The claimEvidence C · limited
Adaptogens are plant magic
The evidence
Real mechanism is dampening cortisol overshoot — a subset of what sleep + exercise + nutrition already do.
The mechanism, in brief
When pressure piles on, the body goes through three steps: it tenses into alarm, holds on in resistance, and collapses when it can hold on no longer. These are the three stages of stress that Selye described. What the adaptogen label sells is keeping you at the resistance step: lift you a little when you are drained,…
Sources (3)
- Panossian, A., & Wikman, G. (2010). Effects of adaptogens on the central nervous system and the molecular mechanisms associated with their stress-protective activity. Pharmaceuticals, 3(1), 188-224.
- Björnsson, H. K., Björnsson, E. S., Avula, B., Khan, I. A., et al. (2020). Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver International, 40(4), 825-829. Five cases of cholestatic/mixed liver injury after 2-12 weeks of ashwagandha use; all self-limited. 3 cases from Iceland (2017-2018) and 2 from the US DILIN (2016); mean age 43; jaundice after 2-12 weeks; cholestatic or mixed injury; pruritus and hyperbilirubinaemia lasted 5-20 weeks; no hepatic failure; liver tests normalized in 1-5 months in 4 (1 lost to follow-up); chemical analysis confirmed ashwagandha with no other toxic compound; 4 were also taking other supplements (rhodiola possibly co-causal in one). Full text: the Icelandic daily doses were 450-1350 mg as recorded from the label, and no patient had recently raised the dose (abstract, PMID 31991029; full text, PMC8041491).
- Philips, C. A., Valsan, A., et al. (2023). Ashwagandha-induced liver injury — A case series from India and literature review. Hepatology Communications, 7(10), e0270. 23 herb-induced liver injury cases; cholestatic predominant; patients with pre-existing chronic liver disease had severe (fatal) outcomes. Retrospective multicentre Indian series, January 2019 to December 2022: of 23 patients with ashwagandha liver injury, the 8 on single-ingredient products are reported in detail (multiherbal or co-hepatotoxic exposures excluded); mostly men, cholestatic hepatitis commonest; 5 had underlying chronic liver disease, 3 of them presented with acute-on-chronic liver failure and all 3 died; the other injuries were prolonged but self-limiting, one became chronic. Chemical analysis found only natural phytochemicals, no adulteration or contamination. Full text: patients took ashwagandha per practitioner advice or product labeling (abstract, PMID 37756041; full text, PMC10531359).