DHEA and pregnenolone is not appropriate for everyone.

These supplements can aggressively push hormone production. Hormones should be tested before starting supplementation. DHEA in particular can have many side effects, especially those related to high androgens (male hormones) and estrogens, as it can be covered downstream to both. Acne and hair loss can easily result from taking too much DHEA.

DHEA and pregnenolone are usually taken together. Taking a lot of one and none of the other may simply deregulate the overall hormonal picture even more. Pregnenolone will feed the cortisol pathway. DHEA can be converted into testosterone.

You may see these adrenal supplements are commonly sold in doses far higher than needed. For women who will benefit from DHEA, typically doses such as 5mg a day or less are sufficient. However, DHEA is often sold in doses of 25mg per pill or higher.

Supplementing with pregnenolone and DHEA for most people is best done with a health care professional. Lab tests should be run to monitor hormone levels.

This is typically not the first option I would try, but can be helpful in certain cases with lab tests.

Adaptogens

Adaptogens help if cortisol is is too high or too low. When taking in the morning it improves energy. At night it is calming and improves sleep.

For most people adrenal adaptogens are the best adrenal supplement to use. Their adaptogenic function makes then helpful for a wide range of people and low chance of side effects. Since they will not force hormone production in the way that DHEA and pregnenolone does, hormone lab tests are not needed.

When adrenal adaptogens work best

• To help with the stresses of over day life. Long work hours, emotion stress and toxic exposure are some common examples of such stress.

• For people with more severe/chronic fatigue – as an adjunct to a more comprehensive plan that is correcting their problem at a more causal level. For example, someone with chronic Candida, may take adaptogens for brain fog and fatigue – but it will not work that well unless the candida is also addressed.

When adrenal adaptogens will not work well

• Cases of more severe fatigue, chronic fatigue syndrome, fibromyalgia, chronic viral infections. In these situations the cause of symptoms needs to be more directly treated, then simply covering up fatigue with an energy supplement. Typically this means working more directly on the immune system and/or detoxification.

• Multiple chemical sensitivity. Some people are so sensitive to different stimuli that even tiny amounts of supplements that are safe for most people make them work. Adrenal supplements may make some people feel “speedy”.

Paradoxical symptoms are common in such cases. This is when a supplement that is supposed to do one thing, causes the complete opposite reaction. In such cases, patients may bounce around from doctor to doctor (and not just MD’s, this include people in natural health) just to be given one treatment plan after another that makes then worse and surprising the practitioner each time with extreme symptoms.

In these cases slow careful detoxification is important. The correct homeopathic remedy may do wonders as well.

People with multiple chemical sensitivities and paradoxical reactions much be treated accordingly. Most advice about what supplements to take for energy will rarely work in these cases.

Adaptogenic herbs for the adrenals.

This is a list of some herbs I most often for adrenals and poor energy. There are many other good herbs available. This list is not meant to be exhaustive.

All of these are good herbs. None are the best, nor are any of these good for everyone. For more information on a holistic herbal medicine intake see this page.

• Licorice (glycyrrhiza glabra). Licorice has an extremely wide range of action. In terms of adrenal function, it acts like a weak steroid hormone (cortisol is the body’s primary steroid it makes on it’s own) which is one reason why it helps with energy. It is also a strong anti-viral. Often it is added to herbal formulas to help drive the action of other herbs. Another common function is to help soothe the digestive system. Regular licorice is used for energy, and “deglycyrrhizinated” or DGL licorice is sold for digestion. DGL has one of the active ingredients, glycyrrhizic acid removed. Therefore it will not have the stimulating effect of regular licorice.

• Ashwagandah (Withania somnifera). Primarily used for fatigue and sleep. It is a strong anti-oxidant and can be used for other conditions such as to increase immunity, arthritis, hypertension, and hypothyroidism.

• Rhodiola. A traditional Chinese medicine herb. Long used for, (and studied by Russians) increased physical stamina.

• Kirin ginseng (Panax notoginseng) and American ginseng (Panax quinquefolius). These are similar. American ginseng is slightly cooling and sweat. Kirin ginseng is more warming. Both help with stress and energy. In Chinese medicine Ginseng was considered calming, and not stimulating at all. However, it helps the body handle stress, improving overall energy.

• Siberian ginseng (Eleutherococcus senticosus). This is not a true ginseng. The name was simply applied to Eleuthrerococcus my marketers. Useful from people under prolonged stress from modern life style. People who are tired, with dark circles under eyes. Can help with sleep as well, but if not needed may be stimulating.

• Rhemannia. A traditional Chinese herb. Helps adrenal and kidney function. At times it can be helpful when signs of weakness in the kidneys (needs to pee all the time, fear, sometimes heart palpitations.)

Glandulars

An adrenal glandular supplements is essentially the dried adrenal gland of and animal turned into a pill. This is not a form a hormone replacement therapy. Adrenal glandulars do not have large amounts of hormones in them. They work much more by giving nutritional support.

Often glandulars are more stimulating than herbs or other adrenal supplements. Some people feel much better on them. However others report feeling “speedy.” Since glandulars are only stimulating these would not be considered adaptogens.

Some people may with to avoid these products because they go against vegan beliefs. That is fine as we have many other ways to support adrenal function. Consider this information for the sake of completeness. No one should ever be told they have to take something that goes against their beliefs, unless there simply is no other option.

Vitamins and minerals

Vitamin C and most of the B vitamins are needed for proper adrenal function. Without these vitamins the adrenals can not convert cholesterol into cortisol. Like other supplements, some people feel much better on adrenal supplements high in B vitamins. Others may feel “speedy,” especially if they are the type who is often sensitive to supplements. Others may feel nothing at all.

In my office I’ll typically do kinesiology muscle testing against different B vitamins. The ones I see needed most often are vitamins B1, B12 and folate. An organic acid functional lab test can also pick up need for B vitamins. I wouldn’t normally run that tests just for B vitamins as it’s usually just as good to figure things out through in office testing and trying the supplement.

Other than cortisol one of the other major adrenal hormones is aldosterone. Aldosterone controls mineral balance. Without enough aldosterone people urinate more frequently, and this also means they are constantly peeing out their minerals. Magnesium may thus be low (often causes muscle cramping) but also sodium.

Sodium is often maligned for causing high blood pressure. Nonetheless many people with adrenal fatigue actually have low blood pressure. They are not able to maintain minerals. Having adequate intake of salt is essential to help the adrenals. Just make sure to get real sea salt, or eat vegetables that contain sodium like celery.