The effects of stress on your health can be far-reaching. Some of the conditions often associated with stress include
high blood pressure,
decreased mental function, and drug or
alcohol abuse. Stress is known to cause changes in the body's chemistry, altering the balance of hormones in our systems in ways that can lower our resistance to disease. As a result, we can become more susceptible to
flus, and other types of illness. Too much stress sometimes brings on outbreaks of
for people who carry these viruses in their systems. Other chronic diseases such as
irritable bowel syndrome,
inflammatory bowel disease, and
may also flare up during times of stress.
If it's possible to avoid situations that cause you to feel tense, unhappy, or worn down, that's obviously to your benefit. However, it isn't always possible to live a stress-free existence. Work deadlines, family demands, relationship problems, traffic jams, missed appointments, forgotten birthdays, personality conflicts, college exams—all of these things, and many more, can be sources of stress. Furthermore, though most of us associate stress with unpleasant events, even wonderful events in our lives, like weddings, vacations, and holidays, can be genuinely stressful.
Not everyone responds to these situations by getting "stressed out." There are those apparently unflappable folks whose pulse rate wouldn't even go up during an earthquake, and then there are those for whom being five minutes late constitutes reason for a state of total panic. How you manage the stress in your life can determine the impact it will have on you.
There are many different methods of dealing with stress. The basics for good health that we all know (but often forget) help in coping with stress: Eating a balanced diet and getting adequate rest help your body adapt and respond to the events in your life. Ironically, stress can interfere with your ability to take care of yourself in this way. When you're worrying so much you can't sleep, getting adequate rest becomes impossible. Stress can affect your eating habits too. So what else can you do? Exercise, meditation, and biofeedback are all widely accepted stress management tools that might help you break out of a stress-induced downward spiral.
For some people, stressful circumstances can trigger symptoms severe enough to warrant seeking medical attention. Conditions associated with stress, such as
panic attacks, may become severe enough to require medications.
One proposed natural approach to treating the physical consequences of stress involves the use of so-called
adaptogens. The term "adaptogen" refers to a hypothetical treatment described as follows: An adaptogen helps the body adapt to stresses of various kinds, whether heat, cold, exertion, trauma, sleep deprivation, toxic exposure, radiation, infection, or psychological stress. Furthermore, an adaptogen should cause no side effects, be effective in treating a wide variety of illnesses, and help return an organism toward balance no matter what may have gone wrong.
However, physical exercise is the only indubitable example of an adaptogen. There is no solid evidence that any substance functions in this way. However there is a bit of suggestive evidence for the herb
Panax ginseng, which is discussed in the next section.
Most of the evidence cited to indicate that
has adaptogenic effects comes from animal studies involving ginseng extracts injected into the abdomen. Such studies are of questionable relevance to the oral use of ginseng by people; furthermore, the majority of these studies were performed in the former Soviet Union and failed to reach acceptable scientific standards. However, a few potentially meaningful studies in humans have found effects that are at least consistent with the possibility of benefits in stressful situations.
According to a number of animal studies, most of which were poorly designed and reported,
Panax ginseng injections into the blood stream or abdomen can increase stamina, improve mental function, protect against radiation, infections, toxins, exhaustion, and stress, and activate white blood cells.1
However, when ginseng is injected into the abdomen or bloodstream, it enters the body directly without going through the digestive tract. This mode of administration is strikingly different from taking ginseng by mouth.
A smaller number of animal studies (again, most of them poorly designed) have looked at the potential benefits of ginseng administered orally, and often reported benefit.2-8 In addition, studies in mice found that consuming ginseng before exposure to a virus significantly increased the survival rate and number of antibodies produced.9,10
Human studies of
have only indirectly examined its potential benefits as an adaptogen. For example, a
study found evidence that
Panax ginseng may improve immune system response.11
This trial enrolled 227 participants at three medical offices in Milan, Italy. Half were given ginseng at a dosage of 100 mg daily, and the other half received
placebo. Four weeks into the study, all participants received influenza vaccine.
The results showed a significant decline in the frequency of colds and flus in the treated group compared to the placebo group (15 versus 42 cases). Also, antibody levels in response to the vaccination rose higher in the treated group than in the placebo group.
These findings have been taken by some researchers to support their belief that ginseng has an adaptogenic effect. However, the study might instead simply indicate a general form of
unrelated to stress.
Other studies have looked at
overall mental function,15-17general well-being,18-21,54
While it is true that positive results in such studies might tend to hint at an adaptogenic effect, the results were, in general, too mixed to provide conclusive evidence for benefit.
The bottom line: It is not clear that
offers general benefits for stress.
For more information, including dosage and safety issues, see the full
Surprisingly, a treatment as simple as
tablets may be helpful for stress.
In a double-blind, placebo-controlled study, 300 men and women were given either a multivitamin-mineral tablet or placebo for 30 days.38
The results showed that people taking the nutritional supplement experienced less anxiety overall and an enhanced ability to cope with stressful circumstances. The supplement used in this study supplied the following nutrients and dosages:
(100 mg), and
Benefits were seen in another double-blind, placebo-controlled trial that enrolled 80 healthy male volunteers.39
The supplement used in this trial was similar but not identical.
It's not clear how these nutrients help stress. But, considering that many of us would benefit from general nutritional supplementation in any case, it might be worth trying.
In the 1940s, Dr. Brekhman, the same scientist who first dubbed
an adaptogen, decided that a much less expensive herb,
Eleutherococcus senticosus, is also an adaptogen. A thorny bush that grows much more rapidly than true ginseng, this plant later received the misleading name of "Siberian" or "Russian ginseng." Its chemical makeup, however, is completely unrelated to that of Panax ginseng.
Panax ginseng, many animal studies finding adaptogenic benefits with eleutherococcus have been reported, but most were relatively poorly designed and used injections rather than oral administration of the herb, making the results not particularly relevant to the normal human usage of the herb.
Numerous human trials of eleutherococcus have been reported as well, some involving enormous numbers of participants. However, most of these were not double-blind and many were not even
controlled, making the results nearly meaningless. (For information on why double-blind, placebo-controlled studies are essential to establish the effectiveness of a treatment, see
Why Does This Database Rely on Double-blind Studies?)
Again, as with
Panax ginseng, a few reasonably well-designed studies in humans have been reported that may have indirect bearing on the herb’s potential adaptogenic properties. For example, in one double-blind trial, participants took either 10 ml of extract of eleutherococcus or placebo 3 times daily for a 4-week period. Blood samples were analyzed to determine changes in immune cells. A statistically significant increase in numbers of cells important to immune functions was observed in the treatment group as compared to the placebo group.
This study has been widely advertised as proving the eleutherococcus strengthens immunity. However, mere changes in immune cell profile do not at all automatically translate into enhanced immunity. (See the
article for more information on why this is so.) More meaningful data was obtained in a double-blind, placebo-controlled study involving 93 people who experience recurrent flare-ups of
Use of eleutherococcus significantly reduced the severity, frequency, and duration of herpes outbreaks relative to placebo during the 6-month trial. This study does suggest a possible immune strengthening effect.
Panax ginseng, eleutherococcus has also been studied for potential
sports performance enhancement benefits, but published studies have not been encouraging.42,55 One small double-blind, placebo-controlled trial of endurance athletes actually found that use of eleutherococcus may increase physiologic signs of stress during intensive training.52
For more information, including dosage and safety issues, see the full
Three small double-blind trials suggest that the herb
Rhodiola rosea) may improve mental alertness in people undergoing sleep deprivation or other stressful circumstances.44,45,56
Numerous other herbs are said to be adaptogens as well. These include
schisandra. However, there is little to no real evidence as yet that they have adaptogenic effects.
One study failed to find greater adaptogenic effects with fish oil as compared to placebo.59
Many people report that they experience stress relief through the use of alternative therapies, such as
yoga. Regarding the use of massage therapy, one study failed to find regular massage more effective for controlling stress than use of a relaxation tape.60 Whereas, a large 2012 review of 35 studies involving 1,794 people found evidence to support the use of yoga to decrease stress and anxiety, although the overall quality of these studies was poor.75
A study failed to find either cognitive behavioral therapy or increased physical activity helpful for stress-related illnesses.68
Preliminary evidence, including small, double blind trials suggest that the amino acid
improve memory and mental function under conditions of sleep deprivation or other forms of stress.50,51,69
One double-blind study found that use of
vitamin C at doses of 3,000 mg daily (slow release) reduced both physical and emotional responses to stress.53
In small double-blind studies, theanine, a constituent of
black tea, appeared to reduce the body's reaction to acute physical or psychological stress.61,65
Benefits have also been seen with a combination of
(2.64 g per day) and
arginine (2.64 g per day).67
One double-blind study found evidence that a processed form of casein (a protein found in milk) may reduce a variety of stress-related symptoms.66
According to another small, double-blind trial, a mixture of soy
lecithin may decrease the physiological response to mental stress.62
Another study evaluated use of phosphatidylserine for reducing stress in golfers, but the benefits seen failed to reach
herbal formula containing
Bacopa monniera and almost 30 other ingredients has shown some promise for treating symptoms of stress. In a 3-month, double-blind, placebo-controlled trial of 42 people in high-stress jobs who complained of fatigue, participants using the herbal formula reported fewer stress-related problems.57 Also, in a 3-month, double-blind, placebo-controlled study of 50 adult students, this formula appeared to improve memory and attention and reduce other signs of stress.58
In naturopathic medicine,
are often recommended for treatment of stress, but there is no evidence that this treatment is effective.
Equivocal evidence hints that
valerian, alone or in combination with lemon balm, might reduce anxiety symptoms during stressful situations.46,63-64
Three studies failed to find
Bach flower remedies helpful for situational anxiety (anxiety caused by stressful situations).70-72
For other natural treatments relevant to stress, see the discussion in the articles on
Schulz V, Hansel R, Tyler VE.
Rational Phytotherapy: A Physicians' Guide to Herbal Medicine.
3rd ed. Berlin, Germany: Springer-Verlag; 1998:271, 273.
Bittles AH, Fulder SJ, Grant EC, et al. The effect of ginseng on the lifespan and stress responses in mice.
Brekhman II, Dardymov IV. Pharmacological investigation of glycosides from Ginseng and
Dua PR, Shanker G, Srimal RC, et al. Adaptogenic activity of Indian
Panax pseudoginseng.Indian J Exp Biol.
Grandhi A, Mujumdar AM, Patwardhan B. A comparative pharmacological investigation of Ashwagandha and Ginseng.
Hiai S, Yokoyama H, Oura H. Features of ginseng saponin induced corticosterone secretion.
Ramachandran U, Divekar HM, Grover SK, et al. New experimental model for the evaluation of adaptogenic products.
Oura HS, Hiai S, Nabetani S, et al. Effect of ginseng extract on endoplasmic reticulum and ribosome.
Singh VK, Agarwal SS, Gupta BM. Immunomodulatory activity of
Singh YN. Effects of kava on neuromuscular transmission and muscle contractility.
Scaglione F, Cattaneo G, Alessandria M, et al. Efficacy and safety of the standardised ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold.
Drugs Exp Clin Res.
Scaglione F, Ferrara F, Dugnani S, et al. Immunomodulatory effects of two extracts of
Drugs Exp Clin Res.
Scaglione F, Cogo R, Cocuzza C, et al. Immunomodulatory effects of
C.A. Meyer (G115) on alveolar macrophages from patients suffering with chronic bronchitis.
Int J Immunother.
Srisurapanon S, Rungroeng K, Apibal S, et al. The effect of standardized ginseng extract on peripheral blood leukocytes and lymphocyte subsets: a preliminary study in young healthy adults.
J Med Assoc Thai.
Sorenson H, Sonne J. A double-masked study of the effects of ginseng on cognitive functions.
Curr Ther Res.
D'Angelo L, Grimaldi R, Caravaggi M, et al. A double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers.
Hallstrom C, Fulder S, Carruthers M. Effects of ginseng on the performance of nurses on night duty.
Comp Med East West.
Caso Marasco A, Vargas Ruiz R, Salas Villagomez A, et al. Double-blind study of a multivitamin complex supplemented with ginseng extract.
Drugs Exp Clin Res.
Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients.
Forgo I, Kayasseh L, Staub JJ. Effect of a standardized ginseng extract on general well-being, reaction time, lung function and gonadal hormones [translated from German].
Cardinal BJ, Engels HJ. Ginseng does not enhance psychological well-being in healthy, young adults: results of a double-blind, placebo-controlled, randomized clinical trial.
J Am Diet Assoc.
Cherdrungsi P, Rungroeng K. Effects of standardized ginseng extract and exercise training on aerobic and anaerobic capacities in humans.
Korean J Ginseng Sci.
Forgo I. Effect of drugs on physical exertion and the hormonal system of athlete [translated from German].
MMW Munch Med Wochenschr.
McNaughton LG, Egan G, Caelli G. A comparison of Chinese and Russian ginseng as ergogenic aids to improve various facets of physical fitness.
Int J Clin Nutr Rev.
Engles HJ, Wirth JC. No ergogenic effects of ginseng (
Panax ginseng) during graded maximal aerobic exercise.
J Am Diet Assoc.
Engels HJ, Said JM, Wirth JC, et al. Failure of chronic ginseng supplementation to affect work performance and energy metabolism in healthy adult females.
Morris AC, Jacobs I, McLellan TM, et al. No ergogenic effect of ginseng ingestion.
Int J Sport Nutr.
Teves MA, Wright JE, Welch MJ, et. al. Effects of ginseng on repeated bouts of exhaustive exercise [abstract].
Med Sci Sports Exerc.
Schlebusch L, Bosch BA, Polglase G, et al. A double-blind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress.
S Afr Med J.
Carroll D, Ring C, Suter M, et al. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind, placebo-controlled trial.
Bohn B, Nebe CT, Birr C. Flow-cytometric studies with eleutherococcus senticosus extract as an immunomodulatory agent.
Williams M. Immuno-protection against herpes simplex type II infection by eleutherococcus root extract.
Int J Alt Complement Med.
Dowling EA, Redondo DR, Branch JD, et al. Effect of
on submaximal and maximal exercise performance.
Med Sci Sports Exerc.
Darbinyan V, Kteyan A, Panossian A, et al. Rhodiola rosea in stress induced fatigue—a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty.
Spasov AA, Wikman GK, Mandrikov VB, et al. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen.
Cropley M, Cave Z. Effect of kava and valerian on physiological responses to psychological stress assessed under laboratory conditions [abstract].
Fahey TD, et al. Hormonal effects of phosphatidylserine during 2 weeks of intense training [abstract].
Med Sci Sports Exerc.
Monteleone P, Maj M, Beinat L, et al. Blunting by chronic phosphatidylserine administration of the stress-induced activation of the hypothalamo-pituitary-adrenal axis in healthy men.
Eur J Clin Pharm.
Fahey TD, Pearl MS. The hormonal and perceptive effects of phosphatidylserine administration during two weeks of resistive exercise-induced overtraining.
Deijen JB, Wientjes CJ, Vullinghs HF, et al. Tyrosine improves cognitive performance and reduces blood pressure in cadets after one week of a combat training course.
Brain Res Bull.
Neri DF, Wiegmann D, Stanny RR, et al. The effects of tyrosine on cognitive performance during extended wakefulness.
Avit Space Environ Med.
Gaffney BT, Hugel HM, Rich PA. The effects of
on steroidal hormone indices of stress and lymphocyte subset numbers in endurance athletes.
Brody S, Preut R, Schommer K, et al. A randomized controlled trial of high dose ascorbic acid for reduction of blood pressure, cortisol, and subjective responses to psychological stress.
Ellis JM, Reddy P. Effects of Panax ginseng on quality of life.
Eschbach LF, Webster MJ, Boyd JC, et al. The effect of Siberian ginseng (Eleutherococcus senticosus) on substrate utilization and performance.
Int J Sport Nutr Exerc Metab.
Shevtsov VA, Zholus BI, Shervarly VI, et al. A randomized trial of two different doses of a SHR-5 rhodiola rosea extract versus placebo and control of capacity for mental work.
Dixit S, Agrawal U, Dubey G. Executive fatigue and its management with Mentat.
Agrawal A, Dubey M, Dubey G. Effects of Mentat on memory span, attention, galvanic skin resistance (GSR) and muscle action potential (EMG) among normal adults.
Bradbury J, Myers SP, Oliver C, et al. An adaptogenic role for omega-3 fatty acids in stress; a randomised placebo controlled double blind intervention study (pilot).
2004 Nov 28. [Epub ahead of print]
Hanley J, Stirling P, Brown C. Randomised controlled trial of therapeutic massage in the management of stress.
Br J Gen Pract.
Kraemer WJ, French DN, Spiering BA, et al. Cortitrol supplementation reduces serum cortisol responses to physical stress.
Hellhammer J, Fries E, Buss C, et al. Effects of soy lecithin phosphatidic acid and phosphatidylserine complex (PAS) on the endocrine and psychological responses to mental stress.
Kohnen R, Oswald WD. The effects of valerian, propranolol, and their combination on activation, performance and mood of healthy volunteers under social stress conditions.
Kennedy DO, Little W, Haskell CF, et al. Anxiolytic effects of a combination of Melissa officinalis and Valeriana officinalis during laboratory induced stress.
Kimura K, Ozeki M, Juneja LR, et al. l-Theanine reduces psychological and physiological stress responses.
2006 Aug 21. [Epub ahead of print]
Kim JH, Desor D, Kim YT, et al. Efficacy of alpha-s1-casein hydrolysate on stress-related symptoms in women.
Eur J Clin Nutr.
Smriga M, Ando T, Akutsu M, et al. Oral treatment with L-lysine and L-arginine reduces anxiety and basal cortisol levels in healthy humans.
Heiden M, Lyskov E, Nakata M, et al. Evaluation of cognitive behavioural training and physical activity for patients with stress-related illnesses: A randomized controlled study.
J Rehabil Med.
Mahoney CR, Castellani J, Kramer FM, et al. Tyrosine supplementation mitigates working memory decrements during cold exposure.
2007 May 22. [Epub ahead of print]
Halberstein R, DeSantis L, Sirkin A, et al. Healing with Bach® Flower Essences: testing a complementary therapy.
Complement Health Pract Rev.
Walach H, Rilling C, Engelke U. Efficacy of Bach-flower remedies in test anxiety: a double-blind, placebo-controlled, randomized trial with partial crossover.
J Anxiety Disord.
Armstrong NC, Ernst E. A randomized, double-blind placebo-controlled trial of a Bach flower remedy.
Complement Ther Nurs Midwifery.
Inoue K, Shirai T, Ochiai H, et al. Blood-pressure-lowering effect of a novel fermented milk containing gamma-aminobutyric acid (GABA) in mild hypertensives.
Eur J Clin Nutr.
Jager R, Purpura M, Geiss KR, et al. The effect of phosphatidylserine on golf performance.
J Int Soc Sports Nutr.
2007 Dec 4.
Li AW, Goldsmith CA. The effects of yoga on anxiety and stress.
Altern Med Rev.
Last reviewed September 2014 by
EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.