Stress Management: Phytotherapeutic Strategies for Adrenal Health

Transcription

Stress Management: Phytotherapeutic Strategies for Adrenal Health
Stress Management:
Phytotherapeutic Strategies
for Adrenal Health
Angela Hywood ND (Australia)
B App Sc (Naturopathy); Dip Bot Med; Dip Hom; Dip NFM
Member NHAA, ANTA, AHG
Hans Selye
• Adrenal research pioneer
• Spent his lifetime in continuing research on General
Adaptation Syndrome (GAS) and wrote some 30
books and more than 1,500 articles on stress and
related problems, including:
 Stress without Distress (1974)
 The Stress of Life (1956)
 Running out of GAS
General Adaptation Syndrome
• Selye formulated the General Adaptation
Syndrome (GAS) as a non-specific response to
stress
• This GAS enables you to increase your power of
resistance to stressors and to adapt to
environmental change
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Stress & Adrenal Depletion
• According to Hans Selye & W. Cannon (1935-6),
stress is a state of threatened homeostasis
 the term was borrowed from physics
• A stressor is any agent or condition which
threatens homeostasis
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SELYE’S STRESS MODEL
General Adaptation Syndrome
normal
resistance
state
anabolic phase
catabolic
phase
alarm phase
resistance phase
exhaustion phase
Phase 1
Phase 2
Phase 3
www.brainconnection.com/topics/?main=fa/selye
Adaptation Energy
• According to Selye there is a finite amount of
“adaptation energy” which declines with increasing
or continuous exposure to stressors
• One of the sequelae to this decrease is faulty
adaptation and disease
Selye H. Br Med J 1950; 1(4667): 1383–1392
Sources of Stress
• Environmental Stress
 Weather (amount of sunlight, temperature)
 Noise
 Pollution
 Radiation (gamma, ionizing, non-ionizing)
- cell phones, computers, electrical
equipment, power lines, air travel etc
Sources of Stress
• Psychological and Social Stressors
 Performance stress (school, job, home)
 Financial
 Emotional worry
 Relationship issues
Sources of Stress
• Physiological Stressors
 Nutritional
deficiency
 Biological aging
 Illness (surgery)
 Trauma
 Toxicity
• Biological
 Viruses
 Bacteria
 Parasites
Adaptogen vs Adrenal Tonics
• Adaptogens conserve adaptation energy
 Eleuthero
 Withania
 Rhodiola
 Codonopsis
 Polygonum
 Korean Ginseng
 Tribulus
Adaptogen vs Adrenal Tonics
• General Tonics increase or release adaptation
energy
 Korean Ginseng
 Astragalus
• Adrenal tonics support the adrenal cortex
 Licorice
 Rehmannia
 Tribulus
Allostasis and Allostatic Load
• Allostasis refers to the process by which our bodies
attempt to maintain homeostasis in response to
environmental change and/or stressors1
• It links the brain which perceives a new or
threatening situation, the endocrine system (HPA
axis), and the immune system1,2
• Allostatic load refers to the cost of adaptation or
the damage that an improperly functioning
allostatic response causes or accumulates1,2
1
2
McEwen BS. Metabolism 2003; 52(10)(suppl. 2): 10-16
Ray O. Am Psychol 2004; 59(1): 29-40
Allostasis and Allostatic Load
• The primary mediators of allostasis are adrenal
steroids (cortisol), catecholamines (epinephrine,
norepinephrine) and dehydroepiandrosterone
(DHEA)
• Each has short term protective adaptive actions
(allostasis) and long term damaging effects
(allostatic load)
McEwen BS, Seeman T, Ann NY. Acad Sci 1999; 896: 30-47
SELYE’S STRESS MODEL
General Adaptation Syndrome
normal
resistance
state
anabolic phase
catabolic
phase
alarm phase
resistance phase
exhaustion phase
Phase 1
Phase 2
Phase 3
Phase 1: Normal Adaptation and Resistance in Alarm phase
both Cortisol and DHEA increase with stress
usually asymptomatic
SELYE’S STRESS MODEL
General Adaptation Syndrome
normal
resistance
state
anabolic phase
catabolic
phase
alarm phase
resistance phase
exhaustion phase
Phase 1
Phase 2
Phase 3
Phase 2: Resistance Phase (early stage of exhaustion)
Cortisol increases but DHEA declines
“stressed”, anxiety attacks, mood swings, small constricted pupils
ANS in sympathetic dominance
SELYE’S STRESS MODEL
General Adaptation Syndrome
normal
resistance
state
anabolic phase
catabolic
phase
alarm phase
resistance phase
exhaustion phase
Phase 1
Phase 2
Phase 3
Phase 3: Exhaustion Phase (late stage of exhaustion)
Both Cortisol and DHEA are low
depression and exhaustion; large pupils
ANS in parasympathetic dominance
Measurement of Cortisol Levels
• The body's level of cortisol in the bloodstream
displays what is known as a diurnal variation
 normal concentrations of cortisol vary
throughout a 24-hour period
• Cortisol levels in normal individuals are highest in
the early morning at around 6-8 am and are lowest
around midnight
Michaud K, Matheson K, Kelly O, Anisman H. Stress 2008; 11(3):177-97
Measurement of Cortisol Levels
• In addition to early morning, cortisol levels may be
somewhat higher after meals
• While the most common test is measurement of
the cortisol level in the blood, some doctors
measure cortisol through a saliva sample, as
salivary cortisol levels have been shown to be an
index of blood cortisol levels
Michaud K, Matheson K, Kelly O, Anisman H. Stress 2008; 11(3):177-97
Sample of Cortisol Circadian Cycle
Figure 1. Circadian Cortisol Profile
30
Free Cortisol (nM)
25
20
15
10
5
0
8 am
Noon
4 pm
Midnight
Reference Ranges
Patient Results
Adrenal Hormones
Involved in the Stress Response
Cortisol influences the activity of:
• Insulin
• Thyroid
• DHEA
• Testosterone
• Estrogen
Adrenal Hormones
Involved in the Stress Response
Cortisol is involved with:
• Blood glucose regulation
• Immune system response
• Bone turnover rate
• Mood and thought
• REM sleep
• Protein catabolism
Manufacture of Cortisol under
Stress
Adrenal Hormones
Involved in the Stress Response
Elevated cortisol is associated with:
•
•
•
•
•
•
•
•
Anxiety
Insulin resistance
Obesity
Osteoporosis
Sex hormone imbalance
Onset insomnia
Accelerated aging
Immune suppression
Adrenal Hormones
Involved in the Stress Response
Low cortisol is associated with:
•
•
•
•
•
•
•
•
•
CFS
Depression
Anorexia nervosa
PMS
Menopause
Fibromyalgia
Impotence in men
Infertility
Maintenance insomnia
DHEA (Dehydroepiandrosterone)
• Functions as an androgen (a male hormone) with
anabolic activity
• Is a precursor to testosterone in men and is a
precursor that is converted to testosterone in men
and estrogen in women
• Reverses immune suppression caused by excess
cortisol levels
Larsen P, et al. Williams Textbook of Endocrinology, 10th edition. Philadelphia:
Saunders Publishers, December 2002.
DHEA (Dehydroepiandrosterone)
• Stimulates bone deposition and remodeling to
prevent osteoporosis
• Improves cardiovascular status by lowering total
cholesterol and LDL levels, thereby lessening
incidences of heart attack
• Increases muscle mass. Decreases percentage of
body fat
• Involved in the thyroid gland's conversion of the
less active T4 to the more active T3
Larsen P, et al. Williams Textbook of Endocrinology, 10th edition. Philadelphia:
Saunders Publishers, December 2002.
DHEA (Dehydroepiandrosterone)
• DHEA negates many of the unfavorable effects of
excess cortisol, creating subsequent improvement
in energy/vitality, sleep, premenstrual symptoms,
and mental clarity
• Accelerates recovery from any kind of acute stress
(eg insufficient sleep, excessive exercise, mental
strain, etc)
Larsen P, et al. Williams Textbook of Endocrinology, 10th edition. Philadelphia:
Saunders Publishers, December 2002.
Adrenal Hormones
Involved in the Stress Response
Low DHEA-S is involved with:
•
•
•
•
•
•
•
•
Decline in immunity
Chronic fatigue
Arthridites
Insomnia
Decreased libido
Obesity
Depression
Osteoporosis
Adrenal Depletion
• In terms of herbal actions required for a treatment
protocol for adrenal depletion:
 Adrenal tonic or restorative herbs
 Adaptogens
 Tonics (general or whole body tonics)
 Nervine tonics
 Immune facilitators
Prolonged Stress
• The systemic effects of stress include:
 Increased levels of stress hormones such as
cortisol
 Decline in certain aspects of immune system
function such as:
- Natural killer cell cytotoxicity
- Secretory-IgA levels
- Disruption of gastrointestinal microflora
balance
Echinacea: A Miracle Herb?
• In an extraordinarily entitled paper: “Echinacea: a
Miracle Herb against Aging and Cancer?”, Dr Sandra
Miller has recently reviewed her research on
Echinacea, specifically Echinacea purpurea root1
• Dr Miller’s interest in Echinacea was triggered by
her team’s research on the drug indomethacin,
which is a COX inhibitor that reduces the
suppressors of natural killer (NK) cells,
prostaglandins2,3
1
2
3
Miller SC. eCAM 2005; 2(3): 309-314
Christopher FL, Dussault I, Miller SC. Immunobiology 1991; 184: 37-52
Dussault I, Miller SC. Nat Immun 1993; 12: 66-78
Echinacea Boosts NK Cells
• In healthy young adult mice, oral doses of
Echinacea purpurea root (0.45 mg per 25 g body
weight, similar to human dose rates) stimulated
NK cell production by bone marrow in the first 7
days which resulted in significantly higher levels
(around 25% more) of NK cells in the spleen by 2
weeks1
• In addition, the ‘helper’ or accessory cells for NK
cells, the monocytes, were also increased by 25%
1
Sun LZ-Y, Currier NL, Miller SC. J Altern Complement Med 1999; 5: 437-446
Echinacea Boosts NK Cells
• The Echinacea treatment influenced no other
white blood cell counts
• Polysaccharides, even by injection, were found to
be not responsible for this effect
• Dr Miller feels that alkylamides are largely
responsible for the effect (personal
communication)
Currier NL, Lejtenyi D, Miller SC. Phytomedicine 2003; 10: 145-153
Echinacea Reverses
Immune Aging
• NK cells decline in number and function with age
and this is thought to be one factor behind the
increase of various cancers with age
• Experiments conducted in healthy, elderly mice
found that 2 weeks of oral doses of Echinacea
returned NK cell numbers in bone marrow and
spleen to the levels of young adults and also
resurrected the functional capacity (target cell
binding, lysis) of these cells1
1
Currier NL, Miller SC. Exp Gerontol 2000; 35: 627-639
Echinacea Reverses
Immune Aging
• On this result Dr Miller writes:
“These observations appear to apply uniquely to
this herb since we could never rejuvenate the NK
cell-mediated component of the immune system in
elderly mice by any of the other typical NK cell
enhancers….”
Miller SC. eCAM 2005; 2(3): 309-314
Echinacea is Beneficial
if Taken Regularly
• One of the persistent controversies about
Echinacea is whether it is safe to be taken
consistently for long periods of time. According to
Miller’s findings, the answer is definitely in the
affirmative
• Mice were fed Echinacea purpurea root from 7
weeks of age to 13 months at the dose previously
described.1 Long-term use of Echinacea was not
only not detrimental, but distinctly beneficial
1
Brousseau M, Miller SC. Biogerontology 2005; 6: 157-163
Echinacea is Beneficial
if Taken Regularly
• By 13 months of age 46% of the control mice fed
the standard chow were still alive compared to
74% of those consuming Echinacea
• As might be expected from previous experiments,
the NK cell levels in the Echinacea-fed mice were
considerably elevated compared to controls
Miller SC. eCAM 2005; 2(3): 309-314
Echinacea is Beneficial
if Taken Regularly
“Given that the key immune cells acting as the first
line of defence against developing neoplasms in
mice and humans are NK cells, it is not difficult to
conclude that sustained enhancement of NK cells
alone, throughout life, could readily account for the
reduced frequency in deaths with advancing age.
Miller SC. eCAM 2005; 2(3): 309-314
Echinacea is Beneficial
if Taken Regularly
Spontaneous neoplasms, clinically undetectable, are
well known to increase with advancing age in
humans and mice.
Thus, the logical corollary from this study indicates
that chronic daily intake of Echinacea, is clearly not
detrimental to the immune system, but rather
prophylactic.”
Miller SC. eCAM 2005; 2(3): 309-314
Clinical Tests To Evaluate
Physiological Stress
• The most accurate objective method to assess
adrenal status is via Adrenal Stress Index (ASI)
Salivary Hormone Test
 Metametrix Labs (www.metametrix.com)
 Diagnostechs Labs (www.diagnostechs.com)
Primary Evaluation for
Adrenal Fatigue
Ragland’s Postural Hypotension Test
• This test is performed by taking the blood pressure
while the patient is lying down, and repeating
immediately after the patient stands up
• A systolic increase of 5 to 10 mm upon standing is
a normal response to this sudden change in gravity
• A systolic blood pressure that fails to rise (or falls)
when standing, adrenal fatigue and a lack of
adrenals ability to adapt to gravitational changes
(physical stressor)
Weatherby D, Ferguson S. In-Office Lab Testing - Functional Terrain Analysis. 2005.
Primary Evaluation for
Adrenal Fatigue
• Pupil Dilation Test
 Equipment required: flashlight and a mirror
 Shine the flashlight into the pupil of one eye
 It should contract if adrenals are healthy and
adapting to light stressor
 If after 30 seconds, it stays the same or, even
worse, dilates, this is an indicator of adrenal
fatigue
• Pain when pressing on adrenal glands (located
over kidneys)
 Palpation or symptom of chronic lower back pain
in the absences of structural issues
Natural Medicine for
Adrenal Health
• These include:
 Adaptogenic herbs such
as Eleuthero and
Withania
 Adrenal Tonic herbs
such as Licorice and
Rehmannia
 Vitamin C
 Vitamin B1
 Vitamin B6
 Vitamin B5 (pantethine)
 Vitamin B12
(methylcobalamin)
 Tyrosine
 Lipoic acid (naturally
found in liver)
 Phosphatidylserine
 Plant sterols, such as
those found in Tribulus
and Korean Ginseng
Rogero MM, Mendes RR, Tirapegui J. Arq Bras Endocrinol Metabol 2005 Jun; 49(3):359-68
Epub 2006 Mar 16
Core Phytotherapy for
Adrenal Health
Adaptogens
 Withania
 Korean Ginseng
 Tribulus
Adrenal Tonics
 Licorice
Adrenal Tonics
• Nourish the adrenal glands
• Allow for improved regulation of cortisol and DHEA
output
• Release stored adaptation energy
• Reduce side effects of corticosteroid drug use
• Cortisol sparing action in cases of Phase 3
exhaustion of adrenals
Mode of Action of Adaptogens
General Effects
• Fine-tune the stress response mechanism so that
Phase 1 of GAS is more efficient
• Response is stronger and faster and feedback control
is more effective so the response is shut off faster
• Have a sparing effect in Phase 2, so that Phase 3 is
delayed
• So they are biphasic, can increase or decrease stress
response
Mills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Churchill
Livingstone, Edinburgh, 2000.
Gaffney B, et al. Medical Hypotheses 2001; 56(5): 567-572
Mode of Action of Adaptogens
Specific Effects
• Positive effects on biosynthesis of RNA and proteins
• Positive effects on carbohydrate metabolism, eg
increased formation of glucose-6-phosphate
• Reduction of catecholamine depletion by inhibition of
catecholamine-O-methyl transferase (COMT) –
especially in CNS (mainly Eleuthero)
• Inhibition of breakdown of corticosteroids via
inhibition of 11-beta hydroxysteroid dehydrogenase
in CNS
Mills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Churchill
Livingstone, Edinburgh, 2000
Gaffney B, et al. Medical Hypotheses 2001; 56(5): 567-572
Mode of Action of Adaptogens
Adaptogens and Immunity
• Increased secretion of glucocorticoids in response to
injury or infection is to prevent defence mechanisms
from overreacting
• Acute and chronic stress can result in immune
suppression (well-known in athletes), probably by
this mechanism
• By their positive effects in Phase 2, adaptogens will
counter chronic immune depletion in stressed
individuals
Mills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Churchill
Livingstone, Edinburgh, 2000.
Actions of Adaptogens
•
•
•
•
•
Improved adaptation to stress
Promote regeneration
Increased concentration
Fewer mental errors
May sensitize corticosteroid feedback on the HPA
axis making the stress response more efficient
• Increase glucocorticoid action
Stress Management Protocol
Treatment Strategy
• Support the adrenal gland function with adrenal
restorative (adrenal tonics) herbs such as:
 Licorice High Grade 1:1
- 2-4 mL per day
- Phase 2 or 3 adrenal stress or exhaustion
- Contraindicated in hypertension
- If hypertensive patient, use Tribulus Forte
(2 tablets twice daily) as alternative
Licorice: Actions
• Adrenal tonic
 Contraindicated in hypertension
• Anti-inflammatory
• Mucoprotective
• Demulcent
• Anti-ulcer (peptic)
• Expectorant
• Antitussive
• Mild laxative
Dose: Licorice High Grade 1:1, 2-4 mL per day
Stress Management Protocol
Treatment Strategy
• Decrease the detrimental effects of stress on the
adrenal glands with adaptogens such as:
 Withania 1:1 (5-10 mL per day) for Phase 2
adrenal stress
 Tribulus Forte (2 tablets twice daily) for Phase 3
adrenal exhaustion
Withania: Actions
• Adrenal adaptogen
 Particularly if high cortisol levels
• Mild sedative or relaxant
 Promotes a feeling of calmness and more
sustained energy
 Useful for insomnia
Withania: Actions
• Anti-inflammatory
• Immune modulating
 Promotes the production of white blood cells
 Enhances immune function
• Antianemic
 Promotes the production of red blood cells
• Promotes growth and appetite in children and
adults
Dose: Withania 1:1 extract, 5-10 mL per day
Phase 2 Adrenal Stress Protocol
ANS in Sympathetic Dominance
• Adrenal Tonic
Licorice High Grade 1:1 (2 mL per day) or Tribulus Forte
(2 tablets twice daily) if patient hypertensive
• Adaptogen
Withania 1:1 extract (5-10 mL per day) or Tribulus Forte
(4 tablets per day) or liquid 2:1 (10 mL per day)
Phase 2 Adrenal Stress Protocol
ANS in Sympathetic Dominance
• Nervous System Support
Valerian Complex tablets (3 to 4 per day)
Zizyphus 1:2 (5 mL per day)
Hawthorn 1:2 (5 mL per day, if cardiac symptoms)
• Simplified Approach
Withania Complex tablets (2 to 4 per day) in the 2-4 pm
energy slump time of the afternoon
Phase 2 Adrenal Stress Protocol
ANS in Sympathetic Dominance
Tonic Herbal Formula
Licorice High Grade
Echinacea Premium
Zizyphus
Withania
Dose: 8 mL with water twice a day
1:1
1:2
1:2
1:1
30 mL
20 mL
20 mL
30 mL
100 mL
Phase 3 Adrenal Stress Protocol
ANS in Parasympathetic Dominance
• Adrenal Tonic
Licorice High Grade 1:1 (4 mL per day)
• Adaptogen
Tribulus Forte (2 tablets twice daily)
• Nervous System Support
Nevaton tablets (4 per day)
• Immune Support
Echinacea Premium (2 tablets or 5 mL per day)
Phase 3 Adrenal Stress Protocol
ANS in Parasympathetic Dominance
Tonic Herbal Formula Grade
Licorice High Grade
St John’s Wort High Grade
Tribulus
Dose: 8 mL with water twice a day
1:1
1:2
2:1
20 mL
30 mL
50 mL
100 mL
Tribulus
• In recent years, Tribulus has gained a reputation
as an optimal herb to support both endogenous GH
and DHEA levels for the age of the individual
• This is a native herb to many parts of the world but
it is the Bulgarian Tribulus which has been
extensively researched
• The active components of Tribulus herb are
steroidal saponins, mainly the furostanol saponins,
especially protodioscin
Tribulus
• Clinically documented benefits include:
 Growth hormone regulation via HP axis
 Intensification of protein synthesis (anabolic)
 Male and female infertility
 Menopause
 Andropause
 Impotence
 Erectile dysfunction
 Libido enhancing
Tribulus: Quality Issues
• Bulgarian clinical trials are based on a leaf extract
containing 40% furostanol saponins by UV-Vis
measurement
• Chinese and Indian sources are of a different Tribulus
chemotype and typically use the fruit, analyzed at 40%
by gravimetric methods
 Gravimetric 40%
 UV
3% by Bulgarian method
• Raw herb results
 Fruit
0.5%
 Aerial parts 3.5%
Stress Management Protocol
Simplified Treatment and Maintenance Strategy
• Withania Complex tablets (3 to 4 per day)
 Ideal for either parasympathetic or sympathetic
dominance due to adrenal stress
 Contains Licorice, hence contraindicated in
hypertension if used long term. Short term use
is appropriate.
Case Study
Case History:
• Female patient aged 46 presents with primary
complaints:
 Onset insomnia for the past 12 years with night
sweats. She had tried pharmaceutical
medications in the past to no avail (temazepam
and hormone replacement therapy)
 She found the insomnia was worse after long
term use of temazepam (rebound insomnia)
Case Study
• Secondary complaints:
 Hot flashes with perspiration: recent female
hormonal pathology tests had revealed slightly
low estrogen with normal progesterone. Thyroid
panel normal (TSH, Free and bound T4 and T3
all within normal range)
 Anxiety syndrome: not previously medicated as
was resistance to the use of anti-anxiolytic or
anti-depressant medications. Highly emotional,
teary and irritable
 Fatigue, worse mid-morning to midday
Case Study
• Secondary complaints continued…
 Very poor libido with subsequent relationship
stress
 Osteopenia (past 18 months), but currently
taking calcium hydroxyapetite prescribed by
primary medical doctor
 Recurrent sinus infections. Three infections in a
8 month period with subsequent antibiotic and
antifungal therapy
Case Study
• Family History:
 Breast cancer (mother)
 Osteoporosis (mother, grandmother)
 Osteoarthritis (mother, grandmother and
grandfather)
Case Study
• Lifestyle Factors:
 Exercise twice weekly (walking)
 Had gained 18 lb over the past 2 years and was
trying to reduce weight with a low carbohydrate
diet but notes difficulty due to intense sugar and
caffeine cravings
 In an unhappy relationship, has 2 young
children
 Works a part-time high stress job
Adrenal Stress Index
Test Results
• Elevated afternoon cortisol
 often associated with poor glucose counter
regulation process
• Low DHEA-S indicated anabolic enhancement is
necessary
 low DHEA-S is precursor issue to low estrogen
and testosterone
• DHEA-S: cortisol relationship:
 maladaption phase 2
Protocol Development
• Manage HPA Axis and support endogenous
production of GH/DHEA
 Tribulus Forte (2 tablets twice daily)
Protocol Development
• Select an adaptogen:
 Withania 1:1 extract
• 5 mL daily in the evening
• Ideal for elevated cortisol
Protocol Development
• Select an adrenal tonic:
 Rehmannia 1:2 extract
• 5 mL mid morning when cortisol is lowest
• Ideal for low DHEA-S and elevated cortisol
Protocol Development
• Supportive Herbal Formula
(Sympathetic dominance basis of support)
Californian Poppy
Valerian
Echinacea Premium
Gotu Kola
Chaste Tree
1:2
1:2
1:2
1:1
1:2
Dose: 8 mL twice daily
100 mL
100 mL
80 mL
120 mL
100 mL
500 mL
Nervine
Nervine
Immune support
MS support
Pineal and Pituitary
Results
• She was re-evaluated after 16 weeks on treatment
with Salivary Adrenal Stress Index testing and her
results showed normal adaptation to stress
 Insomnia was substantially improved, such that
she was achieving 7 hours of continual sleep per
night and waking feeling refreshed
 Libido had improved and menopausal symptoms
had subsided
 Energy remarkably improved - felt more
“reserve” of energy rather than feeling anxious
or fatigued
SELYE’S STRESS MODEL
General adaptation syndrome
normal
resistance
state
anabolic phase
catabolic
phase
3 months recovery time
alarm phase
resistance phase
exhaustion phase
Phase 1
Phase 2
Phase 3
Sympathetic Dominant
Phase 1: Support (ie supporting normal or borderline adrenals)
Simple approach with Withania Complex tablets
SELYE’S STRESS MODEL
General adaptation syndrome
normal
resistance
state
anabolic phase
catabolic
phase
6 months recovery time
alarm phase
resistance phase
exhaustion phase
Phase 1
Phase 2
Phase 3
Sympathetic Dominant
Phase 2: Withania 1:1 will bring elevated cortisol down to normal levels and
to support DHEA. Support with Adrenal tonics such as Tribulus Forte
tablets; Licorice High Grade 1:1. Note: In cases of hypertension use
Tribulus instead of Licorice.
SELYE’S STRESS MODEL
General adaptation syndrome
normal
resistance
state
anabolic phase
catabolic
phase
1 year recovery time
alarm phase
Phase 1
resistance phase
exhaustion phase
Phase 2
Phase 3
Phase 3: Licorice High Grade 1:1, Tribulus Forte tablets, Korean Ginseng.
Note: In cases of hypertension use Tribulus instead of Licorice.
Acknowledgements
I would like to gratefully thank my colleagues
Associate Professor Kerry Bone
Lee Carroll
Curt Hamilton
for contributing to the preparation of information
delivered in this presentation

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