Like so many terms co-opted by the wellness industry, I can’t remember when I first heard the word “adaptogen.” One day it was just there: in the mushroom coffee I was gifted, in the supplements in my medicine cabinet, and plastered on advertisements everywhere I looked.

Proponents claim these plant extracts can help the body adapt (hence the name) to stress, which many of us could seriously use right now. But before you spend your hard-earned cash on these supplements, let’s answer the crucial question: Do they do anything?

What are adaptogens?

Common adaptogens have been used long before they were called “adaptogens.” Ginseng, for example, has a centuries-long history in traditional Chinese medicine. But in the time-honored tradition of the Western wellness industry commercializing aspects of other cultures, these so-called “adaptogens” have become a buzzy wellness trend in recent years.

“I feel like I do one of these interviews a week,” Rashmi Mullur, an integrative endocrinologist at UCLA and the VA in Los Angeles, tells Inverse. “Adaptogens seem to be all the rage.”

Mullur specializes in the treatment of hormone-related disorders but does so using a combination of conventional medicine and complementary treatments such as evidence-based supplements and behavioral and lifestyle modification.

According to Mullur, the word “adaptogen” is mainly used in herbal, functional, and integrative medicine. “It’s not a term that’s widely accepted in conventional medical practice,” she says. “It basically describes a natural product —usually an herbal agent or a plant-based product like a mushroom — that impacts the body’s ability to adapt to stressors.”

Stressors refer to an innumerable list of factors that cause the human body stress, says Mullur. It could be anything from “immune injuries, psychosocial stress, or chronic stress and fatigue.”

Mullur considers adaptogens as a type of nutraceutical — herbal or food-derived products sold as a means to support or enhance overall health.

Two researchers studying adaptogens in 1969 outlined four criteria a substance must meet to be considered an adaptogen:

1. They must reduce the harm caused by stressed states, such as fatigue, infection, and depression.
2. They must have positive excitatory effects on the human body.
3. Their excitatory effects must not cause side effects such as insomnia, low protein synthesis, or excessive energy consumption.
4. Adaptogens themselves must not harm the human body.

Obviously, phrases like “harm the human body” are frustratingly vague. What’s harmful to one body might be perfectly innocuous to another. Still, it’s useful to have a sense of the criteria proponents of adaptogens are using to define them.

Do adaptogens really work?

Unfortunately, how exactly adaptogens work inside the body isn’t totally understood. There are likely countless mechanisms at play and not every substance works the same way inside the body.

“Adaptogens will impact several aspects of the body’s stress response. Some of those are hormonal. Some of those are biochemical, some are neuro-hormonal, meaning they affect hormone signaling in the brain. But it’s across many pathways,” says Mullur. But that “is about all we probably know about it.”

Some adaptogens are better studied than others, and that research has allowed us to get a better understanding of what systems in the body are affected by various adaptogens.

For example, a 2020 review article noted that ginseng might stabilize blood pressure, both by reducing it when it’s too high and increasing pressure when it’s too low. While researchers don’t fully understand the mechanisms through which ginseng works, they think properties in the root promote nitric oxide secretion, which causes blood vessels to dilate, lowering blood pressure. Ginseng also might stimulate alpha-adrenergic receptors, which play a key role in the sympathetic nervous system, otherwise known as our fight or flight response.

However, the bulk of the research on the mechanisms through which adaptogens work in the body isn’t clear-cut.

“There’s data on the biochemical and mechanistic actions of each individual compound, but most of that is being evaluated in studies not in humans, but either in cell cultures or in animal models,” says Mullur. “When you look at ‘adaptogenic activity’ in humans, it’s less well understood.”

That’s likely not the messaging you’re getting from the wellness industry. More likely, you’re being sold a very expensive blend of adaptogens and promises of vastly improved skin, hair, and mental and physical health.

“Supplement companies are in the business of selling you supplements,” Mullur says. “There are baseline conflicts when the wellness industry is advertising the benefits of pathogens without us having robust clinical studies.”

Further, most of the clinical studies she’s seen that do involve humans are usually in trials where people take adaptogens in moderate doses for short periods of time.

“The longest one I’ve seen is six months, but truthfully, more of them are about 12 weeks on average. So that’s about three months of taking something and seeing a tiny bit of change, not taking something forever, which is what nutraceutical companies would love for you to do.”

Can adaptogens be dangerous?

As with any supplement, such as Vitamin D or B12, the most important thing to know is exactly what’s in the products you buy.

Because the Food and Drug Administration doesn’t regulate most supplements in the U.S., adaptogens included, there’s no guarantee that the products contain what their label claims they do.

As an integrative endocrinologist, Mullur cares for patients who take adaptogens on their own accord. She notes that often people turn to integrative medicine because they lack access to traditional care or lack trust in traditional systems of care. But it is smart to consult with a medical practitioner before starting any adaptogen regimen.

“Adaptogens can impact cortisol levels and they can change the hormonal responses in the body. So you don’t want to do this willy nilly,” Mullur says.

Should you take adaptogens?

In addition to overhyping certain supplements, adaptogens are sometimes marketed as replacements for other medications or supplements a doctor might have prescribed as a long-term treatment.

“From an integrative medicine and herbal medicine standpoint, plant-based or natural therapies are not designed to be ‘natural pharmaceuticals.’ You can’t just take a pill and forget about it,” Mullur explains.

“Cultures that use adaptogens as part of their treatment modalities use them for a time-limited period, so the person can ‘adapt’ to said stressor,” she adds.

That stressor may be anything from a new job to a recent breakup.

When exposed to a stressor, Mullur says, “the body has an acute response and, over time, if the stressor persists “adapts” its physiologic functions to maintain a near-normal equilibrium. A concrete example of this is temperature or thermoregulation.”

“The idea that you could go to the local drugstore and pick up 1200 milligrams of ashwagandha and pop it for stress, that’s not the way it’s traditionally intended,” says Mullur.

Adaptogens are a lucrative market: the global adaptogens market was valued at $9.78 billion in 2020 and is expected to reach 16.25 billion by 2028. That’s a lot of incentive to maintain and expand aggressive marketing tactics. If done under the care of a doctor, some adaptogens may be beneficial to your health. But consumers should be clear-eyed about what the science shows, how supplements are marketed, and how these substances have traditionally been used.