The Top 10 Evidence-Based Herbs to Support Adrenal Health

Over the last few years, Americans have been experiencing exponential amounts of stress. In 2022, the American Psychology Association surveyed United States adults and found that 27% of adults were experiencing stress to the point that it impacted their ability to function in their day-to-day lives. With stress leading to overall health, the medical profession and society must recognize and address this rising concern. The adrenal glands are the primary regulator of physiological stress. Ensuring your adrenals are functioning optimally and have the necessary nutrients can ensure you have the tools to mitigate how your body processes stress. There are times in which supplementary support can significantly benefit you. 

Evidence-based herbal medicine can support and heal those looking to take a root-cause approach to stress and their adrenal function. In this article, you’ll learn about the significance of your adrenal glands and the top 10 herbs that support adrenal health. 

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Understanding Adrenal Health

The proper functioning of the adrenal glands is necessary for optimal health and well-being.

The adrenal glands are two small organs that sit on top of each kidney. It’s comprised of two parts: the cortex and the medulla. Each piece plays a vital role in physiological processes in the body. The innermost part is called the adrenal medulla, producing the stress hormone adrenaline. The outer capsule is called the adrenal cortex, which consists of three layers- the zona glomerulosa, the zona fasciculata, and the zona reticularis. Each layer has a specific role in hormone regulation within the body. 

Cortisol, the primary stress hormone measured in functional medicine, is a glucocorticoid hormone produced by the zona fasciculata. While its primary role is to regulate the sleep-wake cycle and alertness when your body goes through a stressful situation, it also plays a role in macronutrient utilization, inflammation modulation, blood pressure, bone health, and blood sugar control. Cortisol can also impact other organs through signaling in the Hypothalamic-Pituitary-Adrenal (HPA) axis. Excess cortisol secretion is a leading contributor to things like Cushing's disease, and in chronic scenarios, cortisol can burn out, leading to adrenal fatigue.  

Providing the nutrients the adrenal gland needs to support its functionality is essential. Vitamin C, magnesium, and B vitamins are the most critical components to support adrenal gland function. Modulating stress through lifestyle factors, like getting appropriate sleep, implementing relaxation techniques, exercising, and addressing any underlying health imbalances that could be contributing are all essential in reaching homeostasis. 

Benefits of Herbs for Adrenal Health

Herbal medicine can be a powerful and effective tool when used appropriately. Conventional medicine does not acknowledge adrenal fatigue as a legitimate diagnosis unless it progresses to a syndrome or disease state like Cushing's. That said, there are minimal treatment options in supporting adrenal glands for well-being and preventative measures in Western medicine. 

From a naturopathic medicine perspective, herbs can be used in various ways, from addressing specific ailments to providing nutritional support and addressing the root cause of dysfunction. Herbal medicines are also multifunctional and can support systems like the HPA axis rather than just one organ at a time. 

Many herbs that help with stress modulation and, ultimately, adrenal health fall under the category of adaptogenic herbs. Some adaptogenic botanicals can mediate stress response by regulating key mediators such as proteins, enzymes, receptors, transcription factors, and molecules involved in the process. Below is a list of the top herbs to support the body’s stress response and adrenal health.

Top 10 Evidence-Based Herbs for Adrenal Support

Adrenal gland support is necessary in those with dysfunction. Here is a comprehensive list of adaptogenic herbs for adrenal health. 

1. Ashwagandha 

This is a widely used natural remedy for stress and anxiety, which impacts adrenal health.  Evidence shows that as little as 250mg daily of Ashwagandha, taken for 60 days, can considerably reduce stress and anxiety compared to a placebo. The data behind Ashwagandha reveals that this plant can benefit many areas of adrenal gland function. In terms of stress, it can attenuate HPA axis activity, which can lower cortisol and DHEA (a hormone released from the zona reticularis of the adrenal cortex). 

While 250mg was suitable for the study mentioned above, dosing may vary based on the route of administration and severity of presentation. Dosing can be as high as 500 mg twice a day in capsule form.

2. Rhodiola Rosea 

This adaptogenic herb has about 140 isolated compounds in its root. Rhodiola has a handful of mechanisms of action, with HPA axis cortisol dampening being the predominant feature. A study looking at the effectiveness of Rhodiola rosea extract in those with stress-related symptoms showed great improvement. The dosing for adrenal support using Rhodiola rose extract WS® 1375 is 200 mg twice a day for four weeks. 

3. Holy Basil (Tulsi) 

Ocimum sanctum, also known as Holy Basil or Tulsi, is a traditional Ayurvedic herbal remedy. One key benefit of this plant is it’s that it is an adaptogenic herb for adrenal health. It can help regulate cortisol levels by enhancing the central nervous system and it’s interaction with the HPA axis, which, like these other plants, will assist you in toning down your body’s stress response. 

The full extract of this plant was shown to be 39% more effective in managing stress than a placebo when used for 6 weeks at 1200mg per day. Holy Basil also has great antioxidant and anti-inflammatory benefits, which can reduce oxidative stress and inflammation, affecting the adrenal glands. Lastly, this plant extract can be used to support blood sugar regulation. Harmful blood sugar fluctuations can lead to an increase in cortisol as the adrenal glands are triggered during spikes. 

Supplementation with Holy Basil is typically in the form of teas, tinctures, or capsules. The capsule dose range is between 500-2000mg per day. Working with a trained practitioner is the best way to determine the appropriate dose for your unique needs. 

4. Licorice Root 

Glycyrrhiza glabra, commonly known as Licorice roots, is traditionally used to increase cortisol in the body. While there is a lot of mention regarding excess cortisol, this herb is one of the natural remedies for adrenal fatigue. In conditions where adrenal insufficiency or burnout has resulted in exhaustion of cortisol secretion, Licorice can be very helpful. The constituents glycyrrhizic acid and glycyrrhetinic acid are the primary active components that can inhibit the enzyme 11 beta-hydroxysteroid dehydrogenase (11-Beta-HSD) that breaks down cortisol in the body, allowing cortisol to stick around and bind to active receptors. You can take this herb as a liquid extract or encapsulated. The recommended dosage for adrenal fatigue is 1 to 4 grams daily, three times a day. 

5. Eleutherococcus senticosus (Siberian Ginseng) 

This ginseng family plant, better known as Eleuthero, is great for maintaining homeostasis under stress. It is a cortisol modulator and regulates the function of the HPA axis, thus decreasing the hypersecretion of cortisol from the adrenal glands. This is a great choice when you are under chronic stress and need an effective and supportive tool. Administration comes in the form of powder, tinctures, or standardized extract. Dosing varies, but a standard tincture dose is 2 to 8ml per day, 1 to 4 grams of whole powder, or 1.25 grams, one to three times a day of a standardized extract. 

6. Schisandra Berry 

This beautiful Chinese magnolia vine is an adaptogenic berry that has been used for decades to support physical health, mental health, and weakness. It’s commonly used in traditional Chinese medicine (TCM) as a tonifier to assist the body’s Qi or “vital force”. This an excellent choice for individuals trying to mitigate mental and physical burnout, as it can help support stamina. There are multiple studies looking at the use of Schisandra in athletes and the adaptogenic support this herb can provide under stress. For adaptogenic use, Schisandra can be dosed between 1.5 to 6 grams per day as a powder extract or 400-500mg capsules two to three times per day. 

7. Astragalus 

A commonly used TCM herb used for mental and physical stress is Astragalus. This plant is particularly helpful during an acute illness as it is an immune system modulator, which can help combat infectious agents, provide anti-inflammatory support, and help the body adjust to stressors during the illness. Appropriate dosing is 4 to 8mL daily or 10-30g per day as a dried root decoction. 

8. Maca Root 

This adaptogenic root is nutrient-rich. It contains vitamin C, phytonutrients, amino acids, and multiple minerals that are especially beneficial for women’s hormonal health. One study revealed that Maca could reduce anxiety and depression and improve sexual dysfunction in postmenopausal women, all of which can contribute to stress and, ultimately, adrenal gland function. Suggestive dosing from the mentioned study is 3.5 grams per day for 6-weeks. 

9. Panax Ginseng 

Asian ginseng, commonly called Panax ginseng or “ginseng,” is used for both physical and mental fatigue. Utilizing this plant medicine during times of stressful physical activity can both support performance and energy. Panax ginseng helps regulate the HPA axis and the brain by stimulating adrenocorticotropic hormone, which leads to cortisol production and its effects on the brain. Dosing is commonly in the form of a dried root powder at 200-600 mg daily. 

10. Reishi Mushroom

Reishi is a medicinal mushroom that is part of the Ganoderma genus of “ Immortality Mushrooms.” In TCM, this mushroom is known to support general wellness and promote longevity. One randomized control trial using a 25% standardized extract of the polysaccharide component of this mushroom revealed that after 8-weeks of supplementation at 5.4g per day, the participants suffering from neurasthenia (nervous system exhaustion) had a reduction in fatigue and improved overall well-being. 

Nervous system fatigue by way of the sympathetic nervous system is intricately connected to adrenal gland function, and thus, to improve one, the other may need support. Dosing should be based on your individual situation. A generalized dosing method for nervous system-related fatigue is 1,800 mg three times a day for eight weeks. 

Incorporating Herbs into Your Lifestyle

A wide variety of integrative and complementary medicine practices utilize herbal medicine to support patient care. Learning the benefits of herbs and integration for adrenal support is an avenue that can provide natural and practical options for your health. The internet has a plethora of information when it comes to holistic modalities. Still, ideally, if you want to use an herb to treat a specific condition or ailment, it is recommended to consult with a trained herbalist or practitioner, such as a naturopathic doctor who has trained in the herb indications, benefits, contraindications, and dosing methods. Like pharmaceutical medications, there can be risks and side effects when herbs are not appropriately used. If you are on prescribed medication, you will want to ensure there are no drug-herb interactions with adrenal-supportive herbs and your specific medication. 

Functional Medicine Testing That Can Support Adrenal Health

There are many functional medicine lab tests that can help support adrenal function. 

Adrenal Stress Test

Assessing adrenal gland function can be done through a comprehensive adrenal gland stress test. Precision Analytical offers an Advanced Adrenal Stress Test that will evaluate multiple salivary samples to determine cortisol levels. In addition, this test looks at DHEA and secretory IgA (SIgA), which can help determine the root cause of adrenal dysfunction. 

Micronutrient Testing

As mentioned above, there are a handful of vitamins and minerals that are needed for optimal adrenal gland function. SpectraCell's Micronutrient Test assess nutritional status of 31 essential vitamins and minerals.

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Summary

Herbal medicine can play a significant role in addressing dysfunction associated with adrenal gland health. Whether you are dealing with stress, fatigue, anxiety, or a condition directly related to adrenal sufficiency, there are a variety of herbs that can be supportive in your healing journey. Working with a skilled practitioner is the key to creating a custom treatment plan to get your health back on track.