Herbs and Supplements to Improve Adrenal Fatigue - DrJockers.com

Herbs and Supplements to Improve Adrenal Fatigue

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Supplements To Improve Adrenal Fatigue

The adrenal glands house over 50 hormones that are used to help us adapt to stress, reproduce and heal.  When our body perceives a threat, a region of the brain called the hypothalamic-pituitary gland signals to the adrenal glands to pump out stress hormones such as cortisol, epinephrine and norepinephrine.  This is a normal and natural response that is life saving and allows us to do things like exercise, play sports, dance and have fun.

There are certain nutrients the body needs in order to produce efficient amounts of adrenal hormones.  When we are under a lot of stress, we deplete these nutrients in order to produce adrenal hormones and metabolic energy.

Overtime, when we are exposed to chronic stress, our hypothalamic-pituitary-adrenal (HPA) axis becomes unable to effectively produce the adrenal hormones and metabolic energy we need to keep up with our demands.  This results in adrenal exhaustion and body burn-out.

The following nutrients will help you adapt more effectively to stress, take the pressure off of your adrenal glands and give you more stamina and a stronger resistance to developing adrenal fatigue and adrenal exhaustion.  Here are the most important herbs and supplements to improve adrenal fatigue.

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Key Nutrients Needed:

There are other nutrients such as using mitochondrial support with things like CoQ10, Alpha lipoic acid, N-Acetyl Cysteine, Acetyl-L-Carnitine that can be very helpful for adrenal function as well.

Additionally, anti-oxidant compounds that help to reduce inflammation in the body will cross-over and have a mild effect at improving adrenal function as well.  However, I am focusing on the most important and widely recognized nutrients and support supplements for adrenal health.

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Vitamin B5: Panthothenic Acid

This nutrient is key for the production of Coenzyme A (CoA).  This is one of the most important molecules needed to sustain life.  CoA is a critical player in energy metabolism, and works to allow carbohydrates, fats and proteins to be used as fuel sources.

B5 is also necessary for the production of the stress hormone cortisol and the sex hormones estrogen and testosterone.  Individuals who have adrenal fatigue are often depleting their B5 levels in order to produce cortisol and need to supplement in order to continue to produce cortisol and avoid adrenal exhaustion (1).

Additionally, they will need B5 in order to support mitochondrial energy production and healthy sex hormone levels.  I will start clients on dosages ranging from 50-100 mg – 2x daily.

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Vitamin B6:  Pyridoxine

Vitamin B6 is a major nutrient for the production of the neurotransmitters serotonin and dopamine which play a large role in mood, sleep, energy and mental drive.  Additionally, B6 is a key part of the bodies ability to manufacture the stress hormones norepinephrine and epinephrine.

B6 is important for the balancing of sodium and potassium around every cell in the body and promoting red blood cell maturation and oxygen delivery to the cells of the body.  B6 is commonly used to help individuals with depression, anxiety and hormonal imbalances (2).

I start clients on dosages ranging from 25-100 mg – 2x daily.

Vitamin C:

This anti-oxidant is directly involved with the production of cortisol in the adrenal cortex.  In addition, it boosts the immune system and protects the adrenal tissue from excessive oxidative stress involved with heavy adrenal hormone production.

Studies have shown that vitamin C helps to modulate the levels of cortisol, epinephrine and norepinephrine in the blood stream (3).

I will start clients with 500-1000 mg – 2x daily in a buffered form in combination with an equivalent amount of citrus bioflavonoids which enhance the utilization of the vitamin C.

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Magnesium: 

Magnesium is one of the most used minerals in our body.  We need roughly 1000 mgs/day for a healthy and active individual to keep up with the demands of the body.  If you are under more stress, you will need 1500-2000 mgs per day.  Magnesium’s importance to the body is compared to oil for a car engine.  Without it, we will sputter on fumes.

Roughly 68% of society does not consume the RDA level and many researchers believe that roughly 80% of Americans are consuming too little (4, 5).  Insufficient magnesium causes the body to struggle to utilize proteins and enzymes including producing neurotransmitters and hormones (such as cortisol, epinephrine, etc.).  In addition, the body is unable to methylate and detoxifiy or utilize anti-oxidants such as vitamin C.

I start my clients on dosages ranging from 200-400 mg – 2-3x daily.  I have seen this make a HUGE difference in energy, sleep, mood and creativity.

Trace Minerals: 

When we are in a state of adrenal fatigue, our physiological processes are moving fast and using up raw materials.  This depletes key electrolytes and other minerals.

You can certainly supplement with trace minerals, but I recommend consuming sea vegetables such as dulse, nori and kelp.  Additionally, consuming bone broth and soups and stews made with bone broth is excellent.  Some veggies have a high amount of trace minerals such as celery and cucumbers.

I also recommend having pink salts such as Himalayan sea salt which has 84 trace minerals.  Using a lot of good salts and good water is very important for someone dealing with adrenal fatigue.

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Probiotics: 

Adrenal fatigue is typically associated with a bad bacterial balance in the gut, called dysbiosis.  When we are under chronic stress, we create an internal environment that favors the overgrowth of bad microbes and we are unable to heal the gut lining (6).

Probiotic supplements help to create balance in the microbiome, heal leaky gut and reduce stress on the body.  I start my clients with the most powerful, research validated strains such as lactobacillus acidophilus and plantarum as well as Bifidobacterium longum and lactis.  I will have clients take 30-100 billion CFU’s daily away from meals to restore microbial harmony.

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Herbal Adaptogens:

There are a specific group of plants with unique characteristics that are called adaptogenic herbs.  These herbs help to coordinate how our body adapts to stress by modulating the utilization of our stress hormones (78).

Adaptogens have adapted themselves over thousands of years of weathering extreme environmental stressors.  Many of these grow in the mountains and in areas of extreme temperature ranges.

Rhodiola, as an example, grows in the some of the coldest regions in the world, including Siberia, Artic regions and the Appalachian mountains in the Northeastern United States.  It is also found in Scandinavia, Iceland the mountains regions of Europe and Asia.

Mountains are known to face both extreme cold at night and extreme heat (due to their closer proximity to the sun) during the middle of the day.  Plants like rhodiola and many other adaptogens have evolved to take on an array of anti-oxidant compounds that help them survive such harsh environmental conditions.

These herbs pass these beneficial anti-oxidant compounds onto us when we consume them.  Not only do these compounds reduce oxidative stress, but they also help to promote physiological homeostasis by improving our HPA axis.

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Adaptogenic herbs include Panex ginsengashwaghandarhodiolacordyceps, astragalus, holy basil, Siberian ginseng (Eleuthero root) and maca as well as others.  Start with small doses of these and gradually go up.

I typically will recommend these herbs in the morning and mid-afternoon for most people.  Some adaptogens work well for reducing a high evening cortisol.  Ashwaghanda in particular is good for this.  Lemon Balm and lavender have adaptogenic qualities that also help to reduce higher evening cortisol and adrenaline levels.

Many of the other herbs such as cordyceps, rhodiola and ginseng are better at increasing your energy and mental clarity.  If you take them at night they could possibly keep you up.  These are great in the morning and mid-day or mid-afternoon.

Just like anything else, you may notice that you respond better to certain adaptogenic herbs better than others.  If you notice the herbs make you more tired and inflamed during the day or stimulate you at night than it may be best to avoid them as you may be having a stress response to the herb itself.

Here is how I recommend using these herbs.

Ashwaghanda: Begin with 400mg – 1x per day and if you feel good using it you can gradually go up to 400-800 mg – 2x per day

Astragalus:  Begin with 500mg – 1x per day and if you feel good using it you can gradually go up to 500 mg – 1000mg – 2x per day

Cordyceps:  Begin with 400mg – 1x per day and if you feel good you can gradually go up to 400-800 mg – 2x per day

Panex Ginseng:  Begin with 200mg – 1x per day and if you feel good you can gradually go up to 400mg – 2x per day 

Holy Basil:  Begin with 300mg – 1x per day and if you feel good you can gradually go up to 300-600mg, 1-2x per day

Maca:  Begin with 1.5g -1x daily and if you feel good you can gradually go up to 1.5-3.0 grams – 2x daily. 

Rhodiola:  Begin with 100mg -1x per day and if you feel good than go up to 100-200 mg – 2x per day

Siberian Ginseng:  Begin with 100mg -1x per day and if you feel good you can gradually go up to 200 mg – 2x per day

For good sleep at night, I recommend diffusing lavender, chamomile or lemon balm (or some combination of all of these), beginning about an hour or two before bed.  You can also put these in a bath and soak with Magnesium salts to help restore the adrenals and lower stress hormone production.

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Licorice Root:

This herb, primarily the glycrrhizinate portion, helps to raise up cortisol and and aldosterone levels (9).  This is only recommended in cases of low cortisol and hypotension.  If one has hypertension, than they should avoid licorice root so as to not raise up aldosterone too high.

There is another form of licorice root called deglycrrhizinated licorice root (DGL) that has the glycrrhizinated portion removed.  This is used to help reduce H Pylori and other pathogenic bacteria and to soothe the stomach and intestinal membranes.

To support the adrenals however, we are looking for low doses of licorice root with the glycrrhizinated portion still in tact.  I recommend this in 35mg droplets such as in this product here.  Take 1-2 droplets at times when cortisol is low throughout the day.

Adrenal Glandulars:

These are specific adrenal supplements that are made up of adrenal gland tissue from either porcine or bovine (pig or cow).  Some of these supplements use the whole adrenal gland while others only use the outer cortex.

This can be an excellent overall supplement to help restore adrenal function as the glandulars are rich in mitochondrial support nutrients such as CoQ10, L carnitine, glutathione precursers, B vitamins and amino acids necessary for good adrenal function.

It is often good to look for supplements that also have pituitary and hypothalamamic glandulars as well to support the entire HPA axis.  Dr Wilson’s formula here is the best I have found.

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Amino Acids:

Certain amino acids can be very helpful for individuals with adrenal fatigue.  Amino acids are best taken 30 minutes before a meal or 2 hours after a meal.  This reduces competition with other amino acids from the meal that was consumed.

Here are the most commonly used amino acids for HPA dysfunction and adrenal fatigue:

L-Tyrosine: 

This is an amino acid that is a precursor to the production of cortisol, dopamine, norepinephrine and epinephrine.  For someone with low cortisol, using tyrosine may be helpful in the production.  This should not used by someone with high cortisol as it will help produce more.

If you choose to supplement with this, you should look for an improvement in focus and concentration.  Begin with 100mg, 1 time and if you don’t notice anything or feel good with it, you can gradually bump this up going up 200 mg and ramp up to 500 mg max.

You can spread this out and take dosages 2-4 times daily.  If you are feeling good with 500 mg, you can take that several times daily as well.  If you notice anxiety, worsensing fatigue and/or irritability, than drop the dosage down.

L-Taurine:

This is a neuroprotective amino acid that works to help maintain cell stability.  It also has anti-oxidant activity and supplementation has been shown to increase the inhibitory neurotransmitter in the brain called GABA.

This should help improve sleep, mood, calmness and relaxation.  Begin with 300 mg – 1x daily and you can ramp up to 1500 mg – 1-2x daily max.  The safe upper limit without side effects is 3 grams daily.

5-HTP:

5-HTP (5-hydroxytryptophan) is a precursor to the neurotransmitter serotonin.  It is easily absorbed in the intestines and has been shown to easily cross the blood brain barrier (10).

Serotonin is important for a number of brain activities, influences norepinephrine and dopamine, regulates mood and behavior, including food cravings.  The use of 5-HTP has been shown to help improve a sense of calm and relaxation (11).

Serotonin in our brain helps us to feel good and calm, but also it is a precursor to the sleep hormone melatonin.  Using 5-HTP supplementation for someone that needs this, should help that individual have improved mood and energy and sleep better. This shouldn’t be taken by anyone who is currently using an SSRI type of anti-depressant.

If the individual is struggling with insomnia than follow this protocol.  I typically begin with 50-100 mg at night before bed.  From that point, if the individual is still not sleeping well, than try increasing the dosage by 50 mg every week until good sleep is attained or you reach the maximum 500 mg.  Overtime, as the adrenals get better, you should be able to reduce the dosage.

L-Theanine: 

This amino acid helps to modulate the HPA axis in such as way as to dampen excitatory neurotransmitter and alpha brain wave activity.  This results in relaxation support and improved sleep quality (121314).

Using 100 mg as a standard dosage is usually effective and tittering up by 50 mg each week if necessary to a maximal 500 mg can be done if necessary.

GABA:

GABA (gamma-aminobutyric acid) is an important inhibitory neurotransmitter found in 30% to 40% of the brain synapses. It helps calm the brain by neutralizing the excitatory effects of glutamate.

Research suggests that GABA supplementation or optimal GABA function in the brain positively affects neurological health, the body’s response to stress, mood, alpha and beta brain waves and sleep (1516).

This can be great for someone with anxiety and insomnia in particular.  It is said not to be able to cross the blood brain barrier in a healthy individual, but people with adrenal fatigue will have greater permeability in their blood brain barrier and will take up and respond to GABA.

Begin with 100 mg and gradually go up by 50mg per week if needed to a maximum dosage of 500 mg.  The key is to find the right dosage that you feel best with.

A great overall supplement I use that has a combination of these amino acids is Mood Protect here

Phosphytidylserine:

This compound is great at improving hypothalamic-pituitary function.  This is the key regulator in the HPA axis and it improves the feedback between the brain and the adrenals (17).  You can take up to 600-800 mg orally as a highly effective dosage or do a topical application that crosses into the bloodstream transdermally.

I personally like to support the HPA axis with a combination supplement that uses a smaller dosage of phosphytidylserine and mitochondrial support with CoQ10, alpha lipoic acid, Acetyl L-carnitine and N-Acetyl Cysteine.  This product has helped me and many of my clients dramatically improve adrenal health and mental energy.

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Hormones:

I don’t use hormone replacement with my clients and would rather focus on addressing major deficiencies, reducing toxicities and supporting the bodies healing process.  With that said, there is a time and place for adrenal hormone support in the form of small doses of pregnenolone and DHEA.  However, please don’t use them without the supervision of a qualified medical professional.

Pregnenolone: 

This is the major precursor to many of the key hormones that are produced by the adrenal glands.  The normal dosage is 25mg, spread into 2 dosages.  This is contraindicated in cases of hyperthyroidism and should never be taken after 6pm as it blocks GABA production and can lead to insomnia.

Warning signs of too much pregnenolone can include heart arrhythmia’s including palpitations or abnormal heart rhythms, insomnia and/or headaches.  If you have any of these while taking pregnenolone, than be sure to consult with your functional health practitioner.

The pregnenolone product I recommend for clients can be found here

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DHEA: 

This another precursor hormone for the production of both stress and sex hormones.  Using this can be very helpful, but tittering the dosage can take clinical skill.  The average adult dosage is typically between 10-25 mg but may start as small as 5mg.

DHEA is the precursor to the sex hormones testosterone and estrogen.  If the individual has liver stress, methylation problems and/or a history of sex organ cancer such as breast, uterine, ovarian or prostate than it be best to avoid DHEA supplementation.

Starting with small doses is key as some women will turn DHEA into testosterone and increase their risk of Polycystic ovarian syndrome.   Some men with elevated aromatase enzymes will turn this into estrogen.  This is one reason why it is important to have a functional health practicioner trained in the use of these bioidentical hormones before starting usage.

Warning signs of poor DHEA utilization would include abnormal heart rhythms, increased blood pressure, insomnia, facial hair or hair loss.  If you have any of these while using DHEA, immediately consult with your functional health practicioner.  The DHEA product I recommend for clients can be found here

Summary:

There is a wide variety of key nutrients and compounds to support adrenal hormone and neurotransmitter production and the overall health of the HPA axis.  Some of these nutrients you can begin supplementing with immediately, while others should only be used with the care of a trained practitioner.

Sources For This Article Include:

  1. Jaroenporn S, Yamamoto T, Itabashi A, Nakamura K, Azumano I, Watanabe G, Taya K. Effects of pantothenic acid supplementation on adrenal steroid secretion from male rats. Biol Pharm Bull. 2008 Jun;31(6):1205-8. PMID: 18520055
  2. Hvas AM, Juul S, Bech P, Nexø E. Vitamin B6 level is associated with symptoms of depression. Psychother Psychosom. 2004 Nov-Dec;73(6):340-3. PMID: 15479988
  3. Influence of Vitamin C Supplementation on Cytokine Changes Following an Ultramarathon Link Here
  4. King DE, Mainous AG 3rd, Geesey ME, Woolson RF. Dietary magnesium and C-reactive protein levels. J Am Coll Nutr. 2005 Jun;24(3):166-71. PMID: 15930481
  5. Magnesium – National Institutes of Health Link Here
  6. Eutamene H, Bueno L. Role of probiotics in correcting abnormalities of colonic flora induced by stress. Gut. 2007;56(11):1495-1497.
  7. Panossian A, Wikman G. Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity. Curr Clin Pharmacol. 2009 Sep;4(3):198-219. PMID: 19500070
  8. Panossian AG. Adaptogens in mental and behavioral disorders. Psychiatr Clin North Am. 2013 Mar;36(1):49-64. PMID: 23538076
  9. Omar HR, Komarova I, El-Ghonemi M, et al. Licorice abuse: time to send a warning message. Therapeutic Advances in Endocrinology and Metabolism. 2012;3(4):125-138.
  10. Birdsall TC. 5-Hydroxytryptophan: a clinically-effective serotonin precursor. Altern Med Rev. 1998 Aug;3(4):271-80. PMID: 9727088
  11. Turner EH, Loftis JM, Blackwell AD. Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophan. Pharmacol Ther. 2006 Mar;109(3):325-38. PMID: 16023217
  12. Di X, Yan J, Zhao Y, Zhang J, Shi Z, Chang Y, Zhao B. L-theanine protects the APP (Swedish mutation) transgenic SH-SY5Y cell against glutamate-induced excitotoxicity via inhibition of the NMDA receptor pathway. Neuroscience. 2010 Jul 14;168(3):778-86. PMID: 20416364
  13. Yamada T, Terashima T, Okubo T, Juneja LR, Yokogoshi H. Effects of theanine, r-glutamylethylamide, on neurotransmitter release and its relationship with glutamic acid neurotransmission. Nutr Neurosci. 2005 Aug;8(4):219-26. PMID: 16493792
  14. Nobre AC, Rao A, Owen GN. L-theanine, a natural constituent in tea, and its effect on mental state. Asia Pac J Clin Nutr. 2008;17 Suppl 1:167-8. PMID: 18296328
  15. Fatemi SH, Folsom TD, Thuras PD. Deficits in GABA(B) receptor system in schizophrenia and mood disorders: a postmortem study. Schizophr Res. 2011 May;128(1-3):37-43. PMID: 21303731
  16. Mombereau C, Kaupmann K, Froestl W, Sansig G, van der Putten H, Cryan JF. Genetic and pharmacological evidence of a role for GABA(B) receptors in the modulation of anxiety- and antidepressant-like behavior. Neuropsychopharmacology. 2004 Jun;29(6):1050-62. PMID: 15039762
  17. Monteleone P, Maj M, Beinat L, Natale M, Kemali D. Blunting by chronic phosphatidylserine administration of the stress-induced activation of the hypothalamo-pituitary-adrenal axis in healthy men. Eur J Clin Pharmacol. 1992;42(4):385-8. PMID: 1325348

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5 Responses to Herbs and Supplements to Improve Adrenal Fatigue

  1. Josh Finlay September 6, 2016 at 7:25 am #

    Hi David, Do you not find the studies linking chronic carbohydrate restriction with HPA axis dysfunction alarming?
    Thanks
    Josh

    • Dr. Jockers September 6, 2016 at 7:29 am #

      Hey Josh, this is why we recommend a cyclical ketogenic approach. It works very good for individuals with adrenal fatigue.

  2. Clelia Ibello November 15, 2016 at 2:23 pm #

    Dr David
    In 2008 had nephrectomy of left kidney do to cancer. My right kidney is at 62% function. Is it a good idea to be on keto way of life? I am 79 and over weight, like very much to loose many pounds. I have been on keto from Oct 1st. My weight goes up and done. I measured with keto stick and Am on moderate ketosis. The reason I started keto not only to shad pounds, but my knees started to hurt starting this may 2016. I am enthusiastic watching your tape.

    • Dr. Jockers November 18, 2016 at 5:39 am #

      Sorry to hear about your history Clelia! Praying for you to get great results with keto!

  3. Karen Cann April 10, 2017 at 4:32 am #

    Have you ever use standard process products with your patients?

    Dr. Karen Cann

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