Is Adrenal Fatigue Real?

How to use the Top 5 Stress, Cortisol, Adrenal Supplements: (Part 1 of 2)

Mark Stein
OptimizeBetter
9 min readSep 30, 2020

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Is adrenal fatigue real?

The technical and incomplete answer is no.

Adrenal fatigue is not a medically recognized condition.

Instead, it is a catch-all buzzword representing symptoms of adrenal gland dysfunction.

We’ll explore how to address what is actually happening in part two.

And as we mention this, we’ll use the phrase “adrenal fatigue” in this article for referential purposes only.

In part one, we’ll explore how to lower or raise cortisol using the top cortisol supplements for adrenal fatigue.

So, let’s get started on how to lower or raise cortisol using the top science-backed supplements.

What is Cortisol: The “Flight-or-Fight” Hormone

As a steroid hormone regulating several core body processes, including metabolism and immune response, cortisol plays a critical role in managing our body's stress response.

Too much or too little cortisol can cause us problems and promote chronic stress and disease.

The following conditions can be caused by high cortisol, and some of these conditions can also cause high cortisol levels.

What are the Symptoms of High Cortisol

  • Cognitive Disorders
  • Flushed and Round Face
  • Frequent Urination
  • High Blood Pressure
  • Increased Thirst
  • Low Sex Drive
  • Metabolic Disease
  • Mood Shifts (Anxiety, Depression, Irritability)
  • Muscle Weakness
  • Osteoporosis
  • Rapid Weight Gain (Abdomen, chest, and face, along with thin arms and legs)
  • Skin (Bruises and purple stretch marks)
  • Sleep Disorders

What are the Symptoms of Low Cortisol?

  • Darkening of Skin Regions
  • Dizziness (Upon standing)
  • Fatigue
  • Low Blood Pressure
  • Mood Changes
  • Muscle Weakness
  • Weight Loss
  • Untreated insufficient cortisol levels can pose a potentially life-threatening condition.

Cortisol Supplements for Adrenal Fatigue (Micronutrients)

Before we get into adrenal fatigue recovery, we want to look at the micronutrients which are involved in adrenal and cortisol support.

We want to ensure the adequate intake of the following key micronutrients.

  1. B-1
  2. B-5
  3. B-6
  4. B-9 (Folate)
  5. B-12
  6. CoQ10
  7. Magnesium
  8. Omega-3's (Cod liver oil, fish oil; algae oil or krill oil might be superior omega-3's.)
  9. Potassium
  10. Selenium
  11. Vitamin C
  12. Vitamin E
  13. Zinc

B5, magnesium, omega-3, potassium, vitamin C, and zinc are the most critically important.

Top 5 Cortisol Supplements for Adrenal Fatigue

Adaptogen plant supplements perform best in research studies for cortisol lowering effects.

#1 Ashwagandha

Ashwagandha, “Indian Ginseng”, is the popular adaptogen plant supplement for anxiety, sleep, metabolic health, hormones, reproductive health, stress, along with an array of others.

While it has clinical support for anxiety and sleep, ashwagandha’s strongest proven action is lowering chronic stress and high cortisol levels.

Traditionally celebrated as a nerve tonic, Ashwagandha is a sacred plant in Ayurvedic medicine.

Ashwagandha improves stress, happiness, and cortisol levels in multiple research studies.

KSM-66 (5%) and Sensoril (10%) are the two types of Ashwagandha supplements.

Some report KSM-66 as a stimulating daytime Ashwagandha, with Sensoril as a calming nighttime Ashwagandha, and others report opposite invariable effects or no varying effects amongst the two.

Dosage:

Studies use a standardized Ashwagandha extract of 300 mg, two times per day, with daily doses up to 1 gram seen as safe. Users should be aware a small subset of males seem to report sexual and long-term negative serotonin-type side effects referred to by a new term, Post-SSRI Sexual Dysfunction, (PSSD). It is both fat- and water-soluble and effective with or without food.

#2 Phosphatidylserine

As a naturally occurring fat, phosphatidylserine exists in high concentrations in our nervous system and brain.

Phosphatidylserine lowers ACTH and cortisol levels following a stress test in clinical studies.

In other studies, phosphatidylserine improves mood and calm in those undergoing stressful situations.

Phosphatidylserine is the only supplement approved by the US Food and Drug Administration, FDA, to treat cognitive decline and dementia.

The total content of all phospholipids, such as lecithin and algae and krill oil, is 3% phosphatidylserine, along with phosphatidylcholine and phosphatidylinositol.

Dosage:

The effects of phosphatidylserine only performs at doses of 300 to 400 mg, and not with higher dosages.

#3 Rhodiola Rosea

Rhodiola Rosea is an adaptogenic cold climate, high altitude plant, delivering anti-stress and anti-fatigue benefits.

As an MAO-A and MAO-B inhibitor, which makes Rhodiola Rosea a believed antidepressant and ADHD supplement, while possibly offering mild anxiety benefits.

Acting on acetylcholine, dopamine, norepinephrine, and serotonin, it also lowers primary inflammatory cytokines, IL-1, IL-6, and TNF-alpha.

While the studies showing Rhodiola Rosea’s anti-stress actions are of poor quality, they demonstrate potent and rapid anti-stress actions.

Rhodiola Rosea has two listed active compounds; rosavins and salidrosides.

Salidrosides support the HPA axis, the hypothalamus, and adrenal and pituitary glands, which maintains our stress response.

Dosage:

Common Rhodiola extracts are 1% salidrosides and 3% rosavins or 5% salidrosides. 400 to 600 mg per day of standardized Rhodiola Rosea extract is the typical dose.

#4 Ginkgo Biloba

Ginkgo biloba is the world’s oldest cognitive-enhancing plant, and similarly one of the oldest and well-studied supplements

As another reliable adaptogenic plant, ginkgo Biloba offers an array of benefits.

In combating stress, ginkgo significantly lowers systolic and diastolic blood pressure, improving central and peripheral blood flow, while also boosting mood and cognition.

Ginkgo Biloba's actions support the ACE2 enzyme, along with acting as a vasodilator.

Effective for some types of anxiety, depression, ginkgo Biloba also provides a disputed benefit for cognitive issues such as dementia and ADHD.

The notable ginkgo Biloba effects on cardiovascular issues due to elevated cortisol are clear.

It now appears ginkgo Biloba can improve sleep disturbed by high cortisol levels.

Dosage:

240 mg EGb or standardized extracts are taken before bedtime is shown to improve sleep, through believed cortisol lowering actions. Other studies show it being used at 120 mg twice a day for cardiovascular blood flow support.

#5 Bacopa Monnieri

As another adaptogenic plant, bacopa monnieri lowers stress and depression in small research studies.

Offering evidence as a memory enhancer, bacopa monnieri also lowers cortisol.

Specifically, in animal studies, bacopa improves memory loss due to acute and chronic stress.

In other animal studies, bacopa improves symptoms of depression and anxiety.

We know stress causes blood and brain chemistry changes.

As cortisol rises in the blood, norepinephrine levels rise in the brain causing dopamine and serotonin to drop.

One animal study shows bacopa addressing and normalizing this stress response reaction in the brain.

With this limited evidence, bacopa could lower depression and stress through neurotransmitter balancing, while improving inflammation and oxidative stress in the brain.

Dosage:

We see 300 to 450 mg standardized bacopa extracts used as the typical dosage across research studies.

Rising Star: Lion’s Mane

Much like bacopa, quality lion’s mane, human studies are few.

The widely popular medicinal mushroom lion’s mane is used for cognition (brain fog), depression, focus, memory, Parkinson’s, depression, sleep, and lowering anxiety, cortisol, and stress.

While quality studies have been lacking to support its uses, lion’s mane is the recipient of exciting research on nerve growth and regeneration in its believed BDNF promoting actions.

Paul Stamets, a mycologist, suggests his research will show lion’s mane improves cognition along with psilocybin and niacin, thus influencing neurogenesis, the growth of new neurons forming in the brain.

This could deliver for those with brain and nervous system issues and degenerative neurological diseases.

Imbalances in nerve growth factor (NFG) and myelin, (nerve fiber insulation), can increase the incidence of neurological diseases such as Alzheimer’s and multiple sclerosis.

A human study shows lion’s mane improving focus while lowering anxiety.

Researchers believe lion’s mane is a stimulant of NFG and brain-derived growth factor (BDNF) and improving these targets can increase cognition and memory through the production of new neurons.

Lion’s mane appears to increase and decrease the following pro-inflammatory cytokines: AP-1, IL-1-beta, IL-6, IL-8, NF-kb, SOD, and TNF-alpha.

As IL-1, IL-6, and TNF-alpha are the key pro-inflammatory cytokines affecting HPA-axis dysfunction and high cortisol levels, it will be important to better understand this relationship.

Dosage:

Standardized extracts of 500 to 3,000 mg per day in divided doses. As with Ashwagandha, some users report Post SSRI-Sexual Dysfunction with lion’s mane.

Adrenal Supplements (Low Cortisol, Low Blood Pressure)

  • 5-HTP
  • Caffeine
  • Cordyceps (Another adaptogenic rising star)
  • Licorice (Most well-supported and used)
  • Yohimbe

Adrenal Supplements (Top 9 Notables)

L-Theanine:

We see less stress from individuals taking 200 mg theanine in research studies.

Lavender Essential Oil:

Lavender performs with cortisol decreases in the aromatherapy form.

Maca:

Cortisol reductions were seen in postmenopausal women.

Mucuna:

Mucuna shows a lowering of cortisol in chronically stressed men.

Omega-3's:

Benefits are seen with Omega-3'd for ADHD, depression, and other cognitive and mood disorders caused by stress.

Prebiotics:

Dietary fiber can lower high cortisol levels in healthy individuals.

Saffron Essential Oil:

Cortisol lowering effects are seen with women only.

Tongkat Ali (LongJack) (Eurycoma):

Cortisol reductions noted in chronically stressed individuals.

Vitamin C:

Exercise-induced spikes with pro- or anti-inflammatory actions at 500 to 1,500 mg. (This might translate to cortisol lowering effects for those on the Ketogenic diet and intermittent fasting.)

Adrenal Supplements (Others)

Black seed oil, DHEA, curcumin, lemon balm, melatonin (night time), l-lysine, SAM-e, alpha-lipoic acid, St. John’s wort, lecithin, probiotics, phosphatidylserine, maca, astragalus, eleuthero, NAC, Tribulus Terrestris, holy basil, Panax ginseng, Schisandra, butyrate, magnolia bark, hops, Chinese skullcap, kava, valerian, taurine, salvia sclarea, TMG, theaflavins, agmatine, rose essential oil, tyrosine, DLPA, cocoa, cacao, dark chocolate, green tea, black tea, matcha, garlic, wild salmon, berries, chamomile, alpha-GPC, CDP-choline.

Adrenal Fatigue and Cortisol Supplements Conclusions

As is the case with most other conditions, the insufficiency or deficiency of micronutrients should be addressed first and foremost when using cortisol supplements for adrenal fatigue.

We want to understand what is happening at the level of root causes.

Do we have high or low cortisol levels?

Are we experiencing high daytime cortisol levels, causing us debilitating stress?

Or are we experiencing high nighttime cortisol levels, which is disturbing our sleep?

Addressing the root cause of medical conditions is where we can create the most meaningful and lasting change.

Join us for part two, as we examine adrenal and cortisol lifestyle optimization strategies.

What’s your favorite anti-stress supplement?

Your Friend in Health

Mark Stein

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