I often speak about the effect of stress on Hashimoto’s. I, as well as many of my clients, have noted that symptoms will start (or worsen) during a time of stress. I can personally vouch for this, and likely you can, too!
It has been 10 years since I wrote my first book on Hashimoto’s, yet at the time of writing, there was no “official research” to connect stress to Hashimoto’s and hypothyroidism. It’s silly to me sometimes that these days, we need large institutions to conduct trials on something that we feel and observe with our own eyes. That said, in recent years, studies have focused on the stress and thyroid connection, and have finally proven the consequences of stress on Hashimoto’s… and I am grateful that the many things I talked about 10 years ago are finally being proven in the research world. 🙂
We all feel stressed at times. That’s just a part of life. But if you start to feel like everyone around you is suddenly irritating, if your body seems weighted down by constant fatigue, and if your days have become overwhelming or anxiety-ridden, these are signals that your body needs help!
Ninety percent of people in my Hashimoto’s community have identified a period of stress, prior to the onset of their thyroid symptoms. In my clinical practice, I have also found that about 90 percent of my clients (who do an adrenal saliva stress test) have some degree of adrenal dysfunction, which indicates that they have an impaired ability to handle stress.
Of course, it’s important to address the root cause whenever possible, and get rid of the stressor(s) the best we can. We can’t always get rid of the stressor (the demanding schedule, the unending commute, etc.) – nonetheless, we can increase our body’s ability to handle stress. I’ve written about various strategies that can help with building resilience (a nap is one of my favorites), and go into great detail on this in my new book, Adrenal Transformation Protocol.
For the purposes of this article, I’d love to do a deep-dive focus on adaptogenic herbs, as one way to increase our body’s resilience and lower the impact of all types of chronic stress.
I love using adrenal adaptogens, especially during my own peak periods of stress (did someone say, “holidays” or “book deadline”?), and I have joked in the past that adaptogens make all the people in my life much easier to tolerate.
Adaptogens have also been shown to have many additional health benefits. One of my favorite adaptogenic herbs, ashwagandha, for example, has been shown to be beneficial for normalizing thyroid hormone levels, as well as for reducing anxiety and improving one’s overall mood.
This article features a long list of adaptogens, each of which has fascinating and unique properties. Some, when used together, can offer a synergistic effect, and these (quite possibly my top five ;-)) work together to address many of the causes of adrenal symptoms:
- Ashwagandha (antidepressant and neuroprotectant; may help boost T3)
- American ginseng (can help reduce stress and anxiety)
- Eleuthero (can help with fatigue and low energy)
- Licorice (can help with gut inflammation, viral infections, and low cortisol)
- Rhodiola rosea (helps with stress response, mood, and the health of the mitochondria)
I often suggest people reach for an adaptogen versus rushing to get a prescription for an anxiety medication! Many adaptogens are anti-inflammatory, neuroprotective, and supportive of a healthy immune function, as well as a calm mood.
Would you like to know if adaptogenic herbs might be of benefit to you?
Read this article to learn:
- The qualities that make adaptogenic herbs so beneficial
- How adaptogens benefit those with Hashimoto’s
- Conventional treatments that may be replaced by adaptogens
- Various adaptogens that I recommend (and why)
- Four simple steps to building greater stress resilience
The Qualities That Make Adaptogenic Herbs So Beneficial
Adaptogenic herbs support the body’s ability to deal with stressors. Most adaptogens have been used for thousands of years in Eastern medical practices, such as traditional Chinese medicine (TCM) and Ayurveda.
In the 1940s, Dr. Nikolai Lazarev defined adaptogens as “an agent that raises the body’s ability to resist stress by countering undesired stressors, whether physical, chemical, emotional, or biological.” In 1998, the Food and Drug Administration (FDA) defined an adaptogen as a new kind of metabolic regulator that has been proven to help in environmental adaptation and to prevent external harms.
Adaptogens are thought to work by normalizing the hypothalamic-pituitary-adrenal (HPA) axis, which may suppress the hypothalamus and pituitary gland as well as thyroid function, where it interrupts the conversion of T4 to T3, when one has adrenal dysfunction. You can learn more about the HPA axis and adrenals here in the linked article.
When your body is stressed, the hypothalamus (brain) signals the pituitary to effectively deal with the stressor. The pituitary gland signals the adrenal glands to release more or less cortisol. The cortisol helps our body deal with the stress (giving us more energy or conserving it, halting the production of reproductive and digestion hormones that are not needed during the period of stress, etc.). If the stress lingers, the feedback mechanism in the HPA keeps telling the glands it needs more and more cortisol, until finally the glands become exhausted and just ignore the signals. That’s when symptoms occur, our immunity breaks down, our gut can suffer, and our hormones become imbalanced. This can have an impact on our thyroid hormones, which I’ll talk about in the next section.
Keep in mind that “stress” is broadly defined as anything that impacts the body’s natural balance (called homeostasis), causing inflammation and a burden on the adrenals. So again, that can mean mental stress, environmental stress, food sensitivities, nutrient deficiencies, blood sugar imbalance, infections, and more.
In order to be considered an adaptogen, an herb must possess several qualities. First, the herb must be non-toxic at normal doses. Secondly, the herb should help the entire body cope with any type of stress. Finally, the herb should help the body to return to a “normal” state regardless of how the stress is currently affecting the person’s function. In other words, an adaptogenic herb needs to be able to both tone down overactive systems (normalize too much cortisol production) and boost underactive systems (increase cortisol production) in the body.
I have actually found that most people with Hashimoto’s have underactive adrenals and low cortisol levels. Low cortisol will result in even greater inflammation and poor tissue repair, and will prevent key systems (such as the gut) from working optimally and/or healing. This can also mean fewer nutrients are absorbed. There is a cascade of issues relating to unhealthy adrenals.
While many people take adaptogens to deal with chronic mental stress, it’s important that we do not forget that adaptogens address all types of stress and underlying inflammation! Oftentimes, herbalists will select specific adaptogens to customize an herbal offering, depending on the symptoms the patient is experiencing.
Plants considered to be adaptogens will have one or more of the following attributes:
- Supportive of healthy adrenal function
- Antihyperglycemic (antidiabetic)
- Sexual and reproductive function enhancing
- Protective of the liver (hepatoprotective) and/or kidney
- Preventative of oxidative damage
And there’s more…
How Adaptogens Benefit Those with Hashimoto’s
If you look at the above list of potential attributes of adaptogens, you’ll see why adaptogens can be so beneficial for those with Hashimoto’s. Many of the top triggers for Hashimoto’s can be addressed by the benefits found on this list, including the ability to address: adrenal issues/stress, inflammation, viruses, parasites, blood sugar control issues, and leaky gut.
I have found that most people with Hashimoto’s are likely to have numerous signs and symptoms of adrenal dysfunction (also referred to as adrenal insufficiency/hypocortisolism). Unfortunately, if left untreated – even when a person is prescribed thyroid hormone medication – many will often continue to feel fatigued, irritable, anxious, overwhelmed, and possibly a bit “crazy.”
Reporting these types of symptoms to a medical professional is likely to lead to a prescription for Prozac! But in my view, it’s often useful to first look at how to better support the overwhelmed adrenals.
It’s important to note that the idea of “adrenal dysfunction” is considered controversial and not subscribed to by everyone in the medical field. However, I think we can all agree that chronic stress is very real for so many of us, and this absolutely can affect us physically. We also know that finding ways to eliminate the stressors we have control over, and mitigating the effects of the ones we can’t control, will have far-reaching health benefits.
Two new studies support the theory that stress can be a trigger for Hashimoto’s. The first case is outlined in a 2019 report by Roberto Vita and his research team, and published in Revista da Associação Médica Brasileira. Here, a 28-year-old woman with Hashimoto’s, whose thyroid hormone levels had been stable for 12 years, experienced a psychologically stressful event when she failed to graduate from her chosen major. When doctors examined her three months after this event, they observed moderate Hashitoxicosis (transient Hashimoto’s) which presented as fatigue and palpitations. When they tested her thyroid levels, they found that her free thyroid hormones levels were 1.5 to 2-fold over the normal upper limit, her TSH was suppressed, her serum thyroglobulin antibodies (TgAb) were undetectable, while her TPO levels were positive at levels threefold higher compared to the previous year (1,242.0 vs. 398 U/mL). 
The second study was a randomized controlled trial led by researcher Zoe S. Markomanolaki and published in a 2019 issue of Journal of Molecular Biochemistry. 60 adult women with Hashimoto’s completed questionnaires on stress, anxiety, depression, and lifestyle at the beginning of a stress management program and again, eight weeks later. Laboratory thyroid function tests (anti-TPO, anti-TG antibodies and TSH) were also measured at baseline and at the end of the study. The program included breathing and relaxation techniques, dietary changes, cognitive therapy, and guided imagery. After eight weeks, patients in the intervention group demonstrated statistically significant beneficial decrements in the rate change of anti-TG titers and the levels of stress, depression, and anxiety, as well as better lifestyle scores, compared to the control group. 
I too have seen an interesting connection between stress and TG-antibodies.
Research has shown that some adaptogens may have the ability to lower levels of thyroid antibodies along with addressing triggers and symptoms of Hashimoto’s. I’ll talk about which adaptogens I particularly like, later in this article.
As I mentioned earlier, adaptogens can help with adrenal stress. Adrenal stress promotes autoimmunity by weakening our immune system; when the adrenals become stressed, the excess cortisol can lead to an increased production of inflammatory proteins associated with a heightened immune response.  Also, as cortisol levels initially increase, this can decrease the liver’s ability to clear excess estrogens (which are then recirculated as toxins). This increases the level of thyroid binding globulin (TBG) which binds thyroid hormone and leads to lower levels of free thyroid hormone available for use by the body.
Conventional Treatments that May Be Replaced by Adaptogens
When faced with the cluster of symptoms of adrenal dysfunction, including anxiety, fatigue, irritability, mood swings and feeling down, many conventional doctors may reach for a prescription pad or a referral to a psychiatrist.
In my own case years ago, and in the case of many of my clients as well, the solution given by conventional medicine for “fatigue, irritability, brain fog, anxiety and feeling down” is often prescription medications such as SSRIs (selective serotonin reuptake inhibitors such as Lexapro, Prozac, Zoloft, etc.), stimulant medications (including Provigil or Adderrall), and sometimes anxiolytic medications (such as benzodiazepines: Xanax, Ativan, etc.).
As a functional medicine pharmacist, I fully recognize the benefits of these medications given the right situation, and I always want to emphasize root causes. Psychiatric medications can save lives, but at the same time, there isn’t such a thing as “Prozac deficiency.” There are, however, underlying root causes, such as blood sugar control issues, lack of sleep, and nutrient deficiencies, that can lead to mood alterations.
Who Should Take Extra Precautions When Trying Adaptogens
I love recommending adaptogens, as I believe that they are a good option for most people looking for gentle stress relief. However, as with all substances, they can affect each individual differently. Please consider the following and be sure to read the precautions on individual labels before you try a new herb, supplement, or blend. (In the list below, I have done my best to provide precautions under each individual adaptogen.)
Please use extra caution and speak with your practitioner before taking adaptogens if:
- You are taking medications: Many supplements – including adaptogens – can interact with certain medications. In particular, those associated with blood clotting, blood pressure, and blood sugar levels, as well as drugs that may impact the liver or autoimmune system, can cause reactions if they interact with certain herbs. However, there are other medications that can be problematic. Please consult with a good functional practitioner to review your current list of medications before starting any supplementation.
- You are taking thyroid hormones: I recommend that you work with your doctor whenever you start a lifestyle or complementary intervention to address Hashimoto’s. Some herbs and supplements can affect your thyroid hormone levels. Aloe vera, for instance, has the potential to reduce TSH, which could lead to a reduction in your need for thyroid medications. I recommend that you closely monitor your thyroid symptoms, thyroid hormones, and thyroid antibodies, and test hormone levels every six to 12 weeks, to ensure your thyroid medication dosage is optimized. (This is a great idea for any lifestyle intervention, but a must for lifestyle changes that could impact your TSH.)
- You are pregnant or nursing: Most adaptogens are not to be taken during pregnancy. Some, but not all, adaptogens may be taken during lactation. (Please see the section on adaptogens for nursing moms, to find out what’s safe to take while breastfeeding. :-))
- You have specific health conditions: Some adaptogens may have other contraindications relating to pre-existing health conditions. Where I have made specific supplement recommendations, you should find additional info and precautions at the provided link.
Various Adaptogens I May Recommend (and Why)
The following section is an overview of several adaptogenic herbs that may increase the body’s ability to resist stress, and have been helpful in relieving adrenal dysfunction when used in combination with vitamins and minerals. These can be used alongside other core lifestyle changes and adrenal protocols I’ve developed to heal the adrenals.
I’ll talk about which ones you might want to start with at the end.
Aloe vera (Aloe barbadensis)
This adaptogen may be beneficial for Hashimoto’s.
Aloe vera has been found to reduce thyroid antibodies as well as improve TSH and free T4 levels.  It is a strong antiviral and a great adaptogen for people with herpes viruses, including the Epstein-Barr Virus (EBV). This family of viruses can often be triggers for Hashimoto’s. A 2015 study published in Endokrynologia Polska found the Epstein-Barr virus in the thyroid cells of 80 percent of people with Hashimoto’s and 62.5 percent of people with Graves’. 
Research has shown aloe vera can also be helpful for balancing blood sugar and helping with digestive issues, as well as being protective of the liver. My recommendation for a quality aloe vera supplement is Rootcology’s Aloe.
See my detailed article on aloe vera for important additional information regarding aloe vera.
Precautions: Aloe vera may interact with certain medications. Do not take aloe if you are taking any of the following medications: anticoagulant/antiplatelet drugs, antidiabetic medications, blood thinners, corticosteroids (including prednisone and prednisolone), cardiac glycoside drugs (including digoxin and digitoxin), diuretic medications, sevoflurane, or stimulant laxatives.
There may be other medications that may interact with aloe, so please consult with your practitioner to review your current list of medications before starting supplementation.
Some individuals may be sensitive to anthraquinone compounds, which are present in aloe latex (taken from the outer skin of the plant) and aloe whole leaf extracts. (Rootcology’s Aloe is tested for anthraquinone, and the content is below a detection limit of 0.1 ppm.)
Due to its laxative effect, aloe latex may also cause a loss of minerals, such as potassium and sodium.
There is one study which found that aloe vera (whole-leaf extract) caused intestinal irritation and acted as a carcinogen within the large intestine of rats.  However, the concentration, as well as the strength, was over ten times the amount that someone would take in a daily dose, equaling a very high dose of 14.4 grams. Additionally, this study used whole-leaf extract (which contains the aloe latex from the outer rim, as well as the gel from the inside of the plant), which is different from the aloe vera that I recommend.
Aloe vera should not be used by those who are pregnant or breastfeeding, diabetic, or have a bowel obstruction. Please check with your healthcare provider before using aloe vera if you have intestinal issues such as Crohn’s disease or ulcerative colitis.
Because aloe vera can lower TSH, this could reduce your requirement (or need) for thyroid meds. So as you move forward with supplementation, please look out for the following symptoms of being overmedicated: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, heat intolerance, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and/or excessive sweating. Be sure to check in with your doctor while taking aloe vera to see if you need a thyroid hormone adjustment. 🙂
American ginseng (Panax quinquefolium)
This adaptogenic herb is a favorite of mine, and I use it in my adrenal support blend, Rootcology Adrenal Support. It has also been found to have anti-inflammation, antioxidation, anti-fatigue, antiaging, and even anticancer effects, while also providing immunostimulatory effects.
Research shows that ginseng regulates immune response and associated hormones to support hormonal balance, helps to suppress anxiety and depression, prevents stress-related diseases, and supports the hypothalamic-pituitary-adrenal (HPA) axis. 
It has been thought that its ginsenoside content plays a role in all of these benefits. Ginsenosides are also thought to be neuroprotective. Animal experiments have shown that ginsenosides are effective in treating nervous system diseases, such as Parkinson’s and Alzheimer’s disease, as well as having the ability to improve working memory (bye-bye brain fog!). 
American ginseng has also been shown to be a safe and effective adjunct treatment in the management of Type 2 diabetes. 
Some of my clients use American ginseng as a sleep aid; it can also help alleviate the effects of time differences syndrome (disruption of circadian rhythm).
Precautions: Ginseng may decrease the effect of warfarin (Coumadin), leading to an increased risk of bleeding. Some medications for depression (monoamine oxidase inhibitors in particular), such as tranylcypromine (Parnate), phenelzine (Nardil) and others, may be too stimulating to take with ginseng, causing insomnia and other symptoms. Caution should be used if taking medications for blood sugar control, as blood levels can drop too low. Other possible drug interactions include heart medications and painkillers such as morphine. Use caution when taking ginseng with caffeine or other stimulants.
Amla (Emblica officinalis) – Indian Gooseberry
Studies have shown that amla (Indian gooseberry) has anti-inflammatory, immunomodulatory, cardioprotective, and antimutagenic (potentially important in the treatment of cancer) properties. It may be beneficial for pain relief, liver health, heart health, fever reduction, gut health (reducing diarrhea), wound healing, brain health, and more. 
There is research relating to its potential anti-diabetic effects in preventing/reducing hyperglycemia and diabetic nephropathy, as well as providing effective support in other conditions such as protein wasting, neuropathy, cardiac complications, cataractogenesis, and more. 
Precautions: Amla may increase the risk of bleeding in some people. It might decrease blood sugar levels, so use caution if you take medications for diabetes — your doctor may need to adjust your dose.
Ashwagandha (Withania somnifera) – Indian Ginseng
Ashwagandha is a popular adaptogenic herb found to have many anti-stress properties, along with being neuroprotective, anti-arthritic, anti-inflammatory, and analgesic. Unlike some adaptogens, it has more of a calming effect. 
I have found it to be extremely helpful for those who are fatigued during the day but have a hard time sleeping at night — AKA those of us that can sometimes find ourselves “wired and tired.”
It is my favorite adaptogenic herb for Hashimoto’s (which is why I made it an integral part of my adrenal support blend, Rootcology Adrenal Support).
In my clinical practice, I have seen ashwagandha help normalize thyroid hormone levels in cases of subclinical hypothyroidism. In one small study published in 2017 in the Journal of Complementary Medicine, after eight weeks of treatment, ashwagandha was found to improve serum TSH, T3 and T4 levels, normalizing serum levels. 
Ashwagandha has helped to improve mood disorders in many of my clients. Research supports that ashwagandha may offer antidepressant, antioxidant, anti-inflammatory and neuroprotective benefits on top of being an effective treatment for subclinical hypothyroidism. Still, other research has shown it may reduce anxiety, improve sleep, and even help address sexual dysfunction in women. 
If you are looking for a stand-alone ashwagandha supplement, I recommend Ashwagandha by Pure Encapsulations.
Precautions: Ashwagandha should not be taken by pregnant or lactating women. It may be contraindicated for individuals who have allergic reactions to nightshades (eggplant, bell peppers, white potatoes, tomatoes, cayenne pepper, etc.). People taking immunosuppressant medications or sedatives should consult with their practitioner in regards to any potential contrary effects. If you are taking thyroid medications, be sure to monitor your thyroid function with your practitioner, as ashwagandha can increase thyroid hormone levels and your needs for thyroid hormones may decrease.
Asian Ginseng (Panax ginseng)
Asian ginseng is often used for its stimulating properties and as an adaptogen when the body is under emotional or physical stress (such as fatigue or due to prolonged exercise).
Like American ginseng, its major active ingredients are ginsenosides, which have been shown in Asian ginseng studies to have a variety of therapeutic effects, including anti-inflammatory, antioxidation, vasorelaxation, immune-modulating, antiallergic, antidiabetic, and anticancer effects.
Ginseng and ginsenosides have also been studied for their effect on primary cardiovascular risk factors such as oxidative stress, hypertension and hyperlipidemia. Ginseng and ginsenosides have been found to play a primary role in preventing cardiovascular disease. 
There is also evidence for the use of ginseng for respiratory tract infections; it has been shown to decrease the risk of developing symptoms of an upper respiratory tract infection and to decrease the duration and severity if such an infection develops. 
If you are looking for this particular support, you may want to check out Panax Ginseng by Pure Encapsulations.
Precautions: Asian ginseng is not recommended for pregnant or lactating women. It can decrease blood glucose levels. Because of its stimulating properties, ginseng can cause anxiety, insomnia, heart palpitations, tachycardia and blood pressure changes. There are uncertainties about ginseng’s interaction with some medications such as warfarin (Coumadin), diabetes medications or immunosuppressants, so always consult with your practitioner.
Astragalus (Astragalus membranaceus)
This adaptogen supports improved immune function and is often used to decrease fatigue. Astragalus has been shown to provide immunomodulating, antioxidant, anti-inflammatory, as well as anticancer effects. In vitro and animal studies indicate that astragalus and its constituents have anti-inflammatory, antioxidant, and antiviral activities, along with exerting protective effects on the kidney, the heart, bone health, and the nervous system.
I typically suggest clients try Astragalus Root Extract by Vital Nutrients.
Precautions: There are a number of potential contraindications for astragalus. It has estrogenic properties, so it may interfere with hormone therapies. Its immune-stimulating properties could affect those with autoimmune diseases. Certain medications, including immunosuppressants, anticoagulants, diuretics, antihypertensive medications, P-glycoprotein substrates, and gemcitabine, may interact with it. Astragalus may also affect blood sugar and blood pressure levels for some people.
Chaga Mushroom (Inonotus obliquus)
Extracts of chaga mushroom have been used for their favorable effects on cardiac function and lipid metabolism, as well as for their anti-inflammatory, anti-bacterial, antioxidant, and anti-tumor properties.
In laboratory studies, chaga has also been found to inhibit the hepatitis C virus and human immunodeficiency virus (HIV). 
Additionally, chaga has demonstrated antidiabetic effects as well as immunomodulating and pain-relieving properties. Some animal studies have also confirmed these findings, with chaga displaying antioxidant, anti-allergic, antidiabetic, and cognition-enhancing effects. 
Chaga extracts and constituents have demonstrated inhibitory and proapoptotic (causing apoptosis, or programmed cell death) effects against liver, lung, and colon cancer cells. In animal models, it inhibited melanoma cell growth. I love this chaga coffee blend, which also contains lion’s mane, from Four Sigmatic.
Precautions: Chaga mushrooms are high in oxalates, and excessive intake may have toxic effects if you already have an oxalate build-up. There are potential drug interactions with anticoagulant or antiplatelet medications, as well as hypoglycemic or blood sugar medications. Please consult with your practitioner for additional information.
Chinese Skullcap (Scutellaria baicalensis)
Chinese skullcap (also known as Huang Qin) has been shown to have pharmacological effects, including anti-inflammatory, anti-cancer, antibacterial, antiviral, hepatoprotection, antioxidant, neuroprotective, and anticonvulsant effects.
In vitro and animal studies found that it lowered blood cholesterol levels and showed anticancer effects, causing apoptosis (cell death) in various cancer cells, including brain tumor cells, head and neck squamous cell carcinoma, and prostate cancer cells. 
It is one of the main components of an herbal remedy used today in alternative medicine (called Sho-saiko-to or SST) for liver conditions such as hepatitis, carcinoma, and hepatic fibrosis.
Research shows that this adaptogen may also have antiviral activity against Epstein-Barr Virus (EBV) and may even help to counteract the growth of nasopharyngeal carcinoma, which is associated with EBV. 
Precautions: While it has been promoted as protective of the liver, there have been some identified cases of liver damage while taking Chinese skullcap. Medication interactions include: blood thinners, statins, and Cytochrome P450 substrate drugs.
Cordyceps (Cordyceps sinensis)
Cordyceps is another favorite herb and adaptogen with many benefits for those with Hashimoto’s. It is antiviral, antitumor, immunomodulating, antioxidant, antimicrobial, hypoglycemic, and anti-inflammatory. It may also help with fatigue, depression, and libido. 
Research has shown that cordycepin (isolated from cordyceps) has antiviral activity against a number of viruses, including EBV, influenza, and HIV. This same research also suggests that cordycepin has antitumor actions against Gammaherpesvirinae, a subfamily of viruses which includes EBV. 
Cordyceps may also have the ability to reduce levels of thyroid antibodies, as it dampens Hashimoto’s immunoinflammatory process. Studies using a drug derived from cordyceps, called Corbrin Capsule, have shown improvements in the autoimmune condition, as well as lowered levels of thyroid antibodies. These positive results applied to both Graves’ as well as Hashimoto’s patients who used Cobrin Capsule along with conventional thyroid hormone replacement medications. 
Cordyceps has another interesting connection to Hashimoto’s as well — it is rich in selenium, and selenium supplementation has been shown to reduce thyroid antibody levels.
In my practice, due to cordyceps’ potent antiviral effects, I often recommend Cordyceps by NOW when a client’s health timeline or testing indicates a viral infection such as Epstein-Barr Virus or another herpes virus, or when they present with pituitary issues.
Precautions: Cordyceps should not be taken by pregnant or lactating women. Cordyceps can interfere with blood clotting. People with existing autoimmune diseases (including multiple sclerosis, rheumatoid arthritis, and lupus) should consult with their physician, as cordyceps could interfere with medications.
Some possible medication interactions to discuss with your doctor are: cyclophosphamide (Cytoxan, Neosar), prednisone (Deltasone, Orasone), azathioprine (Imuran), basiliximab (Simulect), daclizumab (Zenapax), mycophenolate (CellCept), cyclosporine (Neoral, Sandimmune), muromonab-CD3 (OKT3, Orthoclone OKT3), tacrolimus (FK506, Prograf), sirolimus (Rapamune), corticosteroids (glucocorticoids), and others.
Dang Shen (Codonopsis pilosula)
Research has found many bioactive properties of dang shen, including anti-tumor, anti-diabetic, anti-aging, anti-inflammatory, antioxidant, and hepatoprotective properties. Additionally, it has shown positive effects on immunity and nervous system health. 
I’ve not used dang shen often in my practice, but colleagues recommend it to support the immune system and provide support for poor gastrointestinal function.
Precautions: Women who are pregnant or lactating should discuss its use with their doctor. Dang shen may slow blood clotting and could lower blood pressure. Medications that may interact with dang shen include digoxin (Lanoxin), anticoagulants, antiplatelet medications, and warfarin (Coumadin).
Eleuthero (Eleutherococcus senticosus) – Siberian Ginseng
I often say that eleuthero, one of my all-time favorites, is my go-to for those who work too hard and play too hard (and those likely to not get enough sleep!)… anyone out there have those Type A characteristics? Wait, just me? 🙂
Eleuthero, which is also known as Siberian ginseng (but is unrelated to true ginseng), is also part of my Adrenal Support Blend. It is anti-stress and adrenal supportive, as well as antibacterial, antioxidant, anti-fatigue, antimicrobial, chemoprotectant, and immunomodulating. It has been shown to boost one’s immunity as well as to increase endurance and performance, combat fatigue, improve recovery from overtraining, enhance mitochondrial activity, and enhance energy levels. 
Research has found that eleuthero may be supportive of antidiabetic effects. One study concluded that chemicals found in eleuthero can enhance glucose uptake, improve insulin resistance, and help regulate glucose metabolism. 
Precautions: Eleuthero may increase blood pressure, cause palpitations, increase blood sugar, and increase bleeding — so people with hypertension, cardiovascular disease, diabetes, or blood clotting issues should discuss with their doctor before use. Side effects can include irritability, anxiety, melancholy, mild drowsiness, and uterine bleeding at higher doses. Do not use if pregnant or breastfeeding, as there is a risk of excess bleeding. Use with caution if you have mania/schizophrenia, and/or if you are taking medications for this. Eleuthrero may mimic estrogen, and certain reproductive cancers/disorders related to estrogen could worsen — if you have such a condition, avoid this herb. 
Guduchi (Tinospora cordifolia)
Guduchi is used in various herbal preparations for many properties, including: antiperiodic, antispasmodic, anti-microbial, anti-osteoporotic, anti-inflammatory, anti-arthritic, anti-allergic, and anti-diabetic. This anti-stress adaptogen is also hepatoprotective and immunomodulatory, and shows antineoplastic (anti-tumor) activities.
Guduchi has many biologically active compounds viewed as having potential application in clinical research. Some examples of investigations include rheumatoid arthritis treatment as well as use as an anti-osteoporotic (helping to maintain bone density).
As with most adaptogens, different parts of the plant are used to access different biological compounds. As one example, the stem of guduchi has been used in traditional folk medicine for the treatment of diabetes. It is reported to mediate anti-diabetic effects through mitigating oxidative stress and regulating blood glucose. 
Some clinicians recommend a supplement containing guduchi during allergy season, as it helps the body’s immune response during this time. That supplement is HistaEze by Designs for Health, which contains an extract of the plant, Tinofend®, that has been clinically shown to regulate key immune mediators, as well as help support the body in ridding itself of allergens by reducing the number of cells containing histamine.
Precautions: Guduchi might lower blood sugar levels. Those taking medications for diabetes should consult with their doctor, as the combination of diabetes medications and guduchi could cause your blood sugar to go too low. It may cause the immune system to become more active, so those with autoimmune diseases should discuss it with their doctor. Medications such as immunosuppressants and corticosteroids may be affected, as they could interact with guduchi.
He Shou Wu (Polygonum multiflorum)
Laboratory studies as well as clinical practice applications have shown this adaptogen (also referred to as fo-ti in the United States) to possess many attributes, including being hepatoprotective and antidiabetic. Other therapeutic actions seen are anti-tumor, anti-oxidant, antibacterial, anti-inflammatory, anti-HIV, nephroprotection (supportive of the kidney), and anti-atherosclerotic (supportive of the arteries). It has also been used as an anti-aging agent and to address insomnia.
Some animal studies have found it to be protective of neurodegenerative diseases, hyperlipidemia and cardiovascular diseases. 
Precautions: While this adaptogen has been used to support the liver, there have been reports of liver damage and problems (such as hepatitis) from using it. If pregnant or lactating, there can be a laxative effect (that can also pass into breast milk). He Shou Wu might reduce blood sugar levels, so people with diabetes need to watch for signs of hypoglycemia. He Shou Wu might display estrogenic activity, so those with hormone-sensitive conditions (uterine cancer, breast cancer, ovarian cancer, uterine fibroids, endometriosis) should avoid using it. Potential drug interactions include: digoxin (Lanoxin), anti-diabetes drugs, medications that are known to harm the liver (acetaminophen, amiodarone, carbamazepine, isoniazid, methotrexate, methyldopa, fluconazole, itraconazole, erythromycin, phenytoin, lovastatin, pravastatin, simvastatin and others), stimulant laxatives, warfarin (Coumadin), and water pills/diuretic drugs.
He Shou Wu may also have negative interactions with medications that are changed by the liver: amitriptyline, haloperidol, ondansetron, propranolol, theophylline, and verapamil.
Acid reducers such as omeprazole (Prilosec), lansoprazole (Prevacid), as well as pantoprazole (Protonix), diazepam (Valium), carisoprodol (Soma) and nelfinavir (Viracept), may also have negative interactions. There are many others, including ibuprofen (Motrin), celecoxib (Celebrex), warfarin (Coumadin), fexofenadine (Allegra), etc. Please do consult with your doctor when taking any new supplements; this is especially true for one with so many contraindications.
Holy Basil (Ocimum sanctum)
The anti-inflammatory effects of holy basil (also known as tulsi) have been documented in many in vitro and in vivo studies.
As an adaptogen, preclinical studies have demonstrated that holy basil provided anti-stress effects comparable to antidepressant drugs. Some two dozen studies have found it has favorable clinical effects across multiple areas, including metabolic disorders, mood conditions, immunity and infections. There are additional studies evaluating it for its anticancer, immunomodulatory, antimicrobial and neuroprotective effects. It has been found to have a pain lowering effect in animal studies having surgically-induced brain injuries (shown to reduce oxidative damage and neurological deficits).
Numerous studies have found it has potent pharmacological actions that include the above, as well as being an antioxidant that is hepatoprotective and antidiabetic. 
I love drinking tulsi tea to support my overall stress levels. This has become my go-to adaptogen during lactation, as it is also a galactagogue (which means it increases milk supply).
Precautions: Discuss with your doctor if pregnant or lactating. Holy basil might lower blood sugar levels or could potentially lower thyroxine levels; medications may need to be adjusted. Medications that may have contraindications include those that slow blood clotting such as warfarin (Coumadin), aspirin, clopidogrel (Plavix), and others. Taking holy basil with pentobarbital may cause excessive drowsiness.
Jiaogulan (Gynostemma pentaphyllum)
Research has found jiaogulan to have many adaptogenic properties, including being anti-inflammatory, antioxidative, neuroprotective, lipid metabolism regulatory (important for fat metabolism), antiproliferative (antitumor), and anxiolytic (anxiety reducer).
It is used as an adjunct herbal treatment in diabetes, cardiovascular disease, hepatitis and cancer.
Drinking jiaogulan tea has been shown to reduce fasting blood sugar levels and improve insulin sensitivity in people with diabetes.
Taking jiaogulan may decrease total cholesterol levels while increasing the “good” high-density lipoprotein (HDL)/total cholesterol ratio in people with high cholesterol levels. 
Precautions: Do not use if pregnant, as one of the chemicals in jiaogulan has been linked to possible birth defects. Jiaogulan may cause the immune system to become more active, especially if you have an autoimmune condition, so be sure to consult with your doctor before taking it. It may slow blood clotting or lower blood sugar levels. Medications that may interact with jiaogulan include those that decrease the immune system (corticosteroids, prednisone, others) and those that slow blood-clotting (anticoagulant and antiplatelet medications).
Licorice (Glycyrrhiza glabra)
Licorice is another great adaptogen that has strong anti-stress properties, as well as a number of other clinical uses. I recommend it as an antiviral, as well as for gastrointestinal support (it can reduce inflammation and irritation of the GI tract). I also recommend it as an expectorant. I like to use licorice cough drops.
Licorice contains chemicals thought to thin mucus secretions and decrease swelling. It has also been found in research to be: anti-inflammatory, spasmolytic, laxative, anti-depressive, antibacterial, anti-ulcer, and anti-diabetic. 
I use licorice for clients with fatigue due to low cortisol, as it contains an enzyme that increases circulating cortisol (rather than allowing it to be broken down into inactive cortisone). Keeping cortisol around longer prevents the body from stealing pregnenolone in order to make more cortisol, and may be helpful for adrenal dysfunction.
I have often found it helpful for those with low blood pressure. However, those with high blood pressure should avoid it.
Licorice is part of my adrenal support blend, Rootcology Adrenal Support.
Precautions: Licorice can contribute to sodium and water retention, as well as the excretion of potassium, resulting in elevated blood pressure. Caution should be used when considering licorice for susceptible individuals. Do not take orally during pregnancy, as chemicals within licorice may be toxic. Licorice side effects are increased for those with hypertension, old age, prolonged gastrointestinal transient time, and hypokalemia; they are more prevalent in women.
Other people who might want to avoid licorice include: People who eat a lot of salt or have heart disease, kidney disease, hormone-sensitive conditions, or a muscle condition called hypertonia.
Additional side effects can include absence of a menstrual period, fatigue, headaches, and decreased sexual interest and function in men.
Potential medication interactions include warfarin (Coumadin), digoxin (Lanoxin), oral estrogens, ethacrynic acid (Edercrin), furosemide (Lasix), medications for high blood pressure, medications for inflammation (such as hydrocortisone, prednisone, dexamethasone, etc.), water pills, and medications that are changed by the liver.
Always discuss your current health condition and medications with your doctor before taking new supplements.
Goji Berries (Lycium chinensis)
Goji berries (also known as lycium fruits) have many health-promoting components and demonstrate antioxidant, immune supportive, anticancer, antiaging, anti-radiation, and hemopoiesis (supportive of blood cell formation) properties. 
As an adaptogen, goji berries have been shown to alleviate oxidative stress and offer protective benefits, such as preventing free radicals from damaging DNA, proteins, and lipids. It has shown some beneficial pharmacological activities related to disease management (atherosclerosis, hypertension, and diabetes). 
Lycium fruit is rich in betaine, and it is useful in supporting liver and stomach function. Studies have reported on all of these benefits. 
Please note that goji berries are part of the nightshade family and should be avoided by those with a sensitivity to them.
Precautions: Use precaution during pregnancy; in animal studies, goji berries have been found to cause the uterus to contract. Some people may be allergic to goji berries (those with allergies to peaches, nuts, tomatoes, and tobacco, in particular). Medications that show potential interaction issues include: diabetes medications (goji berries might lower blood sugar levels), blood pressure medications (goji berries may lower blood pressure), and medications that are changed by the liver (such as warfarin, diazepam, amitriptyline, diclofenac, fluvastatin, and many others).
Maca (Lepidium meyenii)
Maca is a well-known adaptogen that supports our body’s stress response and adrenals. I have found that it helps my clients with their energy levels and overall mood, as well as symptoms of hormone imbalance (brain fog, memory, metabolism, hot flashes).
In a clinical pilot study published in the International Journal of Biomedical Science, perimenopausal women found that maca reduced symptoms such as insomnia, hot flashes, and depression by 74 to 87 percent! 
There is growing research that supports these benefits. There is also research showing that maca may provide fertility-enhancer properties (as well as support improvements to libido and sexual function). Maca has been shown to reduce anxiety and depression. Clinical trials found that it may also improve sexual desire. 
Additional studies have shown maca to have antioxidant and neuroprotective effects.
Maca is packed with nutrients, including many important minerals for those with Hashimoto’s (magnesium, zinc, potassium, etc.) along with essential amino acids, vitamins, and fatty acids. It also contains glucosinolates, which are believed to have anti-cancer benefits. 
My favorite supplement for Maca is Femmenessence, as it can help with serious hormonal imbalances, supporting our libido and pituitary issues.
I also love making Maca Lattes (using powdered maca) as part of a daily way to balance one’s adrenals. Many participants in my Adrenal Transformation Program (the basis of my upcoming book) credit maca lattes for restoring their libido and giving them a way to overcome their afternoon slump, without caffeine. 🙂
Here’s the Maca Latte recipe that I use in my Adrenal Transformation Protocol book:
Maca Latte Recipe (Serves 1)
- 1 tablespoon maca powder
- 1 tablespoon full-fat canned coconut milk
- 1 teaspoon ground cinnamon, plus more for garnish (optional)
- 1 cup hot water
- Stevia to taste (optional)
Blend the maca, coconut milk, cinnamon, hot water, and stevia (if using) together in a blender, then top with some extra cinnamon if desired.
Note: Maca can help stabilize the adrenals. However, it may have different effects for different people. As such, it may be best to start with 1 teaspoon to determine how you tolerate it, and then work your way up to the recommended 1 tablespoon.
Please note that not everyone will respond well to maca. Please be on the lookout for side effects like heart palpitations or jitters, as a minority of people may not tolerate maca, and these symptoms would be an indication that it’s not for you!
Precautions: There isn’t a lot of research or data on side effects or drug interaction concerns with maca. In general, even though maca has not been shown to be estrogenic, if you have any hormone-sensitive conditions, you should first consult with your doctor to see if it’s appropriate for you.
Prince Seng (Pseudostellaria heterophylla)
Prince Seng (also known as Tai Zi Shen and false starwort) has many attributes, including being antifungal, anti-fatigue, antioxidant, antidiabetic, antitussive, and immunomodulatory. It has also been shown to have protective effects on retinal injury as well as exercise-induced oxidative stress. 
It has been used in traditional Chinese medicine to treat issues relating to the lungs, and is being studied for potential use in treating lung conditions such as COPD. Additionally, it has shown benefits in treating chronic fatigue syndrome. 
Herbalists sometimes recommend Prince Seng for cases of fatigue as well as for coughs (as an antitussive).
Precautions: There is limited data as to the overall safety of this herb. Please do not use it if you are pregnant or breastfeeding, or consult with your practitioner if you have health concerns.
Reishi (Ganoderma lucidum)
Reishi is a medicinal mushroom that has been used for over 2000 years. While there is a good deal of in vitro research and animal studies on this mushroom, there is little well-orchestrated clinical research to draw upon. Having said that, I have seen good results using reishi mushroom for its immune-boosting effects (in particular for upper respiratory viral infections), as well as for reducing overall stress.
Available studies have shown reishi to have antiviral, antibacterial, anti-inflammatory, anticancer and immunomodulating effects. Studies (mostly in animals) have also suggested that reishi helps in modulating blood glucose levels as well as has a hepatoprotective effect. 
Probably the most promising area that reishi is being studied for is its anticancer properties, which have been attributed to pharmacologically bioactive compounds such as polysaccharides, glucans, and triterpenes.  Glucans may activate the immune system, while triterpenes may have a toxic effect against cancer cells.
If you want to give reishi a try, I love Four Sigmatic’s Mushroom Cacao Mix with Reishi. I like to drink a cup of this as part of my nighttime ritual to help me drift off into a restful sleep. Their Reishi Elixir blend is also great for relaxing before bed!
Precautions: If pregnant or lactating, please consult with your doctor before taking this product. Those taking blood thinning medications should not take reishi without consulting their doctor. Other possible side-effects include nosebleeds, mild gastrointestinal upset, dry mouth and throat, and dizziness.
Maral Root (Rhaponticum carthamoides or Stemmacantha carthamoides)
Maral root has exhibited numerous biological effects, including: adaptogenic, antiparasitic, antimicrobial, antioxidant, immunomodulatory, antitumor, and anticancer. Some people take maral root for improved athletic performance, to increase energy or endurance, to treat muscle overstrain, or to increase muscle mass. Some may use it as a stimulant or to improve male sex dysfunction. 
In one animal study, maral root supplementation improved glucose and lipid metabolism, and was shown to be helpful in addressing metabolic syndrome, inflammation, and stress. Maral root exhibited better results than two commercially available alternatives (that promoted anti-obesity and antidiabetic properties). 
In other laboratory research, maral root effectively treated cancer cells. 
Precautions: If pregnant or lactating please, consult your doctor before use. Maral root may cause blood clotting to slow.
Rhodiola (Rhodiola rosea)
I love rhodiola (which is why it is included in my Rootcology Adrenal Support blend).
Sometimes referred to as golden root, this is a wonderful adaptogen that not only helps us maintain a healthy stress response, but has been found to improve depressive symptoms, insomnia, low mood, and mood instability.
I think of rhodiola as the adaptogen focused on our nervous system health. In particular, I have found rhodiola to be helpful for my clients with depressed cortisol levels. It has a stimulatory effect on people in a state of adrenal dysfunction and fatigue.
In animal studies, rhodiola has been found to enhance mitochondrial function, significantly increasing exercise capacity and reducing the oxidative stress damage to muscles.  The combination of anti-stress effects and increased available energy is why I love rhodiola for adrenal support.
One of the main chemicals in rhodiola is salidroside, found to have neuroprotective effects that reduce the impact of stress on the immune system and the neuro-endocrine system. Studies have found an anti-fatigue effect along with cognitive function improvements, such as memory improvements (during stressful conditions), when people took rhodiola. Clinical studies have also shown it can diminish depressive symptoms. In one study, those taking rhodiola had significantly reduced depressive symptoms, including emotional instability and insomnia. 
In animal studies, rhodiola has also been shown to have an inhibitory effect on the development of hypertension and hyperglycemia (two of the major risk factors for vascular disease). Other findings in animal studies indicate it may also play a protective role in supporting healthy heart muscle function and blood flow. 
Because of its pharmacological properties, it is also being looked at for possible therapeutic value in other diseases, such as Parkinson’s disease, Alzheimer’s disease, cerebrovascular disease, and diabetes. 
While I love recommending blends like Rootcology Adrenal Support that contain rhodiola, along with additional adaptogens due to their synergistic effects, some individuals may wish to start with one adaptogen at a time, and rhodiola is also available as a standalone supplement: Rhodiola Rosea by Pure Encapsulations.
Precautions: Rhodiola may be contraindicated for individuals taking antidepressant, adrenergic-blocking and antiarrhythmic medications. Some people may react to its stimulatory effect and experience insomnia, headaches, irritability or excitement.
Schisandra (Schisandra chinensis)
Schisandra is another good anti-stress adaptogen that has also been studied for its central nervous system effects. It has been shown to have antihepatotoxic, anti-inflammatory, antioxidant, anti-viral, antibacterial, immunomodulatory, and antitumor activities.
Studies relating to acetaminophen-induced liver injury demonstrated strong hepatoprotective effects. Many additional studies have shown that the chemicals in schisandra may be able to improve liver function by promoting liver cell growth and stimulating enzymes in the liver.
Schisandra has been shown to help in states of exhaustion, to increase alertness, improve one’s ability to learn and memorize, and improve mental performance and overall concentration. As such, it has been used as an adjunct treatment for a number of conditions, including Parkinson’s, Alzheimer’s disease, ADHD, and depression. It has also been found to be beneficial as a sleep aid, as well as an adaptogen that can alleviate circadian rhythm disruptions due to time changes.
In animal studies, it has also been found to work as an antiasthmatic treatment, as it may lower airway hyperresponsiveness. It appears to also reduce pulmonary inflammation and cough frequency. 
Precautions: If you are pregnant or lactating, consult your doctor before using schisandra; it may cause the uterus to contract. Those with high blood pressure or diabetes, those on psychiatric medications, or those who are sensitive to mildly stimulating herbs (such as those with epilepsy, for example), should use caution. People taking medications for GERD or peptic ulcers may want to avoid schisandra due to it causing a potential increase in stomach acid.
Shatavari (Asparagus racemosus)
I often talk about shatavari as an adaptogen for women, as historically it has deep roots relating to its ability to address women’s stress, including psychological stress as well as inflammation of the female reproductive system. 
The word “shatavari” itself means “woman of a hundred husbands.” I’m not sure if the interpretation is focused on the stress of having a hundred husbands, the energy requirement to look after the many children you are likely to have with so many husbands, or the libido and fertility requirement (since the herb is thought to increase vitality and fertility, and may also have aphrodisiac effects)! I just know that I only have one husband and one son, and adaptogens have helped me to keep up with both! 🙂
Pharmacological properties of shatavari, most identified through laboratory studies, include: antiulcer, antitussive, antioxidant, antidiabetic, antidiarrheal, antibacterial, antiprotozoal, anti-inflammatory, antidepressant, and immunomodulatory. It has been used as an aphrodisiac.
It is used for a number of nervous disorders, coughs, bronchitis, inflammations, neuropathy and hepatopathy. Relating to the female reproductive system, it is used for hormonal imbalance, follicular growth and development, polycystic ovarian syndrome (PCOS), oocyte quality, and infertility. Possible mechanisms for how it works include the reduction of oxidative stress along with it being a powerful antioxidant.
Precautions: Shatavari is contraindicated for those who are pregnant or are taking prescription lithium.
Shilajit (Ashphaltum bitumen)
Shilajit is an interesting adaptogen made from decomposed organic matter that has hardened into rock. About 60-80 percent of shilajit consists of fulvic acid, the rest consisting of minerals and other properties, including selenium (which we know helps lower thyroid antibodies). Fulvic acid is a potent antioxidant. 
Along with its anti-stress effects, other properties of shilajit include: anti-inflammatory, antiulcerogenic, antidiabetic, cognitive and memory enhancer, antianxiety, antiallergic, immunomodulatory, analgesic, antifungal, and neuroprotective. 
It has been used for a variety of disease treatments, including as a neuroprotective agent supporting cognitive function. It improves memory, and in vitro studies have shown it to act as an anti-aggregation factor of tau protein (found in Alzheimer’s disease). 
It has been used for a variety of nervous disorders, insomnia, anemia (it contains a high level of iron), digestive disorders, joint disorders (it appears to reduce joint inflammation and pain) and rheumatoid arthritis, gastric issues, stomach ulcers, asthma, chronic bronchitis, colitis, diabetes, and a number of other diseases.
It appears to have protective properties for people at high altitudes, exhibiting a number of important actions, including: transporting nutrients into deep tissue to overcome lethargy and fatigue, energy production, preventing hypoxia due to cold exposure, etc. 
Precautions: The fulvic acid in shilajit might increase activity of the immune system. Fulvic acid is responsible for the mild hypothyroid effect of humic (soil) substances, so its use in hypothyroid conditions is controversial, although I personally think in some cases, the benefits may outweigh the risks.
Suma (Pfaffia paniculata) – Brazilian ginseng
Suma is used for its anti-fatigue, anti-inflammatory, anti-stress, antitumor and immune supportive properties. Most data comes from laboratory studies. It has been found to be effective in relieving pain and as an anti-inflammatory drug (antitumor). Still, other studies have shown it to have antitumor and cancer chemopreventive activity, and it has demonstrated intestinal anti-inflammatory activity as well.
There have additionally been some studies showing improvements in learning and memory in both aged animals and elderly human subjects. 
Precautions: Do not use if pregnant or breastfeeding.
Adaptogens for Nursing Moms
Are adaptogens safe for nursing moms?
When I discovered that my adrenals were flatlined (for the third time), I was nursing a new baby, so I didn’t feel comfortable taking hormones and adrenal support blends. Some women take oral progesterone, but it seemed to drop my milk supply.
While some adaptogens are safe for nursing moms and their babies, and may promote milk supply, I couldn’t find an adrenal support blend that I was comfortable with while nursing. Some types of ginseng found in adrenal support blends, as well as B6 in excess of 50 mg, can lower prolactin levels, while eleuthero can lead to excess bleeding and worsen estrogen dominance, which is already a thing in postpartum. 😉
Instead of a blend, consider a B-complex vitamin that has under 50 mg of vitamin B6 (or use individual B vitamins), along with a vitamin C supplement, and gentle nursing-friendly individual adaptogens.
Here is a list of adaptogenic herbs that I have researched and are considered safe and supportive for those who are breastfeeding:
- Holy basil (tulsi) tea. Tulsi tea is my go-to adaptogen during lactation. It also acts as a galactagogue and can help raise cortisol levels when needed. I like this one from Organic India, and recommend one or two tea bags per day.
- I recommend the hot cacao with reishi from Four Sigmatic, one packet a day.
- Rhodiola. This is a gentle adaptogen that is generally considered safe for nursing mothers.
- Shatavari. I suggest this supplement from Organic India, and recommend one to two capsules, two times per day.
When trying holy basil (tulsi), shatavari, reishi, and/or rhodiola, I recommend starting with one herb at a time. These four are the gentlest of the adaptogens and are most often used in lactation. Holy basil and shatavari may promote milk supply, so be sure to discuss with your lactation consultant, midwife and/or doctor.
Is it Better to Take Individual Adaptogens, or Adaptogens as Part of an Adrenal Blend?
Unless I am breastfeeding, I like to use blends because they contain a mix of synergistic adaptogens as well as the B vitamins and vitamin C, which are also important for restoring the stress response. That way you don’t become “Pilbo Baggins”, where you have to take 20+ different bottles of pills!
Rootcology’s Adrenal Support blend features five adaptogens that work synergistically to address many of the causes of adrenal dysfunction. Working together, these five ingredients can help to balance cortisol, balance blood sugar, improve mitochondrial function, reduce gut inflammation, improve low T3 levels, and even improve iron levels!
However, blends may not be the best choice for those who have specific health conditions. For instance, the above blend contains both licorice and eleuthero, both of which may not be suitable if you have high blood pressure.
If you do have elevated blood pressure, I suggest this Daily Stress Formula, a blend of adaptogenic herbs, vitamins, minerals, and amino acids that is similar to the Rootcology blend, but does not contain licorice.
You may also wish to use standalone adaptogens if you are a nursing mom, are sensitive to any of the ingredients in adrenal blends, have specific medical or health concerns, or are just sensitive in general.
7 Simple Steps to Building Greater Stress Resilience
So before you say, “But what should I try first, and at what dose?”, let me give you some suggestions about starting out with adaptogens.
- Do your research and don’t be afraid to try one or two out, so long as you’ve read the precautions and have checked with your doctor first if you have health conditions and/or are on any medications. Adaptogens are generally safe to take, but in a way they still work differently for everyone. Start with a gentle tea or a single supplement, and keep a daily journal to track whether or not you see improvements in symptoms.
- If you are experiencing ongoing stress, I encourage you to dig deeper to understand whether there is more at play. For instance, if you have symptoms such as insomnia, fatigue, brain fog, mood swings, blood sugar swings (e.g. feeling “hangry”), or feeling “tired but wired”, especially at night, you may have some level of adrenal dysfunction. You can learn more about adrenal dysfunction, as well as how to address and treat it through an at-home protocol, in my latest book, Adrenal Transformation Protocol! In it, I outline a comprehensive, four-week protocol that you can use to get control of adrenal dysfunction and get your cortisol levels in check. I’ve had to heal my own adrenals (more than once!), and I’ve helped thousands of my readers over the years heal theirs. Through my years of experience, I’ve developed my own process based on extensive research and plenty of experimenting on myself. 🙂
- If you don’t already have one, please find a good integrative or functional practitioner that you can work with, in order to evaluate your overall health as well as your Hashimoto’s root causes and adrenal health. Conventional doctors will likely not know a lot about adaptogens, especially relating to what would work best for your particular Hashimoto’s root causes. Having a functional doctor will really make a difference.
- Remember, you can’t just “supplement away” your lifestyle decisions. Adaptogens, while amazing, are not a substitute for making healthy decisions elsewhere in our life (such as choosing a better diet to support our thyroid, removing known food sensitivities, removing toxins and stressors, and addressing other underlying root causes for Hashimoto’s). You’ll find that addressing your root causes, even just one at a time, will result in you feeling better and will likely improve your thyroid hormone levels as well.
- Talk with your functional doctor about other adaptogens on my list that might make sense for you to try, given their specific benefits to your unique root causes and symptoms. There are several that are helpful for blood sugar, and others to help deal with viruses.
- Add some “me time” in every day. If you are suffering from adrenal dysfunction, there are many things that you can do that can help support your adrenals and make you feel better! Try a few of these starting today:
- Make an intentional effort to get more quality sleep. Getting more sleep makes 74 percent of my clients feel better!
- Spend time with loved ones. Seventy-three percent of my clients say this washes away a lot of their perceived stress. Yes, the stressor doesn’t go away, but you can at least put it away and deprioritize it for a while.
- Get out in nature! Seventy-one percent appreciate connecting with the out-of-doors and natural light.
- Go for a walk. Sixty-six percent enjoy getting some movement in as well as taking a breather from other more focused and/or stressful work.
- Get a massage. Sixty-two percent find this relaxing (extra points if your spouse/partner is giving you your massage, or you are giving them theirs!)
- Read a good book. Sixty-one percent of you find this a great de-stressor.
- Just sit on a bench! Sixty percent say this downtime is a great chance to relax the mind and reboot one’s system (extra points if the bench has a view or you are sitting there with your beloved or your beloved pet).
- Start with a proven blend that contains a mix of (the best!) adrenal-supporting supplements, at an easy recommended dose. You will likely have better results, as you’ll get a great blend of all the best anti-stress nutrients in one supplement. This will also ensure you have minimal side-effects.
My Rootcology Adrenal Support supplement contains my top five favorite adaptogens, including American ginseng, eleuthero, ashwagandha, and rhodiola. I especially like that ashwagandha has research-supported benefits specific for thyroid health. I also added licorice to the blend to help with overcoming fatigue (licorice was one of the herbs that really helped me!). This blend also contains needed B and C vitamins. It’s a great way to start out on adrenal recovery.
Here’s what one person reported:
“I have Hashimoto’s thyroiditis and adrenal fatigue. I decided to try [Rootcology Adrenal Support] after reading an article by Dr. Izabella Wentz, PharmD. I noticed a positive difference shortly after I started taking this supplement. My energy was much more balanced throughout the day rather than being exhausted in the afternoon an wide awake after dinner. I was surprised because I had tried similar products without noticing a change.” – MP
I generally recommend continuing this adrenal support blend long-term, as life is inevitably full of stress. For added convenience, you can subscribe to get Adrenal Support delivered straight to your door on a schedule of your choosing. As a bonus, the Subscribe & Save option will give you a 10 percent off discount!
We all go through stressful periods in life, and day-to-day stress is also (unfortunately) so normal that we might not realize just how much stress we are under!
I suggest trying gentle remedies, such as the ones above (so long as they are safe for you and your unique health needs), to help you on your journey. Even taking five or ten minutes each day to consciously take a step back and do something different — try a new activity, take a long(er) walk, improve your sleep routine, or shut those phone notifications off — you will notice a difference, and then you can build other stress-reducing habits from there.
In addition, take a look at what your “normal” life looks like, as changing some seemingly small habits could make a huge difference. For instance, so many people that struggle with coffee addiction actually have adrenal issues! Other symptoms of adrenal dysfunction include insomnia, brain fog, blood sugar swings, weight struggles, anxiety, and hormonal imbalance.
I am so excited to announce that my book, Adrenal Transformation Protocol, is now available to order here! In addition to featuring adrenal adaptogens in the book, I focus on utilizing safety signals to transform adrenal dysfunction into a healing and balanced state, so that you can thrive.
In the past, I focused heavily on lifestyle solutions and hormones, like getting more sleep, quitting caffeine, and using the hormones pregnenolone and DHEA to rebalance adrenals.
After becoming a new mom and finding myself in adrenal dysfunction once more, AND without access to sleep or hormones due to having a newborn, I knew I had to find a better and more sustainable way to heal. Thankfully, I was able to find an approach to healing, even though my lifestyle wasn’t (and still isn’t) perfect.
I knew that my body was responding to the various stress symptoms in the environment, and I decided to send it safety signals instead, to put it into a healing and rebuilding state.
The protocol worked so well for me, I decided to pilot it as a program with a small group in 2020! Despite all of the things that happened in 2020, people reported that the program helped them rebalance their stress response. Now over 3000 people have done this protocol, and I am sharing it in my new book, Adrenal Transformation Protocol, which outlines a simple four-week plan to help you recover your adrenal function and finally feel better.
The protocol is designed to help you feel calm, strong, excited about life, and brilliant once more! I love helping people take charge of their own health and feel more empowered and educated.
I also cover adrenal protocols in my book Hashimoto’s Protocol that was published in 2017, although as many have asked, the protocols in my new book are much more evolved and advanced. 🙂
Have you ever tried adaptogens and had success? Please let me know about your experiences with adaptogens in the comments below!
I love staying in touch with my readers! For continued updates and interaction, follow me at Facebook, Instagram, Pinterest , and TikTok. You can also sign up for my newsletter to get helpful information, new research, resources, giveaways, and more, delivered straight to your inbox!
 Vita R, Cernaro V, Benvenga S. Stress-induced hashitoxicosis: case report and relative HLA serotype and genotype. Rev Assoc Med Bras (1992). 2019;65(6):830-833. Published 2019 Jul 22. doi:10.1590/1806-92188.8.131.520
 Markomanolaki ZS, Tigani X, Siamatras T, et al. Stress Management in Women with Hashimoto’s thyroiditis: A Randomized Controlled Trial. J Mol Biochem. 2019;8(1):3-12.
 Morey JN, Boggero IA, Scott AB, Segerstrom SC. Current Directions in Stress and Human Immune Function. Curr Opin Psychol. 2015;5:13-17. doi:10.1016/j.copsyc.2015.03.00
 Metro D, Cernaro V, Papa M, Benvenga S. Marked improvement of thyroid function and autoimmunity by Aloe barbadensis miller juice in patients with subclinical hypothyroidism. J Clin Transl Endocrinol. 2018;11:18-25. doi:10.1016/j.jcte.2018.01.003
 Janegova A, Janega P, Rychly B, Kuracinova K, Babal P. The role of Epstein-Barr virus infection in the development of autoimmune thyroid diseases. Endokrynol Pol. 2015;66(2):132-136. doi:10.5603/EP.2015.0020
 Guo X, Mei N. Aloe vera: A review of toxicity and adverse clinical effects. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2016;34(2):77-96. doi:10.1080/10590501.2016.1166826
 Lee S, Rhee DK. Effects of ginseng on stress-related depression, anxiety, and the hypothalamic-pituitary-adrenal axis. J Ginseng Res. 2017;41(4):589-594. doi:10.1016/j.jgr.2017.01.010
 Zheng M, Xin Y, Li Y, et al. Ginsenosides: A Potential Neuroprotective Agent. Biomed Res Int. 2018;2018:8174345.
 Chen W, Balan P, Popovich DG. Review of Ginseng Anti-Diabetic Studies. Molecules. 2019;24(24):4501. Published 2019 Dec 9. doi:10.3390/molecules24244501
 Baliga MS, Dsouza JJ. Amla (Emblica officinalis Gaertn), a wonder berry in the treatment and prevention of cancer. Eur J Cancer Prev. 2011 May;20(3):225-39.
 D’souza JJ, D’souza PP, Fazal F, Kumar A, Bhat HP, Baliga MS. Anti-diabetic effects of the Indian indigenous fruit Emblica officinalis Gaertn: active constituents and modes of action. Food Funct. 2014 Apr;5(4):635-44.
 Karkon Varnosfaderani S, Hashem-Dabaghian F, Amin G, et al. Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: a double-blind, randomized, placebo-controlled clinical trial. J Integr Med. 2018;16(2):126-131. doi:10.1016/j.joim.2018.02.008
 Singh N, Bhalla M, de Jager P, et al. An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):208-13
 Sharma AK, Basu I, Singh S. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med. 2018;24(3):243-248. doi:10.1089/acm.2017.0183
 Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. doi:10.1097/MD.0000000000017186; Dongre S, Langade D, Bhattacharyya S. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. Biomed Res Int. 2015;2015:284154. doi:10.1155/2015/284154
 Kim JH, Yi YS, Kim MY, Cho JY. Role of ginsenosides, the main active components of Panax ginseng, in inflammatory responses and diseases. J Ginseng Res. 2017;41(4):435–443
 Alsayari A, Muhsinah AB, Almaghaslah D, Annadurai S, Wahab S. Pharmacological Efficacy of Ginseng against Respiratory Tract Infections. Molecules. 2021;26(13):4095. Published 2021 Jul 5. doi:10.3390/molecules26134095
 Arata S, Watanabe J, Maeda M, et al. Continuous intake of the Chaga mushroom (Inonotus obliquus) aqueous extract suppresses cancer progression and maintains body temperature in mice. Heliyon. 2016;2(5):e00111. Published 2016 May 12. doi:10.1016/j.heliyon.2016.e00111; Wang J, Wang C, Li S, et al. Anti-diabetic effects of Inonotus obliquus polysaccharides in streptozotocin-induced type 2 diabetic mice and potential mechanism via PI3K-Akt signal pathway. Biomed Pharmacother. 2017;95:1669-1677. doi:10.1016/j.biopha.2017.09.104
 Lu Y, Jia Y, Xue Z, Li N, Liu J, Chen H. Recent Developments in Inonotus obliquus (Chaga mushroom) Polysaccharides: Isolation, Structural Characteristics, Biological Activities and Application. Polymers (Basel). 2021;13(9):1441. Published 2021 Apr 29. doi:10.3390/polym13091441
 Wang L, Zhang D, Wang N, Li S, Tan HY, Feng Y. Polyphenols of Chinese skullcap roots: from chemical profiles to anticancer effects. RSC Adv. 2019;9(44):25518-25532. Published 2019 Aug 15. doi:10.1039/c9ra03229k
 Zhang Y, Wang H, Liu Y, et al. Baicalein inhibits growth of Epstein-Barr virus-positive nasopharyngeal carcinoma by repressing the activity of EBNA1 Q-promoter. Biomed Pharmacother. 2018;102:1003-1014. doi:10.1016/j.biopha.2018.03.114
 Das G, Shin HS, Leyva-Gómez G, et al. Cordyceps spp.: A Review on Its Immune-Stimulatory and Other Biological Potentials. Front Pharmacol. 2021;11:602364. Published 2021 Feb 8. doi:10.3389/fphar.2020.602364
 Ryu E, Son M, Lee M, et al. Cordycepin is a novel chemical suppressor of Epstein-Barr virus replication. Oncoscience. 2014;1(12):866-881. Published 2014 Dec 18. doi:10.18632/oncoscience.110
 He T, Zhao R, Lu Y, et al. Dual-Directional Immunomodulatory Effects of Corbrin Capsule on Autoimmune Thyroid Diseases. Evid Based Complement Alternat Med. 2016;2016:1360386. doi:10.1155/2016/1360386
 He JY, Ma N, Zhu S, Komatsu K, Li ZY, Fu WM. The genus Codonopsis (Campanulaceae): a review of phytochemistry, bioactivity and quality control. J Nat Med. 2015;69(1):1-21. doi:10.1007/s11418-014-0861-9
 Huang LZ, Huang BK, Ye Q, Qin LP. Bioactivity-guided fractionation for anti-fatigue property of Acanthopanax senticosus. J Ethnopharmacol. 2011;133(1):213-219. doi:10.1016/j.jep.2010.09.032
 Ahn J, Um MY, Lee H, Jung CH, Heo SH, Ha TY. Eleutheroside E, An Active Component of Eleutherococcus senticosus, Ameliorates Insulin Resistance in Type 2 Diabetic db/db Mice. Evid Based Complement Alternat Med. 2013;2013:934183. doi:10.1155/2013/934183
 Siberian Ginseng. RX List. Reviewed on June 11, 2021. Accessed Dec 7, 2022. https://www.rxlist.com/siberian_ginseng/supplements.htm
 Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012;31(4):151–159. doi:10.4103/0257-7941.107344
 Bounda GA, Feng YU. Review of clinical studies of Polygonum multiflorum Thunb. and its isolated bioactive compounds. Pharmacognosy Res. 2015;7(3):225–236.
 Jamshidi N, Cohen MM. The Clinical Efficacy and Safety of Tulsi in Humans: A Systematic Review of the Literature. Evid Based Complement Alternat Med. 2017;2017:9217567. doi:10.1155/2017/9217567; Cohen MM. Tulsi – Ocimum sanctum: A herb for all reasons. J Ayurveda Integr Med. 2014;5(4):251-259. doi:10.4103/0975-9476.146554
 Li Y, Lin W, Huang J, Xie Y, Ma W. Anti-cancer effects of Gynostemma pentaphyllum (Thunb.) Makino (Jiaogulan). Chin Med. 2016;11:43. Published 2016 Sep 27; Su C, Li N, Ren R, et al. Progress in the Medicinal Value, Bioactive Compounds, and Pharmacological Activities of Gynostemma pentaphyllum. Molecules. 2021;26(20):6249. Published 2021 Oct 15. doi:10.3390/molecules26206249
 Degner SC, Papoutsis AJ, Romagnolo DF. Health Benefits of Traditional Culinary and Medicinal Mediterranean Plants. Complementary and Alternative Therapies and the Aging Population. 2009;541-562. doi:10.1016/B978-0-12-374228-5.00026-3
 Potterat O. Goji (Lycium barbarum and L. chinense): Phytochemistry, pharmacology and safety in the perspective of traditional uses and recent popularity. Planta Med. 2010 Jan;76(1):7-19; Lee HW, Kim YH, Kim YH, Lee GH, Lee MY. Discrimination of Lycium chinense and Lycium barbarum by taste pattern and betaine analysis. Int J Clin Exp Med. 2014;7(8):2053–2059. Published 2014 Aug 15
 Gao Y, Wei Y, Wang Y, Gao F, Chen Z. Lycium Barbarum: A Traditional Chinese Herb and A Promising Anti-Aging Agent. Aging Dis. 2017;8(6):778-791. Published 2017 Dec 1. doi:10.14336/AD.2017.0725
 Bahaji Azami NL, Sun M. Zeaxanthin Dipalmitate in the Treatment of Liver Disease. Evid Based Complement Alternat Med. 2019;2019:1475163. Published 2019 Aug 21. doi:10.1155/2019/1475163; Chen H, Olatunji OJ, Zhou Y. Anti-oxidative, anti-secretory and anti-inflammatory activities of the extract from the root bark of Lycium chinense (Cortex Lycii) against gastric ulcer in mice. J Nat Med. 2016;70(3):610-619. doi:10.1007/s11418-016-0984-2
 Dording CM, Fisher L, Papakostas G, et al. A double-blind, randomized, pilot dose-finding study of maca root (L. meyenii) for the management of SSRI-induced sexual dysfunction. CNS Neurosci Ther. 2008;14(3):182-191. doi:10.1111/j.1755-5949.2008.00052.x
 Maca. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; April 10, 2019.
 da Silva Leitão Peres N , Cabrera Parra Bortoluzzi L , Medeiros Marques LL , et al. Medicinal effects of Peruvian maca (Lepidium meyenii): a review. Food Funct. 2020;11(1):83-92. doi:10.1039/c9fo02732g
 Hu DJ, Shakerian F, Zhao J, Li SP. Chemistry, pharmacology and analysis of Pseudostellaria heterophylla: a mini-review. Chin Med. 2019;14:21. Published 2019 May 23. doi:10.1186/s13020-019-0243-z
 Lu F, Yang H, Lin SD, et al. Cyclic Peptide Extracts Derived From Pseudostellaria heterophylla Ameliorates COPD via Regulation of the TLR4/MyD88 Pathway Proteins. Front Pharmacol. 2020;11:850. Published 2020 Jun 9. doi:10.3389/fphar.2020.00850; Sheng R, Xu X, Tang Q, et al. Polysaccharide of radix pseudostellariae improves chronic fatigue syndrome induced by poly I:C in mice. Evid Based Complement Alternat Med. 2011;2011:840516. doi:10.1093/ecam/nep208
 Viroel FJM, Laurino LF, Caetano ÉLA, et al. Ganoderma lucidum Modulates Glucose, Lipid Peroxidation and Hepatic Metabolism in Streptozotocin-Induced Diabetic Pregnant Rats. Antioxidants (Basel). 2022;11(6):1035. Published 2022 May 24. doi:10.3390/antiox11061035
 Sohretoglu D, Huang S. Ganoderma lucidum Polysaccharides as An Anti-cancer Agent. Anticancer Agents Med Chem. 2018;18(5):667-674. doi:10.2174/1871520617666171113121246
 Kokoska L, Janovska D. Chemistry and pharmacology of Rhaponticum carthamoides: a review. Phytochemistry. 2009;70(7):842-855. doi:10.1016/j.phytochem.2009.04.008
 Dushkin M, Khrapova M, Kovshik G, et al. Effects of rhaponticum carthamoides versus glycyrrhiza glabra and punica granatum extracts on metabolic syndrome signs in rats. BMC Complement Altern Med. 2014;14:33. Published 2014 Jan 20. doi:10.1186/1472-6882-14-33
 Skała E, Synowiec E, Kowalczyk T, Śliwiński T, Sitarek P. Rhaponticum carthamoides Transformed Root Extract Has Potent Anticancer Activity in Human Leukemia and Lung Adenocarcinoma Cell Lines. Oxid Med Cell Longev. 2018;2018:8198652. Published 2018 Dec 9. doi:10.1155/2018/8198652
 Dun Y, Liu S, Zhang W, Xie M, Qiu L. Exercise Combined with Rhodiola sacra Supplementation Improves Exercise Capacity and Ameliorates Exhaustive Exercise-Induced Muscle Damage through Enhancement of Mitochondrial Quality Control. Oxid Med Cell Longev. 2017;2017:8024857. doi:10.1155/2017/8024857
 Lee Y, Jung JC, Jang S, et al. Anti-Inflammatory and Neuroprotective Effects of Constituents Isolated from Rhodiola rosea. Evid Based Complement Alternat Med. 2013;2013:514049. doi:10.1155/2013/514049; Cropley M, Banks AP, Boyle J. The Effects of Rhodiola rosea L. Extract on Anxiety, Stress, Cognition and Other Mood Symptoms. Phytother Res. 2015;29(12):1934-1939. doi:10.1002/ptr.5486
 Chen Y, Tang M, Yuan S, et al. Rhodiola rosea: A Therapeutic Candidate on Cardiovascular Diseases. Oxid Med Cell Longev. 2022;2022:1348795. Published 2022 Feb 27. doi:10.1155/2022/1348795
 Zhuang W, Yue L, Dang X, et al. Rosenroot (Rhodiola): Potential Applications in Aging-related Diseases. Aging Dis. 2019;10(1):134–146. Published 2019 Feb 1; Chen T, Yao L, Ke D, et al. Treatment with Rhodiola crenulata root extract ameliorates insulin resistance in fructose-fed rats by modulating sarcolemmal and intracellular fatty acid translocase/CD36 redistribution in skeletal muscle. BMC Complement Altern Med. 2016;16:209. Published 2016 Jul 12. doi:10.1186/s12906-016-1176-z
 Szopa A, Ekiert R, Ekiert H. Current knowledge of Schisandra chinensis (Turcz.) Baill. (Chinese magnolia vine) as a medicinal plant species: a review on the bioactive components, pharmacological properties, analytical and biotechnological studies. Phytochem Rev. 2017;16(2):195-218. doi:10.1007/s11101-016-9470-4
 Pandey AK, Gupta A, Tiwari M, et al. Impact of stress on female reproductive health disorders: Possible beneficial effects of shatavari (Asparagus racemosus). Biomed Pharmacother. 2018;103:46-49. doi:10.1016/j.biopha.2018.04.003
 Schepetkin IA, Xie G, Jutila MA, Quinn MT. Complement-fixing activity of fulvic acid from Shilajit and other natural sources. Phytother Res. 2009;23(3):373–384.
 Stohs SJ. Safety and efficacy of shilajit (mumie, moomiyo). Phytother Res. 2014;28(4):475-479. doi:10.1002/ptr.5018
 Carrasco-Gallardo C, Guzmán L, Maccioni RB. Shilajit: a natural phytocomplex with potential procognitive activity. Int J Alzheimers Dis. 2012;2012:674142. doi:10.1155/2012/674142
 Meena H, Pandey HK, Arya MC, Ahmed Z. Shilajit: A panacea for high-altitude problems. Int J Ayurveda Res. 2010;1(1):37-40. doi:10.4103/0974-7788.59942
 Pinello KC, Fonseca Ede S, Akisue G, et al. Effects of Pfaffia paniculata (Brazilian ginseng) extract on macrophage activity. Life Sci. 2006 Feb 16;78(12):1287-92. Epub 2005 Oct 7; Costa CA, Tanimoto A, Quaglio AE, et al. Anti-inflammatory effects of Brazilian ginseng (Pfaffia paniculata) on TNBS-induced intestinal inflammation: experimental evidence. Int Immunopharmacol. 2015 Sep;28(1):459-69; Carneiro CS, Costa-Pinto FA, da Silva AP, et al. Pfaffia paniculata (Brazilian ginseng) methanolic extract reduces angiogenesis in mice. Exp Toxicol Pathol. 2007 Aug;58(6):427-31; da Silva TC, Cogliati B, da Silva AP, et al. Pfaffia paniculata (Brazilian ginseng) roots decrease proliferation and increase apoptosis but do not affect cell communication in murine hepatocarcinogenesis. Exp Toxicol Pathol. 2010 Mar;62(2):145-55; Costa CARA, Quaglio AEV, Di Stasi LC. Pfaffia paniculata (Brazilian ginseng) extract modulates Mapk and mucin pathways in intestinal inflammation. J Ethnopharmacol. 2018;213:21-25. doi:10.1016/j.jep.2017.10.009
Note: Originally published in October 2019, this article has been revised and updated for accuracy and thoroughness.