I've been seeing more and more patients coming to me on self-prescribed adaptogenic herbs. They're suddenly all the rage. Shoot, after I saw a clothing company write a blog post on adaptogens, I knew I had to chime in….

Don't get me wrong - I absolutely love adaptogens and use them all the time in my practice. I've even joked with my colleagues that the world might be a better place if there were adaptogens in the water. But here's the thing, as with just about everything in functional medicine, not everyone will benefit from the same treatment. Each adaptogen has different actions and benefits.

You may have heard of some of these herbs already or may even be taking them your self. Some common adaptogens include Ashwagandha, Rhodiola, Tulsi, Reishi…ring a bell? If not, don't worry, I've got you covered.

What is an adaptogen?

Adaptogens are a group of herbs that help the body adapt to stress. They affect the HPA axis (hypothalamic, pituitary, adrenal axis), a part of the endocrine system that plays a role in how we perceive and respond to stress.

They are helpful for all different types of stress. Stress can either be acute stress (short-term) or chronic stress (long-term). It's also important to know that stress isn't just mental or emotional stress (e.g. I’m feeling so overwhelmed with work/school/family). Stress can also be physical stress, like inflammation, malnutrition, lack of sleep, overexercise, etc.

Who needs adaptogens?

Adaptogens are one of those are things that I feel most adults can benefit from. With that being said, I can't emphasize enough that you cannot out supplement stress! You absolutely need to be prioritizing self-care in addition to taking these herbs. One of my favorite self-care practices for myself and my patients is mindfulness meditation. I recently watched this excellent Netflix documentary on mindfulness. If I can't convince you, hopefully, this can. Check it out: The Mind, Explained: Mindfulness

My favorite adaptogens & when to use them

Rhodiola rosea

Take Rhodiola if stress is causing you to have a low mood, depression or generally feeling overwhelmed. Rhodiola is also great for physical stress and can prevent altitude sickness and improve physical and mental performance. It's essential to be mindful of the dose with Rhodiola. Doses of 400 mg and higher have been shown to lower the stress hormone cortisol; however, not everyone who has high stress has high cortisol. Cortisol may be too low and reducing it more isn't desirable in those cases.

Eleutherococcus senticosus (aka eleuthero)

Take Eleuthero if stress is causing you to have low energy. Eleuthero is my go to for physical stress. It’s been found to increase endurance in athletes. And it’s a good antioxidant reducing damage to cells from environmental exposures such as heavy metal, pesticides, chemotherapy, et.

Withania (aka Ashwawgandha)

Take Ashwagandha if stress is causing you to feel anxious. It's also helpful if your sleep becomes disrupted from stress. I use Ashwagandha in formulas to lower cortisol levels. It's useful in enhancing male fertility.

Holy Basil (aka Tulsi)

Take holy basil if you need something that's quickly soothing. My favorite thing about holy basil is how delicious it is as a tea. It's part of the mint family and has a mild pleasant flavor. You can find Tulsi tea at most grocery stores. I stash some in my desk and keep some at home for a quick and easy cup of calm. It's naturally caffeine-free so you can enjoy it any time of day.

Hypericum (St. John's Wort)

Take St. John's wort if stress is causing you have mild to moderate depression. St. John's Wort should be monitored in patients who are taking antidepressant medication, including SSRIs and MAO inhibitors.

Cordyceps sinenses

Take cordyceps if you are stressed and have nutrient deficiencies. Cordyceps is an adaptogenic mushroom that is rich in B vitamins. B vitamins are essential for combating stress, maintaining healthy energy and creating neurotransmitters (which impact your mood and are the signals used by your nervous system to communicate).

Reishi

Take reishi if you get sick a lot when you're stressed. Reishi is another adaptogenic mushroom and is great for boosting the immune system.

Glycyrrhiza glabra (aka licorice root)

Take licorice if you've had long term chronic stress and feel depleted or burnt out. Licorice root has been found to extend the half-life of cortisol, meaning it's helpful for people who have low cortisol levels. But be careful, licorice shouldn't be used by those with high blood pressure.

Treatment & HPA testing

I've always been fascinated by herbal medicine and love and appreciate all the unique qualities of herbs. When it comes to adaptogens, I like to use them individually, as well as together in combination formulas.

In my practice, I find it beneficial to make patients a customized formula specific to their unique needs. Individualization is a foundation of functional medicine. By listening to my patients' symptoms and history, as well as measuring and monitoring hormones like cortisol, DHEA and melatonin, I can individualize their treatment. I'm a big fan of testing because, as I mentioned above, you don't want to take an herb or supplement that is going to impact your cortisol in a counterproductive way.