Brigid Titgemeier, MS, RDN, LD, IFNCP

Brigid is a functional nutrition dietitian, graduate school instructor, and functional medicine patient. Brigid's passion for helping others use food as medicine stems from her 15 year experience of battling her own health issues and continuing to learn how to heal herself.

Today, Brigid works with CEOs and executives, using personalized nutrition coaching and advanced lab testing to create optimal health. She has worked with nearly four thousand patients in her own business and as a founding dietitian of the Cleveland Clinic Center for Functional Medicine. In addition to studying nutrition for ten years, through school, her dietetic internship and two advanced functional medicine credentialing programs, she has also trained under and worked with the leading functional medicine doctors.

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Adaptogens and Nutrients to Curb the Stress Response and Boost Adrenal Health

Chronically elevated cortisol levels are becoming all too common. That is likely because they are driven by new societal norms: demanding work schedules, ever-growing to-do lists, over-exercising, and being ‘on’ 24-7. High levels of stress present in the modern world cause the body to produce increasing amounts of cortisol in order to prepare the body to deal with each stressful scenario. What your body doesn’t realize is that the stress you now face is not typically the life-or-death encounters once faced by your ancestors. When giving a presentation or overbooking your calendar, your body undergoes the same biological processes that it would if you were running from a bear. Hormones that once helped direct blood to vital organs to allow you to engage successfully in fight-or-flight now course through your veins with each email notification you receive.

Chronic stress causes your body to produce more cortisol, interfering with the natural drop in cortisol levels that naturally happens as the day goes on. The adrenal glands overproduce the stress hormone cortisol, leading to an activation of the sympathetic nervous system. This dysfunction causes the body to experience all kinds of unpleasant symptoms such as fatigue, fat storage, depression, and memory loss. High levels of cortisol can also lead to impaired thyroid function and decreased activity of hormones such as progesterone, estrogen, DHEA and testosterone. For a more in-depth look at HPA Axis Dysfunction, view my original post on stress and the adrenals.[1]

HPA Axis Dysfunction, high cortisol and burnout are such wide-spread problems, but how can you fix them? While there are many different supplements you can take to reduce the effects of stress on the adrenals, it is important to understand that you cannot out-supplement your stress. Though each of the below herbs and nutrients plays an important part in regulating your stress response, none will be able to treat your adrenal dysfunction if you do not address the underlying cause.

It is too easy to blow off self-care in favor of what you have decided is more productive. If you spend more hours of the day battling the clock, a full inbox, and your to-do lists, this over-exertion may be a primary driver of your high cortisol levels. Those hair-pulling hours spent trying to be two people at once come with a cost—they have the ability to change your physiology. And you may not notice the price you are paying until you become bankrupt. To help improve this, start to listen to your body –it may be screaming for you to do less. You may benefit from taking more time for rest rather than approaching wellness from a ‘what more can I do?’ mentality.

Other root causes can range from mental stress and trauma to physical injury and illness, but these causes must be successfully identified in order to decrease your cortisol surges and begin healing your HPA Axis Dysfunction. Once you have begun to address these underlying causes, you may benefit from incorporating the following foods and supplements as tools to help speed up your recovery.

Adaptogens

Adaptogens are an increasingly trendy topic in today’s wellness world, but what exactly are they? Adaptogens are herbs that have been used in traditional medicine for thousands of years and are thought to be beneficial through their ability to bring a person’s bodily functions back to homeostasis. This regulation is most profoundly seen in how adaptogens can protect the body against the physical result of stress. While stress will engage your HPA axis, adaptogens can regulate the amount of stress hormone produced in response to stressful events. They can also regulate cellular sensitivity to the stress hormones that are being produced, giving your body a higher tolerance for stress.[2] While there are many adaptogens that can be useful in treating a variety of conditions, two are powerful in restoring proper adrenal function.

Ashwagandha

Ashwagandha is known for its ability to reduce stress, anxiety, and fatigue. It accomplishes these tasks through its ability to help calm the central nervous system, which is responsible for interpreting and signaling events as stressful. In fact, supplementing with ashwagandha can lower levels of cortisol within the body. Lower cortisol means less is produced by the adrenals, reducing their workload. In a study of patients with chronic stress, not only did those taking the ashwagandha report reduced feelings of anxiety and insomnia over that of the placebo group, but their serum cortisol levels dropped as well.[3] Not only can the ashwagandha increase the body’s ability to respond to chronic stressors by producing less cortisol, but it can also reduce symptoms associated with chronic stress.

Rhodiola

Another important adaptogen for adrenal health is rhodiola. Similarly to ashwagandha, rhodiola can also reduce the secretion of cortisol during stressful scenarios. Furthermore, it can reduce fatigue caused by stress, improving mental and physical performance. This herb is able to reduce the body’s response to outside stressors since the phenolic compounds present in rhodiola closely mirror the structures of hormones such as epinephrine that are involved in the activation of the stress system. The efficacy of rhodiola has been proven in multiple studies, showing its ability to reduce the biological response to not only mental, but physical stress as well.[4]

Due to their strong taste, both of these adaptogens are typically found in supplement form. While adaptogens can be incredible tools for healing HPA Axis Dysfunction, it is important to note that those with autoimmune conditions should be cautious when taking them as the same stress mitigating responses of these herbs can also stimulate the immune system.

Nutrients

Phosphatidylserine

Phosphatidylserine (say that ten times fast!) is a phospholipid that is present in every cell in the body, though it is found in high concentrations in the brain, lungs, heart, liver and skeletal muscle. Phosphatidylserine has been shown to protect against high levels of stress, improve memory, enhance mood, and speed up recovery after exercise.[5]

In a study of patients supplementing with soy-derived phosphatidylserine, participants taking the supplement reduced both serum ACTH (hormones that signal to the adrenals to release cortisol) and cortisol levels.[6] While you can synthesize phosphatidylserine, you get most of it from the food you consume. It is present in small amounts in organ meats, certain fish, and soybeans, though supplementing 300-800mg is often necessary. Most supplements are derived from soy so if you cannot eat soy, be sure to purchase a product that’s soy-free. Click here for a sunflower-based supplement.[7]

Vitamin C

This powerful antioxidant is involved in many functions across the body, such as regulating the immune system, restoring and repairing tissues, and maintaining cartilage. Vitamin C is also used by the adrenal glands in the production of hormones. In times of stress, vitamin C can become depleted as it is used up in production of these hormones. In terms of adrenal health, vitamin C can reduce both the physical and psychological effects of stress.

Men supplementing with 1000 mg of vitamin C had faster recovery times in terms of the biological responses to stress and reported lower subjective feelings of stress than those not supplementing.[8] The faster recovery time as well as the reduced response to stress allow those supplementing with vitamin C to produce less of the stress hormones and bounce back faster when faced with stressful situations.

Vitamin C is an essential nutrient, meaning your body can’t synthesize this vitamin on its own and you must get it from food and supplements. Food sources include broccoli, brussels sprouts, cauliflower, kale, strawberries, oranges and more. You may need additional vitamin C supplementation from a high-quality brand in order to best see the stress-reducing effects. Some supplement between 1-4 grams of vitamin C per day, in divided doses for increased absorption. Side effects of high levels of vitamin C include loose stools, nausea, stomach cramps, and low blood sugar levels. It’s also not recommended for those with recurrent kidney stone formation, renal impairment, or hemochromatosis.

Magnesium

Magnesium is one of the most important minerals, serving as a co-factor for 300 processes that happen in the body. It also plays a crucial role in balancing electrolytes throughout the body. When magnesium levels are low, the point at which the adrenal glands produce adrenaline and cortisol is much lower, meaning you become biologically more sensitive to small stressors. Furthermore, you tend to burn through magnesium via the urine during times of stress, further exacerbating this issue, and causing a vicious cycle of a lower stress threshold and ever decreasing levels of magnesium.[9] Supplementing with magnesium can suppress the release of stress hormones, as was found in studies on athletes performing tasks of great physical stress.[10] While magnesium is found in high amounts in nuts and seeds, spinach, black beans, and dark chocolate, most people require additional magnesium supplementation. If you have regular bowel movements, it’s best to supplement with Magnesium Glycinate as this form has the highest absorption.

Omega-3s

Omega-3 fatty acids are essential fatty acids, meaning the body does not make them. The other kind of essential fatty acids that the body needs to consume in food sources are omega-6s. But as a society, people have greatly increased their intake of omega-6 fatty acids mainly through processed seed oils such as sunflower oil, safflower oil, and soybean oil. The increased consumption of these oils means people are getting too many omega-6s in their diets, not enough omega-3s, which throws off your omega-6:omega-3 ratio.

Omega-3s are powerful anti-inflammatory agents, reducing the production of pro-inflammatory hormones that can lead to many chronic health issues. Not only has low intake of omega-3s been shown to further dysregulate the HPA axis and autonomic nervous system[11], but supplementing with certain fish oils high in omega-3s has been shown to blunt adrenal activity during mentally stressful scenarios.[12] The highest absorbed omega-3s can be found in fish such as wild salmon, sardines, anchovies, herring, cod, and rainbow trout. It’s recommended to consume 2-3 servings per week but additional supplementation for fish oil is often beneficial.[13]

Diet

There are a few important things to note about diet and adrenal health. Low-carb and fasting mimicking diets are not suggested for those with HPA Axis Dysfunction. Both of these diets cause low amounts of glucose to be present in the blood, causing the body to produce cortisol to keep blood sugar levels in a healthy range. While these diets can be incredibly beneficial for preventing and treating many chronic conditions, it’s best to avoid until proper adrenal function is restored.

In this same vein, it’s best to avoid eating habits that cause blood sugar levels to plummet, such as going for long stretches of time without eating or consuming highly processed, high glycemic foods that eventually lead to a spike and subsequent crash in blood sugar levels. Those with HPA Axis Dysfunction tend to do best when eating every 3-4 hours. For additional nutrition recommendations, click here to read my previous article on adrenal health.[14]

Jamie Foti contributed to this article.

[1] https://beingbrigid.devphase.io/is-stress-hurting-your-health-what-you-need-to-know-about-adrenal-dysfunction/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991026/

[3] https://www.ncbi.nlm.nih.gov/pubmed/23439798

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991026/

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503954/

[6] https://www.ncbi.nlm.nih.gov/pubmed/15512856

[7] https://beingbrigid2.ehealthpro.com/products/ps-150-phosphatidyl-serine-150mg-60-caps

[8] https://www.ncbi.nlm.nih.gov/pubmed/11862365

[9] https://www.ncbi.nlm.nih.gov/pubmed/26591563

[10] https://www.ncbi.nlm.nih.gov/pubmed/28670189

[11] https://www.ncbi.nlm.nih.gov/pubmed/30077075