In this newsletter:

• What is botanical medicine?

• Is botanical medicine safe and effective?

• Adaptogens and the research behind them

• Ways to add adaptogens to your daily life

Imagine Hogwarts from Harry Potter but in real life. Sometimes that’s what it felt like to go to Bastyr University’s Naturopathic Medicine Program. The Bastyr Seattle campus is located in St. Edwards State Park in a building that was a Catholic seminary. There is a de-commissioned Catholic chapel and is located on the edge of Lake Washington surrounded by the forest and hiking trails. Then there is the herb garden that is part of the immersive education experience.

From the very beginning of our medical education, we learned the basic sciences while also learning the basics of botanical medicine—a foundational therapy in naturopathic medicine.

Prior to this, the extent of my exposure to botanical medicine growing up in a Chinese-American household was using some Chinese herbal medicines in the form of my grandfather using Tiger Balm for aches and pains, Dit Da Jow for bruises, White Flower Oil for stomach aches, and Pei Pa Koa cough syrup.

You are likely using some form of botanical medicine and don’t realize it.

Many herbs and spices used in cooking have medicinal benefits—ginger, garlic, onions, rosemary, thyme, cayenne, and even the humble black pepper.

What is botanical medicine?

Botanical medicine is often used interchangeably with herbal medicine. These are various preparations derived from plants to treat disease or promote health and wellbeing.

The idea is that plants contain active constituents that have medicinal properties. There are hundreds of types of compounds that can be categorized based on their structure and function. This is the same reason we consume fruits and vegetables for their nutrients and phytonutrients. This is why I always say that aating food is so much more than calories-in-calories-out.

These constituents are like little packets of information given to us by nature.

There are botanical medicine practices that are unique to the different regions of the world that became Ayurvedic Medicine, Chinese Medicine, and Western Herbal Medicine. There are thousands of years of practice and scientific research that is behind these systems of medicine.

What we might see as simple folk-remedies have a lot of scientific backing to how they work.

How safe and effective are botanical medicines?

The number one emphasis my professors passed on to me is that our role as doctors is to determine if a botanical medicine is 1) safe and 2) effective.

There are a few scenarios that can happen based on this criteria:

• Safe and effective

• Safe but not effective

• Not safe but effective

• Not safe and not effective

This is where the understanding of the constituents, preparations, dose, and medical context come into play.

Can you imagine our ancestors strolling through the forest or hiking up a mountain seeing a plant or flower they’ve never seen and being curious enough to taste, smell, or just put a leaf on their skin?

This type of empirical research was how our ancestors figured out what was safe and effective or not. This was a series of trial and error and this information was passed on by word of mouth or documented in writing.

And for every poisonous plant, there must have been a first person to discover that to be the case!

Today, there are scientists and researchers who are studying these in labs and some of these constituents or their derivatives get turned into the pharmaceuticals we use today.

So are botanical medicines safe and effective?

There are many herbs that are safe and innocuous, but also herbs that are considered low-dose herbs, that when used inappropriately, can quickly lead to toxicity and potentially death.

So safety and effectiveness depends on the plant and its specific constituents. This is why its important to have a basic understanding of how these botanicals work or work with someone who has had training in botanical medicine.

Adaptogens for a stressful and chaotic world

One of the most interesting and safe category of botanical medicines are adaptogens. The term "adaptogen" first showed up in 1940 by a scientist from the USSR, N. Lazarev while describing the botanical medicine Schisandra chinesis.

Adaptogens regulate and balance the body’s response to stress and have to meet three main criteria¹:

1. Must be non-specific and must assist the human body in resisting a wide range of adverse conditions, such as physical, chemical, or biological stress

2. Must maintain homeostasis in humans—these substances can offset or resist physical disorders caused by external stress.

3. Must NOT harm the normal functions of the human body.

By definition, they are safe. The beauty is that adaptogens can be used on a regular basis to maintain resilience to stress. I like to use the term allostasis, which I feel is a more accurate term than homeostasis, because it means responding appropriately to a stressor—bend don’t break.

Homeostasis, on the other hand, means to keep constant. To remain constant during a time of stress would mean physiologically not meaning the demands of stress. If I am running from a tiger, I want my adrenaline to spike and my heart rate to go up so I can run and get as far as I can!

Adaptogens are nature’s ultimate rebalancing tonic. This means that if you are feeling wired and anxious or in a state of burnout and exhaustion, adaptogens will help bring you back towards a healthy baseline.

Adaptogens have different "personalities"

Each adaptogen has its own unique characteristics and use cases. In medicine we call a use case an "indication" and describe the mechanism as an "action."

Here are some examples of my favorites along with main actions and indications:

Note: I will use both proper names and common names to refer to these herbs. Say them fast enough, and it sounds like you are casting a magical spell!

Ganoderma lucidum aka Reishi or Ling zhi

Actions: immunomodulator, adaptogen, antineoplastic (anti-cancer)

Indications: cancer, stress (chronic effects of stress), hypertension, chronic fatigue syndrome, diabetes mellitus, herpes zoster

Panax quinquefolius aka American Ginseng

Actions: adaptogen, stimulating (but less so compared to others), immune modulating, insulin sensitizing, phytoestrogen, nootropic

Indications: immunodeficiency, prevention of infection (e.g. flu prevention in kids), acute or chronic uncompensated stress, cancer treatment and prevention, diabetes mellitus, atherosclerosis, fatigue

Eleutherococcus senticosus aka Eleuthero aka Acanthopanax

Actions: immunomodulator, insulin sensitizer, adaptogen

Indications: chronic uncompensated stress, chronic infections, prevention of infection, cancer treatment and prevention, immune suppression, diabetes mellitus, adjunct to cancer chemotherapy and radiation therapy, rheumatoid arthritis, chronic fatigue syndrome (mild-to-moderate)

Withania somnifera aka Ashwaganda

Actions: calming, adaptogen, nervine, immunomodulator

Indications: chronic uncompensated stress, anxiety, insomnia, erectile dysfunction, male infertility, diabetes mellitus, autoimmune disease, osteoarthritis

Ways to add adaptogens to your daily life

Choose A Preparation - Herbal preparations can come in many forms—as food, water extractions (teas and soups), alcohol extractions (tinctures), glycerin extraction (glycerites), honey extractions (miels), powders, or capsule form.

The best extraction type depends on the constituent that one wants to prioritize and also the plant part used (e.g. root, leaf, flower, berry). And then there is the extraction type that a person will actually take and consume.

Frequency and Dosage - Frequency and dosage matter. I won’t get into specific dosages here because it differs based on adult or child and potency. Since adaptogens are very safe, the important thing is to use them regularly for desired effect. This means taking them daily 2-3 times a day to maintain its effects.

Consult with your doctor or herbalist to find the right specific recommendation for you.

Responsible and Trustworthy Sources - Some herbs are endangered in the regions where they are found in the wild. Also, some herbs are grown with fungicides and herbicides that would introduce toxins into the preparation. You also have to consider the quality of the herbs and preparation itself.

Here are a few places I trust when shopping for herbs (not exhaustive and no affiliation):

• Mountain Rose Herbs - https://mountainroseherbs.com/

• The Herbalist - https://store.theherbalist.com/

• Wise Woman Herbals - https://wisewomanherbals.com/

Do a 30-day challenge - The art of botanical medicine is choosing the right herb for the context and individual. One herb can differently between two people with the same health challenge.

You can do this by yourself by choosing an adaptogen and preparation and using it daily for 30 days. Keep a daily journal and see what changes, if any, happen between the first day and last day. Often the effects are subtle from one day to another, but profound when you zoom out over a month.

And if you find something that works, keep going. If not, experiment with another.

In Closing…

One of my professors, Dr. Yarnell, reminded us that herbs don’t make these constituents for humans, but for themselves. These plants use constituents to ward off predators, as nutrients, and to protect themselves from the stress of their own environments. Humans have learned to harvest these gifts from nature for our own benefit.

Botanical medicines and specifically adaptogens are an amazing gift from nature that can help anyone who has to deal with an an increasingly toxic, stressful, and chaotic world. We can use adaptogens as another tool in our toolbox that have a high safety profile and strong research backing.

P.S. If you are interested in a Healthy By Design consultation session with me where I can help you identify some areas where botanical medicine can fit into your overall health plan, schedule one here https://l.bttr.to/uYxzi or share your feedback or questions via email.

Sources:

1. A preliminary review of studies on adaptogens: comparison of their bioactivity

   in TCM with that of ginseng‑like herbs used worldwide: https://cmjournal.biomedcentral.com/articles/10.1186/s13020-018-0214-9