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adrenal complex

What Is It?
Health Benefits

Forms

Dosage Information

Guidelines for Use

General Interaction

Possible Side Effects

Cautions

References

Evidence Based Rating Scale
 

What Is It?

This combination product contains herbs, vitamins and other nutrients believed to stimulate the adrenals – endocrine glands located on top of each kidney that produce steroid and stress hormones. Nourishing the adrenals is believed to increase energy and reinforce the response to stress, properties particularly valuable to people suffering from fatigue resulting from overwork, emotional strain, chronic fatigue syndrome, and other causes. By helping to maintain healthy stress hormone levels, the combination of nutrients in an adrenal complex may help to prevent or treat conditions such as fatigue, stress, chronic fatigue syndrome and skin problems such as eczema. An adrenal complex also may help patients with Addison’s disease to retain sodium.  The combination of ingredients among adrenal complex products varies, but almost all contain one of the famed "energy tonic" ginsengs (either Siberian or Panax). Most adrenal complex combinations also include licorice, an extensively studied herbal remedy with powers to increase the presence of stress-fighting adrenal hormones such as cortisol. High-quality adrenal complex products also include one or more B vitamins: Vitamin B5 (pantothenic acid) in particular is thought to play an important role in adrenal function. Vitamin B6 and the minerals zinc and magnesium also are important for supporting adrenal function.

Some products also contain a small amount of raw adrenal gland taken from cows, pigs or sheep. While there's no scientific proof that this works, naturopathic physicians have long believed that ingesting trace amounts of raw adrenal gland from an animal can stimulate the gland's function in the human body. However, this raises concern about possible contamination from diseased animal parts. Products made from contaminated or diseased animal organs might be harmful to humans. Any of the individual herbs, vitamins or nutrients contained in adrenal complex products can be purchased separately, however, the combination products are designed for ease and convenience. For more information on any specific ingredient in your particular adrenal complex product, see the separate entries in the WholeHealth MD Reference Library.

Health Benefits

Under stress, a combination of nerve and hormonal signals are sent to the adrenal glands, which release a surge of stress hormones – the most abundant being adrenaline and cortisol. Adrenaline increases your heart rate, elevates your blood pressure and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances the brain’s use of glucose and increases the availability of substances that repair tissues. However, too much of these hormones (caused by chronic stress—the fight or flight response that works in the jungle, but not the office) can lead to increased risk of obesity, insomnia, digestive problems, heart disease, depression, physical illnesses and other conditions.

Specifically, adrenal complex may help to:

Battle fatigue, memory loss and stress associated with chronic fatigue syndrome. The “adaptogen” ginseng (both Siberian and Panax) has been administered in clinical trials to more than 2,200 humans with various illnesses and determined to be effective in increasing energy, enhancing the body’s response to stress and improving mental and physical performance. (1-3) Both Siberian and Panax ginsengs seem to work against stress by affecting the hypothalamic-pituitary-adrenal (HPA) axis, a complex set of direct influences and feedback between the hypothalamus and pituitary gland (parts of the brain), and the adrenal glands. The communication between these three organs is important in regulating the body’s reaction to stress and various body processes, including energy usage. Some evidence indicates a constituent of Panax ginseng (saponins) specifically increases serum cortisol concentrations, and constituents of Siberian ginseng stimulate the HPA axis through inhibition of the enzymes that inactivate cortisol, aldosterone and progesterone. (4-6) These adrenal-enhancing, equilibrating, anti-stress properties of ginseng help explain why it is called an “adaptogen.”

Therefore, an adrenal complex containing ginseng may help improve symptoms of chronic fatigue syndrome (CFS), such as persistent and unexplained exhaustion, diminished ability to concentrate, memory loss, and stress. Additionally, CFS is sensitive to cortisol, so ginseng’s ability to increase levels of the stress hormone is valuable. While anecdotal evidence in this area has been favorable, scientific evidence is conflicting. In one double-blind study of 36 patients who received either 10 ml of a fluid extract of Siberian ginseng or placebo daily for four weeks, the extract was found to be beneficial and potentially useful in treating CFS. The group receiving Siberian ginseng demonstrated significant improvement in various immune system parameters, most notably a significant increase in T helper cells and an increase in natural killer cell activity – both of which are of value in the treatment of CFS. (7)However, a 2004 randomized, controlled trial evaluating the use of Siberian ginseng to treat chronic fatigue syndrome in 76 patients found fatigue was substantially reduced in both treatment (2 grams daily) and placebo groups, with no statistically significant difference between the two groups. After two months, the only statistically significant benefit was seen in the a group of 45 subjects who had less severe fatigue initially. (8)

Memory loss and impaired mental function resulting from chronic fatigue syndrome also may benefit from the ginseng in adrenal complex products. Preliminary evidence suggests the adaptogenic effects of Siberian ginseng may improve memory and feelings of well-being in middle-aged people (whereas other herbs, such as ginkgo biloba, are effective only in the elderly). (9) Also, some studies have shown Panax ginseng alone does not seem to improve memory, but a combination of Panax ginseng and ginkgo leaf extract (by improving blood flow to the brain) can improve memory in otherwise healthy people ages 38 to 66 years. (9-11) An adrenal complex product including Panax ginseng and gingko, therefore, may be most beneficial in improving memory loss and mental function in chronic fatigue syndrome.

Clinical studies have confirmed both ginsengs significantly reduce feelings of stress and anxiety. For example, in a widely cited double-blind study, nurses who had switched from day to night duty received ginseng supplementation, rated themselves for competence, mood, and general well-being, and were given a test for mental and physical performance along with blood cell counts and blood chemistry evaluation. The treatment group had higher scores in competence, mood parameters, and mental and physical performance compared to the placebo group. The nurses taking the ginseng felt more alert, yet more tranquil, and were able to perform better than the nurses who were not taking ginseng. Also, ginseng supplementation corrected the blood sugar levels raised by stress. (12) A 2004 randomized, double-blind study of 20 of elderly patients 65 and older receiving 300 mg dry extract of Siberian ginseng daily found ginseng significantly improved social functioning and mental well-being after four weeks of treatment. However, these improvements were not maintained after eight weeks of treatment. (13)

Like ginseng, licorice can stimulate adrenal gland function, contributing to the increase of energy and improved response to stress. Taken along with Panax ginseng, licorice increases serum cortisol concentrations. (14)

Magnesium and vitamin B6 also should be included in an adrenal complex. Stress increases the release of aldosterone, one of the steroid hormones produced by the adrenal glands that increases absorption of ions and water in the kidneys. An increase in aldosterone, in turn, leads to the absorption of sodium and a loss of magnesium. Therefore, an adrenal complex containing magnesium may help combat this mineral loss. For more information about the use of magnesium supplementation to prevent this loss, refer to the Magnesium article in the WholeHealthMD library. Magnesium, along with vitamin B6, are needed for the body to produce Serotonin, an important mood-enhancing brain chemical. Anxiety and panic attacks sometime result from overreacting to stress. When depression or a panic disorder is persistent – and especially when conventional medication has limited effect – supplementing with magnesium and vitamin B6 may provide significant relief. Taking calcium along with magnesium also may lessen the stress reaction linked to anxiety and panic attacks. (15, 16)

Researchers believe the HPA axis also plays a role in controlling serum zinc levels and that reduced zinc levels may reduce the acute inflammatory response to stress. An adrenal complex containing zinc may help prevent zinc deficiency, which can be caused by critical illness.

Treat Addison’s disease. In addition to improving energy, licorice also may be useful in treating Addison’s disease – a severe disease of adrenal insufficiency – by suppressing the main enzyme responsible for inactivating cortisol, aldosterone and progesterone. (17) Several individual cases of the efficacy of licorice in treating Addison’s disease have been reported. Because Addison’s disease is characterized by the urinary loss of sodium, treatment generally includes interventions to help retain sodium. Regular ingestion of licorice can cause sodium and water retention. In one case, a 42-year-old woman with an undiagnosed case of Addison’s disease added 46 g of salt to her diet every week by eating licorice and soy sauce. The licorice seemed to improve her condition by inhibiting the breakdown of cortisol, allowing more to accumulate. (18) Aside from anecdotal evidence, the use of licorice to treat Addison’s disease has not been well studied. Clinical studies are needed in this area. Note that this sodium retaining quality of licorice can be problematic for patients with hypertension and should be supervised by a physician.

Improve adrenal function. Patients who suffer from chronic stress may have a deficiency in Vitamin B5, or pantothenic acid, which results in adrenal atrophy. This deterioration of the adrenal glands is often characterized by fatigue, headache, sleep disturbances, nausea, and abdominal discomfort. Pantothenic acid supplementation has been found to be effective in treating and preventing this condition. (19)

Treat acne, eczema and psoriasis. Because extracts made from the adrenal cortex contain small amounts of corticosteroids, they are typically used as “natural” cortisone in severe cases of allergy and inflammation. Some components of adrenal complex – licorice and zinc – may improve skin irritations such as eczema, psoriasis and shingles. Licorice cream applied directly to irritated skin can help to reduce inflammation and relieve such symptoms as itching and burning. (20) It also boosts the effectiveness of cortisone creams. Zinc improves skin health by enhancing the immune system, reducing Inflammation, and promoting healthy hormone levels. Adding zinc supplements to your diet may lead to more efficient recovery from acne, burns, psoriasis, rosacea, and eczema. (21, 22) By regulating levels of hormones implicated in the development of acne lesions, Vitamin B6 may help to control outbreaks, particularly those triggered by menstrual cycles or menopause.

Treat thyroid conditions. Nutritionally oriented physicians believe that there is a relationship between thyroid and adrenal function. They may recommend taking an adrenal complex in some cases of over or under activity of the thyroid. However, scientific evidence is lacking in this area. Research is needed to determine the effect of an adrenal complex in thyroid disorders.

Forms

  • Capsule
  • Extract
  • Injection
  • IV
  • Powder
  • Tablet

Dosage Information

Dosages vary according to specific formulas, as amounts of each individual ingredient in adrenal complex vary among formulas. Follow label instructions.

Generally, the following dosages should be met:

  • Ginseng: 2 to 4 ml of fluid extract, 100 to 200 mg of solid extract (dry-powdered), or 2 to 4 g of dried root daily.
  • Licorice: 400 to 450 mg daily or 1 tsp liquid extract daily. Note that licorice candy is most often flavored with anise and does not actually contain licorice. Read the label first.
  • Magnesium, 250 to 500 mg daily.
  • Pantothenic acid (B5): 50 to 100 mg daily.
  •  Zinc: 20 to 30 mg daily.
  • Vitamin B6: 50 to 100 mg daily.

Guidelines for Use

Vegetarians may want to avoid adrenal complex products containing raw adrenal gland from animals. For more information about each nutrient, refer to the specific entries (Siberian or Panax ginseng, licorice, pantothenic acid, and so on) in our WholeHealthMD Reference Library.

General Interaction

For possible interactions with a specific drug or dietary supplement, refer to the separate entries in our WholeHealthMD Reference Library.

Possible Side Effects

Refer to separate entries in our WholeHealthMD Reference Library.

Cautions

  • Several components of adrenal complex products (i.e. ginseng, licorice) are safe only for short-term usage. Most should be used only for three to six weeks.
  • Some components of adrenal complex products may increase blood pressure. Avoid these products if your blood pressure is already high: monitor if it is not.
  •  See individual entries in the WholeHealthMD Reference Library for further cautions about specific ingredients contained in your adrenal complex.

References

1. Davydov M, Krikorian AD. Eleutherococcus senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an adaptogen: a closer look. J Ethnopharmacol. 2000;72:345-393.
2. Coleman CI, Hebert JH, Reddy P. The effects of Panax ginseng on quality of life. J Clin Pharm Ther. 2003;28:5-15.
3. Ong YC, Yong EL. Panax (ginseng) – panacea or placebo? Molecular and cellular basis of its pharmacological activity. Ann Acad Med Singapore. 2000;29:42-6.
4. Hiai S, Yokoyama H, Oura H, et al. Stimulation of pituitary-adrenocortical system by ginseng saponin. Endocrinol Jpn. 1979;26:661-5.
5. Kase Y, Saitoh K, Ishige, et al. Mechanisms by which Hange-shashin-to reduces prostaglandin E2 levels. Biol Pharm Bull. 1998;21:1277-81.
6.Medon PJ, Ferguson PW, Watson CF. Effects of Eleutherococcus senticosus extracts on hexobarbital metabollism in vivo and in vitro. J Ethnopharmacol. 1984;10:235-41.
7. Bohn B, Nebe CT, Birr C. Flow-cytometric studies with Eleutherococcus senticosus extract as an immunomodulatory agent. Arzniemitteforschung. 1987;37:1193-96.
8. Hartz AJ, Bentler S, Noyes R, et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med. 2004 Jan;34(1):51-61.
9. Winther K, Ranlov C, Rein E, et al. Russian root (Siberian ginseng) improves cognitive functions in middle-aged people, whereas Ginkgo biloba seems effective only in the elderly. J Neurological Sci. 1997;150:S90.
10. Wesnes KA, Ward T, McGinty A, Petrini O. The memory enhancing effects of a Ginkgo biloba/Panax ginseng combination in healthy middle-aged volunteers. Psychopharmacology. 2000;152:353-61.
11. Scholey AB, Kennedy DO. Acute, dose-dependent cognitive effects of Ginkgo biloba, Panax ginseng and their combination in healthy young volunteers: differential interactions with cognitive demand. Hum Psychopharmacol. 2002;17:35-44.
12. Hallstrom C, Fulder S, Carruthers M. Effect of ginseng on the performance of nurses on night duty. Comp Med East West. 1982;6:277-82.
13. Cicero AF, Derosa G, Brillante R, et al. Effects of Siberian ginseng (Eleutherococcus senticosus maxim.) on elderly quality of life: a randomized clinical trial. Arch Gerontol Geriatr Suppl. 2004;9:69-73.
14. Kase Y, Saitoh K, Ishige A, et al. Mechanisms by which Hange-shashin-to reduces prostaglandin E2 levels. Biol Pharm Bull. 1998;21:1277-81.
15. Eby GA, EBY KL. Rapid recovery from major depression using magnesium treatment. Med Hypotheses. 2006;67(2):362-70. Epub 2006 Mar 20.
16. Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Curr Med Res Opin. 2004;20:63-71.
17. Armanini D, Karbowiak I, Funder JW. Affinity of liquorice derivatives for mineralocorticoid and glucocorticoid receptors. Clin Endocrinol (Oxf). 1983;19:609-12.
18. Cooper H, Bhattacharya B, Verma V, et al. Liquorice and soy sauce, a life-saving concoction in a patient with Addison’s disease. Ann Clin Biochem. 2007 Jul;44(Pt 4):397-9.
19. McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
20. Saeedi M, Morteza-Semnani K, Ghoreishi MR. The treatment of atopic dermatitis with licorice gel. J Dermatolog Treat. 2003 Sep;14(3):153-7.
21. Michaelsson G, Ljunghall K. Patients with dermatitis herpetiformis, acne, psoriasis and Darier’s disease have low epidermal zinc concentrations. Acta Derm Venereol. 1990;70:304-8.
22. Berger MM, Spertini F, Shenkin A, et al. Trace element supplementation modulates pulmonary infection rates after major burns: a double-blind, placebo-controlled trial. Am J Clin Nutr. 1998;68:365-71.

Evidence Based Rating Scale  

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.

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Licorice 

 

 

 

 

 

Date Published: 04/18/2005

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