Are all adaptogens created equal? A comparative review and trend analysis of clinical data

Introduction The use of adaptogenic ingredients in dietary supplements and herbal medicines is increasingly common. The pharmacological effects of generally acknowledged adaptogens at tissue and cellular levels through various mechanisms result in a range of clinically relevant effects, such as increasing resilience during the stress response, supporting more rapid recovery from stressors, and decreasing the intensity of post-stress exhaustion. While clinical effects for adaptogens should be non-specific, traditional use and commercial marketing suggest different applications for individual adaptogens. To this end, the authors conducted a comparative review of clinical research to test the hypothesis based on traditional understanding that adaptogen-specific effect profiles exist and that adaptogens have differentiable clinical relevance. Methods A comparative trend analysis of clinical evidence using accepted vote-counting methodology and data synthesis was conducted on seven generally acknowledged adaptogens: ashwagandha ( Withania somnifera ), schisandra ( Schisandra spp.), eleuthero ( Eleutherococcus senticosus ), rhodiola ( Rhodiola rosea ), Asian ginseng ( Panax ginseng ), reishi (species of Ganoderma ), and cordyceps (species of Cordyceps and Ophiocordyceps along with affiliated Paecilomyces hepiali ). Results A total of 275 clinical studies were included and scored based on primary and secondary outcomes across seven clinical outcome domains: energy, cognition, mood, sleep, immunologic and inflammatory balance, cardiometabolic health, and the reproductive system. Trend analysis of this dataset identified which adaptogens showed significant positive directions of effect in each domain, and demonstrated some significant differences in clinical outcome distribution profiles for each adaptogen. Discussion Individual adaptogens show unique effect profiles measured by the outcomes of clinical research in diverse domains, corroborated by traditional use.