Clinician perspectives and understanding of the adaptogenic concept: A focus group study with Naturopaths and Western Herbalists

BACKGROUND: Herbal adaptogens are plant medicines which have traditional associations with herbal ‘tonics’ and promote homeostasis and non-specifically increase resistance to stress. Current definitions of adaptogens have been derived from extensive laboratory research, however there has not been sufficient clinical data for the concept to be standardised by regulatory bodies in Europe or Australia, nor is there clarity around how adaptogens are used and understood by herbalist clinicians themselves. This study aimed to identify how Australian Naturopaths measure adaptogenic activity relative to the clinical outcomes they aim to achieve. METHODS: A qualitative methodology was implemented using focus groups and thematic analysis. RESULTS: Three focus groups were conducted with a total of 17 Naturopaths with a Bachelor degree or higher qualification and over five years clinical experience. Three core themes were identified: ambiguous cultural origins with divergent perceptions on sources of knowledge about adaptogens; raising vitality and having a restorative effect, and intersystem activity. Within these three central themes, a number of sub-themes were identified. CONCLUSIONS: Naturopathic clinicians utilise both subjective and objective measures of vitalistic signs across multiple body systems; however, the current available research may not accurately reflect expert clinician understanding and use of adaptogens. The study opens pathways to developing novel approaches to measuring adaptogenic activity which may facilitate the process of international standardisation of the adaptogenic concept for the development of well-designed clinical studies.