Adrenal fatigue is one of the most common health issues plaguing many people today.
It saps your vital energy, wrecks your sleep patterns, and throws your hormone levels out of whack.
The worst part is that it can’t be technically diagnosed by a doctor which means there’s no conventional medicine that offers adrenal support.
Fortunately, adrenal fatigue symptoms can be easily addressed with natural remedies including herbal treatment.
One of the most potent benefits of herbal medicine is its ability to ease your body’s innate stress response and restore optimal adrenal health.
The following article details the best herbs for adrenal fatigue.
Best Herbs For Adrenal Fatigue
Rhodiola Rosea by Nootropics Depot
Bacopa Monnieri by Nootropics Depot
Panax Ginseng by Nootropics Depot
Supercritical Holy Basil Solution | 12-20% Eugenol + 3-8% by Nootropics Depot
Learn more about the nootropic benefits of adaptogenic herbs! – Click HERE
What Is Adrenal Fatigue?
Conceived in the late 90s by chiropractor James L. Wilson Ph.D., the term adrenal fatigue describes burnout of the adrenal glands in response to stressful situations.
It is a vicious neverending cycle that negatively affects adrenal health. Constant and persistent physical or psychological stress leads to overworking of the adrenal glands.
Unable to bear the burden of constantly pumping out cortisol, the adrenal glands begin to function below normal threshold levels.
This chronic burden eventually slows your entire HPA pathway until the adrenal glands can no longer produce sufficient levels of cortisol to keep up with the ongoing stress.
As a result, adrenal fatigue occurs.
To make matters worse, adrenal fatigue involves exhaustion and a decline in healthy energy levels, thus contributing to the negative feedback loop of adrenal fatigue.1Rashmi S Mullur, MAKING A DIFFERENCE IN ADRENAL FATIGUE, Endocr Pract. 2018
Adrenal fatigue vs. adrenal insufficiency
Adrenal fatigue is a mild form of adrenal insufficiency when adrenal function declines when it is overworked.
There are two primary types of adrenal insufficiency:
- Primary adrenal insufficiency, also known as Addison’s disease, occurs due to the failure of the adrenal glands to produce sufficient amounts of adrenal hormones. Causes of Addison’s disease include autoimmune diseases, infections, cancer, or inherited disorders.
- Secondary adrenal insufficiency occurs when the pituitary gland does not produce sufficient amounts of ACTH to stimulate the adrenal glands (see below The HPA Axis).
Symptoms of adrenal fatigue are similar to adrenal insufficiency, therefore, it is challenging to distinguish between these two conditions clinically.
However, abnormal test results such as blood concentration measurement or saliva testing of hormones will indicate adrenal insufficiency. Hormonal levels in adrenal fatigue may be within normal limits.2R D Siegel , J Melby, Fatigue: the role of adrenal insufficiency, Hosp Pract (Off Ed). 19943Irina Bancos, Stefanie Hahner, Jeremy Tomlinson, Wiebke Arlt , Diagnosis and management of adrenal insufficiency, Lancet Diabetes Endocrinol. 20154Nada Younes, Isabelle Bourdeau, Andre Lacroix, Latent Adrenal Insufficiency: From Concept to Diagnosis, Front Endocrinol (Lausanne). 2021
What Causes Adrenal Fatigue?
Chronic Stress
Any prolonged physical, emotional, or mental stress, such as grief, anxiety, traumatic life events, unemployment, lack of sleep, etc.
Overuse of antibiotics
Research shows that overuse of antibiotics can have a deleterious effect on cortisol hormone production.5Elke Thijs,Katrien Wierckx,Stefaan Vandecasteele,and Annick Van den Bruel, Adrenal insufficiency, be aware of drug interactions!, Endocrinol Diabetes Metab Case Rep. 2019
Autoimmune condition
Many autoimmune diseases have a connection with each other. For instance, autoimmune diseases that impair thyroid function and reduce thyroid hormones will also indirectly attack adrenal function.6Anna A Kasperlik-Załuska , Barbara Czarnocka, Włodzimierz Czech, Autoimmunity as the most frequent cause of idiopathic secondary adrenal insufficiency: report of 111 cases, Autoimmunity. 2003
Blood Sugar
Excessive consumption of sugar causes an imbalance of blood sugar levels, resulting in an increase in insulin resistance. As a result, blood sugar levels will remain consistently high, indirectly adding stress to the body.
Because of this ‘sugar stress’ the adrenals will release cortisol. But cortisol will further exacerbate the blood sugar imbalance as this stress hormone impairs insulin secretion and reduces insulin sensitivity.7Tanja C Adam, Rebecca E Hasson, Emily E Ventura, Claudia Toledo-Corral, Kim-Ann Le, Swapna Mahurkar, Christianne J Lane, Marc J Weigensberg, Michael I Goran, Cortisol is negatively associated with insulin sensitivity in overweight Latino youth, J Clin Endocrinol Metab. 2010
Can Adrenal Fatigue Go Away?
Adrenal fatigue is not a permanent health condition. It can go away if the ongoing stressor is managed appropriately. It is almost impossible to avoid it, and even more difficult to reduce stress. It may take time, but one has to be patient with themselves and their body.
The following few steps help you overcome adrenal fatigue:
- Consuming healthy foods such as skipping processed foods and focusing on nutrient-dense foods
- Limiting caffeine and alcohol intake
- Ensure that you are getting adequate amounts of B vitamins, vitamin C, and magnesium
- Getting enough sleep
- Staying hydrated
- Practicing self-care such as meditation or relaxation
Common Symptoms Of Adrenal Fatigue
Adrenal fatigue has a wide range of vague symptoms such as:
- fatigue or feeling exhausted all the time
- insomnia or difficulty waking up in the mornings
- low motivation, feeling irritable or unhappy
- brain fog
- joint pain
- allergies or flu-like symptoms like body aches
- salt or sweet cravings
- unexplained weight loss or weight gain
- loss of body hair or skin discoloration
- lightheadedness, low blood pressure
What Does Adrenal Fatigue Feel Like
How adrenal fatigue feels can be highly individual.
Some simple ways to describe it include a general feeling of malaise, brain fog, feverish, achy, and just flat-out tired.
It typically follows a period of emotional and/or physical stress.
Stress response
Improper management of acute stress can seamlessly transition into chronic stress.
In response to this chronic stress, your brain communicates to your adrenal glands to release the appropriate hormones to appropriately manage the stressor.
This is known as the HPA Axis.
Over time, this pathway becomes exhausted as it is a negative feedback loop.
Since chronic stress elicits a constant flow of adrenal hormones, the brain doesn’t see the need to add more to the mix as there is already enough in circulation.
The brain begins to shut down the HPA Axis and eventually you stop releasing enough hormones to live optimally.
These hormones deliver energy for simple physical actions like getting up from sitting down, immune health, and daily energy. They even help you maintain a stable emotional balance.
Eventually, as the HPA axis fails to deliver, you experience adrenal exhaustion and all of its subsequent symptoms like extreme fatigue, lowered mental performance, and diminished mental clarity.
Adrenal Glands & The HPA Axis
What are the Adrenal Glands?
The adrenal glands are a pair of small triangular-shaped organs present on top of the kidneys. Despite their size, the adrenal glands produce some of the most important hormones in the body.
These glands are divided into two parts, the outer cortex, and the inner medulla.
The cortex produces 3 hormones:
- glucocorticoids: also known as cortisol, is the stress hormone, that is released during physical or emotional stress.
- mineralocorticoids: also known as aldosterone, the hormone that maintains the salt and water balance in the body, thus effectively assisting in blood pressure control
- androgens, also known as testosterone
On the other hand, the adrenal medulla produces the infamous flight or fight hormones, adrenaline and noradrenaline.
The adrenal glands are not self-governing organs, they are a part of a bigger network, the endocrine system.
In this system, the adrenals communicate with various hormones and organs in the body to ultimately regulate adrenal hormones production and secretion.8Meghan Dutt , Chase J. Wehrle , Ishwarlal Jialal , Physiology, Adrenal Gland, StatPearls Publishing. 2022
The HPA Axis
The hypothalamic-pituitary-adrenal (HPA) axis is the motherboard that controls the production and secretion of adrenal hormones.
The hypothalamus is a small region present at the base of the brain. One of its numerous functions includes producing the corticotropin-releasing hormone (CRH). CRH then travels a little further downwards, towards the small pea-sized gland, the pituitary gland.
Upon reaching its destination, CRH will stimulate the cells of the anterior pituitary to produce the adrenocorticotropic hormone (ACTH). ACTH will make the long journey towards the adrenal glands, stimulating the adrenal cortex to produce cortisol.
Any type of stressor will trigger the HPA axis, with cortisol production being the end goal.
However, when the stress hormone levels increase, this sends negative feedback to the hypothalamus and pituitary, commanding them to stop the production of CRH and ACTH.
Problems arise when communication within the HPA axis is severed. Or when the stress hormone levels are persistently elevated due to chronic stress.9Filip Van Den Eede, Greta Moorkens, Boudewijn Van Houdenhove, Paul Cosyns, Stephan J Claes, Hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome, Neuropsychobiology. 2007
Adrenal Fatigue And Your Immune System
To understand how adrenal fatigue can impact your immune system, it is necessary to know how cortisol normally affects the immune system.
Under normal conditions, cortisol suppresses the immune system due to its anti-inflammatory effects.
During acute stress (lasting for a couple of minutes), immune cells along with pro-inflammatory cells are mobilized into the bloodstream to prepare the human body for infection or injury.
However, chronic stress yields entirely different health consequences. Inflammation is a short-term response for eliminating pathogens and initiating healing.
But long-term systemic inflammation can lead to immune system dysregulation, thus increasing the risk of chronic diseases or activation of dormant viruses.
Chronic stress will lead to persistently elevated cortisol levels. As a result, immune cells develop a resistance to the actions of cortisol. And the development of glucocorticoid resistance leads to sustained unresolved inflammation.
Consequently, this increases an individual’s susceptibility to infections, autoimmune diseases, and cancer.
However, it is necessary to note that the immune response to stressors is different for every person, resulting in contrasting immune health amongst individuals.10Jennifer N Morey, Ian A Boggero, April B Scott, Suzanne C Segerstrom, Current Directions in Stress and Human Immune Function, Curr Opin Psychol. 201511Roberto Zefferino, Sante Di Gioia , Massimo Conese, Molecular links between endocrine, nervous and immune system during chronic stress, Brain Behav. 202112Terrence Deak , Immune cells and cytokine circuits: toward a working model for understanding direct immune-to-adrenal communication pathways, Endocrinology. 2008
How Adaptogenic Herbs Improve Adrenal Fatigue
Let’s now discuss the best natural treatments to fight adrenal fatigue using adaptogenic herbs.
Adaptogenic herbs are like nature’s cheat code for boosting the function of your HPA axis.
For centuries, herbal medicine has been the basis for various ailments in traditional Chinese medicine and Ayurvedic medicine. In fact, there are several adaptogenic herbs that can be used specifically as adrenal fatigue herbs.13Lian-Ying Liao , Yi-Fan He , Li Li, Hong Meng , Yin-Mao Dong , Fan Yi , Pei-Gen Xiao, A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide, Chin Med. 2018
Adaptogenic Herbs and Adrenal Support
Adaptogenic herbs are a class of herbs that maintain and enhance the function of the human body. However, for a herb to be classified as an adaptogenic herb, it must meet the following three criteria:
- Adaptogenic herbs are non-specific, assisting the body deal with a wide range of adverse conditions (physical, biological, or chemical stress).
- Adaptogenic herbs maintain homeostasis within the body, that is restore the balance between the systems in the body.
- Adaptogenic herbs do not interfere with the normal functions of the body.
Read on to find out which adaptogenic herbs support adrenal health and function.
Top Adrenal Fatigue Adaptogenic Herbs
Rhodiola Rosea
Also known as golden root or roseroot, Rhodiola Rosea is a worldwide botanical adaptogen that has various protective effects such as anti-cancer, anti-diabetic, anti-inflammatory, cardioprotective, and immunoprotective.
Rhodiola Rosea balances cortisol levels and support healthy energy levels in individuals with adrenal fatigue.14Wei-Ling Pu, Meng-Ying Zhang, Ru-Yu Bai , Li-Kang Sun , Wen-Hua Li, Ying-Li Yu, Yue Zhang, Lei Song, Zhao-Xin Wang , Yan-Fei Peng, Hong Shi, Kun Zhou 6, Tian-Xiang Li, Anti-inflammatory effects of Rhodiola rosea L.: A review, Biomed Pharmacother. 2020
Bacopa Monnieri
Bacopa Monnieri is an Indian herb that inhibits inflammatory processes in the brain thus protecting it from oxidative damage and boosting mental clarity.15Michelle D Nemetchek, Andrea A Stierle, Donald B Stierle , Diana I Lurie, The Ayurvedic plant Bacopa monnieri inhibits inflammatory pathways in the brain, J Ethnopharmacol. 201716Tamara Simpson, Matthew Pase , Con Stough, Bacopa monnieri as an Antioxidant Therapy to Reduce Oxidative Stress in the Aging Brain, Evid Based Complement Alternat Med. 2015
Holy Basil
Native to southeast Asia, Holy Basil also known as Tulsi, has been used for thousands of years for its therapeutic effects in Ayurvedic medicine.
This plant possesses anti-inflammatory and antioxidant properties thus improving immune function, blood circulation, mental endurance, and cognition.
Holy Basil supports adrenal health by lowering elevated cortisol levels and regulating blood sugar levels.17Suneetha Sampath, S C Mahapatra, M M Padhi, Ratna Sharma, Anjana Talwar, Holy basil (Ocimum sanctum Linn.) leaf extract enhances specific cognitive parameters in healthy adult volunteers: A placebo controlled study, Indian J Physiol Pharmacol. 201518Edwin Jothie Richard, Ramanaiah Illuri , Bharathi Bethapudi , Senthilkumar Anandhakumar , Anirban Bhaskar , Chandrasekaran Chinampudur Velusami, Deepak Mundkinajeddu , Amit Agarwal, Anti-stress Activity of Ocimum sanctum: Possible Effects on Hypothalamic-Pituitary-Adrenal Axis, Phytother Res. 2016
Schisandra
Sometimes called the ultimate super berry, Schisandra improves the body’s resistance to stressful situations.
Research demonstrates that it offsets the negative effects of psychological stress and strenuous exercise due to immune dysfunction.
Schisandra is also a great herb to improve overall immune function.19Jie Li , Jian Wang, Jia-Qing Shao, Hong Du, Yang-Tian Wang, Li Peng, Effect of Schisandra chinensis on interleukins, glucose metabolism, and pituitary-adrenal and gonadal axis in rats under strenuous swimming exercise, Chin J Integr Med. 2015
Licorice Root
This adaptogenic herb potentiates the action of cortisol, thus enhancing stress response.
But improper use of licorice root can lead to pseudoaldosteronism, a medical condition that is characterized by high blood pressure.
Licorice root also reduces testosterone levels, exerting estrogen-like activity in women.20D Armanini , C Fiore, M J Mattarello, J Bielenberg, M Palermo History of the endocrine effects of licorice, Exp Clin Endocrinol Diabetes. 2002
Berberine
Studies reveal that Berberine inhibits the activity of the HPA axis, thus decreasing the production of cortisol.
Cortisol increases insulin resistance by inhibiting the transport of glucose into the cells and tissues. As a result, this increases the concentration of blood glucose levels. This scenario is favorable during temporary fight or flight situations.
However, chronically elevated cortisol levels will lead to high blood glucose levels, thus, inadvertently increasing stress on a cellular level.
Berberine aims to restore balance by decreasing the excessive production of cortisol.21Jia Mi , Wenda He, Jiawei Lv, Kai Zhuang, Heqing Huang , Shijian Quan, Effect of berberine on the HPA-axis pathway and skeletal muscle GLUT4 in type 2 diabetes mellitus rats, Diabetes Metab Syndr Obes. 2019
Reishi
This adaptogenic herb, also known as Lingzhi, is commonly used in traditional Chinese medicine to improve overall health.
Reishi has a broad range of benefits as it possesses immune regulating, anti-inflammatory, anti-diabetic, anti-neurodegenerative, and anti-bacterial properties.22Ewa Seweryn , Anna Ziała , Andrzej Gamian, Health-Promoting of Polysaccharides Extracted from Ganoderma lucidum, Nutrients. 2021
Cordyceps
Cordyceps is a type of medicinal fungus, whose bioactive component, cordycepin, possesses many therapeutic functions.
This fungus relieves stress by reducing the levels of cortisol and by diminishing the effects of stress on the body.23Syed Amir Ashraf, Abd Elmoneim O. Elkhalifa, Arif Jamal Siddiqui, Mitesh Patel, Amir Mahgoub Awadelkareem, Mejdi Snoussi, Mohammad Saquib Ashraf, Mohd Adnan, and Sibte Hadi, Cordycepin for Health and Wellbeing: A Potent Bioactive Metabolite of an Entomopathogenic Medicinal Fungus Cordyceps with Its Nutraceutical and Therapeutic Potential, Molecules. 2020
Panax Ginseng
This popular adaptogenic herb is best known for improving your mood and energy levels.
Also known as Korean ginseng, this herb prevents adrenal fatigue by reducing the response of the HPA axis to physical stress.24Won-Suk Sung, Ha-Ra Kang, Chan-Yung Jung, Seong-Sik Park, Seung-Ho Lee, Eun-Jung Kim, Efficacy of Korean red ginseng (Panax ginseng) for middle-aged and moderate level of chronic fatigue patients: A randomized, double-blind, placebo-controlled trial, Complement Ther Med. 202025Won-Suk Sung, Ha-Ra Kang, Chan-Yung Jung, Seong-Sik Park, Seung-Ho Lee, Eun-Jung Kim, Efficacy of Korean red ginseng (Panax ginseng) for middle-aged and moderate level of chronic fatigue patients: A randomized, double-blind, placebo-controlled trial, Complement Ther Med. 2020
Ashwagandha
Ashwagandha is popularly known to reduce anxiety because of its calming effects on the nervous system.
Research demonstrates that Ashwagandha improves sleep quality, and reduces stress and anxiety.26Jaysing Salve , Sucheta Pate , Khokan Debnath , Deepak Langade , Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study, Cureus. 2019
However, ashwagandha also boosts testosterone levels. An effect that may or may not be desirable by some individuals.27Adrian L Lopresti, Peter D Drummond , Stephen J Smith, A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha ( Withania somnifera) in Aging, Overweight Males, Am J Mens Health. 2019
Skullcap
Skullcap is a Native American plant that treats anxiety, stress, and insomnia.
This plant enhances the production and secretion of GABA within the central nervous system, thereby improving overall mood.28Lei Liu, Changhong Liu, Yicun Wang, Pu Wang, Yuxin Li, Bingjin Li, Herbal Medicine for Anxiety, Depression and Insomnia, Curr Neuropharmacol. 2015
Skullcap also modulates immune and endocrine function by targeting the overactive HPA axis.29Fiona Limanaqi, Francesca Biagioni, Carla Letizia Busceti,Maico Polzella, Cinzia Fabrizi, and Francesco Fornai, Potential Antidepressant Effects of Scutellaria baicalensis, Hericium erinaceus and Rhodiola rosea, Antioxidants (Basel). 2020
Gotu Kola
Gotu Kola also protects the nervous system as it improves cognition and reduces the risk of neurodegenerative diseases. Through its actions on the central nervous system, Gotu Kola reduces the brain fog associated with adrenal fatigue.30Boju Sun , Lili Wu, You Wu , Chengfei Zhang , Lingling Qin, Misa Hayashi, Maya Kudo, Ming Gao , Tonghua Liu, Therapeutic Potential of Centella asiatica and Its Triterpenes: A Review, Front Pharmacol. 202031Jia Hui Wong, Anna M Barron , Jafri Malin Abdullah, Mitoprotective Effects of Centella asiatica (L.) Urb.: Anti-Inflammatory and Neuroprotective Opportunities in Neurodegenerative Disease, Front Pharmacol. 2021
Medical Treatments Of Adrenal Fatigue
Typically, doctors initiate medical treatment when derangement of hormonal levels occurs, such as in Addison’s disease.
The most common treatment of Addison’s disease is the replacement of the depleting hormones; cortisol and aldosterone.
Hydrocortisone, prednisone, dexamethasone, or methylprednisolone replaces cortisol.
Fludrocortisone treatment replaces aldosterone, which normalizes blood pressure.32Aaron Michels , Nicole Michels , Addison disease: early detection and treatment principles,Am Fam Physician. 2014
Adrenal Fatigue Is Not Diagnosable By Most Doctors
Most doctors provide a clinical diagnosis when there is evidence of a hormonal imbalance, such as seen in blood tests or special investigations. And since the International Classification of Diseases (ICD-10) does not delineate it as a clinical disorder, many doctors may not consider adrenal fatigue as a possible diagnosis when managing a patient.
Additionally, there are no effective screening tools for adrenal fatigue diagnosis.
For these reasons, doctors may miss this crucial diagnosis of adrenal fatigue.
Common Vitamin and Mineral Deficiencies Associated With Adrenal Fatigue
Many vitamin and mineral deficiencies have an association with adrenal fatigue; these deficiencies may either contribute to adrenal fatigue or exacerbate the condition.
Vitamin D
Vitamin D is famously known as the vitamin that supports bone health.
One significant effect of cortisol is that it weakens bone structure. Therefore, the bone health of an individual dealing with adrenal fatigue, who is also vitamin D deficient will be poor; increasing their risk of osteoporosis.
Studies have also found an association between cortisol overproduction and low vitamin D levels.33G Muscogiuri , B Altieri , M Penna-Martinez , K Badenhoop , Focus on vitamin D and the adrenal gland, Horm Metab Res. 2015
B Vitamins
B complex vitamins protect the body from the detrimental effects of cortisol by regulating cortisol production, restoring adrenal function, and reversing the adverse effects of cortisol.34David A. Camfield,Mark A. Wetherell,Andrew B. Scholey,Katherine H. M. Cox,1 Erin Fogg, David J. White,Jerome Sarris, Marni Kras, Con Stough, Avni Sali, and Andrew Pipingas, The Effects of Multivitamin Supplementation on Diurnal Cortisol Secretion and Perceived Stress, Nutrients. 2013
Vitamin C
Vitamin C is popular for its anti-oxidant and anti-inflammatory effects. Several kinds of research demonstrate that vitamin C restores stress response and improves immune function by maintaining the HPA axis.35Paul E Marik, Vitamin C: an essential “stress hormone” during sepsis, J Thorac Dis. 2020
Magnesium
During acute stress, magnesium levels increase to diminish the adverse effect of stress. Sustained chronic stress can lead to the depletion of this vital mineral, which further exacerbates the stress response. Therefore, supplementation with magnesium is necessary to counteract the negative effects of cortisol and to prevent magnesium deficiency in adrenal fatigue.36Magdalena D. Cuciureanu and Robert Vink., Magnesium and stress, University of Adelaide Press; 201137Etienne Pouteau , Marmar Kabir-Ahmadi , Lionel Noah , Andre Mazur , Louise Dye , Juliane Hellhammer , Gisele Pickering , Claude Dubray, Superiority of magnesium and vitamin B6 over magnesium alone on severe stress in healthy adults with low magnesemia: A randomized, single-blind clinical trial, PLoS One. 2018
Risks and Side Effects Of Herbs
These adaptogenic herbs are mostly safe to consume but side effects may occur in a dose-dependent manner (manifestation of side effects as dose of herbs increases)..
Side effects include:
- stomach ache, indigestion, or heartburn
- nausea, vomiting
- Rhodiola Rosea can cause dry mouth and dizziness
- Holy Basil, Cordyceps, and Reishi mushrooms delay clotting mechanisms in the blood (act as blood thinners)
When consuming adaptogenic herbs, it is necessary to know that some of these herbs can interact with your prescribed medication. So thoroughly research these herbs to find the one that is best suited for you.
The Takeaway
Experiencing adrenal fatigue can be frustrating. Regardless, there are solutions present to get you out of this rut.
The first and most crucial step to combating adrenal fatigue is recognizing that you have this condition.
The above-mentioned adaptogenic herbs are just a few of the natural treatments available that support adrenal health.
Keeping your overall health in check with a healthy diet and lifestyle is the other side of the equation.
- 1Rashmi S Mullur, MAKING A DIFFERENCE IN ADRENAL FATIGUE, Endocr Pract. 2018
- 2R D Siegel , J Melby, Fatigue: the role of adrenal insufficiency, Hosp Pract (Off Ed). 1994
- 3Irina Bancos, Stefanie Hahner, Jeremy Tomlinson, Wiebke Arlt , Diagnosis and management of adrenal insufficiency, Lancet Diabetes Endocrinol. 2015
- 4Nada Younes, Isabelle Bourdeau, Andre Lacroix, Latent Adrenal Insufficiency: From Concept to Diagnosis, Front Endocrinol (Lausanne). 2021
- 5Elke Thijs,Katrien Wierckx,Stefaan Vandecasteele,and Annick Van den Bruel, Adrenal insufficiency, be aware of drug interactions!, Endocrinol Diabetes Metab Case Rep. 2019
- 6Anna A Kasperlik-Załuska , Barbara Czarnocka, Włodzimierz Czech, Autoimmunity as the most frequent cause of idiopathic secondary adrenal insufficiency: report of 111 cases, Autoimmunity. 2003
- 7Tanja C Adam, Rebecca E Hasson, Emily E Ventura, Claudia Toledo-Corral, Kim-Ann Le, Swapna Mahurkar, Christianne J Lane, Marc J Weigensberg, Michael I Goran, Cortisol is negatively associated with insulin sensitivity in overweight Latino youth, J Clin Endocrinol Metab. 2010
- 8Meghan Dutt , Chase J. Wehrle , Ishwarlal Jialal , Physiology, Adrenal Gland, StatPearls Publishing. 2022
- 9Filip Van Den Eede, Greta Moorkens, Boudewijn Van Houdenhove, Paul Cosyns, Stephan J Claes, Hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome, Neuropsychobiology. 2007
- 10Jennifer N Morey, Ian A Boggero, April B Scott, Suzanne C Segerstrom, Current Directions in Stress and Human Immune Function, Curr Opin Psychol. 2015
- 11Roberto Zefferino, Sante Di Gioia , Massimo Conese, Molecular links between endocrine, nervous and immune system during chronic stress, Brain Behav. 2021
- 12Terrence Deak , Immune cells and cytokine circuits: toward a working model for understanding direct immune-to-adrenal communication pathways, Endocrinology. 2008
- 13Lian-Ying Liao , Yi-Fan He , Li Li, Hong Meng , Yin-Mao Dong , Fan Yi , Pei-Gen Xiao, A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide, Chin Med. 2018
- 14Wei-Ling Pu, Meng-Ying Zhang, Ru-Yu Bai , Li-Kang Sun , Wen-Hua Li, Ying-Li Yu, Yue Zhang, Lei Song, Zhao-Xin Wang , Yan-Fei Peng, Hong Shi, Kun Zhou 6, Tian-Xiang Li, Anti-inflammatory effects of Rhodiola rosea L.: A review, Biomed Pharmacother. 2020
- 15Michelle D Nemetchek, Andrea A Stierle, Donald B Stierle , Diana I Lurie, The Ayurvedic plant Bacopa monnieri inhibits inflammatory pathways in the brain, J Ethnopharmacol. 2017
- 16Tamara Simpson, Matthew Pase , Con Stough, Bacopa monnieri as an Antioxidant Therapy to Reduce Oxidative Stress in the Aging Brain, Evid Based Complement Alternat Med. 2015
- 17Suneetha Sampath, S C Mahapatra, M M Padhi, Ratna Sharma, Anjana Talwar, Holy basil (Ocimum sanctum Linn.) leaf extract enhances specific cognitive parameters in healthy adult volunteers: A placebo controlled study, Indian J Physiol Pharmacol. 2015
- 18Edwin Jothie Richard, Ramanaiah Illuri , Bharathi Bethapudi , Senthilkumar Anandhakumar , Anirban Bhaskar , Chandrasekaran Chinampudur Velusami, Deepak Mundkinajeddu , Amit Agarwal, Anti-stress Activity of Ocimum sanctum: Possible Effects on Hypothalamic-Pituitary-Adrenal Axis, Phytother Res. 2016
- 19Jie Li , Jian Wang, Jia-Qing Shao, Hong Du, Yang-Tian Wang, Li Peng, Effect of Schisandra chinensis on interleukins, glucose metabolism, and pituitary-adrenal and gonadal axis in rats under strenuous swimming exercise, Chin J Integr Med. 2015
- 20D Armanini , C Fiore, M J Mattarello, J Bielenberg, M Palermo History of the endocrine effects of licorice, Exp Clin Endocrinol Diabetes. 2002
- 21Jia Mi , Wenda He, Jiawei Lv, Kai Zhuang, Heqing Huang , Shijian Quan, Effect of berberine on the HPA-axis pathway and skeletal muscle GLUT4 in type 2 diabetes mellitus rats, Diabetes Metab Syndr Obes. 2019
- 22Ewa Seweryn , Anna Ziała , Andrzej Gamian, Health-Promoting of Polysaccharides Extracted from Ganoderma lucidum, Nutrients. 2021
- 23Syed Amir Ashraf, Abd Elmoneim O. Elkhalifa, Arif Jamal Siddiqui, Mitesh Patel, Amir Mahgoub Awadelkareem, Mejdi Snoussi, Mohammad Saquib Ashraf, Mohd Adnan, and Sibte Hadi, Cordycepin for Health and Wellbeing: A Potent Bioactive Metabolite of an Entomopathogenic Medicinal Fungus Cordyceps with Its Nutraceutical and Therapeutic Potential, Molecules. 2020
- 24Won-Suk Sung, Ha-Ra Kang, Chan-Yung Jung, Seong-Sik Park, Seung-Ho Lee, Eun-Jung Kim, Efficacy of Korean red ginseng (Panax ginseng) for middle-aged and moderate level of chronic fatigue patients: A randomized, double-blind, placebo-controlled trial, Complement Ther Med. 2020
- 25Won-Suk Sung, Ha-Ra Kang, Chan-Yung Jung, Seong-Sik Park, Seung-Ho Lee, Eun-Jung Kim, Efficacy of Korean red ginseng (Panax ginseng) for middle-aged and moderate level of chronic fatigue patients: A randomized, double-blind, placebo-controlled trial, Complement Ther Med. 2020
- 26Jaysing Salve , Sucheta Pate , Khokan Debnath , Deepak Langade , Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study, Cureus. 2019
- 27Adrian L Lopresti, Peter D Drummond , Stephen J Smith, A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha ( Withania somnifera) in Aging, Overweight Males, Am J Mens Health. 2019
- 28Lei Liu, Changhong Liu, Yicun Wang, Pu Wang, Yuxin Li, Bingjin Li, Herbal Medicine for Anxiety, Depression and Insomnia, Curr Neuropharmacol. 2015
- 29Fiona Limanaqi, Francesca Biagioni, Carla Letizia Busceti,Maico Polzella, Cinzia Fabrizi, and Francesco Fornai, Potential Antidepressant Effects of Scutellaria baicalensis, Hericium erinaceus and Rhodiola rosea, Antioxidants (Basel). 2020
- 30Boju Sun , Lili Wu, You Wu , Chengfei Zhang , Lingling Qin, Misa Hayashi, Maya Kudo, Ming Gao , Tonghua Liu, Therapeutic Potential of Centella asiatica and Its Triterpenes: A Review, Front Pharmacol. 2020
- 31Jia Hui Wong, Anna M Barron , Jafri Malin Abdullah, Mitoprotective Effects of Centella asiatica (L.) Urb.: Anti-Inflammatory and Neuroprotective Opportunities in Neurodegenerative Disease, Front Pharmacol. 2021
- 32Aaron Michels , Nicole Michels , Addison disease: early detection and treatment principles,Am Fam Physician. 2014
- 33G Muscogiuri , B Altieri , M Penna-Martinez , K Badenhoop , Focus on vitamin D and the adrenal gland, Horm Metab Res. 2015
- 34David A. Camfield,Mark A. Wetherell,Andrew B. Scholey,Katherine H. M. Cox,1 Erin Fogg, David J. White,Jerome Sarris, Marni Kras, Con Stough, Avni Sali, and Andrew Pipingas, The Effects of Multivitamin Supplementation on Diurnal Cortisol Secretion and Perceived Stress, Nutrients. 2013
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