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Adrenal adaptogens are one of the most commonly prescribed supplements by functional medicine practitioners due to the impact of chronic stress on the majority of sick patients. Stress breaks your body down in every way imaginable so mitigating the negative effects of stress is priority number one in most patients.
I’ve been using adrenal adaptogens in my practice for over 15 years now and I’d like to share my favorite adrenal adaptogens that may help you feel better. Adrenal adaptogens can cause negative reactions in some patients so do not take any of these without proper evaluation from a healthcare practitioner to avoid side effects.
What is an adrenal adaptogen?
An adaptogen has “non-specific” activity and acts by increasing resistance of the organism to a broad spectrum of adverse biological, chemical, and physical factors. Adaptogens act by regulating and normalizing organ and system function in the body. Adaptogens work primarily by affecting the Hypothalamic-Pituitary-Adrenal (HPA) axis and the autonomic nervous system. Thus, adaptogens modulate our response to stress (physical, environmental, or emotional) and help regulate the interconnected endocrine, immune, and nervous systems.
Your adrenal glands produce cortisol and adrenaline which make you more susceptible to infections and weaken the immune system. Adaptogens can help with infections through immune-building properties over time.
Adrenal adaptogen myths
Adrenal adaptogens do not increase cortisol levels above that of normal physiologic levels. Adrenal adaptogens do not lower cortisol levels below that of normal physiologic levels. Adrenal adaptogens will only help to normalize levels that may be too high or too low.
“Adrenal fatigue” does not exist based on the most recent scientific evidence. There is no doubt that adrenal gland and HPA-axis dysfunction exists but not in the way that adrenal fatigue has be traditionally described. I still use the term on this website since it is searched for online so I want people to be educated when they come to this website.
Rhodiola rosea is a flowering perennial native to sub-Arctic regions around the globe, notably Scandinavia and Russia, where it has been studied extensively since the 1960’s. Traditionally used in Russia and Mongolia for the treatment of long-term illness and weakness caused by infection, Rhodiola root has been studied for its favorable effect on central nervous system activity and neurotransmitter levels (e.g. dopamine, monoamines and beta-endorphins).
Widely regarded as an effective natural antidepressant, rhodiola is distinguished by its lack of side effects. In addition to mood health, rhodiola has been shown to help improve sleep quality, memory and learning, to help reduce binge eating and to help increase stress tolerance in astronauts. Rhodiola is rich in potent antioxidants including vitamin C, catechins, organic acids, proanthocyanidins and the active compounds salidroside and rosavin.
Rhodiola has the following positive effects on the body:
- Enhances utilization of glucose
- Increases serotonin levels in the brain
- Improves energy and stamina
- Balances norepinephrine (adrenaline)
- Improves dopamine levels
- Reduces anxiety
- Enhances memory and brain function
- Antioxidant properties
- Stimulates healing
- Increases work productivity
- High altitude sickness
- Improves Depression
- Improves female fertility
Although low in potential side effects, Rhodiola can be over-stimulating for some patients and can actually cause insomnia.
Recommended dose is 200-600mg a day in divided doses in the morning and around noon with the above caution in mind. Don’t take Rhodiola anytime after the lunch hour.
Ashwagandha (Withania somnifera) is a well-researched, multipatented herbal extract, standardized to contain uniquely high levels of withanolides—bioactive compounds in ashwagandha. Long revered in Ayurvedic medicine as a prominent Rasayana (rejuvenator) and nerve tonic, research suggests that concentrated extracts of Ashwagandha may help to support a normal stress response by promoting healthy cortisol balance and cell-mediated immunity. Studies including a 2008 randomized, double-blind, placebo-controlled human trial suggest that Sensoril® may help to significantly decrease biochemical and subjective indicators of stress and anxiety with no adverse effects.
Ashwagandha has the following benefits on the body:
- Increases strength and stamina
- Improves memory
- Provides deep and restful sleep
- Antioxidant properties
- Immune system enhancement
- Enhances T4 and T3 levels
- Improves semen quality
- Improves generalized weakness
- Reduces muscle and joint pain
Ashwagandha is in the nightshade family so use with caution if you have issues with tomato, potato, eggplant, tobacco, paprika, or goji berries.
Recommended dose is 500-2,000mg/day in single or divided doses depending on the goal of the individual. Some people will take it before bed to help with sleep and others will take it in the morning and evening.
Panax ginseng is a well known energy tonic that helps to enhance physical endurance and support reproductive hormone balance, particularly in men. Panax has been shown to support healthy metabolic function when the body is under stress by boosting fat burning and sparing carbohydrate metabolism. Research suggests that ginseng saponin may help to enhance HPA axis sensitivity and to attenuate stress-induced increases in plasma cortisol levels.
Panax ginseng properties include:
- Improves fatigue
- Improves cancer-related fatigue
- Improves libido
- Improves and balances immune health
- Supports brain function
- Reduces weakness
- Enhances physical performance and stamina
- May help CFS
- Cardiotonic for congestive heart failure
- Can be used as a bitter tonic for digestion
- Improves blood sugar
Panax ginseng is especially recommended by herbalists for the elderly over the age of 70.
Recommended dose is 250-750mg/day in divided doses.
Eleuthero (Eleutherococcus senticosus), once known as Siberian ginseng, was one of the first adaptogenic herbs to be researched extensively in the Soviet Union, where modern interest in this class of herbs developed. Eleuthero is routinely used by Russian athletes to enhance performance and promote recovery from injury.
It has been shown to increase alertness, fight fatigue and shorten recovery times following illness. Active principles, which are concentrated in the root, include eleutherosides A-M, polysaccharides, beta sitosterol and lignans. Eleuthero is further noted for having immunomodulatory benefits.
Eleuthero has the following benefits:
- Increases energy and stamina
- Creates an anabolic state via increasing DHEA and lowering cortisol
- Anti-depressant (MAO inhibitor)
- Improves blood sugar metabolism
- Improves focus and ability to finish tasks
- Enhances the immune system
- Provides mental clarity
- Protects from radiation damage
- May benefit CFS/CFIDS
- Prevents common cold and pharyngitis
- Reduces muscle and joint pain
- Balances blood pressure if too high or too low
- Autoimmune diseases
- Improves athletic performance
- Jet lag
Recommended dose is 100-600mg twice a day via capsule. Eleuthero should not be taken after 3pm as it can be too stimulating and cause insomnia.
Licorice is considered a “probable” adaptogen at this point meaning we don’t know for certain if it truly is an adaptogen by definition.
Licorice root powder is anti-inflammatory which helps to soothe the irritation that often occurs in mucosal tissues lining the GI tract as a result of chronic low-grade stress. Licorice has been used for centuries by traditional Chinese and Western herbalists to help balance stress and support healthy adrenal function. Because it inhibits the conversion of cortisol to cortisone, licorice also may help to optimize cortisol levels in people suffering from abnormal adrenal function.
Some patients don’t do well with licorice but HPA Select has a small amount of licorice which isn’t enough to cause the usual problems. Licorice should not be taken by those with high blood pressure and it should never be taken without doctor supervision.
This recommendation may surprise some people but some herbalists now consider cordyceps as an adrenal adaptogen.
Naturally occurring Cordyceps sinensis is a wild fungus found on the Qinghai-Tibetan Plateau of China at an altitude of about 10,000 feet. Cordyceps species is known as a traditional Chinese medicine (TCM) as it has wide applications in the pharmaceutical and health sector. This medicinal mushroom was in the limelight during the Chinese National Games in 1993, when a group of women athletes broke nine world records, admitted that they had been taking Cordyceps regularly. It has been previously reported that Cordyceps also enhances physical stamina making it very useful for elderly people and athletes.
Cordyceps works by enhancing endurance and cellular energy in the form of ATP. In addition to supporting the HPA-axis, cordyceps has the following qualities:
Since cordyceps is too expensive for realistic supplementation, most of the products on the market are adulterated to the point that they are not true cordyceps. Additionally, they may contain toxins such as heavy metals depending on where it is harvested. Therefore, I recommend the Cs-4 form of cordyceps which is a standardized fermented form of cordyceps which has nearly similar effectiveness to whole cordyceps.
Recommended dose is 1,500mg twice a day with or without food.
How to take adrenal adaptogens
HPA Select by Moss Nutrition has rhodiola, ashwagandha, eleuthero, panax ginseng, and a small amount of licorice in it which gives you all of the above adaptogens except for cordyceps. I usually use 2 capsules in the morning and for more difficult cases I’ll recommend 2 more capsules with lunch. It doesn’t matter if it is taken with food or on an empty stomach.
Some patients have serious side effects from HPA Select so do not take this product without proper healthcare practitioner supervision.
Cordyceps Select by Moss Nutrition is the Cs-4 form of cordyceps mentioned above. As noted with HPA Select, do not take without proper medical supervision as cordyceps could make your autoimmune condition worse if used improperly. I do not normally combine HPA Select with Cordyceps depending on my goal with the patient.
If you have issues with overly stimulating adaptogens like rhodiola, eleuthero, or panax ginseng, then I usually use Ashwagandha Select by Moss Nutrition since ashwagandha is not a stimulating adaptogen.
Ashwagandha can cause side effects because it is a nightshade as mentioned above. It also has immune stimulating properties that might cause problems with some individuals with specific autoimmune diseases, especially Graves’ disease which it should never be taken with.
Any of the above adaptogens can be taken in isolation but be sure the quality of the supplements aren’t in question so you’re not wasting money. Many over-the-counter supplements do not contain what is claimed on the label and they can also be contaminated with toxic substances like chemicals or heavy metals depending on where they are grown and what country they are from.
Adrenal adaptogens will usually cause some improvement right away but they can also take a long time to kick in. It is recommended that adaptogens be taken for many months to develop their long-term health benefits.
As noted above, do not take any of the above products or herbs without proper doctor supervision. They can cause unwanted side effects and even make your illness worse depending on what you’re dealing with. If used improperly, adaptogens can make autoimmunity worse in some cases resulting in increased body tissue destruction. At the same time, adaptogens can be a vital part of healing autoimmune disease when they are used properly with the right patient presentation.
Adrenal adaptogens have a long history with many potential health benefits so don’t overlook these as a vital tool in your healing journey. Please discuss this information with your healthcare practitioner who is properly trained in herbal medicine for the best approach to utilizing these valuable supplements.