Efficacy of Ergothioneine Supplementation on Postpartum Fatigue, Sleep Quality, and Quality of Life: A Randomized, Double-Blind, Placebo-Controlled Trial

Background: Postpartum asthenia, characterized by severe fatigue, sleep disturbances, and physiological stress, lacks effective targeted interventions. Ergothioneine (EGT) is a unique, naturally occurring antioxidant that actively accumulates in mitochondria, offering a compelling therapeutic rationale for systemic recovery. This study aimed to evaluate the efficacy of EGT in accelerating postpartum functional restoration and alleviating fatigue. Methods: This single-center, randomized, double-blind, placebo-controlled trial enrolled 40 postpartum women (SF-36 total score [≤] 70) who had ceased breastfeeding. Participants were randomized (1:1) to receive either 120 mg/day of EGT or a matched placebo for 30 days. Efficacy was assessed using the SF-36, Pittsburgh Sleep Quality Index (PSQI), Fatigue Scale-14 (FS-14), and Traditional Chinese Medicine (TCM) asthenia scale. To rigorously evaluate the treatment effects, advanced statistical modeling, including Linear Mixed-Effects Models (LMM) and Analysis of Covariance (ANCOVA) adjusted for baseline covariates, was employed. Results: All 40 participants completed the trial. The EGT group demonstrated robust and accelerated functional recovery. Notably, significant improvements in sleep quality (p = 0.0361) and systemic fatigue (p = 0.0059) were observed as early as Day 15. Importantly, EGT yielded a statistically significant between-group superiority in alleviating mental fatigue compared to placebo at Day 15 (p = 0.0313). By Day 30, the EGT cohort exhibited substantial within-group improvements across all primary metrics, including SF-36 (+35.94%, p = 0.0006) and FS-14 (-27.78%, p = 0.0011). Furthermore, as an additional physiological benefit, EGT induced a selective and significant reduction in hepatic transaminases (ALT: -30.42%; AST: -17.44%) within normal limits, a trend not observed in the placebo group. EGT was exceptionally well-tolerated with no treatment-related adverse events. Conclusions: EGT supplementation (120 mg/day) safely accelerates postpartum functional recovery, offering rapid relief from mental fatigue and sleep disturbances within 15 days, while concurrently optimizing hepatic physiological status. These preliminary clinical signals warrant confirmation in larger, adequately powered cohorts. Trial Registration: ChiCTR2500114171; Prospectively registered on 2025-12-08.