Adaptogen Monographs Part 1: The Core Six

What Makes an Adaptogen

The term was coined by Nikolai Lazarev in 1947 and formalized by Israel Brekhman in 1968 with three defining criteria:

1. Non-toxic: An adaptogen must be safe for long-term use with minimal side effects — it causes no additional stress to the organism
2. Non-specific resistance: It must increase the body’s resistance to a broad range of stressors — physical, chemical, biological, psychological — not just one
3. Normalizing effect: It must have a balancing influence on physiology regardless of the direction of deviation from normal. If cortisol is too high, it lowers it. If cortisol is too low, it raises it. This bidirectional modulation is what distinguishes adaptogens from stimulants (which only push one direction)

The mechanism: adaptogens modulate the hypothalamic-pituitary-adrenal (HPA) axis and the sympathoadrenal system at multiple points. They regulate cortisol production, influence cortisol receptor sensitivity, modulate heat shock protein expression, support mitochondrial efficiency, and regulate inflammatory mediators. They do not override the stress response — they calibrate it.

Think of adaptogens not as drugs that push a specific biochemical lever, but as tuning forks that help the body find its own resonant frequency.

---

1. Ashwagandha (Withania somnifera)

Sanskrit name: Ashwagandha — “smell of the horse” (referring to both the root’s odor and the implication that it confers the vigor and strength of a stallion)

Tradition: Rasayana (rejuvenative) in Ayurveda for over 3,000 years. Used for fatigue, weakness, sexual vitality, immune support, cognitive enhancement, and as a general tonic.

Active compounds: Withanolides (steroidal lactones) — particularly withaferin A, withanolide D, and withanoside IV. The withanolide content determines potency and varies dramatically between extracts.

Standardized extracts:

• KSM-66: Full-spectrum root extract, standardized to 5% withanolides. Produced using a milk-based extraction process (traditional). The most clinically studied extract
• Sensoril: Root and leaf extract, standardized to 10% withanolide glycosides + 32% oligosaccharides. Higher withanolide content per milligram; often used at lower doses

Evidence

Cortisol reduction: Chandrasekhar (2012) — 64 adults with chronic stress, randomized to 300mg KSM-66 twice daily or placebo for 60 days. The ashwagandha group showed a 27.9% reduction in serum cortisol versus 7.9% in placebo. Perceived stress, anxiety (Hamilton Anxiety Scale), and insomnia all significantly improved.

Thyroid support: Sharma (2018) — 50 hypothyroid patients, randomized to 600mg ashwagandha root extract or placebo for 8 weeks. The ashwagandha group showed significant improvement in TSH (normalized toward optimal), T3, and T4 levels. This is one of the few supplements with clinical evidence for improving thyroid function from the hypothyroid side.

Testosterone: Lopresti (2019) — overweight men aged 40-70, 300mg KSM-66 twice daily for 8 weeks. Significant increase in testosterone (14.7%), DHEA-S (18.2%), and improvement in fatigue, vigor, and sexual well-being. Earlier studies (Wankhede 2015) showed increased muscle strength and size combined with resistance training.

Anxiety: Pratte (2014) — systematic review of 5 RCTs. All five showed significant benefit of ashwagandha over placebo for anxiety symptoms. Effect sizes were large.

Sleep: Langade (2019) — 300mg KSM-66 twice daily improved sleep quality (Pittsburgh Sleep Quality Index), sleep onset latency, and sleep efficiency in insomnia patients.

Endurance and recovery: Choudhary (2015) — improved cardiorespiratory endurance and recovery in athletes.

Dosing

• KSM-66: 300-600mg daily (typically 300mg twice daily)
• Sensoril: 125-250mg daily
• Traditional powder: 3-6g daily in warm milk (traditional preparation)
• Best taken with food; can be taken morning and evening

Cautions

• Nightshade family (Solanaceae) — avoid in strict nightshade elimination protocols
• May potentiate thyroid medication (check thyroid levels if on levothyroxine)
• Autoimmune thyroid disease (Hashimoto’s, Graves’): use with caution — ashwagandha’s immune-modulating and thyroid-stimulating properties may overstimulate thyroid autoimmunity in some patients. Monitor closely
• May potentiate sedatives and anxiolytics
• Avoid in pregnancy (traditional abortifacient at high doses in some traditions)
• GI upset in some patients; taking with food reduces this

---

2. Rhodiola rosea (Golden Root, Arctic Root)

Tradition: Used for centuries in Scandinavian and Russian folk medicine for endurance, stamina, mental performance, and high-altitude adaptation. Vikings consumed it before raids. Sherpas used it for altitude.

Active compounds: Rosavins (rosavin, rosarin, rosin) and salidroside (tyrosol glucoside). The standardization ratio matters: authentic Rhodiola rosea extract should contain approximately 3% rosavins and 1% salidroside — this is the ratio naturally occurring in the root and the ratio used in most clinical studies.

Evidence

Fatigue and burnout: Olsson (2009) — 60 individuals with stress-related fatigue, randomized to 576mg Rhodiola extract (SHR-5) or placebo for 28 days. The Rhodiola group showed significant improvement in burnout symptoms, cortisol response, and mental performance under fatigue conditions.

Depression: Mao (2015) — 57 adults with mild to moderate depression, randomized to Rhodiola 340mg, sertraline 50mg, or placebo for 12 weeks. Rhodiola was slightly less effective than sertraline for depression scores but had significantly fewer side effects. The weight of evidence supports Rhodiola as an augmentation strategy or first-line option for mild depression, not as a replacement for SSRIs in moderate-to-severe depression.

Cognitive performance: Spasov (2000) — Rhodiola improved mental performance during periods of low-intensity work and stress, including night shift duty, examination periods, and military training.

Exercise endurance: Multiple studies show improved time to exhaustion, VO2 max, and reduced perceived exertion during endurance exercise. Mechanism: Rhodiola supports mitochondrial ATP production and fatty acid oxidation.

Dosing

• 200-600mg daily, standardized to 3% rosavins and 1% salidroside
• Best taken morning and early afternoon (stimulating for some — avoid evening dosing)
• Often most effective at lower doses (200-400mg); higher doses sometimes paradoxically less effective (inverted U dose-response curve)
• Cycle: 5 days on, 2 days off, or 3 weeks on, 1 week off (to maintain sensitivity)

Cautions

• Stimulating: can cause insomnia, agitation, or anxiety in sensitive individuals — start low, take in the morning
• Bipolar disorder: theoretical risk of triggering mania (stimulating effect). Use with psychiatric oversight
• May potentiate stimulant medications
• Rare: vivid dreams, headache at higher doses

---

3. Panax Ginseng (Korean/Asian Ginseng)

Tradition: “King of herbs” in Traditional Chinese Medicine for 2,000+ years. Classified as a “qi tonic” — restoring vital energy. The name “Panax” comes from the Greek panakeia — “all-healing.”

Active compounds: Ginsenosides (also called panaxosides) — over 30 identified. Different ginsenosides have different effects: Rg1 is stimulating, Rb1 is calming. The ratio determines the overall effect profile. Standardized extracts typically contain 4-7% ginsenosides.

Evidence

Cognitive performance: Reay (2005) — 200mg Panax ginseng improved cognitive performance and mood during sustained mental demand. Kennedy (2003) demonstrated improved speed of attention and working memory.

Immune function: Scaglione (1996) — 227 participants, randomized to 100mg ginseng extract (G115) or placebo for 12 weeks during flu season. The ginseng group had 65% fewer colds and flu. NK cell activity was significantly higher in the ginseng group.

Blood sugar: Vuksan (2000) — Panax ginseng and American ginseng both reduced postprandial glucose in type 2 diabetes. Ginsenoside Rb1 appears to improve insulin sensitivity and support beta-cell function.

Erectile function: Multiple studies show improvement in erectile function — mechanism involves nitric oxide enhancement (similar to PDE5 inhibitors but milder). Hong (2002) — improvement in International Index of Erectile Function scores.

Dosing

• 200-400mg standardized extract (4-7% ginsenosides) daily
• Traditional: 1-2g dried root, simmered as decoction
• Best taken morning on an empty stomach
• Cycle: traditional Chinese medicine recommends discontinuing periodically (e.g., 3 months on, 1 month off)

Cautions

• Stimulating: can raise blood pressure in hypertensive individuals — monitor
• Anticoagulant interaction: may enhance or interfere with warfarin — check INR
• Insomnia at higher doses or with evening use
• Estrogenic effects: some ginsenosides bind estrogen receptors weakly — theoretical concern in hormone-sensitive cancers (evidence unclear)
• “Ginseng abuse syndrome” (Siegel 1979) described at high doses: hypertension, nervousness, insomnia, diarrhea — likely from adulterated products or excessive dosing

American ginseng (Panax quinquefolius): Different ginsenoside profile — more Rb1 (calming), less Rg1 (stimulating). Traditional Chinese medicine considers it “cooler” and more yin-nourishing. Preferred for patients who find Korean ginseng too stimulating, or those with yin-deficiency patterns (hot, dry, anxious).

---

4. Holy Basil (Tulsi — Ocimum tenuiflorum)

Tradition: “The Incomparable One” — sacred in Hinduism, grown in nearly every Hindu household. Used in Ayurveda as a rasayana for longevity, cognitive clarity, respiratory health, and spiritual cultivation. Three main varieties: Rama (green leaf), Krishna (purple leaf), Vana (wild leaf) — all therapeutically active.

Active compounds: Ursolic acid, eugenol, rosmarinic acid, apigenin, ocimarin, orientin. The essential oil is rich in eugenol (anti-inflammatory, antimicrobial).

Evidence

Stress and cortisol: Jamshidi and Cohen (2017) — systematic review of 24 studies (including human clinical trials). Consistent findings: Holy Basil reduced anxiety, stress, and depression symptoms, normalized blood glucose, improved cognition, and supported immune function. Saxena (2012) — 150 patients, 1200mg/day of Tulsi extract for 6 weeks, showed significant reduction in generalized anxiety symptoms.

Blood sugar: Agrawal (1996) — Holy Basil significantly reduced fasting and postprandial blood glucose in type 2 diabetes patients. Mechanism: improves insulin sensitivity and supports pancreatic beta-cell function.

Lipids: Multiple studies show reduction in total cholesterol, LDL, and triglycerides.

Cognitive enhancement: Traditional use supported by emerging evidence showing neuroprotective effects through antioxidant and anti-inflammatory mechanisms in the brain.

Dosing

• Extract: 300-600mg standardized extract, 1-2 times daily
• Tea: 2-3 cups daily (dried leaf, steeped 5-10 minutes) — this is the traditional and arguably most pleasant form. Tulsi tea is widely available and makes an excellent caffeine-free daily beverage
• Fresh leaf: 5-10 leaves daily, chewed or added to food
• Essential oil: not for internal use (concentrated eugenol is irritating)

Cautions

• May lower blood sugar — monitor in diabetics on medication
• Fertility: high-dose animal studies showed reversible anti-fertility effects (reduced sperm count, altered estrous cycle). Clinical relevance in humans at standard doses is uncertain, but couples actively trying to conceive may want to avoid very high doses
• Blood thinning: eugenol has mild anticoagulant properties. Caution with anticoagulant medications and before surgery
• Generally very well tolerated — one of the safest adaptogens

---

5. Eleuthero (Eleutherococcus senticosus — Siberian Ginseng)

Tradition: Russian folk medicine, then extensively studied by the Soviet Union — Brekhman’s primary research subject. Soviet athletes, cosmonauts, and military personnel used Eleuthero to enhance performance and stress resistance. Note: not actually ginseng (different genus), but the name persisted.

Active compounds: Eleutherosides (A through M) — a diverse group including lignans, sterols, and coumarins. Eleutherosides B (syringin) and E (syringaresinol) are the primary active markers.

Evidence

Endurance: Kuo (2010) — recreational athletes showed improved endurance performance, increased VO2 max, and enhanced fat utilization during exercise after Eleuthero supplementation.

Immune function: Bohn (1987) — Eleuthero increased lymphocyte counts and NK cell activity in healthy volunteers. Traditional use for preventing colds and infections during winter.

Cognitive performance and fatigue: Winther (2004) — improved cognitive function and quality of life in elderly adults. Multiple Soviet-era studies (methodological quality variable) showed enhanced work output, reduced absenteeism, and improved stress tolerance in workers and athletes.

Anti-fatigue: Huang (2011) — systematic review supported anti-fatigue effects, though noted heterogeneity in study designs.

Dosing

• 300-400mg standardized extract (0.8% eleutherosides B+E) daily
• Fluid extract: 2-4 mL, 1-3 times daily
• Dried root: 2-4g daily as decoction
• Best taken morning and midday — avoid evening (mild stimulant effect)

Cautions

• May increase blood pressure in some individuals — monitor
• Insomnia if taken too late in the day
• Avoid in acute infection (immune stimulation may worsen certain immune-mediated conditions)
• Drug interactions: theoretical interaction with digoxin (one case report of elevated digoxin levels — may have been contamination with actual ginseng in the product)
• Quality control: Eleuthero has historically been subject to adulteration — verify species identity with reputable brands

---

6. Schisandra chinensis (Five-Flavor Berry)

Tradition: One of the 50 fundamental herbs in Traditional Chinese Medicine. Named “five-flavor berry” (wu wei zi) because it contains all five flavors — sweet, sour, salty, bitter, pungent — which in TCM theory means it enters all five yin organs (liver, heart, spleen, lung, kidney). Used as a harmonizing herb, liver protectant, lung tonic, and mental enhancer. Russian research in the 1950s-60s classified it as an adaptogen alongside Eleuthero.

Active compounds: Schisandrin B (the most studied lignan), schisandrin A, gomisin A, and other dibenzocyclooctadiene lignans. These are the primary bioactive compounds responsible for hepatoprotective, adaptogenic, and antioxidant effects.

Evidence

Liver protection: Panossian (2008) — comprehensive review documenting Schisandra’s hepatoprotective effects. Schisandrin B protects hepatocytes from toxic insult (carbon tetrachloride, acetaminophen, aflatoxin) through multiple mechanisms: enhancing glutathione synthesis, reducing lipid peroxidation, and modulating cytochrome P450 enzymes. Traditional and modern use in hepatitis, liver cirrhosis, and as a liver-protective agent during drug therapy.

Endurance and physical performance: Panossian and Wikman (2009) — Schisandra improved exercise tolerance, reduced fatigue, and enhanced recovery. Soviet-era research in athletes and military showed increased work capacity and reduced errors under stress.

Cognitive function: Improved accuracy, attention, and speed of cognitive tasks under stress conditions. Traditional use as a “mind tonic.”

Anti-inflammatory and antioxidant: Multiple in vitro and animal studies demonstrate potent antioxidant activity, NF-kB inhibition, and reduced inflammatory cytokines.

Stress adaptation: Like other adaptogens, Schisandra normalizes HPA axis function — reducing excessive cortisol while supporting deficient cortisol production.

Dosing

• Standardized extract: 500-1000mg daily (containing 3-5% schisandrin)
• Dried berry: 1.5-6g daily (can be chewed or decocted)
• Tincture: 2-4 mL, 1-2 times daily
• Tea: 5-10 dried berries steeped in hot water — a pleasant sour-sweet tea
• Traditionally taken with meals

Cautions

• Increases stomach acid secretion: beneficial for those with hypochlorhydria (low stomach acid) but potentially problematic for active GERD or peptic ulcer disease
• May affect drug metabolism (CYP3A4 modulation) — potential interactions with medications metabolized by this pathway (statins, immunosuppressants, some calcium channel blockers). Review medications
• Pregnancy: traditionally avoided in early pregnancy
• Epilepsy: theoretical concern based on CNS activity — use with caution
• May cause heartburn or epigastric discomfort in sensitive individuals

---

Practical Considerations

Combining Adaptogens

Adaptogens are traditionally used in combination, not isolation. The clinical effect of a well-chosen combination often exceeds the sum of individual components. Common clinical pairings:

• Ashwagandha + Rhodiola: Calming + energizing — balances the nervous system. Morning Rhodiola, evening ashwagandha
• Holy Basil + Ashwagandha: Deep relaxation, anxiety, sleep support
• Eleuthero + Rhodiola: Physical performance, endurance, athletic support
• Schisandra + Ashwagandha: Liver protection during detoxification + adrenal support

Cycling

Adaptogens are most effective with cycling — periodic breaks prevent accommodation (the body adapting to the point of reduced response). Common patterns: 5 days on / 2 off, 3 weeks on / 1 off, or 2 months on / 2 weeks off. Rotate between adaptogens seasonally to maintain responsiveness.

Quality

• Third-party testing (NSF, USP, ConsumerLab) for identity, potency, and contaminants
• Standardized extracts with identified active compounds
• Organic when possible (reduces pesticide burden — ironic to take a detox herb laced with pesticides)
• Avoid proprietary blends that hide individual doses

These six plants have survived thousands of years of empirical testing across multiple cultures, and modern science continues to validate what traditional healers observed. They are not panaceas. They are calibrators — helping a stressed, depleted, overstimulated body find its way back to center.

Which of these six speaks to the pattern your body is currently running?