'Adaptogens' make up one of the smaller, but very robust, corners of holistic and herbal medicine. Their names - rhodiola rosea, milk thistle, cordyceps - suggest mystical, healing properties. Packaged up and sold to us in the form of powders, capsules and even coffees, they promise to 'heal' and 'restore' by alleviating stress and exhaustion, even promising a bit of skin-brightening for extra good measure. The promises they make are as vague as they are inviting. But what even are adaptogens? And do they really work?
A class of botanicals – adaptogens are supposed to help your body ‘adapt to’ the stresses of life – be they physical, chemical and/or biological. The term was initially coined in the 1940s by Russian researchers but adaptogens have been used in Ayurvedic and traditional Chinese medicine for far longer. They fall broadly into three categories: herbs and plants, mushrooms, and foods, and come in several forms and compounds. Largely they are consumed as supplements.
Once consumed, adaptogens are believed to affect the hypothalamic-pituitary-adrenal axis (HPA axis), which controls reactions to stress and regulates many body processes, including digestion and the immune system. They are meant to both calm you if you are feeling stressed, or energise you if you are feeling exhausted, and enable your body to better cope with these stressors. They sound like the ultimate wellness solution to the chaos of modern life. Given the global wellness industry was worth $4.5 trillion (around £3.9 trillion) in 2018 and is set to continue growing, it’s hardly a surprise that many start ups are using Instagram friendly packaging to sell them to the Western world.
Figuring out how well adaptogens work (if at all) is tough because there are so many. The most well known are ashwagandha, panax (asian) ginseng and reishi mushrooms. There are however far more and, according to herbalists, each have different functions. Ashwagandha is the most researched, with 20 clinical trials testing the claims around the herb. It is meant to aide with chronic stress and, according to Dr Merry FRCPI PhD, an infectious disease specialist who reviewed seven popular claims for adaptogens in her piece for Smart But Healthy, "there is very limited (but positive) information on ashwagandha for chronic stress".
Other adaptogens don't fare as well in their clinical analysis: the Cochrane Dementia and Cognitive Improvement group evaluated ginseng for its supposed ability to improve mental performance: they said "there is a lack of convincing evidence to support panax ginseng for cognitive enhancing effects."
Of the studies done so far on cordyceps, an adaptogen fungus that grows on moth larvae (nice), claimed that it boosted immunity and endurance, Dr. Merry says that "it is impossible to make any overarching recommendations due to variability in the study designs and outcomes."
While there is evidence that some adaptogens can affect your body's biological response to stress, almost all studies have focused on a cellular level, exposing isolated animal or human cells to adaptogens and observing the effects. It's a huge leap to go from a single cell on a petri dish to a capsule having the same effect on a whole person.
Then there are the potential risks: messing with the body's stress response could actually incite cancer growth, as shown by large clinical trails where mega-doses of antioxidants (a large number of which are adaptogens) were shown to induce, not curb, cancer growth. In other worrying news, Dr Rashmi Mullur, an assistant professor of medicine in the department of endocrinology and associate chief of integrative medicine at UCLA, says that ashwagandha has been reported to potentially cause miscarriage. She previously told Vox that because it binds to steroid receptors, it can affect hormonal function. “I certainly wouldn’t advise anyone to take it in pregnancy.”
This is not to say that adaptogens cause cancer or incite miscarriage – only that in the world of unregulated herbal medicines there are still many unanswered questions around the benefits or detrimental effects of nearly everything.
As with many traditional remedies, it would be dismissive to reject adaptogens out of hand as thousands of years of use in the non-Western world suggest at least some efficacy.
However, the fact they're not regulated is a cause for concern: even if you go in with the best intentions, you have no way of knowing if what the label says you're consuming has any of the benefits or even that balance of ingredients. Mullur advises against mixtures of several ingredients as it’s hard to know what in it is hurting or harming you.
If you're looking to adaptogens to help ease the stresses of daily life, and they do for you, that is wonderful. But anxiety about spending money (especially on something that may not work) can compound with the anxiety it is meant to be alleviating. When there is so much uncertainty, it's always best to be cautious. The causes of stress, anxiety, and exhaustion are all too complicated to be treated by one powder – far more likely to fair better if you look into what is making you feel that way, instead of applying a powdery herbal capsule.