It can be truly disheartening when, having had a nutrient or herb recommended to you by a fellow sufferer, it only makes you feel worse. However, a key factor in understanding adrenal fatigue is acknowledging the very different, and sometimes paradoxical responses, that individuals may exhibit. These responses may vary according to the severity of adrenal fatigue, the general constitution of the individual; the same individual may also respond differently at separate points in their treatment.

This unpredictable reaction seems to occur most often when adaptogenic herbs are given to individuals with severe adrenal fatigue. Adaptogenic herbs – which include ginseng and ashwaganda – are prized for their ability to normalise hormonal secretions at the adrenal glands, boosting cortisol levels when they are low and attenuating them when they are high. However, this effect may only be reliable in cases of mild fatigue. When severe adrenal fatigue is present (to the level that normal 9-to-5 function has become impossible), it appears that these herbs can have an unwanted effect and bring about an ‘adrenal crash’. Exactly what component of the herbs is responsible for this is not yet unclear, although it is believed that a stimulatory factor is responsible.

While this does not preclude the use of adaptogenic herbs in severe adrenal fatigue, it does suggest that both practitioners and individuals should exercise caution before attempting to bolster flagging adrenal output with adaptogenic herbs. Other herbs like licorice root and echinacea, while showing more reliable responses, should also be considered with some caution as they too have been known to cause paradoxical responses, if to a lower extent. In any case, they do serve a purpose in cases of adrenal fatigue but any patient undergoing self-navigation may do best to avoid such compounds. This call should be made only by a suitably knowledgeable practitioner.

While these herbs tend to make up the majority of unwanted reactions, sufferers of severe adrenal fatigue are also known to react badly to adrenal extracts on occasions. Again, exactly why this occurs has not yet been established. It is thought that the adrenal extracts, which provide nucleic acids, fatty acids and enzymes unique to the organs, can provide nourishment to the adrenals which can stimulate activity in some parts of the adrenal tissue before the whole gland is ready to function. As with many other compounds, bad reactions can occur at some (higher) doses, when other doses were fine. In any case, a need to introduce functional foods and supplements in a timely manner is most definitely highlighted. Using a diary to record reactions is also a simple but important tool.

A practitioner familiar with the concerns can analyse the history of the patient and, in doing so, assess their general constitution. Those with a stronger constitution are generally expected to handle nutritional intervention better than others and may reach a state of ‘full recovery’ quicker, and with less crashes, than others. Another overlooked factor in the assessment of an individual’s constitution is the nutritional status of organs across the body. Due to eating habits and the mineral depletion of our soil, most people are coming in very short on their ideal intake of vitamins, minerals and phytonutrients. This is likely to have severe consequence in someone under severe internal stress. A full-spectrum multivitamin, plus sufficient levels of magnesium, zinc and iodine are always vital to nourish the other organs sufficiently.

When we consider the range of reactions that can occur between two individuals using the same supplement, it becomes clear that medical science cannot yet explain all the complex interactions that occur at the adrenal glands and elsewhere. It serves to underline the point that every sufferer of adrenal fatigue must be approached as an individual and, despite success with a herb elsewhere, no assumptions should be made in providing a well-considered and tailored treatment plan.

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