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Have you ever heard this retort to an insult: “Just who do you think you are?” I was thinking about that in relation to adrenal glandular function. We think we know who we are, but in fact, the hormones made by the adrenal gland can profoundly influence our health, personality, emotions and communication style. Many years ago, I had a difficult dental surgery because my wisdom teeth had grown in sideways and were pressing on things they shouldn’t. The dentist was quite worried about swelling in the area after the lengthy extraction, and so prescribed a steroid called Decadron (dexamethasone). There are many hormones our adrenal glands make, and one is called cortisol. The synthetic analog of cortisol for drug administration is hydrocortisone, which is what is given to people who don’t make enough cortisol. Decadron (dexamethasone) is 40 to 50 times stronger than hydrocortisone. I have never been so crazy wired in my life! I slept two or three hours a night, cleaned like a maniacal Mr. Clean (I removed lightbulbs from the lamps and washed them), wrote embarrassing 14-page hand-written letters to my friends, and couldn’t stop talking. This went on for a few days, and once the medication was discontinued, I knew for certain that I was not exactly who I thought I was, but who my adrenal hormones told me to be. And then I went to bed and slept the sleep of the totally exhausted.
We have two adrenal glands, each one sitting atop a kidney. The adrenal glands have an important goal: to keep us alive in emergency circumstances. They provide the needed energy, strength, focus, alertness, stamina and visual acuity to get us out of stressful predicaments, whether a primitive human fighting off a saber-tooth tiger or a modern human fighting to emerge from a car accident in sub-zero weather.
This is a bit simplified, but your adrenal glands produce four classes of hormones:
• Mineralocorticoids, the most important of which is aldosterone, which regulates blood pressure via kidney function.
• Glucocorticoids, the most important of which is cortisol, which regulates sugar metabolism and energy.
• Adrenal androgens, including dehydroepiandrosterone (DHEA), testosterone, and adrenocorticotropic hormone (ACTH) all of which influence the other adrenal hormones and some of which can convert to estrogen if needed.
• Catecholamines, including epinephrine and norepinephrine (also called adrenalin and noradrenalin) and small amounts of dopamine, which influence the fight or flight physiological response.
All of them affect how your body works, and all of them affect your thinking. Keeping your adrenal glands balanced and healthy is crucially important for both mind and body.
There are so many things that can cause disrupted adrenal function, but basically, the problem is usually either you are overproducing one or more adrenal hormones (ie, cortisol) or you are underproducing adrenal hormones.
The way to improve adrenal health is to first focus on nutrients that boost the health of the adrenal gland, then look at nutrients that play a role in either nudging up or settling down adrenal hormone production.
The B-vitamin Family
One of the best things you can do for adrenal health is to make sure you are getting optimal amounts of B-vitamins in their bioactive form. This means vitamin B-12, B-6 and folate are already converted to the human form, bypassing liver conversion. This assures proper levels and utilization for adrenal function. The adrenal gland needs these B-vitamins to make adrenal hormones like norepinephrine.
Vitamin C
The greatest store of vitamin C is in the adrenal glands, and it is depleted quickly under stress. Therefore, supplementing with vitamin C can be useful.
DHEA
Dehydroepiandrosterone (DHEA) is made by the adrenal glands and can remain DHEA or metabolize into more than 100 other compounds, including testosterone and estrogen, based on the needs of the body. DHEA levels peak in youth and fall off with age. If your adrenals are not working at optimal levels, supplementing with DHEA can augment the amounts made by the gland. Conversely, if you are over-responding to stressors with excessive cortisol production, having solid levels of DHEA on board will help modulate that process to reduce cortisol overproduction. That is why you might see DHEA and the B-vitamin family in products that are designed to increase adrenal function and also in products targeting a reduction in cortisol.
Licorice
Licorice (Glycyrrhiza glabra) is a powerful medicine for adrenal function, because it helps keep adrenal hormones active in the blood stream longer. This is very useful for people who need to nudge up their adrenal hormone function a bit. Low levels of licorice, less than 1,000 mg a day, are safe and very therapeutic for adrenal health. However, taken at doses of 57 grams (57,000 mg) per day for two weeks or more, licorice can increase blood pressure and have other adverse effects. This would be taking more than 50 capsules of licorice a day! Keeping the dose to less than 1,000 is very beneficial and should have no negative impact on blood pressure.
Rehmannia
Rehmannia (Rehmannia glutinosa) is a pretty purple flower that contains a compound called catalpol. Catalpol is a mild adrenal stimulant—it politely asks the adrenal gland to please make a little more of the adrenal hormones. This is another intervention that is very useful for improving adrenal function.
Ashwagandha
Ashwagandha (Withania somnifera) contains a number of potent natural compounds that are strong supports for adrenal function. This clinically studied herb can improve fatigue, ameliorate the ravages of too much stress, and improve stamina. Studies have found that ashwagandha mildly decreases levels of cortisol and significantly reduces feelings of fatigue and stress—by more than 50 percent in one clinical trial. In a 60-day, double-blind, placebo-controlled study, volunteers received either ashwagandha or placebo. By the 60th day, the differences were quite significant. In the ashwagandha group, physical stress symptoms were reduced 76 percent, tension and insomnia by 69 percent, and depression scores by 79 percent. The extract used in this study was KSM-66, which is standardized to withanolides content.
Rhodiola
Rhodiola (Rhodiola rosea) is a plant that contains salidrosides, rosavin, rosin and rosarian. These are the nutrients that are responsible for rhodiola’s ability to support healthy adrenal activity, reduce stress, increase energy and improve mental performance. In other research studies, rhodiola was shown to be able to reduce mental fatigue and improve well-being in college students taking final exams. In fact, the final exam grades were improved, too.
In Conclusion
This is just scratching the surface of natural medicines for adrenal function. Actual bovine adrenal extracts can be very effective, and there are nutrients that decrease cortisol, like phosphatidylserine. Tyrosine is an amino acid used by your adrenal glands to make hormones. Red ginseng can definitely improve energy in the adrenally depleted. It may take some trial and error, but you can put together a regimen that improves your adrenal health. VR
References:
Padayatty SJ, Doppman JL, Chang R, Human adrenal glands secrete vitamin C in response to adrenocorticotrophic hormone. Am J Clin Nutr. 2007;86(1):145-9.
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.
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.
Binder G, Weber S, Ehrismann M, et al. Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: a double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab. 2009;94(4):1182-90.
Deijen JB, Orlebeke JF. Effect of tyrosine on cognitive function and blood pressure under stress. Brain Res Bull. 1994;33(3):319-23.
Isbrucker RA, Burdock GA. Risk and safety assessment on the consumption of Licorice root (Glycyrrhiza sp.), its extract and powder as a food ingredient, with emphasis on the pharmacology and toxicology of glycyrrhizin. Regul Toxicol Pharmacol. 2006c;46(3):167-92.
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.
Vitamin B6. In: In: Hendler SS, ed. PDR for Nutritional Supplements, 2nd ed. Montvale, NJ: Physician’s Desk Reference; 2008:634-644.
Coombs G. Pantothenic Acid. In: The Vitamins: Fundamental Aspects in Nutrition and Health. San Diego, California: Academic Press, Inc; 1992:345-356.
Dharmananda S. Rehmannia. Available at: www.itmonline.org/arts/rehmann.htm. Accessed on December 3, 2009.
Blood tonics. In: Reid DP. Chinese Herbal Medicine. Boston, Mass: Shambala Publications; 1992:150.
Glandulars. In: Hendler SS, ed. PDR for Nutritional Supplements, 2nd ed. Montvale, NJ: Physician’s Desk Reference; 2008:264.
Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186.
Fuladi S, Emami SA, Mohammadpour AH, Karimani A, Manteghi AA, Sahebkar A. Assessment of Withania somnifera root extract efficacy in patients with generalized anxiety disorder: A randomized double-blind placebo-controlled trial [published online ahead of print, 2020 Apr 13]. Curr Clin Pharmacol. 2020;10.2174/1574884715666200413120413.
Kumar A, Kalonia H. Protective effect of Withania somnifera Dunal on the behavioral and biochemical alterations in sleep-disturbed mice (Grid over water suspended method). Indian J Exp Biol. 2007 Jun;45(6):524-8.
Saykally JN, Hatic H, Keeley KL, Jain SC, Ravindranath V, Citron BA. Withania somnifera Extract Protects Model Neurons from In Vitro Traumatic Injury. Cell Transplant. 2017 Jul;26(7):1193-1201. doi: 10.1177/0963689717714320.
Choudhary D, Bhattacharyya S, Bose S. Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions. J Diet Suppl. 2017 Nov 2;14(6):599-612.
Chengappa KN, Bowie CR, Schlicht PJ, Fleet D, Brar JS, Jindal R. Randomized placebo-controlled adjunctive study of an extract of Withania somnifera for cognitive dysfunction in bipolar disorder. J Clin Psychiatry. 2013;74(11):1076-1083. doi:10.4088/JCP.13m08413.
Sharma AK, Basu I, Singh S. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med. 2018 Mar;24(3):243-248.
Shenoy S, et al. Effects of eight-week supplementation of Ashwagandha on cardiorespiratory endurance in elite Indian cyclists. J Ayurveda Integr Med. 2012;3(4):209-14.
Choudhary B, Shetty A, Langade DG. Efficacy of Ashwagandha (Withania somnifera [L.] Dunal) in improving cardiorespiratory endurance in healthy athletic adults. Ayu. 2015;36(1):63-68. doi:10.4103/0974-8520.169002.
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;34(3):255-62.
Darbinyan V, Kteyan A, Panossian A, et al. 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.
Edwards D, Heufelder A, Zimmermann A. Therapeutic effects and safety of Rhodiola rosea extract WS 1375 in subjects with life-stress symptoms–results of an open-label study. Phytother Res. 2012 Aug;26(8):1220–5.
Olsson EM, von Schéele B, Panossian AG. A Randomised, Double-Blind, Placebo-Controlled, Parallel-Group Study of the Standardised Extract SHR-5 of the Roots of Rhodiola rosea in the Treatment of Subjects with Stress-Related Fatigue. Planta Medica. 2008 Nov 18.
Shevtsov VA, Zholus BI, Shervarly VI, et al. A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine. 2003;10:95-105.
Camfield DA, Wetherell MA, Scholey AB, Cox KH, Fogg E, White DJ, Sarris J, Kras M, Stough C, Sali A, Pipingas A. The effects of multivitamin supplementation on diurnal cortisol secretion and perceived stress. Nutrients. 2013 Nov 11;5(11):4429-50. doi: 10.3390/nu5114429. PMID: 24284609; PMCID: PMC3847740.
Stough C, Scholey A, Lloyd J, Spong J, Myers S, Downey LA. The effect of 90 day administration of a high dose vitamin B-complex on work stress. Hum Psychopharmacol. 2011 Oct;26(7):470-6. doi: 10.1002/hup.1229. Epub 2011 Sep 8. PMID: 21905094. [Link to abstract: https://pubmed.ncbi.nlm.nih.gov/21905094/.
Schlebusch L, Bosch BA, Polglase G, Kleinschmidt I, Pillay BJ, Cassimjee MH. A double-blind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress. S Afr Med J. 2000 Dec;90(12):1216-23. PMID: 11234653. [Link to abstract: https://pubmed.ncbi.nlm.nih.gov/11234653/.
Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals. Nutrients. 2019 Sep 16;11(9):2232. doi: 10.3390/nu11092232. PMID: 31527485; PMCID: PMC6770181.
Brody S, Preut R, Schommer K, Schürmeyer TH. A randomized controlled trial of high dose ascorbic acid for reduction of blood pressure, cortisol, and subjective responses to psychological stress. Psychopharmacology (Berl). 2002 Jan;159(3):319-24. doi: 10.1007/s00213-001-0929-6. Epub 2001 Nov 20. PMID: 11862365.
Kamin HS, Kertes DA. Cortisol and DHEA in development and psychopathology. Horm Behav. 2017 Mar;89:69-85. doi: 10.1016/j.yhbeh.2016.11.018. Epub 2016 Dec 12. PMID: 27979632.
Kroboth PD, Amico JA, Stone RA, Folan M, Frye RF, Kroboth FJ, Bigos KL, Fabian TJ, Linares AM, Pollock BG, Hakala C. Influence of DHEA administration on 24-hour cortisol concentrations. J Clin Psychopharmacol. 2003 Feb;23(1):96-9. doi: 10.1097/00004714-200302000-00014. PMID: 12544381.
Rabijewski M, Papierska L, Binkowska M, Maksym R, Jankowska K, Skrzypulec-Plinta W, Zgliczynski W. Supplementation of dehydroepiandrosterone (DHEA) in pre- and postmenopausal women – position statement of expert panel of Polish Menopause and Andropause Society. Ginekol Pol. 2020;91(9):554-562. doi: 10.5603/GP.2020.0091. PMID: 33030737.
Bentley C, Hazeldine J, Greig C, Lord J, Foster M. Dehydroepiandrosterone: a potential therapeutic agent in the treatment and rehabilitation of the traumatically injured patient. Burns Trauma. 2019 Aug 2;7:26. doi: 10.1186/s41038-019-0158-z. PMID: 31388512; PMCID: PMC6676517.
Parker CR Jr. Dehydroepiandrosterone and dehydroepiandrosterone sulfate production in the human adrenal during development and aging. Steroids. 1999 Sep;64(9):640-7. doi: 10.1016/s0039-128x(99)00046-x. PMID: 10503722.
Walther A, Seuffert J. Testosterone and Dehydroepiandrosterone Treatment in Ageing Men: Are We All Set? World J Mens Health. 2020;38(2):178-190. doi:10.5534/wjmh.190006 www.ncbi.nlm.nih.gov/pmc/articles/PMC7076306/.
Alhaj HA, Massey AE, McAllister-Williams RH. Effects of DHEA administration on episodic memory, cortisol and mood in healthy young men: a double-blind, placebo-controlled study. Psychopharmacology (Berl). 2006 Nov;188(4):541-51. doi: 10.1007/s00213-005-0136-y. Epub 2005 Oct 18. PMID: 16231168.
Hakamata Y, Izawa S, Sato E, Komi S, Murayama N, Moriguchi Y, Hanakawa T, Inoue Y, Tagaya H. Higher cortisol levels at diurnal trough predict greater attentional bias towards threat in healthy young adults. J Affect Disord. 2013 Nov;151(2):775-779. doi: 10.1016/j.jad.2013.06.031. Epub 2013 Jul 17. PMID: 23870426.
Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of scientific affairs and education for EuroPharma, Inc.
Have you ever heard this retort to an insult: “Just who do you think you are?” I was thinking about that in relation to adrenal glandular function. We think we know who we are, but in fact, the hormones made by the adrenal gland can profoundly influence our health, personality, emotions and communication style. Many years ago, I had a difficult dental surgery because my wisdom teeth had grown in sideways and were pressing on things they shouldn’t. The dentist was quite worried about swelling in the area after the lengthy extraction, and so prescribed a steroid called Decadron (dexamethasone). There are many hormones our adrenal glands make, and one is called cortisol. The synthetic analog of cortisol for drug administration is hydrocortisone, which is what is given to people who don’t make enough cortisol. Decadron (dexamethasone) is 40 to 50 times stronger than hydrocortisone. I have never been so crazy wired in my life! I slept two or three hours a night, cleaned like a maniacal Mr. Clean (I removed lightbulbs from the lamps and washed them), wrote embarrassing 14-page hand-written letters to my friends, and couldn’t stop talking. This went on for a few days, and once the medication was discontinued, I knew for certain that I was not exactly who I thought I was, but who my adrenal hormones told me to be. And then I went to bed and slept the sleep of the totally exhausted.
We have two adrenal glands, each one sitting atop a kidney. The adrenal glands have an important goal: to keep us alive in emergency circumstances. They provide the needed energy, strength, focus, alertness, stamina and visual acuity to get us out of stressful predicaments, whether a primitive human fighting off a saber-tooth tiger or a modern human fighting to emerge from a car accident in sub-zero weather.
This is a bit simplified, but your adrenal glands produce four classes of hormones:
• Mineralocorticoids, the most important of which is aldosterone, which regulates blood pressure via kidney function.
• Glucocorticoids, the most important of which is cortisol, which regulates sugar metabolism and energy.
• Adrenal androgens, including dehydroepiandrosterone (DHEA), testosterone, and adrenocorticotropic hormone (ACTH) all of which influence the other adrenal hormones and some of which can convert to estrogen if needed.
• Catecholamines, including epinephrine and norepinephrine (also called adrenalin and noradrenalin) and small amounts of dopamine, which influence the fight or flight physiological response.
All of them affect how your body works, and all of them affect your thinking. Keeping your adrenal glands balanced and healthy is crucially important for both mind and body.
There are so many things that can cause disrupted adrenal function, but basically, the problem is usually either you are overproducing one or more adrenal hormones (ie, cortisol) or you are underproducing adrenal hormones.
The way to improve adrenal health is to first focus on nutrients that boost the health of the adrenal gland, then look at nutrients that play a role in either nudging up or settling down adrenal hormone production.
The B-vitamin Family
One of the best things you can do for adrenal health is to make sure you are getting optimal amounts of B-vitamins in their bioactive form. This means vitamin B-12, B-6 and folate are already converted to the human form, bypassing liver conversion. This assures proper levels and utilization for adrenal function. The adrenal gland needs these B-vitamins to make adrenal hormones like norepinephrine.
Vitamin C
The greatest store of vitamin C is in the adrenal glands, and it is depleted quickly under stress. Therefore, supplementing with vitamin C can be useful.
DHEA
Dehydroepiandrosterone (DHEA) is made by the adrenal glands and can remain DHEA or metabolize into more than 100 other compounds, including testosterone and estrogen, based on the needs of the body. DHEA levels peak in youth and fall off with age. If your adrenals are not working at optimal levels, supplementing with DHEA can augment the amounts made by the gland. Conversely, if you are over-responding to stressors with excessive cortisol production, having solid levels of DHEA on board will help modulate that process to reduce cortisol overproduction. That is why you might see DHEA and the B-vitamin family in products that are designed to increase adrenal function and also in products targeting a reduction in cortisol.
Licorice
Licorice (Glycyrrhiza glabra) is a powerful medicine for adrenal function, because it helps keep adrenal hormones active in the blood stream longer. This is very useful for people who need to nudge up their adrenal hormone function a bit. Low levels of licorice, less than 1,000 mg a day, are safe and very therapeutic for adrenal health. However, taken at doses of 57 grams (57,000 mg) per day for two weeks or more, licorice can increase blood pressure and have other adverse effects. This would be taking more than 50 capsules of licorice a day! Keeping the dose to less than 1,000 is very beneficial and should have no negative impact on blood pressure.
Rehmannia
Rehmannia (Rehmannia glutinosa) is a pretty purple flower that contains a compound called catalpol. Catalpol is a mild adrenal stimulant—it politely asks the adrenal gland to please make a little more of the adrenal hormones. This is another intervention that is very useful for improving adrenal function.
Ashwagandha
Ashwagandha (Withania somnifera) contains a number of potent natural compounds that are strong supports for adrenal function. This clinically studied herb can improve fatigue, ameliorate the ravages of too much stress, and improve stamina. Studies have found that ashwagandha mildly decreases levels of cortisol and significantly reduces feelings of fatigue and stress—by more than 50 percent in one clinical trial. In a 60-day, double-blind, placebo-controlled study, volunteers received either ashwagandha or placebo. By the 60th day, the differences were quite significant. In the ashwagandha group, physical stress symptoms were reduced 76 percent, tension and insomnia by 69 percent, and depression scores by 79 percent. The extract used in this study was KSM-66, which is standardized to withanolides content.
Rhodiola
Rhodiola (Rhodiola rosea) is a plant that contains salidrosides, rosavin, rosin and rosarian. These are the nutrients that are responsible for rhodiola’s ability to support healthy adrenal activity, reduce stress, increase energy and improve mental performance. In other research studies, rhodiola was shown to be able to reduce mental fatigue and improve well-being in college students taking final exams. In fact, the final exam grades were improved, too.
In Conclusion
This is just scratching the surface of natural medicines for adrenal function. Actual bovine adrenal extracts can be very effective, and there are nutrients that decrease cortisol, like phosphatidylserine. Tyrosine is an amino acid used by your adrenal glands to make hormones. Red ginseng can definitely improve energy in the adrenally depleted. It may take some trial and error, but you can put together a regimen that improves your adrenal health. VR
References:
Padayatty SJ, Doppman JL, Chang R, Human adrenal glands secrete vitamin C in response to adrenocorticotrophic hormone. Am J Clin Nutr. 2007;86(1):145-9.
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.
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.
Binder G, Weber S, Ehrismann M, et al. Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: a double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab. 2009;94(4):1182-90.
Deijen JB, Orlebeke JF. Effect of tyrosine on cognitive function and blood pressure under stress. Brain Res Bull. 1994;33(3):319-23.
Isbrucker RA, Burdock GA. Risk and safety assessment on the consumption of Licorice root (Glycyrrhiza sp.), its extract and powder as a food ingredient, with emphasis on the pharmacology and toxicology of glycyrrhizin. Regul Toxicol Pharmacol. 2006c;46(3):167-92.
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.
Vitamin B6. In: In: Hendler SS, ed. PDR for Nutritional Supplements, 2nd ed. Montvale, NJ: Physician’s Desk Reference; 2008:634-644.
Coombs G. Pantothenic Acid. In: The Vitamins: Fundamental Aspects in Nutrition and Health. San Diego, California: Academic Press, Inc; 1992:345-356.
Dharmananda S. Rehmannia. Available at: www.itmonline.org/arts/rehmann.htm. Accessed on December 3, 2009.
Blood tonics. In: Reid DP. Chinese Herbal Medicine. Boston, Mass: Shambala Publications; 1992:150.
Glandulars. In: Hendler SS, ed. PDR for Nutritional Supplements, 2nd ed. Montvale, NJ: Physician’s Desk Reference; 2008:264.
Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186.
Fuladi S, Emami SA, Mohammadpour AH, Karimani A, Manteghi AA, Sahebkar A. Assessment of Withania somnifera root extract efficacy in patients with generalized anxiety disorder: A randomized double-blind placebo-controlled trial [published online ahead of print, 2020 Apr 13]. Curr Clin Pharmacol. 2020;10.2174/1574884715666200413120413.
Kumar A, Kalonia H. Protective effect of Withania somnifera Dunal on the behavioral and biochemical alterations in sleep-disturbed mice (Grid over water suspended method). Indian J Exp Biol. 2007 Jun;45(6):524-8.
Saykally JN, Hatic H, Keeley KL, Jain SC, Ravindranath V, Citron BA. Withania somnifera Extract Protects Model Neurons from In Vitro Traumatic Injury. Cell Transplant. 2017 Jul;26(7):1193-1201. doi: 10.1177/0963689717714320.
Choudhary D, Bhattacharyya S, Bose S. Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions. J Diet Suppl. 2017 Nov 2;14(6):599-612.
Chengappa KN, Bowie CR, Schlicht PJ, Fleet D, Brar JS, Jindal R. Randomized placebo-controlled adjunctive study of an extract of Withania somnifera for cognitive dysfunction in bipolar disorder. J Clin Psychiatry. 2013;74(11):1076-1083. doi:10.4088/JCP.13m08413.
Sharma AK, Basu I, Singh S. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med. 2018 Mar;24(3):243-248.
Shenoy S, et al. Effects of eight-week supplementation of Ashwagandha on cardiorespiratory endurance in elite Indian cyclists. J Ayurveda Integr Med. 2012;3(4):209-14.
Choudhary B, Shetty A, Langade DG. Efficacy of Ashwagandha (Withania somnifera [L.] Dunal) in improving cardiorespiratory endurance in healthy athletic adults. Ayu. 2015;36(1):63-68. doi:10.4103/0974-8520.169002.
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;34(3):255-62.
Darbinyan V, Kteyan A, Panossian A, et al. 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.
Edwards D, Heufelder A, Zimmermann A. Therapeutic effects and safety of Rhodiola rosea extract WS 1375 in subjects with life-stress symptoms–results of an open-label study. Phytother Res. 2012 Aug;26(8):1220–5.
Olsson EM, von Schéele B, Panossian AG. A Randomised, Double-Blind, Placebo-Controlled, Parallel-Group Study of the Standardised Extract SHR-5 of the Roots of Rhodiola rosea in the Treatment of Subjects with Stress-Related Fatigue. Planta Medica. 2008 Nov 18.
Shevtsov VA, Zholus BI, Shervarly VI, et al. A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine. 2003;10:95-105.
Camfield DA, Wetherell MA, Scholey AB, Cox KH, Fogg E, White DJ, Sarris J, Kras M, Stough C, Sali A, Pipingas A. The effects of multivitamin supplementation on diurnal cortisol secretion and perceived stress. Nutrients. 2013 Nov 11;5(11):4429-50. doi: 10.3390/nu5114429. PMID: 24284609; PMCID: PMC3847740.
Stough C, Scholey A, Lloyd J, Spong J, Myers S, Downey LA. The effect of 90 day administration of a high dose vitamin B-complex on work stress. Hum Psychopharmacol. 2011 Oct;26(7):470-6. doi: 10.1002/hup.1229. Epub 2011 Sep 8. PMID: 21905094. [Link to abstract: https://pubmed.ncbi.nlm.nih.gov/21905094/.
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Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of scientific affairs and education for EuroPharma, Inc.
