Optimal DX Optimal Guide to Adrenal Support

Your adrenal glands produce hormones such as cortisol, DHEA, epinephrine, and norepinephrine that help you cope with stress.

Extreme or chronic stress can lead to burnout, fatigue, and exhaustion. In this case, your adrenal glands may not be able to respond as effectively as they should.

In the “exhaustion” phase, insufficiency of adrenal hormones can lead to extreme fatigue, weakness, insomnia, anxiety, and depression. If adrenal insufficiency advances to the pathological stage, low blood pressure, dizziness upon standing, craving for salt, and even nausea and vomiting can occur.

You can help reduce the effects of adrenal exhaustion by adopting healthy coping strategies, positive lifestyle changes, and nutrition habits that help you thrive, not just survive.

Lifestyle

• Slow down and take the time you need for self-care.
• Include quiet time and relaxation as part of your daily routine.
• Incorporate deep breathing, gentle stretching, and walking daily.
• Add moderate-intensity exercise into your routine as soon as you feel able.
• Get the sleep you need to rest and repair. Most people need 6-8 hours of quality sleep per night.
• Minimize stressors or, if able, remove yourself from a stressful situation.
• Avoid physical stressors such as allergies, environmental toxins, smoking, excess alcohol, hormone imbalances, and a “fast food” lifestyle.

Nutrition

• Maintain a healthy weight.
• Adopt a healthy diet that contains an abundance of fresh vegetables and whole fruits along with whole grains, legumes, nuts, seeds, herbs, spices, quality protein, and healthy fats.
• Fill up your plate and lunch box with fresh vegetables and fruits, and high-quality protein.
• Minimize highly processed nutrient-deficient foods.
• Hydrate adequately with purified mineral-rich water.
• Adequate intake of specific nutrients, including bioactive B vitamins, vitamin C, vitamin D, magnesium, zinc, and omega-3 fatty acids, is crucial to adrenal function.
• Herbal medicine may be appropriate as well including ashwagandha, ginseng, rhodiola, and schisandra.
• Low doses of DHEA and pregnenolone may be supportive as well.

Supportive Supplements

Adaptogens

Adaptogen is a term applied to herbs that have a normalizing effect on physiology and encourage non-specific resistance to stressors.(Anderson 2008) They are associated with improving the body’s ability to adapt to stress and normalize metabolic functions.(Todorova 2021)

Ashwagandha (Withania somnifera) 250 mg of standardized extract once or twice daily (Stengler 2016)

• Extract doses can range from 225 to 1,250 mg per day for 6 to 8 weeks to reduce feelings of stress and anxiety and to decreased fatigue, sleeplessness, and stress hormone levels (Office of Dietary Supplements 2023; Abedon 2008; Lopresti 2019).
• Whole root granules of 12,000 mg/day (equivalent to 6,000 mg of root powder) have also been used (Office of Dietary Supplements 2023).

• Demonstrated effects on stress-induced fatigue, immune changes, and corticosterone elevations in an animal model of stress (Kimura 2004).
• Improvements in some aspects of mental health and social functioning in elderly after 4 weeks of 300 mg dried extract per day (Cicero 2004).

• Supplementation associated with improvements in Perceived Stress Scale and Profile of Mood States, Athens Insomnia Scale scores; buffered stress response to Maastricht Acute Stress Test; lower salivary cortisol, amylase, blood pressure, and subjective stress ratings (Lopresti 2022).

Rhodiola rosea 200 mg/d standardized extract standardized (Anghelescu 2018)

• A standardized extract (200 mg per day for 12 weeks) improved performance speed and task accuracy in situations of simulated multi-tasking (Heldmann 2016).
• Supplementation of 170 mg/d of extract containing approximately 4.5 mg salidroside for 14 days reduced fatigue in under stressful conditions (Darbinyan 2000).
• In a review of literature, doses of 200 mg/d of a standardized extract helps normalize the release of stress hormones while boosting energy metabolism (Anghelescu 2018).

B-complex vitamins

50 to 100 mg/d (Stengler 2016)

• B vitamins are required for steroid biosynthesis in the adrenal cortex (Anderson 2008).

Note: High levels of B6 may have neurological side effects; use under the guidance of a health professional.

Antioxidants:

Vit C – 1000 mg two to three times daily (Stengler 2016); Vit E (as RRR-α-tocopherol) – 150 mg/d

• Vitamins C and E help protect the adrenals from free radical damage for optimal functioning (Anderson 2008).
• Vitamin E alleviated adverse effects of immobilization stress in an animal model (Asir 2022)

Licorice root

500 mg two to three times daily (Stengler 2016)

• May increase cortisol levels by inhibiting an enzyme that converts cortisol into cortisone effects (Omar 2012).

Note: Must be used with caution and oversight due to hypertensive effects; use under the guidance of a health professional.

Optimal Takeaways

Identify stressors

• Take an inventory of the stressors in your life and decide what can stay and what must go
• Anticipate and plan for the stress that you can’t control…how you react to stress makes all the difference in how it will affect you.

Assess current lifestyle habits

• Are you putting aside time for self-care?
• Do you get enough sleep?
• How much general physical activity (housework, gardening, climbing stairs instead of taking the elevator, etc.) as well as structured exercise (e.g., aerobics, exercise classes, weightlifting, etc.) do you get?
• Can you put aside 15-20 minutes per day for relaxation and deep breathing exercises?

Adopt healthy eating habits

• Plan ahead and sit down for healthy well-balanced meals.
• Plan for nutrient-dense snacks that you can take on the road or have available in the fridge.
• Be sure to consume no fewer than 5 servings of fresh fruits and vegetables daily, an abundance of other plant-based foods, and healthy protein and fat sources.
• Take a few deep breaths before meals to promote a “rest and digest” mode.
• Focus on what you eat and choose to eat without outside distractions such as television, computers, and other screens.

References

Abedon, Bruce et al. "A standardized Withania somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study." JANA 11 (2008): 50-56.

Anderson, D. “Assessment and nutraceutical management of stress-induced adrenal dysfunction.” Integrative Medicine 7.5 (2008): 18-25.

Anghelescu, Ion-George, et al. "Stress management and the role of Rhodiola rosea: a review." International Journal of Psychiatry in Clinical Practice 22.4 (2018): 242-252.

Aşır, F., Y. Nergiz, and A. Pala. "Vitamin E protected the mouse adrenal gland against immobilization stress." Polish Journal of Veterinary Sciences (2022): 447-454.

Cicero, Arrigo Francesco Giuseppe, et al. "Effects of Siberian ginseng (Eleutherococcus senticosus maxim.) on elderly quality of life: a randomized clinical trial." Archives of Gerontology and Geriatrics 38 (2004): 69-74.

Fact sheet for health professionals. Ashwagandha: Is it helpful for stress, anxiety, or sleep? National Institutes of Health Office of Dietary Supplements. Accessed June 18, 2024. https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/

Geiker, N R W et al. “Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa?.” Obesity reviews : an official journal of the International Association for the Study of Obesity vol. 19,1 (2018): 81-97. doi:10.1111/obr.12603

Heldmann, M., et al. "EP 116. Impact of Rhodiola Rosea extract WS1375 on electrophysiological correlates of attention allocation in a dual task paradigm." Clinical Neurophysiology 127.9 (2016): e290.

Kimura, Yoshiyuki, and Maho Sumiyoshi. "Effects of various Eleutherococcus senticosus cortex on swimming time, natural killer activity and corticosterone level in forced swimming stressed mice." Journal of Ethnopharmacology 95.2-3 (2004): 447-453.

Lopresti, Adrian L et al. “An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study.” Medicine vol. 98,37 (2019): e17186. doi:10.1097/MD.0000000000017186

Lopresti, Adrian L et al. “A randomized, double-blind, placebo-controlled trial investigating the effects of an Ocimum tenuiflorum (Holy Basil) extract (Holixer™) on stress, mood, and sleep in adults experiencing stress.” Frontiers in Nutrition vol. 9 965130. 2 Sep. 2022, doi:10.3389/fnut.2022.965130

Omar, Hesham R et al. “Licorice abuse: time to send a warning message.” Therapeutic advances in endocrinology and metabolism vol. 3,4 (2012): 125-38. doi:10.1177/2042018812454322

Murray, Michael T., and Joseph Pizzorno. The encyclopedia of natural medicine third edition. Simon and Schuster, 2012.

Noland, Diana, Jeanne A. Drisko, and Leigh Wagner, eds. Integrative and functional medical nutrition therapy: principles and practices. Springer Nature, 2020.

NIH NICHD. What are the symptoms of adrenal gland disorders? https://www.nichd.nih.gov/health/topics/adrenalgland/conditioninfo/symptoms

Stengler M, et al. Prescription for Natural Cures: A Self-care Guide for Treating Health Problems With Natural Remedies Including Diet, Nutrition, Supplements, and Other Holistic Methods. Third ed. Turner Publishing Co, 2016.

Todorova, Velislava et al. "Plant adaptogens—History and future perspectives." Nutrients, 13.8 (2021): 2861.