Vitamins, supplements and DHEA adrenal fatigue — aside from DHEA, pregnenolone, and licorice extract, vitamin C, vitamin B6 and others can yield excellent results
Patients may get tired and fatigued, but the adrenal glands don’t. Adrenal burnout, or fatigue, simply doesn’t exist.
It’s is in no way to diminish what people are going through, but we should call it what it really is — over-adaptation. They are more accurately feeling overwhelmed and over-adapted due to a multitude of reasons — some possibly going back for years.
People with burdens of stress early in their lives store those experiences in their hippocampus. The interactions between adverse childhood events, and an already-inhibited ability to deal with stressors because of the compromised response of the hypothalamic-pituitary-adrenal (HPA) axis, can echo well into adulthood.1
The weight of negative experiences early in life essentially program the way that a person responds to challenges. By affecting the HPA axis and regions of the brain and establish patterns associated with establish patterns associated with memory, fear response, and conflict strategies, adverse childhood events create challenging conditions for practitioners to address in a concrete, meaningful way. 2-7
Supplements and adrenal fatigue issues
However, supplemental interventions can make a notable difference, and help patients change behavior patterns and more easily adapt to daily challenges. Adaptogens, including ashwagandha (Withania somnifera) and rhodiola (Rhodiola rosea) are two of the most effective.
In a 60-day placebo-controlled clinical test, volunteers in ashwagandha and placebo groups completed surveys relating to anxiety, stress, depression, and fatigue, including the 28-item version of the General Health Questionnaire (GHQ-28), the Perceived Stress Scale (PSS), and the Depression Anxiety Stress Scale (DASS) questionnaire.
In the GHQ-28 questionnaire assessment, the ashwagandha group showed clear reductions in many stress-related symptoms, including:
- Somatic symptoms by 76.1%
- Anxiety and insomnia by 69.7%
- Social dysfunction by 68.1%
- Severe depression by 79.2%
In PSS scores, participants in the ashwagandha group noted a 44% reduction while the placebo group saw only a 5.5% reduction.
Results of the DASS questionnaire were similar. After 60 days, the ashwagandha group saw reductions in:
- Depression by 77%
- Anxiety by 75.6%
- Stress by 64.2%
Serum cortisol levels were reduced in the ashwagandha by 27.9% versus 7.9 in the placebo group compared to baseline.8
Clinical research with rhodiola has shown improvements in concentration and mental performance for physicians on night duty, and neuro-motor tests and mental fatigue in college students.9,10
Rhodiola may also alleviate symptoms of depression. The Nordic Journal of Psychiatry reported a placebo-controlled clinical trial using two dosage levels of rhodiola (340 mg/daily and 680 mg/daily) found that both dosages relieved insomnia, emotional instability, somatic symptoms, and overall depression after six weeks.11
Additionally, there are supplemental ingredients I recommend to patients in combination that target HPA health.
Vitamins, additional supplements and DHEA adrenal fatigue
For example, impairment of allopregnanolone can lead to feelings of anxiety and isolation. But pregnenolone is a precursor to this important neurochemical and can be easily supplemented. For this reason, and its effect on dehydroepiandrosterone (DHEA) levels, pregnenolone is part of the combination of HPA-supporting nutrients I recommend to my patients.12,13
DHEA is also useful for assisting HPA-axis function and patient resilience. DHEA levels typically decline with age, and if a patient is already struggling with stress, supplements for DHEA adrenal fatigue can help. In a clinical trial, low-dosage DHEA appeared to improve alertness, stamina, and initiative. Additionally, a traditional diet, excluding grains, and promoting healthy proteins, fats, fruits, and vegetables may also be effective.14-17
Vitamins C and B6
When speaking of DHEA adrenal fatigue, pregnenolone, and licorice extract, vitamin C (highly concentrated in adrenal tissues), vitamin B6 (in pyridoxal-5-phosphate form to bypass the need for liver conversion), pantothenic acid, rehmannia root extract, L-tyrosine, and bovine adrenal extract can also yield excellent results. These varied ingredients also support a number of related systems beyond the HPA axis, including thyroid, musculoskeletal, and cognitive functions.18-21
A patient’s habitual responses and the resulting sense of exhaustion are much more complicated than a case of “adrenal burnout.” Our duty as responsible practitioners is to point our patients to a more complete, realistic, and accurate diagnosis and treatment plan. With this in mind, we can compassionately educate and help patients work past a sense of feeling overwhelmed and protracted fatigue so they can live to their best potential.
HOLLY LUCILLE, ND, RN, is a nationally recognized, licensed naturopathic doctor, educator, natural products consultant, and television and radio host. She is the author of several books including Creating and Maintaining Balance: A Women’s Guide to Safe, Natural, Hormone Health and The Healing Power of Trauma Comfrey. In addition to seeing patients in her private practice in Los Angeles, she lectures frequently across the country, and makes guest appearances on radio and television, including Dr. Oz and The Doctors. She can be reached at drhollylucille.com.
- Anda RF, Felitti VJ, Bremner JD, et al. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European archives of psychiatry and clinical neuroscience. 2006;256(3):174-186.
- Van Bodegom M, Homberg JR, Henckens MJAG. Modulation of the Hypothalamic-Pituitary-Adrenal Axis by Early Life Stress Exposure. Front Cell Neurosci. 2017 Apr 19;11:87.
- Faravelli C, Lo Sauro C, Godini L, et al. Childhood stressful events, HPA axis and anxiety disorders. World J Psychiatry. 2012 Feb 22;2(1):13-25.
- McEwen, BS. Allostasis and Allostatic Load: Implications for Neuropsychopharmacology. Neuropsychopharmacology. 2000 Feb;22(2):108-24.
- McEwen BS. Brain on stress: how the social environment gets under the skin. Proc Natl Acad Sci U S A. 2012 Oct 16;109 Suppl 2:17180-5.
- McEwen BS. The Brain on Stress: Toward an Integrative Approach to Brain, Body, and Behavior. Perspect Psychol Sci. 2013 Nov;8(6):673-5.
- McEwen BS. Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol. 2008 Apr 7;583(2-3):174-85.
- Chandrasekhar K, Kapoor J, Anishetty S.A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012 Jul;34(3):255-62.
- Darbinyan V, Kteyan A, Panossian A, Gabrielian E, Wikman G, Wagner H. Rhodiola rosea in stress induced fatigue—a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine. 2000;7(5):365-371.
- Spasov AA, Wikman GK, Mandrikov VB, Mironova IA, Neumoin VV. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine. 2000 Apr;7(2):85-9.
- Darbinyan V, Aslanyan G, Amroyan E, Gabrielyan E, Malmström C, Panossian A. Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression. Nord J Psychiatry. 2007;61(5):343-8.
- Karatsoreos IN, McEwen BS. Resilience and vulnerability: a neurobiological perspective. F1000Prime Rep. 2013 May 1;5:13.
- Cacioppo S, Cacioppo JT. Why may allopregnanolone help alleviate loneliness? Med Hypotheses. 2015 Dec;85(6):947-52.
- Soucy P, Luu-The V. Conversion of pregnenolone to DHEA by human 17alpha-hydroxylase/17, 20-lyase (P450c17). Evidence that DHEA is produced from the released intermediate, 17alpha-hydroxypregnenolone. Eur J Biochem. 2000;267(11):3243-7
- Allolio B, Arlt W, Hahner S. DHEA: why, when, and how much–DHEA replacement in adrenal insufficiency. Ann Endocrinol (Paris). 2007;68(4):268-73.
- von Mühlen D, Laughlin GA, Kritz-Silverstein D, Barrett-Connor E. The Dehydroepiandrosterone And WellNess (DAWN) study: research design and methods. Contemp Clin Trials. 2007 Feb;28(2):153-68.
- Johannsson G, Burman P, Wirén L, et al. Low dose dehydroepiandrosterone affects behavior in hypopituitary androgen-deficient women: a placebo-controlled trial. J Clin Endocrinol Metab. 2002;87(5):2046-52.
- Arick CT. Chiropractic Management of a Patient With Chronic Fatigue: A Case Report. Journal of Chiropractic Medicine. 2016;15(4):314-320.
- Patak P, Willenberg HS, Bornstein SR, Vitamin C. is an important cofactor for both adrenal cortex and adrenal medulla. Endocr Res. 2004;30:871–875.
- Padayatty SJ. Human adrenal glands secrete vitamin C in response to adrenocorticotrophici hormone. Am J Clin Nutr. 2007;86(1):145-9.
- Deijen JB, Orlebeke JF. Effect of tyrosine on cognitive function and blood pressure under stress. Brain Res Bull. 1994;33(3):319-23