Review – Adaptogens: Herbs for Strength, Stamina, and Stress Relief by David Winston, RH(AHG), Rochester, VT: Healing Arts Press, 201 I was asked by Healing Arts Press to review this book by David Winston because of my interest in herbal medicine. I continue to look forward to discovering and reviewing new herbal medicine books. The word “Adaptogen” was new to me. Briefly it refers to natural substances that help the body adapt to stress. The book begins with lists of Adaptogens that have been well researched and found around the world. Most of the twenty-five Adaptogens to be discussed have been used for centuries as medicines in the Ayurvedic practice of India or in traditional Chinese medicine (TCM). In my recent review of Healing the Thyroid with Ayurveda: Natural Treatments for Hashimoto’s, Hypothyroidism, and Hyperthyroidism by Marianne Teitelbaum I noted that most of the herbs used were from India, and I expressed a wish that equivalent herbs could be identified that grow naturally here in the United States, specifically in the Northeast. The Earth provides healing herbs everywhere and I have confidence that we can find equivalent healing herbs here rather than having to rely upon shipping them from other distant places. Winston then provides a brief recent history of herbal medicine and notes that because of the Food and Drug Administration and the rise of the pharmaceutical industry the use of botanical medications dropped to near nothing in the United States between 1870 and 1990. Since then there has been a resurgence and interest in the use of natural herbs as medicines and we have been turning to numerous sources of information about these herbs including Germany, India, China and Japan and our Native Americans for their knowledge that continued over those years of decline. Research studies are arising that isolates specific phytochemicals to examine their effects on particular diseases. Though not an Ataptogen, one reported and fascinating piece of research was on Artemisinin, from Artemisia. This phytochemical has been shown to be effective in treating malaria though the causative parasite quickly becomes resistant to it, but additional research has shown that using the entire plant reverses this resistance. I have been enjoying a cup of Artemisia tea most mornings because of its cancer reducing properties. What are the Adaptogens?• First, adaptogens are nontoxic with minimal side effects on physical and mental health.• They produce a nonspecific defense response to stress, i.e. to keep the body balanced when affected by multiple stressors.• They have a normalizing influence on the body and have a bidirectional effect on physiological functions to reregulate the endocrine, nervous, immune, digestive and cardiovascular systems, i.e. they can work both to decrease hyper-functioning and enhance hypo-functioning activity in each system. These herbs influence two master control systems in the body, the hypothalamic-pituitary-adrenal axis (HPA) and the sympathoadrenal system (SAS). The HPA regulates most endocrine functions with the Adaptogen’s homeostatic response to stress enhancing health and well being for both body and mind. The SAS mediates response to external stimuli and is responsible for the fight or flight response. Two classes of Adaptogen phytochemicals provide this mediation: the tricyclic terpenoids, which are similar to hormones and steroids, relieve chronic stress that affects the HPA axis, and the other class, which is similar to adrenaline, relieves acute stress. The whole herb is generally more effective than an isolated phytochemical, and better yet, certain combinations of herbs work together more effectively than a single herb, though some combinations of herbs are inappropriate and contraindicated. In Winston’s review of the history of adapatogens, the word “adaptogen” was first used in Russia in the late 1940’s when finding “tonic substances” was ordered by the government and the research was taken up by the Soviet Academy of Science. Most extensively researched was Siberian Ginseng, Eleuthero, which was found to improved hearing, mental alertness, work output and the quality of work under stress-inducing conditions and in athletic performance. The Adaptogens found in North America include American Ginseng, Reishi Mushroom, Rhodiola Rosea, Bignonia capreolata or Crossvine Boar-hog or Lovage root. Ashwagandha, cordyceps, holy basil, reishi and schisandra are now being grown here. Stress threatens the normal homeostasis while allostasis re-establishes homeostasis through the many hormones secreted by the HPA and SAS systems. Allostasis provides feedback controls along the stress pathway from the alarm stage, to the resistance stage and the exhaustion stage with the loss of vital energy. Adaptogens can increase the effectiveness of other prescribed drugs, mobilize the body to decrease fatigue and slow or reverse the aging process and increase longevity. It can reduce the risk of cancer, one of my major concerns, as well as improving the functioning of all other body systems. The next 92 pages (151-243) are “monographs” of the twenty-five adaptogens, a most valuable resource. In reviewing these adaptogens the taste and energy qualities, the herbal safety, dosage and the herbal preparations are examined. I will select three to review as I look towards the adaptogens that grow in North America, American Ginseng, Reishi Mushroom, and the naturalized White Bryony.American Ginseng American Ginseng’s taste/energy is sweet, bitter, slightly warm and moist. The root is used and occasionally the leaf. It is native to the eastern United States and Canada, from the Catskill Mountains and Berkshires north into Ontario, west to Iowa and south to Alabama, Georgia, Tennessee, North Carolina and Virginia. Hooray, we now live in the Catskills so can grow it in our shaded woodland above the house. It requires rich soil and takes a minimum of seven years to grow to maturity. It is considered very safe and its properties as an adaptogen include antioxidant, bitter tonic, mild central nervous system stimulant, soothes mucous membranes, hypoglycemic and balance to the immune system. It was used extensively by the indigenous people of North America and by the nearby Iroquois to stop vomiting, for lack of appetite, as a mild stimulant, for fevers and asthma, for sores, earaches and painful eyes. The local Delaware used it as a spiritual and ceremonial medicine to improve hunting, and for protection. When discovered by the invaders of this country this Ginseng was shipped to China where it became popular. Daniel Boone made his fortune by trading it, the most valuable cargo to leave New York. It is now used as a folk medicine in Appalachia and the Ozarks. Medicinally it is useful for mild to moderate depletion of the HPA axis and adrenal glands, and for middle-aged people who are noticing a decrease in endurance, energy and strength. It brings balance to the immune system and helps with insomnia associated with chronic fatigue syndrome, jet lag, and cancer-related fatigue. High doses alter the effects of Coumadin so it should be avoided when using this medication.Reishi Mushroom Two species of the Reisi Mushroom, Ganoderma cortisii and Ganoderma sessile grow on oak trees in the southeastern and southwestern United States. Their taste/energy is bitter and warm, and they are considered safe. They are anti-inflammatory, antioxidant, antiviral, a cardiac tonic, protect the liver and restore the immune system. Chinese medicine considers this mushroom a superior herb. Depending upon the color, the blue/green reishi strengthens the eyes, calms the mind and the ethereal soul, and helps the person become more compassionate. The red strengthens the heart, prolongs life and increases cognitive functioning. The white enhances respiratory functioning, relieves coughs and quiets the mind. The yellow strengthens the spleen and helps a person become loyal and honest, while the black strengthens the kidneys. Medicinal research indicates that the Reishi strengthens the immune system and benefits people with allergies and asthma. It is anti-inflammatory, improves cardiovascular functioning and alleviates altitude sickness. Research indicated that it improves cancer related fatigue in breast cancer, enhances the immune system and has anti-tumor activity. It is superior in treating chronic fatigue, and its effect is cumulative with extended use.White Bryony Though White Bryony is native to Europe it has become naturalized in the northwestern United States and attained the status of being a noxious weed. Its taste/energy is bitter and hot. As a possible Adaptogen it is analgesic, anti-inflammatory, cathartic and an immune stimulant. It has a long history in Europe as a homeopathic substance, and is considered dangerous as a drastic cathartic/purgative. In very small doses it treats harsh coughs with sharp, cutting pain. It has been used to treat pleurisy, and bronchitis, and for various pain syndromes. It does not meet the Adaptogen requirement for safety, though depending upon when it is harvested, in early spring or late autumn it is supposedly safe. With the Russian Chernobyl disaster it was used to treat workers exposed to radiation and helps prevent radiation-induced disease. Some articles indicate that bryony improves T-cell immunity, has antimutagenic qualities, and reduces the adverse effects caused by chemotherapy. Russian research suggests that it can enhance athletic performance, and aid in the treatment of cancer. Winston then proceeds to examine Nervines, Nootropics and Restorative Tonics as complementary herbs for Adaptogens. Adaptogens alone cannot make up for lack of sleep, poor diet and lack of exercise. In addition to lifestyle and dietary changes the nervines that calm and relax the body without acting as a sedative can enhance the effects of Adaptogens. The Nootropics enhance memory, slow or prevent the onset of age related cognitive decline, reduce oxidative damage to the brain and improve mood. The restorative tonics enhance vitality, strengthen and nourish in treating fatigue, exhaustion and depression by decreasing cortisol levels. Many of the Nervines, Nootropics, and Restorative Tonics are native to the United States. Among the Nervines are St. John’s Wort, chamomile, hawthorn, and skullcap. The Nootropics include lavender, rosemary and white peony. Among the Restorative Tonics are bee pollen, Goji berries, nettle seed, and saw palmetto. The book concludes with a number of fascinating case studies of the use of Adaptogens in treating patients, the use of combinations of Adaptogens, recipes for using Adaptogens in food, and the use of Adaptogens in animal husbandry. In my reading of other books on medicinal plants, a number of reference books review a large number of plants, and list a very wide range of maladies for which each plant can treat. With so many options it becomes very confusing as to which plants to use for a particular problem. Though the Adaptogens are effective in treating a wide range of problems, the research for Adaptogens is such that these herbs are specific in their effectiveness in providing strength, stamina and stress relief, specificity that gives me greater confidence in how to use them rather than adding to the sense of confusion. I do believe and have faith that our Earth Mother provides what we need to maintain our health and that there are plants here in the northeast of the United States that can be added to the list of Adaptogens, but research in this direction is needed. I highly recommend this book in aiding herbalists in their prescriptions of herbs.