Working with adrenal health is integral to my practice and central to the balance of the entire endocrine system. Here's some of my clinical tips for re-establishing adrenal health.

Common adrenal symptoms 

Common  symptoms present as anxiety, depression, mood swings, insomnia, headaches, low energy, stress, hormonal imbalance, poor immune function, fatigue and dys-glycaemia. Prolonged stress causes increased cortisol secretion and may eventually lead to hypertrophy of the adrenal cortex, adrenal exhaustion and immune suppression.  DHEA-S is the main androgen in both men and women, with levels declining as we age. Reduced levels of DHEA-S may result in fatigue, poor immune function, weight gain, increased ageing, memory loss and poor concentration.

Testing

While symptom pictures will give us a great deal of information, I feel it's important to run pathology tests to understand the patient's cortisol and DHEA pattern. This helps me get their treatment plan on track quickly.

I recommend an Adrenal Salivary Hormone Panel. The Adrenal Hormone Profile is a non-invasive saliva test which monitors the levels of stress hormones cortisol and DHEA over the course of one day.

Herbal Considerations

The two core herbs to repair the health of the adrenal cortex are licorice and rehmannia - true adrenal tonics. I refer to these as "functional foods" to feed the adrenal cortex. By supporting the adrenal cortex cellular health you'll see improved levels of cortisol and DHEA synthesized, with better energy levels as a result.

It's important to partner adrenal tonic herbs with an adrenal adaptogen. Botanical researchers Brekhman and Dardymov formulated a functional definition of adaptogens, which are:

• Non-specific activity (hence they act on general adaptation syndrome)¹  
• Normalising in their properties¹  

Adaptogens do not influence the body more than required, which means they will not overstimulate or over suppress. They are modulating to cortisol and DHEA levels

My favourite clinical adaptogens 

Withania: A mainstay for managing high cortisol yet at the same time, improving "stores" of vitality. Withania is reputed to impart the vigour and strength of a stallion! It's also a key herb for adrenal and sexual health, by supporting healthy testosterone levels and DHEA levels.²

Rhodiola: Excellent for mental and emotional stress causing adrenal fatigue and feelings of overwhelm, depression and poor sleep.^3,4 It's also great for improving stores of vitality and improving the feeling of "coping". I often refer to rhodiola as the herb to recoup from corporate burnout.

Shatavari: Helps improve adrenal reserves in women of who are stressed while trying to conceive or heading into the menopausal years.

Siberian Ginseng: A remarkable herb for those whose stress levels impact their immune system and cause a predisposition to herpes, recurrent infections and adrenal stress for example.⁵ It's also great for pre or post chemotherapy stress management.

Nutritional Considerations

Nutritionally supporting the adrenals is critical and I often prescribe a combination of:

- Tyrosine 500-1500mg per day

- Calcium 800 mg per day

- Magnesium 400 mg per day

- Complete B Multivitamin

- Vit C 2500-5000 mg per day

- B6 25 mg per day

- Zinc 50 mg per day6 

Is adrenal health a core part of your consultation approach?  

References on request