What Are Adaptogens?

The concept behind adaptogens is to restore and rebalance.

Adaptogens are herbs, roots, or plants that might reduce stress, fight fatigue, or improve concentration.

People in parts of Asia and India have been using adaptogens for centuries to treat a variety of ailments. More than 50 years ago, plant adaptogens were first used in professional sports to increase the body's resistance to stress and improve physical endurance.

Still, clinical trials on humans are limited. Critics of adaptogens say the relatively few studies done in humans are very small, recruit only healthy people, and don’t specify the dose of the tested herb or plant substance.

“Yes, there’s a downside to relying on adaptogens too much because we still haven't proven extensively how effective they are,” says Family Medicine and Integrative Health Physician Laurent V. Officer, DO of Dartmouth Hitchcock Medical Center (DHMC). “Let’s not downplay the placebo effect of taking these, either. I think it’s appropriate to be skeptical.”

How do adaptogens work?

Adaptogens interact with your hypothalamic-pituitary-adrenal (HPA) axis, which initiates the body’s stress response. Chronic stress can lead to an imbalance of the HPA axis and elevate your cortisol levels.

“You can experience burnout, exhaustion and fatigue from stress, and adaptogens might help your body return to homeostasis and maintain stability,” Officer says.

Common adaptogens include:

• Ashwagandha: an evergreen shrub used to help reduce anxiety and depression;
• Ginseng: an herb used to combat fatigue;
• Reishi: a type of mushroom used to boost the immune system and potentially fight cancer;
• Rhodiola: a flowering plant used to reduce fatigue, depression, and pain;
• Schisandra: a fruit-bearing vine used for improved concentration, coordination, and endurance;
• Tulsi, also known as holy basil: a perennial plant used to increase focus, decrease anxiety, and boost the immune system.

People take adaptogens as herbal supplements in capsule form, drink them in teas, or add them to soups, smoothies, and other foods as a powder.

To be considered an adaptogen, an herb or plant substance must:

• Be nontoxic at normal doses
• Support the entire body’s ability to cope with stress
• Help the body return to a stable state

“Adaptogens are relatively safe and pretty mild,” says Officer, who has worked with patients to reduce their intake of benzodiazepine, an anti-anxiety medication, by using adaptogens.

Unregulated by the FDA

Adaptogens can be found in the supplement aisle at your local pharmacy or grocery store, but people taking them should research specific brands and products first.

“The challenge with adaptogens, or any supplement, is that you're taking something completely unregulated,” says DMHC Obstetrician Gynecologist Emily A. Donelan, MD. “There’s no oversight or quality control, and we don't actually know what's in those products.”

Still, Donelan says she believes adaptogens, made by a reputable source, are promising as a potential remedy. During a one-year integrative medicine professional training program she completed, Donelan says she tried ashwagandha, made lifestyle changes, and began to feel better.

“It's really hard to know whether it was a placebo effect or something real,” she says. “But after using adaptogens for probably six to eight months, I feel like it helped me with both sleep and anxiety.”

Donelan shares a list of third-party tested adaptogen brands with interested patients. She says some patients noted that after taking adaptogens, they also slept better and felt less anxious.

Talk to your doctor first

If you are on medication for another condition, check with your primary care physician before taking adaptogens.

“I worry about negative interactions with medication or if a patient is taking multiple supplements,” Officer says. “I also worry about where people are getting their ashwagandha or ginseng. Because anytime a company ramps up supplement production, it usually bypasses quality.”

But with proper medical guidance, adaptogens could be helpful, he says.

“Studies have shown some benefit to adaptogens. But everyone is different, and I think taking them is very patient-specific,” Officer says. “I recommend talking to us beforehand.”