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Herbal Therapy & the Adrenal Glands

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Herbal Therapy & the Adrenal Glands

© David L. Hoffmann B.Sc. (Hons), M.N.I.M.H.

Alternative medicine abounds in ideas about and remedies for the adrenal glands. Unfortunately they are often just an expression of a fundamental lack of knowledge about the adrenals. The ideas couched in these terms are often valid and helpful, but invoking some adrenal tonic effect must be based upon actual physiology and not pseudo-science.

The two adrenals sit astride each kidney, deep in the back part of the abdomen. However, it is vital to recognize that each of these glands has two parts, a cortex or outer part, and a medulla or central portion. These have markedly different functions. When therapy is directed towards these glands, it must be appropriate to the adrenal function the practitioner wants to address.

Adrenal Medulla

The adrenal medulla secretes the hormones adrenaline (epinephrine) and noradrenaline (norepinephrine), responsible for the rapid increases in nervous system and metabolic activity involved in the stress response. Summarizing the effects of these two hormones

Adaptogens are the core of this support, with saponins such as the eleuthero sides directly impacting the medulla. Nervine tonic support of some kind is usually indicated as well, although this does not directly impact the medulla. The contribution from such nervines is a more generalized systemic support that eases the impact of tension and anxiety. Bitter tonics can be helpful as well. Examples might include

Herbs for the Adrenal Cortex
Herbal medicines can impact the adrenal cortex in a variety of ways. Most important is the direct effect of plants rich in a specific variety of saponin such as Glycyrrhiza glabra (Liquorice). Glycyrrhiza is proving to be a controversial remedy because of its effects upon the adrenal cortex. Aldosterone is part of what has been called the renin-aldosterone-angiotensin axis, a hormonal homeostatic complex that regulates electrolyte balance in the blood and volume of urine passed. When Glycyrrhiza is eaten or taken in great excess it has a direct impact upon aldosterone leading to potassium depletion. This is a very rare occurrence, but the pharmacology books make a big point of it, to demonstrate the dangers of herbal medicine. On the other hand there are well known cases in Britain of people with addisons disease benefiting greatly from this herb. Thus in overactive conditions Glycyrrhiza should be avoided but in under active it is indicated.

As discussed briefly above, the adaptogens will support the cortex in its response to ACTH.

Cushing's Syndrome
This entity is caused by excessive cortisol, and derives from either excess ACTH from the pituitary, excess production from the adrenal itself, or the use of the cortisone-like steroid drugs. This last cause is all too common.

Adrenal Insufficiency
When both adrenal glands are largely destroyed by lack of circulation during shock or hemorrhage, by infection with tuberculosis or other diseases, by hemorrhage directly into the glands, or by a poorly understood autoimmune disorder, adrenal insufficiency is said to occur. Other causes are less common.

The lack of cortisol leads to increased stimulation by the pituitary in the form of ACTH production. This hormone in excess causes darkening of the skin, one of the early symptoms of adrenal insufficiency. Other symptoms include weight loss, weakness, loss of appetite and energy, and low blood pressure. With any physiologic stress, total decompensation can occur with shock, major chemical imbalances in body chemicals, and death. This emphasizes the importance of cortisone in the body's reaction to stress.

The commonest cause of adrenal insufficiency is the medical use of prednisone or other cortisone-like drugs. When administered for more than two weeks, the drug suppresses the body's own cortisone production which then goes into abeyance for a long time. When the drug is discontinued after prolonged use, months may be required for the body to restore its own production. During this interval adrenal insufficiency may be present, and under stress a true emergency may arise. It is for this reason that such doses are tapered off slowly.

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