Jason Irving explores adaptogens which have been hailed as a panacea for many of our modern struggles.
Adaptogens have been hailed as a panacea for many of our modern struggles. They are wonderful for fatigue, stress and building resilience. However, they are relatively new to science. This article explains the fascinating history behind these medicines.
Introduction
The term adaptogen was first used by scientist Nikolay Lazarev in 1947 to describe substances that can improve an organisms ‘non-specific’ resistance to stress (1). In 1968 the definition was elaborated by fellow Soviet pharmacologists Brekhmam and Dardymov to mean a substance that (2)
- is non-toxic, and causes minimal disturbance to the organism
- is non-specific in pharmacological action, improving the organisms resistance to a broad range of stressors
- tend to have a ‘normalising’ effect on body systems – reducing excess, and raising deficiency
This reflected an attempt to provide scientific support for a common theme in holistic herbal medicine – restoring balance and supporting the body’s natural adaptive resilience.
Not surprisingly herbs with these reported adaptogenic properties remain an attractive prospect for herbalists and patients. As would be expected from such a broad action adaptogens are employed for a whole host of conditions. However, the main therapeutic focus is reducing the extent of the body’s stress response, and improving recovery. Relatedly they will be used to improve stamina and support people with chronic conditions, and improve concentration.
While the word adaptogen is a very recent term, it is not without precedent in the long history of herbal medicine – the preservation and adaptation of herbal uses on which much pharmacological investigation is based. Exploring the histories of the most well known adaptogens shows the connections between their classifications in a variety of herbal traditions and their reinterpretation as adaptogens in the twentieth century.
Siberian ginseng (Eleutherococcus senticosus)
Eleutherococcus senticosus (Rupr. & Maxim.) Maxim.
- Family: Araliaceae
- Synonym: Acanthopanax senticosus (Rupr. & Maxim.) Harms)
While commonly known as Siberian ginseng, it has a wider distribution, growing wild across Northeastern and Central China, North Korea, South Korea, Far Eastern Russia and Japan (3).
It grows as a shrub, reaching heights of around 5 to 8 feet, and its light brown stems are covered in prickly spines. Each palmate leaf consists of five leaflets of varying size. It favours the cool semi-shade of mixed mountainous forests. It produces tiny white flowers in mid-summer, borne on umbels, that produce clusters of black fruits. It is mainly the rhizome with the roots that is used in herbal medicine.
Eleutherococcus senticosus was the main herb of interest to the early researchers on adaptogens in the Soviet Union, and apparently found favour as a replacement for another member of the Araliaceae plant family, Panax ginseng, when supplies were low. Dr. Brekham researched and promoted the herb for convalescents, aiding immunity after surgery and protecting well-being. The herb found favour amongst Soviet athletes as an endurance aid, who then shared its use at international events (4). It has a long history of use in Traditional Chinese Medicine, first recorded in the Shennong Ben Cao Jing c.220 A.D., and is mainly employed today in a range of combination prescriptions for various conditions. It is recommended for general invigoration of Qi, with a particular affinity for the kidneys and liver, supporting their effective functioning, which leads to improvements in the health of the musculoskeletal system (5). It was traditionally used by people living in the subarctic forest regions of Siberia to improve quality of life and protect against infections (6).
Ginseng (Panax ginseng)
Panax ginseng C.A. Mey.
Family: Araliaceae
Commonly known as Korean ginseng, it is historically associated with the country due to the reputation of the quality of the rhizome that grows there, that is still widely exported and remains an important souvenir for Chinese tourists visiting South Korea. Though like the so-called Siberian ginseng it has a wider distribution than its name suggests – spreading wild across North-Eastern China, North Korea, South Korea, and some regions of Far Eastern Russia (7). It has a similar appearance to its close relative, though without the very spiney stem and having yellowish to pink flowers on its umbels that produce red rather than black fruits. It shares a similar habitat. Again, it is the rhizome which is used medicinally, which makes it more at risk of overharvesting and it is now mostly cultivated due to the loss of wild plants, though semi cultivated ‘wild’ ginseng fetches a premium on the market while allowing stocks to be replenished.
The genus name shares the same etymology as panacea, coming from the Ancient Greek pân meaning “all” and ákos meaning “cure”, named for its supposed reputation in Chinese and Korean medicine. Chinese botanist Shiu Ying Hu argued in her 1976 paper that this reputation was based on a misrepresentation of its use in Chinese medicine which was “very specific and restricted”. This was because it was only prescribed for patients “who have the jo (“weak”) symptoms and who need the pu (“tonic”) remedies”, out of ten possible symptom groups with matching remedy types (8). And in Chinese materia medica texts it is generally recommended for the following conditions – lassitude and anorexia, shortness of breath and low voice, diabetes, insomnia and impotence, and for each condition there is a specific combination of other herbs used alongside ginseng (9).
Despite these specific understandings of prescribing in a clinical tradition, Panax ginseng has gained a reputation across the world, including in China and South Korea, as a general tonic and health supplement on its own, to support peak performance at work, in sport and in the bedroom. It is sold as powder, pills, dried root, infused in wine, cooked in soup and in teabags.
Rhodiola (Rhodiola rosea)
Rhodiola rosea L.
Family: Crassulaceae (10)
Both fresh and dried, the root has a rich earthy rose like aroma, hence the species name ‘rosea’ and the common names roseroot and rosewort. It is also known as arctic root due to its affinity for icy habitats, and goldenroot on account of its yellow flowers. It grows upright to around 70cm high, with a fleshy stem and leaves.
Swedish botanist Carl Linnaeus recommended it for “headaches, “hysteria”, hernias, discharges, and as an astringent”(11). Tracing the longer history of the use of roseroot is harder because little detailed work has been published in English as far as I’m aware. For example, there is debate over whether or not Vikings used it for endurance during their long journeys, which seems likely considering the uses we know of today, but there are very little textual records from this period and only a few studies on the archaeobotanical record. However, the root is used today for a range of conditions across its wide distribution – Arctic and mountainous regions of Europe, Asia and North America, covering around 30 countries (12).
According to a review of traditional uses the Sámi people chew on root pieces during long journeys and use it for urinary infections, Inuit people use the root for infections, colds, fatigue, and toothache, and for mental and physical rejuvenation. Evenki people in North-Eastern Russia use it as a ‘universal’ medicine. Elsewhere it is commonly used for fatigue, strengthening the body, mental stamina, stress relief and as a tonic (13).
It has become popular in recent years in commercial preparations for its advertised adaptogenic properties. The plant is of conservation concern due to climate change and overharvesting for the herbal medicine trade in certain areas (14).
Other herbs
Other herbs most commonly referred to as adaptogens are:
- Astragalus (Astragalus mongholicus Bunge (syn. Astragalus membranaceus Fisch. ex Bunge))
- Ashwagandha (Withania somnifera (L.)
- Schisandra (Schisandra chinensis (Turcz.) Baill.)
- American ginseng (Panax quinquefolius L.).
Mills and Bone, in their widely referenced book Principles and Practice of Phytotherapy extend the definition of adaptogen to:
- Goji berry (Lycium spp.)
- Codonopsis (Codonopsis pilosula (Franch.) Nannf.)
- Echinacea (Echinacea spp.)
- Gingko (Gingko biloba L.)
- Gotu kola (Centella asiatica (L.) Urb.)
- Tribulus (Tribulus terrestris L.) (15)
In addition to these herbalist David Hoffman lists many more as adaptogens. Many of these are in the same family as the ginsengs discussed above:
- Wu jia pi (Eleutherococcus sessiliflorus (Rupr. & Maxim.) S.Y.Hu)
- Japanese angelica tree (Aralia elata (Miq.) Seem.)
- Manchurian aralia (Aralia elata var. glabrescens (Franch. & Sav.) Pojark)
- Sakhalin spikenard (Aralia cordata Thunb.)
- Asian devil’s club (Oplopanax elatus (Nakai) Nakai)
And in diverse plant families:
- Silk tree (Albizzia julibrissin Durazz)
- Chickpea (Cicer arietinum L.)
- Indian hoppea (Hoppae dichotoma Willd.)
- Guduchi (Tinospora cordifolia (Willd.) Hook.f. & Thomson)
- Arogyappacha (Trichopus zeylanicus Gaertn.)
- Holy basil (Ocimum tenuiflorum L.)
- Hardy rubber tree (Eucommia ulmoides L.)
- Maral root (Leuzea carthamoides (Willd.) DC.)
- And one species of mushroom, also popular for supporting immunity: lingzhi or reishi (Ganoderma lingzhi (Sheng H. Wu, Y. Cao & Y.C. Dai))(16)
Mechanisms of action
As would be expected all these herbs have a long tradition of use both in the regions they grow and through international trade, combine this with the general nature of their actions and you can see how they have been employed for more conditions than it is possible to account for here.
There are however common themes that emerge when connecting these traditions to their more recent classification as adaptogens – the use for fatigue, general debility, endurance, resilience, as a tonic a ‘universal’, for support of the body as a whole or for optimal function of specific organs or systems.
One of the scientists who defined the term adaptogen distinguished it from a herbal tonic in 1968, describing a tonic action as increasing work capacity and correcting weakness and lack of tone, and from a stimulant which provides a temporary increase in work capacity, followed by a decrease (17).
It should also be noted that when studying traditional medical systems the word ‘tonic’ is often simply a translation into English of words that could be understood quite differently within those cultures, that may be closer to or further from the definition of adaptogen.
Some biochemists have argued that the term adaptogen should not be used as it cannot be linked to a few clear ‘mechanisms of action’ based on isolated compounds, and that scientists should ignore “the fact that the word ‘adaptogen’ was ever invented. While others argue the effect is the same as that of a placebo (18).
The original definition of adaptogen was very clear on the non-specific action, and it is seen as a useful way to bridge different approaches to philosophies of healing.
Despite some scepticism, many researchers are still looking to test the adaptogenic theory, and have focused on many different specific actions to understand the possible effects of these herbs on the body. Some areas that the action is understood in biochemistry are as follows – more efficient use of glycogen, regulating metabolism, inhibiting stress hormones binding to receptors, relaxation of blood vessels, antioxidant activity, steroidal activity, immunostimulant, immunomodulatory, hepaprotective, and antifatigue activities(19). In some cases, as with Panax ginseng, a herb can contain chemicals that have opposing actions that may explain the adaptogenic effect, for example both hypotensive and hypertensive effects (20).
And for randomised controlled trials the focus is normally on work capacity and endurance for exercise, oxygen consumption, heart rate, respiratory exchange rate, blood pressure, blood glucose, tests of cognitive performance, as well as more subjective measures of wellbeing.
Conclusion
The search for a or cure all is not new, the phrase panacea was used for many different species of plants across ancient Greek and Roman texts, that have been linked to the contemporary names lovage (Levisticum sp.), yarrow (Achillea sp.), centaury (Centaurium sp.), tarhan herb (Echinophora), and species of the genus Opopanax, known in English as ‘all heal’.
While the term ‘adaptogen’ is a very recent development in the history of herbal medicine it is not without precedent. It seems there has always been a desire for a general tonic that can provide support to the body’s own resilience, and it is based on real benefits that people have experienced from taking these herbs. While it is not surprising that the idea of a ‘cure all’ plant raises scepticism, when the use of a herb is understood within its specific context it generally becomes clear that different adaptogens will be used for different patients and different manifestations of conditions in clinical practice.
It has become popular among herbalists, probably because it covers the complexity of using plants as medicines while connecting to a pharmacological approach. The ‘non-specific’ action that is so frustrating to biochemical models that rely on isolation and reduction, holds within it an awareness of complexity and the unknown, and of the workings of the body as a whole that may be more than the sum of its parts. More research is still being done to understand how the specific pharmacological actions connect to the more general outcomes in patients, and there are many more herbs that may demonstrate adaptogenic properties that have had very little research on them.
References
- Marina Davydov and A. D. Krikorian, ‘Eleutherococcus Senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an Adaptogen: A Closer Look’, Journal of Ethnopharmacology 72, no. 3 (1 October 2000): 345–93, https://doi.org/10.1016/S0378-8741(00)00181-1.
- I I Brekhman and I V Dardymov, ‘New Substances of Plant Origin Which Increase Nonspecific Resistance’, Annual Review of Pharmacology 9, no. 1 (April 1969): 419–30, https://doi.org/10.1146/annurev.pa.09.040169.002223.
- POWO, ‘POWO’, Database, Plants of the World Online. Facilitated by the Royal Botanic Gardens, Kew., 2022, https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:90431-1. Accessed 15/02/2022.
- Tracy Lee Bleakney, ‘Deconstructing an Adaptogen: Eleutherococcus Senticosus’, Holistic Nursing Practice 22, no. 4 (August 2008): 220–24, https://doi.org/10.1097/01.HNP.0000326005.65310.7c.
- Erich Stöger, Chinese Herbal Medicine: Materia Medica (Eastland Press, 2004).
- Linzhang Huang et al., ‘ChemInform Abstract: Acanthopanax Senticosus: Review of Botany, Chemistry and Pharmacology’, Die Pharmazie 66 (1 February 2011): 83–97, https://doi.org/10.1691/ph.2011.0744.
- POWO, ‘POWO’. https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:91472-1. Accessed 15/02/2022.
- Shiu Ying Hu, ‘The Genus Panax (Ginseng) in Chinese Medicine’, Economic Botany 30, no. 1 (1976): 11–28.
- Yao-Zu Xiang et al., ‘A Comparison of the Ancient Use of Ginseng in Traditional Chinese Medicine with Modern Pharmacological Experiments and Clinical Trials: USE OF GINSENG IN TCM AND CLINICAL TRIALS’, Phytotherapy Research 22, no. 7 (July 2008): 851–58, https://doi.org/10.1002/ptr.2384.
- A. Panossian, G. Wikman, and J. Sarris, ‘Rosenroot (Rhodiola Rosea): Traditional Use, Chemical Composition, Pharmacology and Clinical Efficacy’, Phytomedicine 17, no. 7 (1 June 2010): 481–93, https://doi.org/10.1016/j.phymed.2010.02.002.
- Carl von Linné, Materia Medica (Holmiae: Typis ac sumptibus Laurentii Salvii, 1749), https://www.biodiversitylibrary.org/bibliography/72911. Quoted in Panossian, Wikman, and Sarris, ‘Rosenroot (Rhodiola Rosea)’.
- POWO, ‘POWO’, Database, Plants of the World Online. Facilitated by the Royal Botanic Gardens, Kew., 2022, https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:315148-2. Accessed 15/02/2022.
- J.A. Brinckmann, A.B. Cunningham, and David E.V. Harter, ‘Running out of Time to Smell the Roseroots: Reviewing Threats and Trade in Wild Rhodiola Rosea L’, Journal of Ethnopharmacology 269 (April 2021): 113710, https://doi.org/10.1016/j.jep.2020.113710.
- Brinckmann, Cunningham, and Harter.
- S. Mills and K. Bone, ‘Principles and Practice of Phytotherapy. Modern Herbal Medicine.’, 2000, xx + 643 pp.
- David Hoffmann, Medical Herbalism: The Science and Practice of Herbal Medicine (Inner Traditions / Bear & Co, 2003).
- Committee on Herbal Medicinal Products (HMPC), ‘Reflection Paper on the Adaptogenic Concept’ (European Medicines Agency, May 2008), https://www.ema.europa.eu/en/documents/scientific-guideline/reflection-paper-adaptogenic-concept_en.pdf.
- Davydov and Krikorian, ‘Eleutherococcus Senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an Adaptogen’.
- David Winston and Steven Maimes, Adaptogens: Herbs for Strength, Stamina, and Stress Relief (Inner Traditions / Bear & Co, 2007); Mills and Bone, ‘Principles and Practice of Phytotherapy. Modern Herbal Medicine.’; Joanne Barnes, Linda A. Anderson, and J. D. Phillipson, Herbal Medicines, 3rd ed (London ; Grayslake, IL: Pharmaceutical Press, 2007).
- Barnes, Anderson, and Phillipson, Herbal Medicines. 333.
