Saul Marcus, ND - Naturopathic Doctor

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What adrenal supplements should I take?

There are many supplements which are to help people have more energy. Realistically, while there may be many good supplements out there (and some not so good ones also) it is unlikely that any one is the best for everyone. So it is helpful to understand what different types of supplements there are and when each is appropriate.

What is cortisol

Cortisol is the major stress hormone produced by the adrenal glands. Cortisol plays a major role in regulating energy production. Too little cortisol results in fatigue and often blood sugar problems (among many other symptoms). Too much cortisol leads to problems such are high blood sugar and high blood pressure.

Often people with fatigue problems have too low cortisol. This is also called adrenal fatigue).

Hormonal precursors

Two hormonal precursors that are readily available as supplements are DHEA and pregnenolone. The most difficult step for the adrenals to make cortisol is the conversion of cholesterol into pregnenolone. Therefore taking pregnenolone as a supplement may help.

DHEA, which is converted into testosterone is also available as a supplement. Since low testosterone can also lead to fatigue, taking some DHEA may help as well.

cholesterol to cortisol pathway chart

DHEA and pregnenolone is not appropriate for everyone.

First, since these supplements will more aggressively push hormone conversion, it is best to always have your hormones tested before starting such supplements. Taking these supplements long term can unwittingly cause some hormones to become too high.

DHEA in particular can have many side effects, especially those related to high androgens (male hormones) and estrogens, as it can be covered downstream to both. Acne and hair loss can easily result from taking too much DHEA.

DHEA and pregnenolone need to be in balance. Taking a lot of one and none of the other may simply deregulate the overall hormonal picture even more.

Finally, these supplements are commonly sold in doses far higher than needed. For women who will benefit from DHEA, typically doses such as 5mg a day or less are sufficient. However, DHEA is often sold in doses of 25mg per pill or higher.

Supplementing with pregnenolone and DHEA for most people is best done with a health care professional. Lab tests should be run to monitor hormone levels.

Adaptogenic herbs

Adpatogenic herbs are thsoe that regulate function regardless if it is too high or too low. For the adrenals ashwagandah is a classic example. When taking in the morning it improves energy. At night it is calming and improves sleep.

For most people adrenal adaptogen are the best supplement to use. Their adaptogenic fuction makes then helpful for a wide range of people and low chance of side effets. Since they will not force hormone production in the way that DHEA and pregnenolone does, hormone lab tests are not needed.

Situations where adrenal adaptogens work best

Situations where adrenal adaptogens will not work well

Adaptogenic herbs for the adrenals.

This is a list of some herbs I most often for adrenals and poor energy. There are many other good herbs available. This list is not meant to be exhaustive.


Glandulars are supplements that are made from various parts of animals. Often they are made from endocrine glands.

Glandular supplements do not typically have clinically relevant amounts of actual hormone in them. They seem to work by nutritionally supporting the corresponding organ.

Often glandulars have a stronger action. This is not always good. Some people may feel "speedy" with adrenal glandulars. Dosing is more delicate than with herbs.

Some people may with to avoid these products because they go against vegan beliefs. That is fine as we have many other ways to support adrenal function. Information on glandular is being given for the sake of completeness. No one should ever be told they have to take something that goes against their beliefs, unless there simply is no other option.

Mitochondria and energy support

Many of the stresses that effect the adrenals, can also impair cellular energy production. For more on this go to the page on mitochondria function and supplements for energy.

Vitamins and minerals

Vitamin C and most of the B vitamins are needed for proper adrenal function. Supplementation may help. Minerals are also essential. Other than cortisol one of the other major adrenal hormones is aldosterone. Aldosterone is a major regulator of mineral balance. It causes the kidneys to hold onto minerals. Without enough aldosterone people urinate more frequently, and this also means they are constantly peeing out their minerals. Magnesium may thus be low (often causes muscle cramping) but also sodium.

Sodium is often maligned for causing high blood pressure. Nonetheless many people with adrenal fatigue actually have low blood pressure. They are not able to maintain minerals. Having adequate intake of salt is essential to help the adrenals. Just make sure to get real sea salt, or eat vegetables that contain sodium like celery.