The idea of using tonic remedies to restore balance and health in a person is an ancient idea. The word and concept of an “adaptogen” is a relatively new way of describing a type of remedy commonly found in traditional Chinese (qi and kidney yang tonics), Tibetan, Ayurvedic (Rasayanas), and Native American medicine. The actual word adaptogen was first used by a Soviet scientist, Dr. Nikolai Lazarev, who under grants from the military, was researching substances which produced a “state of nonspecific resistance” (SNIR). The idea was to find ways to enhance the productivity and performance of soldiers, athletes, and workers without using dangerous stimulants. Much of the early research into adaptogens was done by Dr. I.I. Brekhman who, in the late 1950’s, studied Panax ginseng. Looking for a less expensive and more available substitute, he changed his focus to a native Russian shrub, Eleutherococcus senticosis. His first monograph of this now popular herb (Eleuthero or Siberian Ginseng) was published in 1960.
In 1969 Brekhman and Dardymov defined the general pharmacological properties of adaptogenic substances. These include:
a.) The substance is relatively non-toxic to the recipient.
b.) An adaptogen has “non-specific” activity and acts by increasing resistance of the organism to a broad spectrum of adverse biological, chemical, and physical factors.
c.) These substances tend to help regulate or normalize organ and system function within the organism.
Several theories have been suggested to explain the effects of adaptogenic substances. One theory proposed by Davydov and Krikorian argues that adaptogens function primarily due to their antioxidant and free radical scavenging effects. While their theory is partially accurate, it is inadequate to explain the full effects of these medicinals. So while most or all adaptogens have antioxidant activity, having antioxidant properties (ex: Green Tea, Rosemary, Cranberry) is not enough to make a substance an adaptogen. This is true of many amphoteric herbs as well. An amphoteric is a substance that normalizes function of an organ or a system within the body. I think of amphoterics as “food for an organ”. Examples include Hawthorn for the cardiovascular system, Fresh Milky Oat for the nervous system, or Helonias for the female reproductive system. All of these herbs are amphoteric, but none of them qualify as adaptogens. Brekhman and Dardymov’s list of physiological actions of adaptogens states that adaptogens help modulate system function and maintain homeostasis. So all adaptogens act as broad spectrum amphoterics to living organisms, but they rarely have a pronounced effect on only one specific organ or system.
Later research by Panossian postulated that adaptogens work primarily by affecting the Hypothalamic/ Pituitary/Adrenal (HPA) axis and the Sympathoadrenal System (SAS). Thus, adaptogens modulate our response to stress (physical, environmental, or emotional) and help regulate the interconnected endocrine, immune, and nervous systems. This re-regulation of a disordered or highly stressed system is achieved by metabolic regulators such as cytokines, catecholamines, glucocorticoids, cortisol, serotonin, nitric oxide (NO), cholecystokinin, corticotrophin-releasing factor (CRF), and sex hormones. This broad array of biochemical activators helps explain why many adaptogens also have antiinflammatory, antioxidant, anxiolytic, antidepressant or nervine effects as well. In more recent research by Panossian and Wikman (2009), they state that adaptogens work not only via the HPA axis and SAS but also on a cellular level. They actually act a bit like a vaccine, priming cells to more effectively respond to stress. These herbs activate molecular chaperones such as heat shock proteins (Hsp70, Hsp16) which protect the mitochondria from stress-induced damage. FOXO, a forkhead protein, is also up-regulated. It stimulates the cell to produce proteins that help resist stress and enhance longevity. They have also found that adaptogens can down-regulate a stress-activated protein kinase, known as JNK, that is responsible for increasing inflammatory and oxidative compounds and decreasing ATP generation. This is one of the reasons why adaptogens are often effective as part of a treatment protocol for diverse conditions with fatigue, muscle pain, inflammation and weakness, such as CFIDs, fibromyalgia and multiple sclerosis.
Adaptogenic Materia Medica
1. Well-researched adaptogens:
American Ginseng root (Panax quinquefolius) – Bitter, slightly sweet, neutral, moist
Western Classification: Adaptogen, antioxidant, antiinflammatory, bitter tonic, immune amphoteric.
American Ginseng is milder acting and less stimulating than Panax ginseng. It is mildly cooling and moistening and is appropriate for fatigue, recovery from pneumonia or bronchitis (especially with a dry cough), CFIDS, asthma, chronic stress with depression or anxiety, and autoimmune diseases of the lungs or GI tract. I find it of great benefit for jet lag, metabolic syndrome, adrenal deficiency, immune depletion, sexual neurasthenia, and deficient insomnia. It is milder acting and much less likely cause insomnia or nervousness than Asian Ginseng, making it more appropriate for regular use by younger people of both sexes.
Dose: tincture (1:5): 3-5 ml TID
Tea: 1-2 tsp. dried cut/sifted root to 12 oz. water. Gently simmer for 1/2 hour, steep an
additional 1/2 hour. Take 4 oz. three times per day.
Ashwagandha root (Withania somnifera) – Bitter, sweet, warm, dry
Western Classification: Calming adaptogen, antiinflammatory, antioxidant, antispasmodic, astringent, immune amphoteric, sedative (mild), thyroid stimulant.
This herb is one of the most prominent Rasayana (rejuvenative) remedies of Ayurveda. It is one of the few calming adaptogens and has traditionally been used for anxiety, bad dreams, mild OCD, insomnia, and nervous exhaustion. It acts as an antispasmodic and antiinflammatory and is very useful for treating fibromyalgia (with Kava and Scullcap), restless leg syndrome, mild Tourette’s syndrome, and osteo-arthritis. It is an immune amphoteric useful for hyper- and hypo-immune conditions. I find it especially useful for autoimmune conditions affecting the muscles and joints such as rheumatoid arthritis, ankylosing spondylitis, polymyositis, and polymyalgia rheumatica (PMR). It enhances male fertility (sperm count and sperm motility) and, due to its iron content, it benefits iron-deficient anemia (take it simmered in milk with molasses added). Ashwagandha also stimulates thyroid function. Studies in mice showed significant increases of serum T3 (18%) and T4 (111%) after 20 days of use (Panda, et al, 1998). I use it with Bacopa and Bladderwrack for hypothyroidism.
Dose: tincture (1:5): 1.5-2 ml TID
Tea: 1/2 tsp. dried root in 8 oz. water, decoct 10 minutes, steep 1/2 hour. Take 4 oz. TID. The dried root starts to lose its activity after two years.
Asian Ginseng root (Panax ginseng)
Red Ginseng root- Sweet, slightly bitter, warm-hot, moist
White Ginseng root- Sweet, bitter, warm, moist
Western Classification: Stimulating adaptogen, antioxidant, antiinflammatory, antiasthmatic, cardiotonic, CNS stimulant (mild), immune amphoteric.
Ginseng, especially Red Ginseng, is the most stimulating of the adaptogens. Traditionally it is used in Chinese medicine for older men with deficient kidney yang (impotence, fatigue, BPH, low back pain) or for patients with vanquished qi (CFIDS, CHF). It is a useful part of a protocol for deficient depression, exhaustion, Addison’s Disease (with Licorice), deficient insomnia, diabetes, cachexia, immune deficiency allergic asthma (use it with Schisandra and Licorice), erectile dysfunction, and it helps prevent or treat leucopenia in patients receiving chemotherapy or radiation for cancer. A human study using Asian Ginseng showed it reduced symptoms of COPD (Gross, et al, 2002), improved survival times in patients with gastric cancer, and reduced incidence of metastases (Suh, et al, 2002). Overuse of Ginseng in yang (excess) people can cause insomnia, anxiety, increased blood pressure, and irritability. Several other closely related species of Panax such as P. vietnamensis and P. japonicus are also believed to have adaptogenic action.
Dose: tincture (1:5): 1-2 ml up to three times per day.
Tea: Take 1-2 tsp. of the ground herb or one root, slowly decoct (in a nonmetal pot) for 1/2
hour. Let steep an additional hour. Take up to two cups per day.
Cordyceps fungus (Cordyceps sinensis) – Sweet, slightly acrid, warm, moist
Western Classification: Calming adaptogen, antiasthmatic, antileukemic, antioxidant, hepatoprotective, immune potentiator, nephroprotective, sedative (mild).
The caterpillar fungus (winter insect, summer plant) is one of the more unusual adaptogens. While the very expensive parasitized larvae are still available, most Cordyceps is now grown on soybeans. It is used in TCM for deficient kidney yin and yang caused by chronic disease or extremely rigorous labor/athletic training. It improves libido and sperm count, relieves fatigue, anemia, chronic coughs, tinnitus, and bone marrow (erythroid) suppression due to radiation therapy. Cordyceps also has active antitumor and antileukemic activity (use with Panax notoginseng and Isatis), it enhances circulation and cardiac output, as well as lung capacity.
Cordyceps combined with Nettle Seed, Unprocessed Rehmannia, Dan Shen, and Rhubarb is very useful for treating degenerative kidney disease. In human studies Cordyceps has shown significant benefit for male sexual dysfunction, hyperlipidemia, low platelet counts, allergic rhinitis, tinnitus, and chronic tracheitis.
Dose: tincture (1:4 or 1:5): 1-2 ml BID/TID
Tea: 1/2 tsp. mycelia powder or crushed mushroom to 10 oz. water. Decoct for 15
minutes, steep for 1 hour. Take 8 oz. once or twice per day
capsules (standardized proprietary extract CordyMax® Cs-4): 2 capsules per day
Dang Shen root (Codonopsis pilosula) – Sweet, warm, moist
Western Classification: Adaptogen (mild), gastroprotective, hypoglycemic agent, immune potentiator, nervine
Codonopsis, also known as “poor man’s ginseng” is used in TCM as a mild substitute for Panax. It is a spleen qi tonic and is used for poor appetite, gastric irritation, and/or ulcers, fatigue, and weak limbs. It is also a lung qi tonic and can be used for shortness of breath with a dry cough and frequent respiratory tract infections (use it with Prince Seng). Dang Shen is commonly used to strengthen the immune system (cancer, HIV, mononucleosis) and is frequently used in Fu Zheng therapies to prevent side effects from chemotherapy or radiation. It increases hemoglobin levels and the number of red blood cells as well. It is also indicated for insulin resistance and NIDDM along with Chinese Dioscorea, Astragalus, and Lycium fruit.
Dose: tincture (1:4 or 1:5): 2-4 ml TID/QID
Tea: 2-3 tsp. of the dried cut/sifted root or whole root and slowly decoct in 16 oz. of water
for 1/2 hour. Steep an additional hour. Take up to two cups per day.
Eleuthero root (Eleutherococcus senticosis) – Sweet, slightly bitter, neutral
Western Classification: Adaptogen, anticholesteremic, antioxidant, antiinflammatory (mild), immune potentiator, nervine.
Eleuthero (formerly Siberian Ginseng) is less tonifying than the true Ginsengs (Panax spp.). It is neutral energetically and so is appropriate for daily use. It is indicated for the “average” American who is overstressed, undernourished but overfed, doesn’t get enough sleep or exercise, has dark circles under his or her eyes, a quivering tongue, and contracting/dilating pupils. This description of HPA axis depletion without overt pathology is precisely where Eleuthero is useful. Taken regularly it enhances immune function, reduces cortisol levels and inflammatory response, and it promotes improved cognitive and physical performance. In human studies Eleuthero has been successfully used to treat bone marrow suppression caused by chemotherapy or radiation, angina, hypercholesterolemia, and neurasthenia with headache, insomnia, and poor appetite. In clinical practice I also use Eleuthero for white coat hypertension (along with Linden flower, Motherwort, and Chrysanthemum flower), jet lag, and ADHD.
Dose: tincture (1:4): 4-5 ml TID/QID
Fluid extract: 1/2 tsp. 2-3 times per day
Tea: 1-2 tsp. dried powdered root to 12-16 oz. of water. Decoct slowly for 20-30 minutes,
steep 1 hour. Take up to three cups per day.
Licorice rhizome (Glycyrrhiza glabra, G. uralensis) – Sweet, slightly bitter, warm, moist
Western Classification: Adaptogen, antihistamine, antiinflammatory, antidiuretic, antioxidant, antitussive, antiviral, demulcent, hepatoprotective, immune amphoteric, gastroprotective.
Gan Cao (Licorice) is a versatile and commonly used herb in TCM, Unani-Tibb and European herbal traditions. It is an immune amphoteric and can be useful for autoimmune disorders (Lupus, Scleroderma, Crohn’s disease, Rheumatoid Arthritis) as well as immune deficiency conditions (cancer, HIV, CFIDS). It strengthens adrenal function and can be used with Panax ginseng and Cordyceps for Addison’s disease. It is also useful for treating allergies, gastric ulcers, PCOS (with Serenoa and Paeonia), and spasmodic coughs. Excess doses of Licorice can have a hyperaldosterogenic effect (increased retention of sodium and excretion of potassium). Women are more sensitive to this effect than men and patients with hypertension should avoid using this herb on a continual basis.
Dose: tincture (1:5): .5-1 ml TID
Tea: 1/2 tsp. dried root to 8 oz. water, decoct 10-15 minutes, let steep 10-15 minutes.
Take 4 oz. BID.
Rhaponticum root (Rhaponticum carthamoides) synonym: Leuzea carthamoides – Bitter, cool, dry
Western Classification: Adaptogen, anticoagulant, antioxidant, antitumor, cardiac tonic, hepatoprotective, hypoglycemic, immune stimulant, nervine
Is a Russian herb used as a CNS stimulant and as a restorative agent to the nervous system. Animal studies have shown immunostimulant, antitumor, and cognitive enhancing effects. Human studies have shown it is an effective adaptogen, antidepressant (especially for depression due to alcohol withdrawal), immunopotentiator, hepatoprotective, and hypoglycemic agent. It has been listed as an official medicine in the Soviet (now Russian) pharmacopoeia since 1961 and is a popular tonic for athletes (it promotes muscle building and enhances lactic and uric acid excretion). Regular use of the root reduces LDL cholesterol levels, blood viscosity, and blood pressure.
Dose: tincture (1:4) 2-4 ml TID
Tea: 1-2 tsp. Dried root, 12 oz. water, decoct 15-20 minutes, steep 40 minutes, take 4 oz. TID
Rhodiola root (Rhodiola rosea) – Sweet, slightly bitter, cool, neutral
Western Classification: Stimulating adaptogen, antiinflammatory, antioxidant, antidepressant, cardioprotective, immune potentiator, nervine.
Known as Rose Root or Golden Root, Rhodiola has a long history of use in Scandinavia, Eastern Europe, and Russia as a rejuvenative tonic. Rhodiola has been an official medicine in the Soviet Union (now Russia) since 1969, as a mild CNS stimulant, memory enhancer, cardiotonic, and immune tonic. In human studies, this root has been shown to be effective for treating mild depression, neurasthenia, impaired cognitive function (Spasov, et al, 2000), CFIDS, ADHD, erectile dysfunction, amenorrhea, and infertility in women. I find Rhodiola useful for people with deficient (asthenic) depression, altitude sickness (use it with Cordyceps, Reishi, and Holy Basil), and to aid in recovery from head trauma injury. Avoid using Rhodiola in anxious, manic, or bipolar patients. Traditionally, several species of Rhodiola are used in Tibetan medicine for nourishing the lungs, to increase blood circulation, for relieving fatigue, altitude sickness, and weakness. There are a number of other species of Rhodiola which may also hae adaptogenic activity.
Dose: tincture (1:4): 2-3 ml TID
Tea: 1-2 tsp. of the cut/sifted dried root and decoct in 8-10 oz. of water for 15 minutes,
steep (covered) an additional 45 minutes. Take one to three cups per day. Avoid taking it in the
evening as it may cause insomnia in sensitive people.
Standardized extract (3% rosavins and 1% salidrosides): 1/2-1 tablet per day
Wu Wei Zi berries/seeds (Schisandra chinensis) – Sour, pungent, warm, dry
Western Classification: Adaptogen, antioxidant, antiinflammatory, astringent, antiasthmatic, hepatoprotective, immune amphoteric.
Schisandra berries mildly stimulate CNS activity and at the same time produce a calm, focused state of mind. It can be used with Codonopsis or American Ginseng for neurasthenia and exhaustion. It is very useful as part of a protocol for hepatitis B&C (use it with Milk Thistle and Turmeric), asthma (with Licorice), and for nervous system disorders including Parkinson’s disease, Meniere’s syndrome, deficient depression, and teenage or adult ADHD. Wu Wei Zi is used in Fu Zheng therapy to support immune function and prevent side effects caused by cancer chemotherapy. Traditionally, this herb is used to astringe a leaky jing gate (urinary incontinence, leucorrhea, diarrhea, and spermatorrhea) and to reduce excessive sweating.
Dose: tincture (1:5): 2-4 ml TID/QID
Tea: 1 tsp. of the dried berries to 8-10 oz. water, decoct 5-10 minutes, steep 20-30
minutes. Take 4 oz. TID
©David Winston, RH (AHG), 2004. Revised 2013. Excerpted from a larger, previously published article.
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