Quick answer: Adaptogens are herbs and mushrooms that help the body adapt to stress and return to balance. They appear to work partly through the HPA axis, the brain-adrenal stress system. Ashwagandha, rhodiola, holy basil, ginseng, cordyceps and reishi are the most widely used. They work best matched to your stress pattern and used with guidance, since some interact with medications.
Key takeaways
Adaptogens are herbs and mushrooms that help the body adapt to stress and return to balance.
They appear to work partly through the HPA axis, the communication line between the brain and the adrenal glands.
Ashwagandha, rhodiola, holy basil and reishi are common choices, and the best one depends on your stress pattern and medications.
What makes a plant an adaptogen?
An adaptogen is generally safe for regular use and helps the body resist a broad range of stressors. It has a normalizing effect, calming when you are overstimulated and supportive when you are depleted.
Unlike stimulants or sedatives that push the body in one direction, adaptogens are thought to gently bring systems back toward balance.
How adaptogens may work
Adaptogens may work by helping regulate cortisol release and protecting brain cells from stress-related strain. They may also support cellular energy under stress, lower oxidative stress and inflammatory signals, and support balanced GABA, serotonin and dopamine activity.
Commonly used adaptogens
Ashwagandha is the most studied adaptogen for stress, sleep and anxiety, and it is usually calming. Rhodiola has been studied for mental fatigue, burnout and focus and is usually energizing. Holy basil (tulsi) is an Ayurvedic herb used for stress and blood sugar balance.
Panax and American ginseng are used for physical stamina and recovery. Cordyceps and reishi are medicinal mushrooms; cordyceps is used for energy, and reishi for calm and sleep.
Practical tips
Energizing herbs (rhodiola, cordyceps, ginseng) are usually taken earlier in the day, while calming herbs (ashwagandha, reishi, holy basil) are often taken in the evening. Taking them with food can improve tolerance, and many people use them during high-stress periods, then take breaks.
Stress, adaptogens and healthy aging
Chronic stress distorts the signals between the brain, immune system and metabolism. Over time that can feed chronic inflammation and strain mitochondria, and it is associated with faster shortening of telomeres, the protective caps on chromosomes. Building stress resilience is one of the most practical ways to age well. Related: adrenal fatigue vs. adrenal dysfunction and supplements for stress management.
Safety
Ashwagandha has been linked to rare cases of liver injury and can affect thyroid hormone levels. It is not recommended in pregnancy. Ginseng may affect blood sugar and interact with blood thinners. Adaptogens can interact with thyroid, diabetes, blood pressure, sedative and immune-suppressing medications. Talk with your provider first.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if stress is affecting your sleep, energy, mood or digestion, or if you feel wired but tired or burned out. The same is true if you want to know which adaptogen fits your pattern, or if you take medications and want to use herbs safely.
See a medical provider promptly for yellowing of the skin or eyes, dark urine or severe abdominal pain while taking herbs, or thoughts of self-harm (call or text 988).
What the research shows
Ashwagandha is the adaptogen with the most human research. A 2024 meta-analysis by Arumugam and colleagues pooled 9 randomized controlled trials with 558 participants. Compared with placebo, ashwagandha lowered Perceived Stress Scale scores by about 4.7 points, anxiety scores by about 2.2 points and blood cortisol by a small amount. Four of the trials reported mild to moderate side effects. The trials were short and used different extracts and doses, and the authors noted that long-term safety is not well known.
One of the trials behind those results is a 2012 double-blind trial by Chandrasekhar and colleagues. Sixty-four adults with chronic stress took 300 mg of a concentrated ashwagandha root extract or a placebo twice daily for 60 days. The ashwagandha group improved significantly on all stress questionnaires, and their serum cortisol fell more than in the placebo group, with mild, similar side effects in both groups. It was a small, single-center study, so independent replication matters.
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Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Which adaptogen would match my stress pattern, and could it interact with my medications?
Is an adaptogen a reasonable choice alongside my current medications and supplements?
Would it be worth checking any labs before I try an adaptogen, or is my history enough to decide?
What would tell us that an adaptogen is working well for me, and how long should we wait before reviewing it?
Frequently asked questions
What is the best adaptogen for stress?
Ashwagandha is the most studied for stress and sleep. Rhodiola is often chosen for mental fatigue. The best choice depends on your pattern.
Can I take adaptogens every day?
Many people use them daily during stressful periods. Breaks and periodic reassessment are common practice.
Are adaptogens safe with thyroid medication?
Some, such as ashwagandha, can affect thyroid levels. Talk with your prescriber before combining them.
How long do adaptogens take to work?
Some people notice changes within a few weeks, but effects vary. They work best alongside sleep, nutrition and stress practices.
Sources
- Arumugam V, Vijayakumar V, Balakrishnan A, et al. Effects of Ashwagandha (Withania Somnifera) on stress and anxiety: A systematic review and meta-analysis. Explore (NY) 2024. PMID: 39348746. https://pubmed.ncbi.nlm.nih.gov/39348746/
- Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med 2012. PMID: 23439798. https://pubmed.ncbi.nlm.nih.gov/23439798/
- Panossian A, Wikman G. Effects of adaptogens on the central nervous system and the molecular mechanisms associated with their stress-protective activity. Pharmaceuticals (Basel) 2010. PMID: 27713248. https://pmc.ncbi.nlm.nih.gov/articles/PMC3991026/
- Olsson EM, von Schéele B, Panossian AG. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract SHR-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med 2009. PMID: 19016404. https://pubmed.ncbi.nlm.nih.gov/19016404/
- Epel ES, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci U S A 2004. PMID: 15574496. https://pmc.ncbi.nlm.nih.gov/articles/PMC534658/
- Björnsson HK, et al. Ashwagandha-induced liver injury: a case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int 2020. PMID: 31991029. https://pmc.ncbi.nlm.nih.gov/articles/PMC8041491/
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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