Adaptogens - Magic or Snakeoil?

Updated: Aug 22, 2018

Adaptogens are the trendy supplement sneaking into everything from coffee to beauty products. There’s a lot of buzz surrounding these pricey magical mushrooms, but do their health benefits really live up to the hype? We turned to Dr. Charles Lacy to help us demystify the fungi phenomenon taking the wellness scene by storm. Not only does he know everything about all things pharmaceutical, he’s also Guidance Counselor Jenn’s dad (therefore, he is awesome)!

First off, what exactly are adaptogens?

Dr. Lacy: Adaptogens are the hot new player on the health scene although their origins date back some 3000 years. Also known as chi tonifiers, adaptogens originated in traditional Chinese medicine (TCM) and Ayurveda (traditional Indian medicine).

Adaptogens are generally non-toxic biologicals, usually plants or fungi, that are marketed as aiding the body to prepare for or overcome stressors of all types. Physical stressors such as, temperature extremes, pollution, physical exertion, infections, and other putative aggressors to our bodies balancing act. Chemical stressors such as foods, poisons, and other toxins. They are also purportedly useful for Emotional stressors as in mental stress, emotional traumas, anxiety, depression, grief, and cognitive decay.

How do adaptogens actually work with our bodies?

Dr. Lacy: As we age, changes occur to our bodies, due to growth and decay, a process known as apoptosis. Our cells have ticking clocks for their survival, which can affect our lifespans. The cellular process is highly dependent on the function and health of the mitochondria, the power house of the cell (remember back to middle school science class).

The speed with which mitochondria can metabolize energy (make or break caloric intake) is controlled by its conditioning. Like an athlete, regular exposure to a workout strengthens the body. Mitochondria require intermittent exposures to small amounts of stressors (i.e. a workout), a process known as hormesis (a big fancy word for cellular strengthening). This is thought to explain why adaptogens may work to improve human longevity and stress protection.

Adaptogens are theorized to have a variety of effects, but central to their proposed benefit is their ability to return cells and therefore bodies, back to homeostasis (normal balance). The primary part of the body targeted by adaptogens is the stress center of the body, the hypothalamus, pituitary, adrenal axis (HPA). Adaptogens may do for your adrenal glands (stress glands) what exercise does for your muscles. Muscles and every cell in your body, aside from red blood cells, contain mitochondria. The HPA axis also has an effect on the immune system, digestion, energy usage, mood and sexuality. However, for adaptogens to work at all, they usually must be taken on a continuous, chronic basis, which lends itself for scam integrative medicine. Once you sign up, you don’t dare stop, out of the fear of losing what you may have gained but not detected.

This leads me to the question we’re all asking ourselves as we eye pricey bottles of mushroom dust at the crystal this legit or snakeoil?

Dr. Lacy: Sellers of adaptogenic herbs believe this is how they work, although more research is needed. Sadly, supplements overall, are notoriously unregulated. The FDA has no real controls over herbs and does not recommend their use or avoidance, until a severe adverse effect occurs. Additionally, a study in 2018 found that the most commonly used supplements can interact with the foods, drugs and supplements you already take and require close monitoring in many cases.

There is not much scientific research on how adaptogens affect health. Most studies have been performed on animals, which is not a good substitute for human studies. Additionally, human studies would require many years to detect a benefit and as such make these effects very difficult to quantify. There have been some small studies published in niche journals that appear biased, at best in the conclusions.

So they jury is still out on how effective they may actually be. Can you introduce us to some of the star players on Team Adaptogen?

Dr. Lacy: Among adaptogens that should be used for the long term, Ashwagandha (Withania somnifera) and Asian ginseng (Panax ginseng) are the most common. However, there are also “magical-mystical” mushrooms like reishi (Gangoderma lucidum), cordyceps (Cordyceps sinesis), maitake (Grifola fondosa), Lion’s mane (Hericium erinaceus) and chaga mushroom (Ionotus obliquus). Some research has suggested these adaptogens may soothe long-term sources of stress and hormone imbalances. Additionally, holy basil or tulsi may help lower stress levels. However, we do not have definitive scientific support for any of these benefits.

Ashwaghanda is the adaptogen I’ve seen most frequently on the scene...what’s this guy all about?

Dr. Lacy: Ashwagandha is one of the most common and oldest supplements used for its balancing acts. Ashwagandha is a small evergreen shrub that grows to about 4-5 feet tall, found in dry areas of India, the Middle East, and parts of Africa. This adaptogen has the greatest amount of evidence for its benefits, although more data is needed. In India, ashwaghanda is known as the “strength of the stallion,” as it has been traditionally used to support one’s immune system after an illness. Considered an “upper class” herb means it is safe and intended for body nurturing. Due to its effects on stamina it is also thought of as the Indian ginseng.

Clinical research with ashwaghanda root has demonstrated reductions in perceived stress levels by at least a third when compared with placebo, and stress hormone levels by about 25%. Ashwagandha root extract also seems to prevent stress-related weight gain compared to placebo. One concern while using ashwaghanda, is the concurrent use of sedatives or antihypertensive drugs or herbs, as these effects may be extenuated leading to more severe effects.

What about the mystical mushrooms in the adaptogen family?

Dr. Lacy: Reishi (also known as Lingzhi) is one of the most honored mushrooms in TCM. It is considered one of the best overall valuable long-term adaptogens for health and well-being. Along with its stress tonic benefits, it has also been used for altitude sickness, antimicrobial benefits, anti-inflammatory, anti-oxidant and anti-tumor effects. It is safe to use reishi for up to 12 months of continuous use. However, if taken as a manufactured powder, there have been liver toxicities seen when used for longer than 2 months. As is true with other mushrooms, the hot water extracted form (a tea) or the wild mushroom fungus are the most potent and safest (when raised without chemicals).

Cordyceps is a truly unique, dare I say, magical mushroom, at least from its procurement perspective. This fungus is a parasite, which only grows on ghost moth caterpillars in the high mountain regions of China or Tibet. It is used as a stimulant, a tonic, and an adaptogen, which is used to increase energy, enhance stamina, and reduce fatigue. Orally, cordyceps is used for strengthening the immune system, improving athletic performance, reducing the effects of aging, promoting longevity, treating lethargy, and improving liver function in people with hepatitis B. When sourced from a well-respected manufacturer, cordyceps is considered very safe. Some GI side effects such as diarrhea have been described, but this can be eliminated by taking the fungus with food.

Maitake mushroom is one of the most studied adaptogens. This mushroom has a long history of being both a food and a medicinal. The Japanese have long use Maitake as an adaptogen in Kampo medicine. Kampo is a form of TCM improved upon by the Japanese.

Research has shown this mushroom to have anti-tumor activity, which can be complementary to Western chemotherapy. It offers anti-tumor benefits while reducing adverse effects such as hair loss, nausea and pain. However, the grade of evidence used for these conclusions is very low and fraught with poor research. It is a safe product, especially when consumed in its natural state.

Lion’s Mane is another mushroom used both medicinally and for culinary purposes. Lion’s Mane is a relatively new adaptogen used by modern natural-health enthusiasts. Traditionally used in TCM for gastrointestinal issues, one new study suggests it may be useful for nerve health. It has been shown in vitro to induce natural Nerve Growth Factor, which is necessary for nerve sprouting and may prove valuable for neurodegeneration. Researchers are hopeful this mushroom can be helpful for Alzheimer’s disease.

Chaga mushroom is a parasitic fungus that grows on the trunks of trees, throughout Europe, Russia, Korea, parts of the United States, and Canada These mushrooms are rich in a wide variety of minerals, nutrients and vitamins. They also have antioxidant benefits, which theoretically can slow aging and help to prevent exposure-related disease.

A 2010 study found that chaga could slow the growth of lung, breast, and cervical cancer cells in a petri dish. The same study also found that chaga could slow the growth of tumors in mice. Triterpenes, the compounds found in chaga and some other mushrooms, cause tumor cells to self-destruct. Unlike other cancer treatments, however, chaga does not appear to harm healthy cells. Although these studies have found promising results, they have all been carried out on animals or in a laboratory. To prove the anti-cancer benefits of chaga conclusively, researchers will need to conduct extensive studies on humans.

Chaga might affect blood sugar control or increase the risk of bleeding during and after surgery. Stop using chaga at least 2 weeks before a scheduled surgery. Chaga extracts are commonly packaged with other adaptogens, which may improve their overall benefits. However, their combination also significantly increases their negative interactions with other herbs and medications, and should be avoided.

So many mushrooms! They’re not just for Phish concerts anymore (that’s a tagline I’m trying to pitch to Big Adaptogen)! As a constantly anxious stressball, I’d love to know which adaptogens are used for the brain-pains.

Dr. Lacy: Some research suggests that rhodiola (rhodiola rosea) and schisandra (Schisandra chinensis), as well as Siberian ginseng, may help to mediate the flight-fight mechanism common to the acute stress response. Rhodiola rosea, sometimes referred to as Golden Root, Roseroot, Arctic Root or Aaron’s Rod, is an adaptogen with increasing clinical evidence suggesting a wide range of benefits with exceptionally few side effects and dangers. Rhodiola rosea has been categorized as an adaptogen by Russian researchers.

Schisandra is a vining shrub native to northern and northeast China. The fruit of the plant is used as a traditional Chinese medicine known as wu wei zi. Taking schisandra fruit extract orally seems to improve mental concentration and liver function. However, it should not be consumed during pregnancy. It is a typical adaptogen because of its stressor-protective effects. The chemicals in schisandra improve liver function by stimulating enzymes (proteins that speed up biochemical reactions) in the liver and promoting liver cell growth. Chemicals in schisandra may also help the body have more energy, resulting in improved endurance and coordination.

Are there any adaptogens used to boost the immune system?

Dr. Lacy: Orally, Panax ginseng (Red ginseng) is used as an adaptogen for increasing resistance to environmental stress and as a general tonic for improving well-being. It is also used for stimulating immune function, improving physical and athletic stamina, preventing muscle damage from exercise, improving cognitive function, concentration, memory, Alzheimer's disease, and work efficiency.

It can improve immune function. Some evidence suggests that taking a Panax ginseng extract orally daily beginning 4 weeks prior to influenza vaccination and continuing for 8 weeks thereafter can decrease the relative risk of getting the flu or common cold by 65% compared to placebo. Also, clinical research suggests that taking Panax ginseng extract daily for 12 weeks reduces the relative risk of developing influenza-associated acute respiratory tract infections by 44.9% compared to placebo in healthy patients. However, taking Panax ginseng does not seem to affect symptom duration or severity.

Reishi mushroom, alone or in combination with maitake and shitake, might decrease symptoms of a cold or influenza. However, the data is weak and of questionable significance. They have been shown to be safe when taken in their natural forms in combination for up to a year.

What should a new user consider before incorporating adaptogens into their life?

Dr. Lacy: The best approach with adaptogens is to start by adding them to your diet. Reishi mushrooms consumed as food or tea, is a good place to begin. Overall, the best method to consume adaptogens are when they are fresh plants, dried Chinese herbs, or as quality teas with seals of organic approval.

Remember these natural extracts are not a replacement for medical treatments, but should be considered only as an added supplement to your diet. Don’t stop prescribed drugs in favor of these biologicals, as you may lose the benefits of well-studied, evidence-based therapies. This is especially true as adaptogens are intended to improve the body’s natural defenses; they must first be compatible with your existing regimens, including medication, foods and other herbs. It would be prudent to carefully consider products that mix different adaptogens in one product, as the classic herb formulas are designed to balance the benefits, not pile on a bunch of products that have trend appeal. This often suggests the manufacturer is relying on marketing to sell these products and not good science. As with all dietary supplements the take home message is, “buyer beware,’ since very little regulation is centered around these products.

Dr. Lacy, you are truly a Bellagio Fountain of knowledge, and an all around fun-gi (see what I did there?). Thanks so much for giving us the background on these trendy herbs, and your professional opinion about their efficacy.

Charles F. Lacy, Pharm.D., MA, BCPP, FCSHP, FASHP. Dr. Lacy is the Vice President of Executive Affairs, Professor of Complementary Medicine with the College of Medicine and Professor of Pharmacy Practice with the College of Pharmacy at the Roseman University of Health Sciences, which he co-founded in 1999. He has practiced clinical pharmacotherapy and has taught at numerous universities over the past 35 years. He designed and managed the Drug Information and Poison Control Center at Cedars-Sinai Medical Center for 20 years. He is the lead author of the renowned “Drug Information Handbook” and lead editor of the Clinical Reference Library for Lexi-Comp Publications. Additionally, he is has degrees in molecular biology and clinical psychology.

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