Superfoods and adaptogens (marketing category)
Marketing category for plant and animal supplements sold as «whole-body support», «adaptogens against stress», «immunomodulators» and «longevity» products. Includes maca, spirulina, chlorella, royal jelly, oral sea buckthorn, black seed, ashwagandha, rhodiola and dozens more. EFSA has not approved a single health claim for these products in the EU Register on Nutrition and Health Claims. AESAN classifies them as complementos alimenticios without a therapeutic indication. Cochrane systematic reviews on most items are either absent or state insufficient evidence. The category has no approved clinical indication at EMA, FDA or AEMPS.
16 drugs
Also known as: Superfoods, Adaptogens, Whole-body wellness, General health support, Herbal immunomodulators
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DBlack seed (Nigella sativa)Not recommended · Botanical supplement, black seed oil (Nigella sativa, thymoquinone); no EMA HMPC monographBlack seed and black seed oil (Nigella sativa) are sold as a superfood and adaptogen, with promises of stronger immunity, more energy and overall wellbeing. There is no convincing evidence that it delivers these benefits in a healthy person: good-quality studies on this use have not been done. Sleep, regular movement and a varied diet support energy and resilience far more reliably than any single supplement. The seed itself, in culinary amounts, is safe.
- DBoswelliaNot recommended · Botanical supplement, gum resin of Boswellia serrata (Indian frankincense), standardised by AKBA (acetyl-11-keto-beta-boswellic acid); popular iHerb «joint health» categoryBoswellia is actively marketed as a «universal anti-inflammatory for everything» – joints, gut, asthma, eczema, autoimmune disease, oncology, Alzheimer disease and even «brain rejuvenation». The actual evidence base is limited to knee osteoarthritis and a few small RCTs in Crohn disease and ulcerative colitis without confirmation in large studies. For asthma, eczema, rheumatoid arthritis and oncology, in vitro and animal data are not backed by quality human RCTs. EFSA in 2010 rejected all boswellia health claims. AESAN classifies the product as a complemento alimenticio without therapeutic indication. The «anti-inflammatory for everything» idea is marketing, not clinical: 5-lipoxygenase suppression is a narrow pathway, while inflammation in different diseases runs through different mechanisms and requires targeted therapy (DMARDs in rheumatoid arthritis, inhaled corticosteroids in asthma, biologics in Crohn disease). If boswellia was bought for «inflammation in general» or instead of prescribed treatment, discuss with a doctor – real diagnoses are treated with drugs of proven efficacy, not a plant resin.
- DChlorellaNot recommended · Freshwater unicellular green alga (Chlorella vulgaris / pyrenoidosa), supplement, marketed for «mercury detox»Chlorella is a freshwater microalga sold as a powder or tablets and marketed as a superfood and adaptogen, with promises of detox, more energy and immune support. There is no convincing evidence that the supplement delivers these effects in healthy people. It also shows no harm at usual doses, but there is little reason to expect the claimed benefits. For genuine support, sleep, a diet with vegetables and greens, and regular physical activity do far more.
- DChlorophyll (chlorophyllin copper-sodium complex)Not recommended · Plant pigment; in supplements as natural chlorophyll (E140) and the water-soluble copper-sodium complex chlorophyllin (E141). In the European Union it is registered as a food colourant under Regulation (EC) 1333/2008. On iHerb, Amazon and in Spanish herbolarios «liquid chlorophyll» is sold as detox, a source of «liquid sunshine», anti-age, and an acne remedy. AEMPS does not register it as a medicine; AESAN classifies it as a complemento alimenticio without therapeutic indication. FDA has a single OTC-approved use – internal deodorant for ostomy, ileostomy, and incontinence (21 CFR 357.850, Derifil 100 mg)Chlorophyll (copper-sodium chlorophyllin) is a derivative of the plant pigment, marketed as a superfood and adaptogen for "detox", an energy boost, body-odor control, and general wellness. No convincing benefit has been shown for these claims, and there is no solid evidence base for using it as a superfood or adaptogen. The substance is harmless in this role, but sleep, diet, and adequate water do more for energy and body odor, and persistent complaints are worth checking with a doctor to find the cause.
- DKrill oilNot recommended · Phospholipid-bound omega-3 (EPA and DHA) with astaxanthin from Antarctic krill Euphausia superba, supplementKrill oil is marketed as a superfood and adaptogen, promising more energy, stress resilience, and general wellness from its phospholipid-bound omega-3s. The claims lack support: no good-quality studies confirm a benefit of krill oil as a "superfood" or "adaptogen". The substance itself is harmless in this use. To correct an omega-3 deficit or support heart health, talk to your doctor about approaches with real evidence, such as a diet with oily fish and, when indicated, omega-3 products with proven effects.
- DLion's Mane Mushroom (Hericium erinaceus)Not recommended · Medicinal mushroom; in supplements – dried mycelium or fruiting body of Hericium erinaceus. Marketed on iHerb, Amazon, and in Spanish herbolarios as a «natural nootropic», nerve growth factor (NGF) stimulant, and remedy for dementia, anxiety, and ADHD. AEMPS does not register it as a medicine; AESAN classifies it as a complemento alimenticio without therapeutic indication. FDA has no approved indication.Lion mane (Hericium erinaceus) is an edible mushroom sold as a supplement for memory, focus, and mood under the superfood and adaptogen label. There is no convincing evidence that it improves cognition or eases anxiety in people; the available studies are small and low quality. Memory and attention actually benefit from sleep, physical activity, treating the underlying condition, and keeping blood pressure and glucose in range when they are off. Do not take this mushroom in place of a therapy with proven benefit, since that can mean missing the treatment you need.
- DMacaNot recommended · Botanical supplement, Peruvian maca root (Lepidium meyenii), marketed for male and female sexual functionMaca is the root of a Peruvian plant (Lepidium meyenii), sold as a superfood and adaptogen. In this category it gets promoted for energy, libido, stamina and easing menopausal symptoms. Studies have not shown convincing benefit for these claimed effects: there is no solid evidence base for this use. If low energy, libido problems or menopausal symptoms bother you, a doctor can help pin down the cause and choose an approach with proven benefit. Maca should not be taken in place of treatment with established benefit, so you do not miss out on the care you need.
- DMastic gumNot recommended · Over-the-counter botanical supplement, the resin of Pistacia lentiscus var. Chia (Chios mastic), cultivated on the island of Chios in Greece; marketed for functional dyspepsia and H. pyloriChios mastic is marketed as a «natural antibiotic against H. pylori without side effects», a «Crohn and ulcerative colitis remedy», a «liver detox» and a «gastric cancer drug». These claims are not supported by data. EMA HMPC 2015 recognizes only traditional use for mild dyspepsia and superficial skin inflammation. Small pilot studies in Crohn disease and ulcerative colitis are not confirmed in large RCTs. Maastricht VI 2022 and ECCO 2022 for Crohn disease and ulcerative colitis recommend 5-ASA, corticosteroids, immunosuppressants and biologics – mastic is not mentioned in these guidelines. The «liver detox» concept does not exist in modern physiology. The «natural antibiotic» idea creates a risk that patients drop standard H. pylori eradication and progress to atrophic gastritis with raised gastric cancer risk. AEMPS and AESAN classify mastic as a complemento alimenticio without therapeutic indication. If mastic was bought «instead of standard treatment», discuss the plan with a gastroenterologist – real diagnoses are treated with drugs of proven efficacy.
- DPalmitoylethanolamideNot recommended · Endogenous fatty-acid amide (aliamide); in Italy and Spain registered as a complemento alimenticio and «specialty food for medical purposes» for chronic neuropathic painPEA is marketed as a «magic pill for chronic pain of any kind» – from migraine and fibromyalgia to back pain, endometriosis, post-COVID syndrome and even anxiety and depression. The real evidence base is limited to neuropathic pain with a small effect size and high study bias risk. Systematic reviews outside neuropathic pain (migraine, fibromyalgia, post-COVID) either do not exist or state insufficient data. There is no Cochrane review – the protocol was withdrawn in 2018. EFSA has not approved PEA health claims. There is no EMA HMPC monograph. The «universal analgesic» idea is marketing: different chronic-pain types (nociceptive, neuropathic, nociplastic, central sensitisation) run through different mechanisms and need different targeted therapy. The product sells at 40–80 euro per month – a meaningful cost for a small effect. If PEA was bought instead of seeing a pain specialist for persistent pain, discuss with a doctor – chronic pain needs cause diagnosis (disc herniation, neuropathy, central sensitisation) and targeted treatment.
- DPumpkin seed extractNot recommended · Botanical supplement, pumpkin seed extract (Cucurbita pepo); EMA HMPC traditional-use herbal medicinal product for BPH symptoms and overactive bladder; sold on iHerb and Amazon for «prostate health» and women's «urinary comfort»Pumpkin seed extract is marketed as a «full replacement for urology drugs», «universal prostate cancer protection», «intestinal parasite treatment» and «zinc source for testosterone». The zinc in pumpkin seeds is real (about 7–10 mg per 100 g), but doses in standardised extracts are below daily requirements (RDA 11 mg for men) and no meaningful testosterone effect is described in men with normal plasma zinc. AUA 2023 and EAU 2024 clearly state pumpkin seed extract does not replace prescription alpha-blockers and 5-alpha-reductase inhibitors – the clinical effect is several times smaller. Prostate cancer prevention runs through age- and risk-based PSA screening, not supplements. The antiparasitic effect of pumpkin seeds is real for some helminths (taeniasis, ascariasis) at raw seed doses of 60–300 g, but is not recommended as monotherapy – modern antiparasitics (praziquantel, mebendazole, albendazole) are safer and more effective. If the extract was bought «instead of urology treatment», seek a second opinion – untreated BPH can lead to acute urinary retention and chronic kidney injury.
- DPygeum africanumNot recommended · Botanical supplement, bark extract of African plum (Prunus africana); EMA HMPC traditional-use herbal medicinal product for BPH symptoms; popular iHerb and Amazon «prostate health» categoryPygeum is marketed as a «full natural replacement for finasteride and alpha-blockers», «universal prostate cancer protection», «male-pattern hair loss treatment» and «potency booster». No evidence base supports these claims. Cochrane Wilt 2002 showed a moderate symptomatic effect in BPH, not prostate cancer prevention and not androgenetic alopecia treatment. EAU 2024 and AUA 2023 agree: pygeum does not replace alpha-blockers (tamsulosin reduces IPSS by 4–6 points on average, pygeum by 1–2) and does not replace finasteride (proven prostate volume reduction of 20–25%, pygeum less than 5%). Prostate cancer prevention runs through age- and risk-based PSA screening, not supplements. Male-pattern alopecia is treated with finasteride 1 mg/day or topical minoxidil with proven efficacy. If pygeum was bought as a «replacement for drugs», untreated BPH can lead to acute urinary retention, urinary tract infections and chronic kidney injury – seek a second opinion from a urologist.
- DSea buckthornNot recommended · Herbal preparation, sea buckthorn berries and seeds (Hippophae rhamnoides); in Russia sea buckthorn oil is a registered medicinal product for topical useSea buckthorn is marketed as a superfood and adaptogen, with claims that the berries and oil boost immunity, add energy and help the body handle stress. There's no solid evidence that sea buckthorn supplements do this. Sleep, regular activity and a balanced diet do more for energy and resilience; sea buckthorn itself is harmless as part of your diet.
- FBetaine hydrochlorideNot recommended · Over-the-counter supplement, an acidic salt of betaine (trimethylglycine hydrochloride); marketed as a gastric acid replacement for «low stomach acid»; commonly combined with pepsin on iHerb and AmazonBetaine hydrochloride is marketed as a «universal digestive fix for anyone with heartburn, belching and post-meal heaviness». This concept does not hold. In a subset of patients with true hypochlorhydria (atrophic gastritis after long H. pylori carriage, autoimmune gastritis with parietal cell antibodies, post-gastrectomy state) adding hydrochloric acid is also useless – the problem is not acid quantity at the moment but functional parietal-cell mass, and patients need replacement targeted to the specific deficit: vitamin B12 in intrinsic factor deficiency, iron in anemia, surveillance for metaplasia risk. In most people with «low acid» symptoms, objective pH measurement shows normal or elevated acidity. The marketing test «a spoon of apple cider vinegar provokes heartburn = hypochlorhydria diagnosis» has no diagnostic value. If betaine HCl was bought «for digestion», discuss symptoms with a gastroenterologist – the diagnosis of hypochlorhydria is made by specific tests (gastroscopy with biopsy, parietal cell antibodies, gastrin), not by the reaction to apple cider vinegar.
- FMixed tocopherolsNot recommended · Mixed natural tocopherols with predominance of gamma- and delta-forms (plus alpha- and beta-tocopherol), supplement, marketed as «full-spectrum vitamin E», separate from pure alpha-tocopherolMixed tocopherols on iHerb and Amazon are marketed with claims like «longevity», «full-spectrum vitamin E against cancer», «cardioprotection through gamma-tocopherol» and «prostate defence». These claims collide with the clinical data. The SELECT RCT (Klein, JAMA 2011) in 35 533 men over 50 found that 400 IU/day alpha-tocopherol for 5 years raised prostate cancer risk by 17% (HR 1.17, 95% CI 1.004–1.36) versus placebo. The Miller meta-analysis (Ann Intern Med 2005) in 135 967 patients linked high-dose vitamin E (over 400 IU/day) to increased all-cause mortality. EFSA in 2024 revised the Tolerable UL and confirmed 300 mg/day as the upper safe limit for adults. Mixed tocopherols contain less alpha form than pure preparations but do not abolish the systemic risks of high doses. Evidence for «cancer prevention», «longevity» and «cardioprotection via gamma-tocopherol» from RCTs is absent; SEOM 2023 does not recommend vitamin E supplements for cancer prevention. If mixed tocopherols was bought «for longevity», discuss with a doctor; in non-deficient individuals supplementation harms outweigh benefits.
- FNattokinase (serine protease from fermented soybean natto, Bacillus subtilis var. natto)Not recommended · Serine protease isolated from fermented soy natto. Supplements market it as a «natural blood thinner», «protection against stroke and thrombosis», and a «natural warfarin alternative». Neither AEMPS nor EMA register it as a medicine; AESAN classifies it as a complemento alimenticio without therapeutic indication. FDA has issued no approval and warned manufacturers in 2022 about illegal claims of myocardial infarction and stroke prevention.Nattokinase is often pitched as a «natural blood detox», «vessel cleanser», and a way to «remove fibrin deposits» – especially in anti-ageing and biohacking concepts. The «vessel cleansing by a plant enzyme» idea is physiologically untenable: atherosclerotic plaque is not made of fibrin (which nattokinase might split), but of cholesterol deposits, a fibrous cap, calcium, immune cells, and vascular matrix. These structures are not dissolved by an oral enzyme. Modern atherosclerosis prevention runs on statins, ezetimibe, PCSK9 inhibitors when indicated, and blood-pressure and glucose control. EFSA has not authorised any nattokinase health claim under EC 1924/2006; AESAN through RD 1487/2009 prohibits supplement manufacturers from claiming disease prevention or treatment. FDA issued warning letters to nattokinase manufacturers in 2022 for illegal myocardial-infarction and stroke prevention claims.
- FRoyal jellyNot recommended · Bee product, secretion of pharyngeal glands of worker honeybees (Apis mellifera), supplement with high allergen riskRoyal jelly is marketed as an «anti-aging panacea», «immune booster», «women's hormone product», «vital energy» and «eternal youth of the bee queen». None of these claims is supported by human RCTs. EFSA in 2011 rejected all royal jelly health claims – the Panel concluded that a cause-and-effect relationship between consumption and claimed effects is not established. The «hormone of youth» concept is biologically illiterate: 10-HDA and MRJP have no mammalian receptors and the «queen rejuvenation» effect is an insect-development feature not transferable to humans. The main clinical issue is not lack of benefit but real allergy risk: royal proteins cause severe IgE-mediated reactions with reported deaths from anaphylaxis and severe asthma (Thien 1996, Leung 1997). If royal jelly was bought for «general health», discuss with a doctor; the risk outweighs any hypothetical benefit.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit