isothiocyanate extracted from wasabi is safe and improves the fatigue and sleep of healthy volunteers

• Research
• Open Access
• Published: 23 August 2023
• volume 17, Article number: 30 (2023)

Abstract
Background
This study aimed to conduct a preliminary evaluation of the effects of 6-methylsulfinylhexyl isothiocyanate (6-MSITC) contained in wasabi rhizomes on fatigue and sleep and to examine its safety through overdose study.

Methods
A total of 20 healthy volunteers who were experiencing daily fatigue were given powder containing 6-MSITC (4.8 mg/day of 6-MSITC) extracted from wasabi for 4 weeks. Then, fatigue, sleep, autonomic nervous functioning, stress, and immunity were evaluated. In addition, an overdose safety study of the extract powder (up to 16 mg/day of 6-MSITC for 4 weeks) was performed with 30 healthy volunteers in a double-blind, placebo-controlled method.

Results
The powder containing 6-MSITC did not improve fatigue after a mental task, but fatigue before the mental task, sleep, and mood were improved significantly after 4 weeks intake. No changes were observed in the autonomic nerve function, stress, or immune markers. In the overdose safety study, no changes in the parameters or side effects were observed, and the results showed that high doses of the extract powder containing 6-MSITC is safe.

Conclusion
This study confirmed the possibility that this powder extracted from wasabi that contains 6-MSITC might improve fatigue and sleep. However, because the effectiveness evaluation in this study was a single-arm, open-label study and there was no placebo control group, these points must be considered when interpreting the results. Safety was confirmed in an overdose study of more than three times the amount compared to that in the efficacy evaluation study. In the future, further research should be conducted on its effectiveness for treating fatigue and sleep problems.

 

Wasabi I love it, I’m gonna go ahead with this one.