Do adaptogens actually work?


Spend enough time desperately googling cures for “brain fog” and “pathological procrastination” and you’re likely to come across all kinds of things — YouTube videos in which bodybuilders beg you to take vitamin C, shady websites selling generic Adderall, Reddit threads in which weirdos who think they’re doctors speak with clinical precision about enzymes and what does or doesn’t cause liver cancer. An increasingly popular addition to this discourse are adaptogens, a group of herbs (e.g., Siberian ginseng, Arctic root) alleged to help the body deal with stress. As with any hazily understood panacea, it is probably worth doing some research before you flood your system with them. So for this week’s Giz Asks, we reached out to a number of experts to find out whether adaptogens actually work.

Nita Farahany

Professor of Law and Philosophy at Duke University and Founding Director of Duke Science & Society whose work focuses on the ethical, legal, and social implications of emerging technologies

“Adaptogens” is a fancy term for a lot of different herbal supplements that have been used over a long period of time. There’s scientific evidence in favour of some of them — there have been mixed results, for instance, suggesting turmeric may be effective for its anti-inflammatory properties, and that nettle leaf has some beneficial uses. But a lot of modern medicine is derived naturally from plants or plant sources, and those have been well-studied and have good evidence to support them; a lot of the so-called adaptogens haven’t been as well-studied, even if there’s evidence to suggest that they have some potentially beneficial anti-stress properties.

Also, a lot of herbal supplements, taken in high concentrations or just taken at all, can interact with other drugs you’re on and make those medicines less effective. One of the dangers is that a lot of herbal supplements aren’t regulated in the US — the FDA treats them more like food products. The result is that that have a much more relaxed regulatory oversight, which calls into question how pure they are and whether they actually contain the ingredients (or dosages) they say they do. We also might not know if there are other kinds of additives in them, and whether those additives interact with other medications you’re on, or with other underlying conditions you might have. And anything taken in high concentrations, especially high concentrations that aren’t overseen or regulated, can be potentially dangerous to the body.

A lot of the independent research that’s been done on various supplements shows that there’s really significant variation between different manufacturers — 10 brands might claim to have 1,000 micrograms in their product, but in actuality there could be great variability in dosage between brands, or even between bottles from the same brand. So having a company you really trust is important. There’s also a great organisation called, a subscription-based service that does a lot of independent testing of supplements, including adaptogens, and provides recommendations as to which one of the purest or most reliable, which has good manufacturing processes behind it, etc. Personally, I’d want some of that reassurance — I’d really want to trust the company I’m buying from before I start ingesting high concentrations of any of these things.

James David Adams

Associate Professor at the USC School of Pharmacy and an expert in medicinal plants, human drug metabolism, and herbal remedies

Adaptogens definitely work. They’ve been tested in placebo-controlled randomised clinical trials — especially Ashwaganda — and been shown to be effective. Ginseng has been tested by people in China for thousands of years, and they know it works.

There are all kinds of theories about why they do — that they regulate the hypothalamic pituitary axis and the sympathetic adrenal axis (in other words, that they keep your adrenal gland working properly); that they keep your sympathetic neurons working properly.

They’ll only work, though, if you’re under a kind of stress that you’re not used to — i.e., you used to work at a desk, but now you’re digging ditches. It has to be something your body isn’t used to, and it can be psychological as well as physical — your in-law moving into your house, for instance.

It’s important to note that they take weeks to work. In China, they’ll tell you you need to take ginseng for 2-3 weeks minimum to get an effect. Ashwagandha takes 60 days. You have to be patient. Americans aren’t patient, which is why most of the adaptogens sold in the US are just huge doses of caffeine — so that when you take them you can say, wow, that really works!

For athletes, it’s only useful right as you’re starting the season — if, for instance, you’re 18 kg overweight and need to get in shape fast. The adaptogen will help you get there a little faster. But once you’ve been trained for several months, you don’t need an adaptogen — your body is already adapted. You can use the adaptogen for the first month or so, but after that, you should stop taking it — because you don’t need it, and because it’s a mild health risk.

The FDA and the American medical profession in general are very much against adaptogens, and that’s partly because of racism — these come from India and China. The clinical trials are there, the evidence is there, it’s incontrovertible. You can’t dispute it. It’s craziness.

Pieter Cohen

Associate Professor, Medicine, Cambridge Health Alliance

Dietary supplements are often promoted as adaptogens (you can tell if it’s being marketed as a supplement because there will be a “Supplement Facts” panel). The problem is that almost any supplement could conceivably be promoted as an adaptogen because the bar to advertise supplements as having the ability to resist stress is very low. There is no need for a single human study to be performed before manufacturers can place adaptogen-type claims on supplement bottles. This creates a marketplace where it’s extremely difficult for consumers to obtain accurate information about what the actual effects of the supplement will be on the body. For this reason, I recommend that supplements promoted as adaptogens are avoided. If you want to try a particular botanical, a high-quality product that lists only one ingredient and is certified by a high-quality third-party should be used — and remember to tell your doctor you’re giving it a try.

C. Michael White

Department Head and Distinguished Professor, Pharmacy Practice, University of Connecticut

The single cell and small animal studies are very promising. They suggest that adaptogens as a class can reduce cellular inflammation in stress responses that are related to poorer mental performance in humans.

The very preliminary clinical trials for some of the better studied adaptogens like Rhodiola rosea are generally small and of poor quality but seem to support the hypotheses generated from basic science. That does not mean they are ready for prime time but does mean they should continue to be studied in a more rigorous way.

I have demonstrated how different the cellular environment in a Petri dish is than the human one and how these cellular models cannot be a substitute for human data. A couple decades ago, everyone was certain that the antioxidant vitamins E, C, and beta-carotene would dramatically reduce heart disease and cancer. Sales were huge. Unfortunately, when the quality clinical trials like the Heart Protection Study came out they showed clearly that antioxidants were not effective and people wasted their money. So we can be hopeful but should not get caught up in the hype.

It could turn out that some of these adaptogens are effective, but they might cause significant side effects that can only be detected in larger clinical trials. Remember, the absence of known safety issues because of scant data is not the same thing as proof of safety but many people want to jump the gun.

Finally, if you want to jump the gun and start taking an adaptogen now, please only use products that are verified by independent laboratories to have the ingredient you are paying for (several products do not), and don’t have heavy metals, pesticides, herbicides, hidden prescription drugs, mould, and bacteria in them. The proper products carry the USP, NSF, or ConsumerLabs seals of quality., 8 December 2020