Natural Approaches to Fatigue
This blog has not been approved by your local health department and is not intended to provide diagnosis, treatment, or medical advice.
In this article:
- Supporting the Adrenal Gland
- Nutritional Adrenal Support
- Take a High Potency Multiple Vitamin and Mineral Formula
- Fish Oil Supplementation Reduces the Effects of Mental Stress
- Herbs for Adrenal Support
- Caution with Caffeine
Have you ever been extremely tired and then all of a sudden felt a burst of energy? More than likely the sudden burst was due to the release of adrenaline and cortisol from your adrenal glands, a pair of glands that lie on top of each kidney. If you have ever been suddenly frightened, you know what it feels like to have adrenaline surge through your body. Adrenaline was designed to give the body that extra energy boost to escape from danger.
Some basic control mechanisms are geared toward counteracting the everyday stresses of life. However, if stress is extreme, unusual, or long-lasting, these control mechanisms can be quite harmful. Stress triggers a number of biological changes controlled and regulated by the adrenal glands.
An abnormal adrenal response, either deficient or excessive hormone release, significantly alters an individual's response to stress. Often the adrenals become "exhausted" as a result of constant demands placed upon it. Adrenal fatigue is a common side effect of continual stress and corticosteroid administration (e.g., the use of prednisone). An individual with adrenal fatigue or exhaustion will suffer from chronic fatigue and may complain of feeling "stressed out.” They will typically also have a reduced resistance to allergies and infection.
One of the best ways to support the adrenal glands is by dealing with stress effectively. Dealing with stress involves the use of techniques designed to reduce the amount of stress. Exercise and relaxation techniques such as meditation, prayer, biofeedback, and self-hypnosis are vital components of a stress management program. Exercise is itself a physical stressor, however, it is the beneficial way to incorporate the fight or flight response as part of the daily routine. In regards to stress, regular exercise leads to an increased ability to cope with stress and reduces the risk of stress-related diseases.
Relaxation techniques seek to counteract the results of stress by inducing its opposite reaction - relaxation. Although an individual may relax by simply sleeping, watching television, or reading a book, relaxation techniques are designed specifically to produce the "relaxation response."
The physiological effects of the relaxation response are opposite to those seen with stress. The relaxation response is designed for repair, maintenance, and restoration of the body.
To achieve the relaxation response a variety of techniques may be employed, e.g., meditation, prayer, progressive relaxation, self-hypnosis, and biofeedback. The type of relaxation technique best for each person is totally individual. The important thing is that at least 5 to 10 minutes be set aside each day for the performance of a relaxation technique. These sessions will also remind you to breathe in a relaxed effective manner.
Foremost in the nutritional support of proper adrenal function is to eat a low glycemic diet. Avoid refined sugars, especially sucrose and high fructose corn syrup; pastries; doughnuts; beverages packed full of sugars (soft drinks, sports drinks, and many coffee beverages); and other high sugar foods. The sugars in these foods are quickly absorbed into the bloodstream, causing a rapid rise in blood sugar and severely stressing blood sugar control. It is also important to limit starches, pasta, bread, and other carbohydrates to very small portion sizes.
Fluctuations in blood sugar severely stress adrenal function and are a common cause of excess cortisol. Elevated cortisol levels are not only associated with increased feelings of stress, but also loss of appetite control, cravings for sugar, and weight gain. Too much cortisol is also linked to weakening of the immune system, depression, loss of muscle mass, osteoporosis, and brain atrophy.
Another dietary goal is to consume foods rich in potassium and avoiding foods high in sodium. Most Americans have a potassium-to-sodium (K:Na) ratio of less than 1:2. This means most people ingest twice as much sodium as potassium. Researchers recommend a dietary potassium-to-sodium ratio of greater than 5:1 to maintain health. This ratio is ten times higher than the average intake. However, even this may not be optimal. A natural diet rich in fruits and vegetables can produce a K:Na ratio greater than 50:1, as most fruits and vegetables have a K:Na ratio of at least 100:1. For example, here are the average K:Na ratios for several common fresh fruits and vegetables:
- carrots 75:1
- potatoes 110:1
- apples 90:1
- bananas 440:1
- oranges 260:1.
To support the adrenals, the daily intake of potassium should be at least 3 to 5 grams per day and the level of sodium should be no more than 1,500 mg daily.
All essential nutrients are critical in supporting adrenal function. In particular, vitamin C, vitamin B6, zinc, magnesium, and pantothenic acid are necessary nutrients for the manufacture of hormones by the adrenal glands. Supplementation of all of these nutrients at higher than RDI levels in the form of a high-potency multiple vitamin-mineral formula may be appropriate during high periods of stress or in individuals needing adrenal support.
Particularly important for optimal adrenal function is pantothenic acid. Pantothenic acid deficiency results in adrenal atrophy characterized by fatigue, headache, sleep disturbances, nausea, and abdominal discomfort. Pantothenic acid is found in whole grains, legumes, cauliflower, broccoli, salmon, liver, sweet potatoes, and tomatoes. In addition, it is a good idea to take at least an additional 100 mg of pantothenic acid daily.
Fish oils concentrated for EPA and DHA have been shown to have positive effects for patients with many different types of psychological disorders associated with stress including depression, bipolar disorder (manic depression), borderline personality disorder, and attention deficit disorder with hyperactivity (ADHD).
Positive results in clinical trials in these psychological disorders indicate that EPA and DHA may exert an effect in blunting the stress response.
In an elaborate double-blind study conducted at Michigan Technological University, blood pressure, heart rate, muscle sympathetic nerve activity, and blood flow through the calf were recorded during a 5-minute experiment involving exposing 67 non-hypertensive subjects to mental stress. The assessment was made before and after 8 weeks of fish oil or placebo supplementation. The dosage of fish oil provided 1.6 g EPA and 1.1 g DHA for total EPA+DHA of 2.7 g.
Results showed that fish oil reduced the increase in heart rate and muscle sympathetic nerve activity produced by mental stress. These results indicate that fish oils reduced the effects of the sympathetic nervous system on the cardiovascular system indicating that some of its beneficial effects in both psychological and cardiovascular disorders are due to this central effect.
The takeaway message is that it is important to take roughly 3,000 mg EPA+DHA if a person is exposed to significant mental stress on a daily basis as it is good for your brain and heart as well as your ability to deal with stress.
Several botanical medicines support adrenal function. Most notable are Chinese ginseng (Panax ginseng), Siberian ginseng (Eleutherococcus senticosus), rhodiola (Rhodiola rosacea), and ashwagandha (Withania somnifera). All of these plants exert beneficial effects on adrenal function and enhance resistance to stress, and are often referred to as “adaptogens” because they help us adapt to (cope with) stress. These plants have historically been used to:
- Restore vitality in debilitated and feeble individuals.
- Increase feelings of energy.
- Improve mental and physical performance.
- Prevent the negative effects of stress and enhance the body’s response to stress.
These herbs can be used individually or in combination.
Both Siberian and Chinese ginseng enhance our ability to cope with various stressors, both physical and mental. Presumably, this anti-stress action is mediated by mechanisms that control the adrenal glands. Ginseng delays the onset and reduces the severity of the “alarm phase” of the body’s short and long-term response to stress (the general adaptation syndrome).
People taking either of the ginsengs typically report an increased sense of wellbeing. Clinical studies have confirmed that both Siberian and Chinese ginsengs significantly reduce feelings of stress and anxiety. For example, in one double-blind clinical study, nurses who had switched from day to night duty 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 group who were given Chinese ginseng demonstrated higher scores in competence, mood parameters, and mental and physical performance compared with those receiving placebos. The nurses taking the ginseng felt more alert, yet more tranquil, and were able to perform better than the nurses who were not taking the ginseng.
In addition to these human studies, animal studies have shown the ginsengs to exert significant anti-anxiety effects. In several of these studies, the stress-relieving effects were comparable to those of diazepam (Valium); however, diazepam causes behavioral changes, sedative effects, and impaired motor activity, while ginseng has none of these negative effects.
On the basis of the clinical and animal studies, ginseng appears to offer significant benefit to people suffering from stress and anxiety. Chinese ginseng is generally regarded as being more potent than Siberian ginseng, and is probably better for the person who has experienced a great deal of stress, is recovering from a long-standing illness, or has taken corticosteroids such as prednisone for a long time. For the person who is under mild to moderate stress and is experiencing less obvious impairment of adrenal function, Siberian ginseng may be the better choice. Dosages are as follows:
- High-quality crude ginseng root: 1.5–2 g, 1–3 times daily
- Fluid extract: (containing a minimum of 10.5 mg/mL ginsenosides with Rg1:Rb1 greater than or equal to 0.5 by HPLC): 2–4 ml (1/2–1 tsp) 1–3 times daily
- Dried powdered extract standardized to contain 5% ginsenosides with an Rb1/Rg1 ratio of 2:1: 250–500 mg, 1–3 times daily
- Dried root: 2–4 g, 1–3 times daily
- Fluid extract (1:1): 2–4 mL (1/2–1 tsp) 1–3 times daily
- Solid (dry powdered) extract (20:1 or standardized to contain more than 1% eleutheroside E): 100–200 mg 1–3 times daily
Rhodiola (Rhodiola rosea)
Another useful botanical medicine to support stress management is Rhodiola rosea (arctic root), a popular plant in traditional medical systems in Eastern Europe and Asia, where it has traditionally been recommended to help combat fatigue and restore energy. Modern research has confirmed these effects and its adaptogenic qualities. However, the adaptogenic actions of Rhodiola are different from those of the Chinese and Siberian ginseng, which act primarily on the hypothalamus-pituitary-adrenal axis. Rhodiola seems to exert its adaptogenic effects by working on neurotransmitters and endorphins. It appears to offer an advantage over other adaptogens in circumstances of acute stress because it produces a greater feeling of relaxation and greater anti-anxiety effects. A single dose of Rhodiola extract prior to acute stressful events has been shown to prevent stress-induced disruptions in function and performance, but like the ginseng, it has also shown positive results with long-term use. In one randomized, placebo-controlled trial of 60 patients with stress-related fatigue, Rhodiola was found to have an anti-fatigue effect that increased mental performance, particularly the ability to concentrate, as well as decreasing the cortisol response to stress.
On the basis of results of clinical trials with a standardized Rhodiola extract, the therapeutic dose varies according to the rosavin content. For a dosage target of 3.6–7.2 mg of rosavin, the daily dose would be 360–600 mg for an extract standardized for 1% rosavin; 180–300 mg for 2% rosavin; and 100–200 mg for 3.6% rosavin.
Ashwagandha (Withania somnifera)
Ashwagandha (Withania somnifera) has shown impressive clinical results in dealing with stress. It works with the body's natural biological systems to help restore balance to the body and normalize body functions. It helps to increase the body's resistance to stress and reduce physiological responses to stress events. Ashwagandha delivers a variety of benefits that help maintain good health. Among other things:
- Helps counteract the negative effects of stress.
- Increases resistance to fatigue.
- Promotes mental clarity and concentration.
- Supports healthy weight management by inhibiting stress responses that can lead to overeating.
- Improves resistance to stress and tension.
- Helps protect against the effects of aging by protecting against free radical damage to cells.
Two Ashwagandha extracts have exceptional scientific support. KSM-66 and Sensoril. Follow dosage instructions for either of these two high-quality extracts.
There is no question that caffeine is a stimulant that can increase both physical and mental activity, but that increase often comes at the price of poor sleep quality and overstimulation of the adrenal gland. While many Americans definitely ingest way too much caffeine, cultures all around the globe have safely and enthusiastically utilized traditional beverages containing moderate amounts of caffeine to help them make it through the day with higher energy levels. Coffee, green tea, guarana, cola nut, and cocoa are good examples.
In its natural form, the caffeine is provided along with plant compounds that tend to lessen some of the negative effects of caffeine such as anxiety and nervousness. For example, in addition to containing caffeine, green tea also provides the compound L-theanine that counteracts some of the effects of caffeine on the brain that can lead to nervousness and interference with sleep.
There are a few situations where I do not recommend consuming any significant amount of caffeine (e.g., daily intakes in excess of 30-50 mg) including people very sensitive to caffeine or those with insomnia, depression, anxiety, chronic fatigue, fibrocystic breast disease, or high blood pressure. If you suffer from one of these conditions and seek to increase your energy levels, I would recommend herbal approaches to support adrenal functions described above.