Adrenal Health

Today, stress is being acknowledged as a contributing factor in chronic disease. It is not coincidental
that prescription drugs for stress-related ailments such as ulcers, hypertension, depression and anxiety
are at the top of the list of best-selling drugs in America. Natural health practitioners clearly recognize
interventions that can assist the body in restoring and maintaining its built-in resistance mechanisms.
Stress can be physical, environmental, sensory or emotional. Our bodies respond to stress through the
release of chemicals into the blood by the adrenal glands. A surge of adrenaline, norepinephrine,
cortisol and DHEA, triggered by the sympathetic nervous system, induces Phase 1, an acute alarm
phase mechanism to super-charge the mind and body for a short-term fight or flight response. The
physiological changes these hormones stimulate return to normal levels after the stressor is no longer
But in modern society, the physiological responses often continue due to perpetual stress sustaining
glucocorticoid levels, particularly cortisol, in our blood. Coping mechanisms help to keep us buoyant
through an ongoing resistance phase, regarded as Phase 2. In this hyperadrenal state, we become
sympathetic dominant and our level of cortisol remains elevated, while DHEA levels decline.
Symptoms such as irritability, anxiety, fatigue, sleep onset insomnia, low libido, frequent yawning,
sweet cravings, low back pain in the adrenal area, muscle tension, digestive dysfunction, IBS, low basal
temperature and impaired immunity are among the common presentations. Cortisol causes blood
pressure and blood sugar to rise and in prolonged stages also reduces thyroid function and
immunological responses.
If the stress levels persevere, the adrenals do not get a chance to recover and adrenal depletion enters
Phase 3, the exhaustion phase, although there is still a period of resistance before the decline reaches
clinical adrenal exhaustion. During this phase both cortisol and DHEA levels are low and the person
enters parasympathetic dominance. Symptoms of this stage are malaise, low mood, sleep maintenance
insomnia (due to erratic cortisol surges) memory and cognitive challenges as well as a higher incidence
of chronic conditions, such as fibromyalgia, autoimmune disorders and chronic fatigue syndrome.
Clinical signs include possible hyperpigmentation in skin creases, Raglan’s sign (postural hypotension)
and unstable capillary reflex (upon exposure to light the pupil will dilate and quiver before constricting).
Adrenal crisis may occur if adrenal function lapses below the resistance threshold and the adrenals fail
to produce essential hormones. The medical term for this condition is Adrenal Insufficiency.
INTERVENTION STRATEGIES –Key actions and herbs:
ADAPTOGENS conserve adaptation energy. They increase the body’s resistance to physical,
emotional, environmental or biologic stressors and promote normal physiologic functions. Key
adaptogens are Eleuthero, Ashwaganda (aka Withania) and Rhodiola. Astragalus, Gotu Kola, Korean
Ginseng, Schisandra, Shatavari are also classified as herbal adaptogens.
ADRENAL TONICS support and restore the adrenal cortex. They improve the tone, histology, and
function of the adrenals. Licorice and Rehmannia are the key adrenal tonic herbs.
TONICS increase or release adaptation energy. They improve vitality of the whole body.
Korean Ginseng, Rhodiola and Ashwaganda are key herbal tonics. Other tonic herbs include
Astragalus, Codonopsis, Damiana, Ganoderma (immune tonic), Oat Seed, Shatavari and Tribulus.
NERVINE TONICS relax and energize the nervous system. Bacopa, Damiana, Gotu Kola, Motherwort,
Oat Seed, Schisandra, Skullcap and St. John’s Wort are herbs with nervine tonic properties.
Educational Information Compiled by Linda Ryan for MediHerb® ©2009 Not for Public Distribution
Formula combining the key adrenal tonic herbs, Licorice and Rehmannia.
Dosage – 1 tablet 2 to 3 times per day.
 Both herbs in this formula aid in the recuperation of the adrenal cortex. Licorice does not
stimulate the production of cortisol at the adrenal level. This is an important distinction, as this herb
is indicated if someone has high cortisol levels as well as for someone with low cortisol.
Overproduction of cortisol overtaxes the adrenals and Licorice protects, preserves and restores
adrenal balance in these cases. Where cortisol production is low, Licorice acts to extend the body’s
use of its own cortisol, thus reducing the adrenal workload and allowing adrenal recuperation.
 Rehmannia supports recovery of the adrenal cortex cells. It is known that the use of synthetic
glucocorticoid drugs cause adrenal cortex cells to shrink due to the negative feedback through the
HPA axis - as the adrenal cortex ‘is instructed’ to shut down production of the glucocorticoids, its
cells atrophy. Experimental models suggest that Rehmannia prevents and reverses these cellular
changes, possibly by inhibiting the negative feedback from the glucocorticoid to the pituitary gland.
 Rehmannia is used in China for immune modulation, particularly in autoimmune conditions.
 This is an excellent formula to assist a person weaning off of exogenous corticosteroids.
Ashwaganda, Licorice, Skullcap and Korean Ginseng
Dosage – 1 tablet 3 times per day
Actions: Tonic, Adrenal tonic, Adaptogenic, Nervine tonic
For the person with characteristics of adrenal depletion and adrenal dysfunction, such as chronic
fatigue syndrome, fibromyalgia and other chronic presentations.
Indicated for people who are ‘wound up and run down’ at the same time
Combines well with Adrenal Complex tablets
Dosage – 1 to 2 tablets 1 to 2 times per day
Actions: Adaptogenic and Tonic
To prevent adrenal depletion in the person with a busy life that is under constant stress
Promotes energy and stamina to improve physical and cognitive performance
Best used with Adrenal Complex tablets
Astragalus, Echinacea and Eleuthero
Dosage – 1 tablet 3 to 4 times per day
Actions: Immune enhancing, tonic, adaptogenic, anti-inflammatory
Traditionally used in Chinese Herbal Medicine as a tonic for building blood and vitality.
Especially indicated where there is immune depletion and is specific for chronic conditions
Dosage – 1 tablet 3 times per day
The most researched adaptogen. Also provides immune support for chronic conditions
Keeps the healthy person healthy! Best to recommend to the patient before they get to the stage
where they need Rhodiola & Ginseng and Astragalus Complex.
Can be used daily long-term (as in years).
- Cognitive support – Ginkgo 2000 mg tablets (3 to 4 per day) and/or Bacopa Complex (3 per day)
- Nervous system support – Nevaton tablets (3 to 4 per day) or St. Johns Wort tablets (3 to 4 per day)
- Sleep aid and to reduce muscle tension– Valerian Complex tablets (3 to 4 per day)
- Thyroid Support – Thyroid Complex tablets (2 to 3 per day)
Educational Information Compiled by Linda Ryan for MediHerb® ©2009 Not for Public Distribution