Wednesday, 21 November 2018

Adaptogens, the mysterious herbs that supposedly alleviate your stress, explained

Recently, while talking to the New York Times, a marijuana company called CBD the “Bitcoin” of the wellness world. But here is a counterproposal: Adaptogens are actually the cryptocurrency of the wellness world.

Sure, CBD is a bizarrely opaque “miracle” treatment, but many people have some idea what it is, or at least know that it’s a derivative of cannabis. Adaptogens are just as mysterious as CBD or the cryptocurrency Ethereum, and the high-minded promises driving their sales are similarly wild and overreaching. Heck, adaptogen names even sound like crypto names: eleuthero, schisandra, rhodiola.

Broadly speaking, adaptogens are a class of herbal and plant ingredients in supplements that claim to help your body adapt to stress more efficiently. What they supposedly specifically do is cloudier, because there are at least a dozen or more different ones.

Some have long histories as healing modalities over multiple cultures and thousands of years — which gives them a veneer of legitimacy. They act nonspecifically in the body, meaning they don’t work on one single body system or organ, at least according to their proponents. There’s debate among adaptogen believers about which substances can even be considered adaptogens and how they actually work.

As a society, we’re all just really tired and stressed out and looking desperately for some relief, as the rise of viral anxiety products like fidget spinners has shown. Supplement manufacturers have always preyed on those who are looking for a fix that they think they can’t find in the mainstream. Adaptogens have stepped in as a new/old remedy to fill the need for stress relief in the market.

You can buy coffee at Sephora containing adaptogenic mushrooms that will supposedly increase your focus. You can buy adaptogenic coconut butter to “empower your busiest day.” You can buy “dusts” containing adaptogens and other herbs to supposedly help your brain function better and improve your sex life. Ladies, you can even buy an adaptogenic oil “to keep your yoni delicious and supple.”

You can find adaptogenic products at Sephora, Nordstrom, Barneys, and Urban Outfitters. They’re fashionable. You don’t have to hunt them down in natural food stores.

They’ve even proven equally appealing to acolytes of actress and wellness “guru” Gwyneth Paltrow and conspiracy theorist Alex Jones, both of whom prominently feature adaptogen-containing products for sale on the Goop and Infowars websites, respectively. When adaptogens landed a feature in the New York Times this past summer, it was a true sign that the fringe interest has finally bled into the mainstream.

Adaptogens are now a growing sector of the $4 trillion wellness industry. According to statistics reported by the American Botanical Council and based on market research, herbal dietary supplement sales were about $7.45 billion, up 7.7 percent from the prior year. In 2017, that number jumped to about $8.1 billion, up 8.5 percent.

It’s difficult to determine a breakdown of how much of that can be attributed to adaptogens since there are so many — up to a dozen or more, depending whom you ask. The most popular, ashwagandha, was the sixth most popular herbal supplement sold in so-called “natural” retail outlets, with more than $10 million in sales just in natural stores, up 25 percent from 2016. (Most popular adaptogen products are sold in combination with other ingredients, so it’s hard to drill down into their exact sales.) It’s still a small market, but it’s definitely growing.

Adaptogens fall perfectly into the gray area that wellness envelops. The language is often vague and invokes mysticism. Users say they can calm you down and also perk you up, depending on which one you need.

It’s easy to see how this could be incredibly appealing to someone who may be simultaneously stressed and exhausted. It’s also easy to see how marketing them can be used to manipulate people into buying them. As with so many wellness trends, they can’t possibly live up to the hype.

It’s common for proponents to talk about this class of ingredients — usually found in powders, capsules, and now even topically — as if they have magical properties. Definitions tend to be vague and broad, and they’re often applied to more than a dozen different ingredients.

“It’s kind of like your invisible internal shield,” says Elena Severin, the director of branch partnerships at the Detox Market, a chain of “clean beauty” and supplement boutiques that is growing quickly and has stores in LA, New York, and Toronto. It carries multiple brands of adaptogen supplements, including the two most popular, Moon Juice and Sun Potion. (Celestial names maybe not coincidental.)

Severin estimates that over the past year or so, the interest in and questions customers have about adaptogens have tripled.

So an invisible shield, got it. Let’s drill down a bit more.

“The simplest way to understand adaptogens is that they help your body to adapt to life,” writes Tero Isokauppila, the co-founder of the adaptogenic mushroom coffee Four Sigmatic, in an email to Vox. “Rather than serving a single purpose, they give your body whatever it needs right now to bring your body in balance.”

Hmm. Let’s hear from the ultimate authority on them.

“An adaptogen is an herb or mushroom that helps the body find homeostasis,” says Amanda Chantal Bacon, the founder of Moon Juice and arguably the godmother of modern adaptogen awareness, on a call with Vox.

Her viral 2015 Elle interview left the internet agog at the words she used — like “Shilajit resin” and “quinton shots” — in a food diary for the magazine. She’s since been covered in multiple publications, including features in the New Yorker in 2016 and in the New York Times magazine in mid-2017.

Much like Gwyneth Paltrow, who sells Moon Juice products on Goop, she’s taken the negative attention and lowkey ridicule and actually turned it into a booming lifestyle brand. Hers happens to be centered on adaptogens.

Bacon continues. “They’re bidirectional,” she says. “They’re going to move energies both ways.”

She explains that this means the same plant can make one person feel invigorated if they need energy and will calm another one down if they’re a “nervous wreck.”

It should be clear now why this class of substances is difficult to understand. Not surprisingly, these substances might not be the powerhouses that these various evangelizers say they are.

Dr. Rashmi Mullur is an assistant professor of medicine in the department of endocrinology, diabetes, and metabolism and associate chief of integrative medicine at UCLA. She is one of a handful of board-certified endocrinologists who also have integrative medicine certification.

She has an interest in adaptogens and a practice in LA, the city that is basically ground zero for wellness trends. She doesn’t sell or promote any supplement brands, but she does occasionally recommend them for patients.

“Practically everything is listed as an adaptogen online, but an adaptogen is any herb or supplement that helps the body’s response to stress,” says Mullur.

She says there is no standardized medical definition for adaptogens, and that even the concept of “stress” is defined pretty broadly. It can be caused by endocrine issues (cortisol is the usual hormonal culprit there), physical problems, mental problems, and even temperature. They all can cause the sensation we think of as “stress” and make us feel like crap, to use a layperson’s term.

Adaptogens can be derived from plants, herbs, or mushrooms. The most commonly used ones include ashwagandha, rhodiola, a slew of ginseng varieties, eleuthero, cordyceps, and reishi.

The science on most of these is conclusively inconclusive. Many have only been studied on cell lines or in animals, and if there are human studies, they tend to be published in tiny, niche journals. A science writer who reviewed some of the studies for Self noted that many were not “compliant with international criteria for proper clinical trial reporting.”

“I really don’t recommend anything to a patient unless it has some human studies,” says Mullur.

Ashwagandha, which the Detox Market’s Severin says is often a “gateway” into adaptogens for people, is one of the best-studied, and even has a couple of well-designed modern studies, but that’s not saying much. The subject groups were small, meaning you can’t draw any generalized, meaningful conclusions, and there haven’t been follow-up studies to see if the results could be replicated.

But Mullur explains that it’s thought to work along the pathway called the hypothalamic-pituitary-adrenal axis (HPA), a neurological and hormone feedback loop that mediates the stress response. There are still some pretty major caveats here.

Studies “don’t always translate to clinical utility,” Mullur says. A lot of the time, patients assume they’re stressed because of an HPA-induced cortisol response, and they try to self-medicate with adaptogens. “I always want to know what the underlying root cause of the fatigue is. Very rarely is the cause of the fatigue a hormonal imbalance,” says Mullur.

Even if someone does have a stressed-out HPA, it’s really not clear from the small amount of available evidence what dose would be effective, how often it should be taken, or who should or shouldn’t take it.

Plus these substances can have side effects, the way a drug does. Ashwagandha has been reported to potentially cause miscarriage. Mullur explains that because it binds to steroid receptors, it can affect hormonal function. “I certainly wouldn’t advise anyone to take it in pregnancy.”

Unlike many of her contemporaries in endocrinology who don’t know much about adaptogen supplements, though, Mullur does sometimes let her patients take them. However, she discourages mixtures of several ingredients because then it’s hard to know what, if anything, might be helping or causing harm. Many of the most popular formulas, like Moon Juice’s, are sold in mixtures and combinations, and there’s no guarantee what is in the formula and in what quantity.

“I’m helping guide patients through the online mess of information,” Mullur says. And this is the most important point here. Most people who are self-medicating willy-nilly with supplements will likely get no real benefit, and could possibly even harm themselves. Mullur is at least an educated medical source, able to evaluate people’s symptoms, consider the other supplements they’re taking, and try to make some sense of it.

When asked if, ultimately, she thought this new trend of adaptogens everywhere was good or bad, Mullur says, “Probably bad. I don’t want to come across as if I hate all herbal supplements, because I don’t, but I think whenever you have trends in medicine that are unregulated, it’s a breeding ground for misuse and abuse.”

Timothy Caulfield would agree. He’s a professor of health law and science policy at the University of Alberta in Canada and an outspoken advocate against the proliferation of pseudoscience. He wrote a book called Is Gwyneth Paltrow Wrong About Everything?: When Celebrity Culture and Science Clash and hosts a Netflix documentary series debunking various wellness trends called A User’s Guide to Cheating Death.

“In total, the solid science is lacking, particularly in the context of many of the marketing claims associated with adaptogens — like the idea that they can induce calm and focus,” he says in an email to Vox.

The bottom line is that you can’t really broadly apply the promise of vague benefits across an entire class of substances without real evidence. But the wellness industry capitalizes on the existence of a gray area and is adept at claiming things without actually claiming anything.

“When it comes to supplements, the law is that you can market it for just about anything, as long as you stay away from saying it can treat or cure a disease. Without any human data on safety, much less efficacy, it’s entirely legal to advertise a supplement as if it is good for your health,” Dr. Pieter Cohen, an associate professor of medicine at Harvard Medical School who has studied dietary supplements, writes in an email to Vox. “It’s very lucrative for companies but very unfortunate for consumers looking for something that will actually work.”

A three-tiered definition of what can qualify as an adaptogen actually does exist, dating back to some secretive USSR research on adaptogens. It’s still pretty vague, though. According to NutraIngredients, a business-to-business site geared toward supplement and food-based businesses, to be classified as an adaptogen an ingredient must be “nontoxic”; it must work on a variety of bodily systems rather than just one; and it must “normalize” bodily functions. (The adapto-preneurs above also all echoed this definition.)

But, again, it’s not a recognized definition by any official governing or medical body; it’s just the common classification among those who use and study them.

Adaptogens weren’t always called adaptogens, though. Some, like ashwagandha and ginseng, have been long used and studied as healing substances in ayurvedic and Chinese medicine respectively. The modern iteration, however, all started at laboratories behind the Iron Curtain in the mid-20th century, according to a comprehensive 2010 review paper in the journal Pharmaceuticals.

During World War II, Soviet pilots and submarine crews were given schisandra in pill form, for energy and as a “tonic” to calm them down. The Soviets first apparently became interested in it in the late 19th century after learning about its uses in the Far East.

Dr. Israel Brekhman is often credited as being the godfather of adaptogens and the person who coined the term and clarified the definition. He and his partners apparently racked up more than 1,000 studies on the plants, and won the highest award in the Soviet Union at the time for his work.

According to the review article, “The aim of the stress research was to develop drugs and methods able to stimulate the intrinsic adaptive mechanisms of the organism to help it survive in situations of intense or prolonged stress, whilst preferably maintaining the capability for physical and mental work.” The “organism” in question, presumably, was people.

Which brings us back to Amanda Chantal Bacon. What started out as a personal interest for her, exploring supplements for an autoimmune disease, became the Moon Juice empire in only a few short years.

(There is also Sun Potion, which is a staple in trendy wellness stores. The founders stay more out of the limelight than Bacon, but one co-founder told Racked he considered himself “an avenue for these plants,” setting up shop in Santa Barbara several years ago.)

“I wasn’t concerned with the allopathic science behind it, and the plants really worked for me,” says Bacon. Allopathic medicine, otherwise known as the mainstream kind served up in hospitals and by pharmaceutical companies, is highly suspect in some adaptogenic circles.

Bacon started Moon Juice as a shop in LA, but the now-famous — or infamous — Brain Dust, Sex Dust, and other dusts are sold in mainstream beauty and wellness emporiums like Sephora, Urban Outfitters, and Nordstrom.

Her newest offering, a blend of four adaptogens and other ingredients like sunflower oil, is called SuperYou. She says it sold out multiple times at its several retailers and was out of stock on Moon Juice’s website for several weeks. “People were calling shops and driving to stores just to find one in stock,” she says.

The interest in adaptogens by a mainstream, not particularly granola/crunchy consumer has ballooned this year, according to both Bacon and the Detox Market’s Severin. Severin says this is reflected by the customer who is buying SuperYou. “You’re not going to engage in a 30-minute conversation on what adaptogens do. They just want the pill,” she says. Bacon says another capsule formula is in the works.

Adaptogens, as happens with trendy food and wellness ingredients all the time, have now found their way into skin care. Youth to the People, an indie brand popular at Sephora, has an “adaptogen deep moisture cream” that contains ashwagandha, reishi, and rhodiola. Moon Juice has a skin care line too, as well as that “yoni” oil. It includes a serum and facial acid.

Bacon had been against using skin care for a long time, saying she didn’t believe in it. But when she hit her mid-30s and started to see signs of aging, she caved and tried P50, a popular facial acid beloved by beauty editors and celebrities. She was appalled when she discovered she loved it because, in her words, it’s “so dirty, it’s outlawed in Europe.” (There are different versions of the product because one of its original ingredients, phenol, is indeed banned in topical skin care in some countries.)

So her Moon Juice version is the adaptogenic version. The reishi in it supposedly “combats signs of oxidative stress.”

Perhaps the biggest sign that adaptogens are bleeding into the mainstream is that they’ve already penetrated both the far left and far right sides of popular culture. Gwyneth Paltrow’s Goop and Alex Jones’s Infowars both sell supplements containing adaptogens, which Quartz broke down in 2017.

Goop sells Moon Juice products and Four Sigmatic super-mushroom-adaptogen coffees. Infowars sells a product called DNA Force Plus for $75, containing cordyceps, reishi, and other adaptogens, that claims to “support optimal energy levels while adapting your body to handle the daily bombardment of toxins.”

Amazon spits out more than 1,000 results for dozens and dozens of supplement brands when you search for “adaptogens.” But in the end, they have the same major limitations that all supplements do.

“This is a largely evidence-free industry,” says Caulfield, the University of Alberta professor. “Despite the marketing claims, most of us do not need to consume boatloads of supplements. On the contrary, it can be harmful.”

As with all supplements, adaptogens are not regulated by the Food and Drug Administration and they can’t make drug-like claims, which is why the bottles are filled with vague words like “well-being” and “calming.” There’s not a guarantee that the ingredients a company says are in the supplement will be there, and there can even be cross-contamination with prescription medications and other substances.

And, as an article on the University of California Berkeley’s wellness site notes, plant-derived supplements like adaptogens have a lot of potential for substance variability due to different plant species used, which may result in different compounds being derived. There’s even a difference in chemical composition depending on what part of the plant is used. There’s no standardization of this and no universally agreed-upon dosing, so it’s essentially a crapshoot, like all supplements are.

Supplement companies have little motivation to study their own products. “They can just say it works,” says Mullur, the UCLA doctor. “They can sell it or they can spend a bunch of money to study it and potentially find that it has no benefit. There’s too much risk.”

So should you buy ethereum (the cryptocurrency) or eleuthero (the adaptogen)? Sure, but only if you’re comfortable with spending money on the unknown.

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Source: https://www.vox.com/the-goods/2018/11/2/18026400/adaptogens-moon-juice-amanda-chantal-bacon-ashwagandha

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