By: Dr. Amy Whittington, Trilogy’s Naturopathic Physician

Last month’s article outlined the need and usefulness of adrenal testing for those suffering from inexplicable fatigue, lowered immunity, and weight gain, among other symptoms. We reviewed how salivary testing of cortisol levels over the course of a day can determine peaks and valleys in our daytime cortisol levels, and also how alterations in that rhythm can lead to the symptoms listed above, as well as disturbance in sleep, anxiety, depression, a “tired but wired” phenomenon, and other illness. Those fluctuations in cortisol levels usually result from long-term stress, either mental or physical (such as long-term illness, hormone imbalance, or thyroid dysfunction).

As a naturopathic physician, I would prefer to have nearly every patient undergo a salivary cortisol test to determine adrenal health, but that’s not always feasible. Also, if adrenal fatigue is obvious after taking a patient history and ruling out other causes of fatigue and dysfunction, testing may not be necessary. Add to this the fact that it is relatively easy to support adrenal function, and for many, a treatment regimen can be pursued without testing. So, what should you do if you feel like you have been under long-term stress, and you’ve been told by your physician that everything is normal, but you just don’t feel energetic, happy, and well? You should consider supporting your adrenals.

There are several techniques to optimize adrenal function, with the basic tenets of 1) decreasing stress and 2) feeding the adrenal glands the nutrients that we know support its health and its ability to produce hormones.

Decreasing Stress
Although it could be argued that all of us should make an effort to include stress-relieving activities in our daily lives, for those with decreased adrenal function, it is imperative. When you consider that stress was likely the contributing factor that led to erratic cortisol levels, it is easy to understand that unless that stress comes under control, it will be very difficult to overcome adrenal fatigue. Certainly, if it is possible to decrease external stressors, that should be your first step.

However, most of us can easily identify stressors in our lives that simply can’t be avoided, and this makes it vital for us to intentionally add stress-relieving activities to our daily routine. Exercise, meditation, yoga, or your most enjoyed activity can all lead to decreases in the overproduction of cortisol, and improve the predictability of your cortisol levels throughout the day. This can take you out of the cortisol-induced “fight or flight” response, so your body can tend to other processes including your sleep/wake cycle, hormone levels, and immune system. Additionally, decreased peaks or valleys of cortisol will result in less fat storage, more consistent daytime energy levels, and less fluctuation in your mood, 
as well.

Feeding the 
Adrenal Glands
If adding stress-relieving activities does not provide enough support for your adrenals to self-normalize, you might want to consider adding the nutrients that we know support the general health of these small glands. 

The two most prominent nutrients are Vitamin C and B#5 (pantothenic acid). A course of these nutrients can often provide the boost that your adrenal glands require in order to produce cortisol in the pattern desired (high in the morning, low at night).

There are also a handful of herbs that can serve to decrease stress as well as support the adrenals. Panax ginseng, Ashwaganda, Rhodiola, Astragalus and wild 
yam, like Vitamins C and B#5, are all considered safe and do not interact with other medications or herbs (although, as always, 
any additions to your regime should be approved by your treating physician). Licorice (Glycyrrhiza glabra) is also a 
very useful herb for adrenal health, although it 
can also raise blood pressure so must be avoided 
by anyone with hypertension.

In addition, many over-the-counter products are available that combine these nutrients and herbs with other botanicals that are relaxing and even mildly sedative such as Humulus (Hops), Valeriana, Passiflora, and lavender. New Chapter and Gaia Herbs are two brands easily found at healthy food stores. As always, all additions to your supplementation should be reviewed and approved by your treating physician.

Beyond over-the-counter herbs and nutrients, treatment of adrenal health should be recommended and monitored by a physician, and will often be pursued after appropriate cortisol testing. Hormones, including pregnenalone, progesterone, and DHEA are all precursors in the development of cortisol and as such can be used to induce higher levels of cortisol when adrenal fatigue has led to consistently low levels through most of the day.

If you present with severely depressed cortisol levels, your physician may even choose to prescribe a desiccated form of adrenal gland (usually from a bovine source) or a compound form of the hormone itself to replace your deficit.

The health of your adrenals plays an integral part in your overall health, metabolism, and energy, but as mentioned in the previous article, it is not usually tested or treated by traditional physicians. Many forms of over-the-counter adrenal support are safe and useful, especially for those who know that their energy, immunity, and mood have been affected by long-term stress, hormonal changes, or thyroid dysfunction. If your symptoms are severe, seek advice from your local naturopath or integrative physician. Your health can be improved.

Take Care & Stay Healthy,
Dr. Amy Whittington