The Epidemic of Adrenal Drive Syndrome

by Dr. Greg Fors, DC - Board Certified Neurologist DIBCN

It is now estimated as much as 90% of the population is in some degree of adrenal stress. Research has established a strong body of evidence that chronic stress is slowly killing our patients. Over time stress triggers detrimental effects in the body that will cause chronic disease. It is estimated that 75-90% of visits to primary care physicians are related to stress – either acutely or because of chronic problems associated with stress. Therefore, it is vital that we support our patients’ stress physiology and adrenal gland function.

Secreting more than 50 hormones necessary for life, the adrenal glands play a significant role in the body. They respond to stress by short-term secretion of norepinephrine, DHEA and cortisol to help navigate a limited stressful event. However, in states of chronic or unresolved stress, high levels of adrenal hormones like adrenaline and cortisol are generated over time. With proper adrenal testing through a salivary Adrenal Stress Index test you may find many of your patients with unexplained anxiety and insomnia do suffer from high states of adrenaline and cortisol output. These patients are ‘stressed and wired’. I refer to this stage as Adrenal Drive Syndrome; the patient is literally being driven through their day by high levels of norepinephrine and cortisol. Our modern lifestyle and poor diets are contributing factors to this epidemic of Adrenal Drive Syndrome, which can eventually lead to Adrenal Fatigue Syndrome. Common factors that can affect your patients’ adrenal gland function include: poor diets, smoking, lack of exercise, lack of sleep, overwork, lack of relaxation, chronic pain, chronic illness, surgery, drugs, toxins, allergies and infections.

Again the very best way to know if your patient is suffering from stress and adrenal issues is to run a Salivary Adrenal Stress Index Test. The National Institutes of Health (NIH) and the World Health Organization (WHO) recognize saliva cortisol testing as an extremely accurate form of assessment. This is a simple inexpensive noninvasive test in which a patient’s saliva is collected four times a day, morning (8 AM), noon, afternoon (4 PM) and evening (best between 11 PM and midnight). Other steroid hormones, such as estrogen, progesterone, DHEAs and testosterone can be measured along with cortisol in the 8 AM saliva sample, if desired. Saliva tests are reliable indicators of the levels of all steroid hormones (cortisol, DHEAs and all sex steroids) in the body. Some insurance plans also cover saliva cortisol testing. Labs that do a good job in providing this test are Genova Diagnostics, Diagnos-Techs, Alcat and ZRT Labs.

Certain specific herbs known as adaptogens can be helpful in treating patients who are stressed and wired. The term “adaptogen” is a category of botanicals that improve the body’s response and recovery from stress. Adaptogenic herbs have four general properties: (1) harmless to the host; (2) a general nonspecific effect; (3) an increased resistance of the recipient to a variety of physical, chemical, or biological stressors; and (4) a general stabilizer and normalizer to stressful events.

GABA
The neurotransmitter GABA acts like a “brake” during times of chronic stress; it is the most vital inhibitory neurotransmitter in the brain. This is why medications for anxiety, primarily benzodiazepines, stimulate GABA receptors to induce relaxation. Either low GABA levels or decreased GABA receptor function in the brain is associated with several neurological disorders, including anxiety, depression, insomnia, and epilepsy. Because benzodiazepines can be dangerous and addictive, it is vital to help patients find safe alternatives. Studies indicate supplemented GABA and herbs that improve GABA availability or binding, such as Valeriana officinalis can improve stress reduction, relaxation and enhance sleep.

Valeriana officinalis (valerian):
Valeriana officinalis (valerian) is well known for its anxiolytic and sedative effects, it increases GABA release and inhibits GABA breakdown; binds to benzodiazepine receptors. The essential oils in valerian appear to provide its sedative activity, while its valepotriates exert a regulatory effect on the autonomic nervous system. A double-blind trial on 48 adults found valerian reduced subjective sensations of anxiety but did not cause measurable sedation. Comparison of diazepam (2.5mg 3X daily) to valerian extract (50mg 3X daily, standardized to 80% dihydrovaltrate) showed a similar significant reduction in symptoms of anxiety measured on HAMA (human anti-mouse antibodies) after four weeks.1 Four placebo controlled studies found valerian effective in the treatment of insomnia, often associated with stress and anxiety.

Melissa officinalis
Melissa officinalis, compared to other herbs tested, demonstrated the greatest inhibition of GABA-transaminase, the enzyme responsible for degradation of GABA. A crossover randomized controlled study of 24 healthy volunteers examined the effect of a Melissa/valerian combination (80 mg Melissa/120 mg valerian per tablet or placebo. At a combined 600-mg total dose it ameliorated test induced stress.2

Bacopa monniera
The traditional Ayurvedic use of Bacopa monniera for anxiety and poor cognition has been supported both in animal research and in human clinical trials. Research with rats demonstrated a Bacopa extract of 25-percent bacoside A exerted anxiolytic activity comparable to lorazepam, a common benzodiazepine anxiolytic drug. Furthermore, Bacopa extract was found to enhance memory instead of inducing amnesia; a common side effect associated with lorazepam3.

A randomized controlled trial on the effects of Bacopa monniera on 54 elderly subjects randomized to receive 300 mg/day Bacopa or placebo for 12 weeks found the botanical to be of great benefit. Subjects taking Bacopa experienced significant improvement in anxiety compared to placebo, in addition to improvements in cognitive performance and depression scores.4

Kava kava:
Extracts of kava kava have been found to be effective anxiolytic agents. Kava extracts in multiple studies have compared favorably to prescription benzodiazepines and tricyclic antidepressants, without the commonly seen side effects of these drugs. Kava also appears to improve concentration and not impair reaction time. In a double-blind RCT, 29 subjects were treated for four weeks with 100 mg kava extract three times daily, standardized to contain 70% kava lactones. Compared to placebo, the kava group experienced significant decreases in anxiety symptoms measured by HAMA.5

In summation, the detrimental effects of stress are pervasive due to poor diet and the modern lifestyles we live. As physicians, it is our responsibility to care for our patients with the most effective and safest means available to us. It would behoove any physician faced with the epidemic of Adrenal Drive Syndrome in their practice to seek out a nutritional formula with some, or all of the ingredients outlined above. These specific nutraceuticals have been found to rebalance adrenal hormones, balance neurotransmitters, treat anxiety, and support restful sleep.

Biospec Nutritionals Products

BIOSPEC's CLINICAL UPDATES
with Dr. Greg Fors

Biospec Nutritionals has been in business for nearly 20 years and is dedicated to bringing physicians premium quality formulations at prices their patients can afford. Biospec Nutritionals is committed to providing doctors with quality information and education, including this issue of Biospec's Nutritional updates. Find us at www.biospecnutritionals.com or call us at 800.825.7921

Dr. Greg Fors, D.C. is the Chief Science Consultant for Biospec Nutritionals, a Board-certified Neurologist (IBCN), certified in Applied Herbal Sciences (NWHSU) and acupuncture. Trained through the Autism Research Institute he is a registered 'Defeat Autism Now!' Doctor. As the clinic director of the Pain and Brain Healing Center in Blaine Minnesota he specializes in a natural biomedical approach to fibromyalgia, fatigue, depression, autism and ADHD. He is a sought after international lecturer for various post graduate departments and state associations. Dr. Fors is the author of the highly acclaimed book, "Why We Hurt" available through booksellers everywhere.

FOOTNOTES

  1. Andreatini R, Sartori VA, Seabra ML, Leite JR. Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study. Phytother Res 2002;16:650-654
  2. Kennedy DO, Little W, Haskell CF, Scholey AB. Anxiolytic effects of a combination of Melissa officinalis and Valeriana officinalis during laboratory induced stress. Phytother Res 2006;20:96-102.
  3. Bhattacharya SK, Ghosal S. Anxiolytic activity of a standardized extract of Bacopa monniera in an experimental study. Phytomedicine 1998;5:77-82.
  4. Calabrese C, Gregory WL, Leo M, et al. Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med 2008;14:707-713.
  5. Kinzler E, Kromer J, Lehmann E. Effect of a special kava extract in patients with anxiety-, tension-, and excitation states of non-psychotic genesis. Double blind study with placebos over 4 weeks. Arzneimittelforschung 1991;41:584-588. (Article in German)