CLINICAL APPLICATIONS

* Adrenal insufficiency or low adrenal functions

* Premature aging

* Diminished sexual and reproductive functions

* Patients who are “burned out,” with fatigue, no energy, lack of interest, lack of drive and satisfaction

 

WESTERN THERAPEUTIC ACTIONS

* Regulates and improves the function of the adrenal glands and the endocrine system

* Improves mental acuity and physical performance

* Restores normal sexual and reproductive functions

* Enhances the immune system

 

CHINESE THERAPEUTIC ACTIONS

* Tonifies Kidney yin, yang, and jing (essence)

* Tonifies the qi and blood

* Strengthens the Spleen and Stomach

 

DOSAGE

Take 3 to 4 capsules three times daily on an empty stomach with warm water. The dosage may be increased to 6 to 8 capsules three times daily, if necessary. For maintenance, take 1 to 2 capsules daily.

 

INGREDIENTS

Ba Ji Tian (Radix Morindae Officinalis)

Da Zao (Fructus Jujubae)

Du Zhong (Cortex Eucommiae)

Fu Ling (Poria)

Fu Zi (Radix Aconiti Lateralis Praeparata)

Gou Qi Zi (Fructus Lycii)

Mu Dan Pi (Cortex Moutan)

Niu Xi (Radix Achyranthis Bidentatae)

Ren Shen (Radix et Rhizoma Ginseng)

Rou Gui (Cortex Cinnamomi)

Shan Yao (Rhizoma Dioscoreae)

Shan Zhu Yu (Fructus Corni)

Shi Chang Pu (Rhizoma Acori Tatarinowii)

Shu Di Huang (Radix Rehmanniae Praeparata)

Suo Yang (Herba Cynomorii)

Wu Wei Zi (Fructus Schisandrae Chinensis)

Xiao Hui Xiang (Fructus Foeniculi)

Yuan Zhi (Radix Polygalae)

Ze Xie (Rhizoma Alismatis)

Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle)

 

BACKGROUND

The adrenal glands, two triangular glands on top of the kidneys, are responsible for the production and release of cortisol in response to stress. If an individual suffers from chronic stress or manages stress poorly, the function of the adrenal glands will be affected, resulting in adrenal insufficiency or adrenal fatigue. Clinical manifestations including anxiety, depression, fatigue, intolerance for stress, increased allergy and sensitivity to foods and chemicals, and a tendency to feel cold.

 

FORMULA EXPLANATION

Adrenal + is designed to treat patients who are “burned out,” with symptoms of premature aging, fatigue, no energy, lack of interest, drive, and satisfaction. Such conditions may be caused by excessive stress, anxiety, tension, overwork, and lack of rest. From the traditional Chinese medicine perspective, there is an excessive consumption of qi, blood, yin, yang, and Kidney jing (essence), accompanied by deficiency of Spleen, Stomach, Heart and Kidney. Deficiency of the Spleen and Stomach leads to an inadequate supply of qi, shown by symptoms of generalized weakness, fatigue, and anorexia. Deficiency of Heart qi and blood may contribute to forgetfulness, being easily frightened, low-grade fever, and night sweats. Deficiency of yin and yang leads to premature aging. Lastly, the lack of jing (essence) contributes further to Kidney deficiency, leading to decreased libido, spermatorrhea, and other sexual disorders.

        In this formula, a large portion of Ren Shen (Radix et Rhizoma Ginseng) is used because it is the most effective and potent herb to tonify qi, strengthen the Lung and the Spleen, and improve mental functioning. It has excellent adaptogenic functions to help the body adjust to various stressful situations. Studies have shown that Ren Shen (Radix et Rhizoma Ginseng) improves both mental and physical functions.

        In addition, Suo Yang (Herba Cynomorii), Ba Ji Tian (Radix Morindae Officinalis), and Xiao Hui Xiang (Fructus Foeniculi) strengthen the Spleen and the Kidney. Shu Di Huang (Radix Rehmanniae Praeparata) and Gou Qi Zi (Fructus Lycii) nourish the Kidney and benefit qi. Du Zhong (Cortex Eucommiae) and Niu Xi (Radix Achyranthis Bidentatae) tonify the Kidney and strengthen the knees and the lower back. Fu Ling (Poria) and Shan Yao (Rhizoma Dioscoreae) strengthen the Spleen and dissolve dampness. Shan Yao (Rhizoma Dioscoreae) and Wu Wei Zi (Fructus Schisandrae Chinensis) tonify the Lung and prevent leakage of Lung qi. Furthermore, they reduce the loss of fluids from the Kidney, particularly via spermatorrhea. Yuan Zhi (Radix Polygalae) tonifies the Heart and calms the shen (spirit). Shi Chang Pu (Rhizoma Acori Tatarinowii) opens the sensory orifices, improves mental functioning, and increases alertness. Da Zao (Fructus Jujubae) tonifies both qi and blood, and strengthens the Lung and Spleen functions.

        Furthermore, Ze Xie (Rhizoma Alismatis) settles turbidity in the Kidney and controls the potential stagnation that may be associated with the use of Shu Di Huang (Radix Rehmanniae Praeparata). Mu Dan Pi (Cortex Moutan) sedates deficiency fire of the Liver; it also balances the astringent property of Shan Zhu Yu (Fructus Corni). Fu Ling (Poria), as a sedating herb used with Shan Yao (Rhizoma Dioscoreae), dispels damp through urination and tonifies the middle jiao.

        Hot in nature, Fu Zi (Radix Aconiti Lateralis Praeparata) and Rou Gui (Cortex Cinnamomi) revitalize Kidney yang and warm the lower body. Fu Zi (Radix Aconiti Lateralis Praeparata) is excellent for treatment of various chronic cold-type disorders associated with the endocrine, cardiovascular and musculoskeletal systems. Rou Gui (Cortex Cinnamomi) strengthens the Spleen and tonifies Kidney yang.

        Lastly, Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) tonifies qi and harmonizes the actions of the other herbs.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated during pregnancy and nursing.

* This formula is not recommended in cases with exterior or excess conditions. It should not be used in cases of infections and inflammations.

* This formula should be used with caution in patients with yin deficiency, since this formula is warm in nature.

* This formula may be taken with a small amount of salt as a channel-guiding substance to enhance the Kidney-tonic properties.

* Patients who wear a pacemaker, or individuals who take antiarrhythmic drugs or cardiac glycosides such as Lanoxin (digoxin), should not take this formula. Fu Zi (Radix Aconiti Lateralis Praeparata) may interact with these drugs by affecting the rhythm and potentiating the contractile strength of the heart.[1]

 

CLINICAL NOTES

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Overall thin and weak pulse

 

SUPPLEMENTARY FORMULAS

* For an immediate boost of energy, use with Vibrant.

* For long-term restoration of vitality, use with Imperial Tonic.

* For patients with hypothyroidism, use with Thyro-forte.

* For sexual and reproductive disorders, use with Vitality.

* For compromised immune system, use with Immune +.

* For stomach and duodenal ulcers, use with GI Care.

* For stress and anxiety, use with Calm.

* For severe stress and anxiety, use with Calm (ES).

* For stress, anxiety, and insomnia, use with Calm ZZZ.

* For insomnia, use with Schisandra ZZZ.

* For obesity, use with Herbalite.

* For weakness and deficiency of the Lung, use with Cordyceps 3.

* For poor memory, use with Enhance Memory.

* For general Kidney yang deficiency, add Kidney Tonic (Yang).

* For general Kidney yin deficiency, add Kidney Tonic (Yin).

* For male infertility, add Vital Essence.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Apply moxa to Mingmen (GV 4), Shenshu (BL 23), Guanyuan (CV 4)

* Needle Shenshu (BL 23), Sanyinjiao (SP 6), Zusanli (ST 36), Qihai (CV 6), Mingmen (GV 4), Shenque (CV 8)

 

Classic Master Tung's Points:

* Fatigue: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Beimian (T 44.07), Sanyan (T 11.21), Zhitong (T 44.13)

* Diminished sexual function:

·    Female: Fuke (T 11.24), Qimen (T 33.01), Qijiao (T 33.02), Qizheng (T 33.03), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21)

·    Male: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Tongshen (T 88.09), Tongwei (T 88.10), Sanshen (T 44.27)*

·    Bleed tender points on the Kidney area of the back from L1-L5 with cupping.

·    Long-term treatment with moxa to the Kidney area on the back from L1-L5, Guanyuan (CV 4), Zhongji (CV 3)

 

Master Tung’s Points by Dr. Chuan-Min Wang:

* Mild to moderate adrenal insufficiency: Tianhuangfu [shenguan] (T 77.18)

* Moderate to severe adrenal insufficiency: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21)

 

Balance Method by Dr. Richard Tan:

* Left side: Hegu (LI 4), Fuliu (KI 7), Ligou (LR 5), and Kidney point on the ear

* Right side: Zusanli (ST 36), Yanglingquan (GB 34), Tongli (HT 5)

* Left and right sides can be alternated from treatment to treatment.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Addison’s disease: Adrenal Gland, Endocrine, Pituitary, Exciting Point, Thalamus, San Jiao, Kidney, Liver

* Regulating the function of endocrine glands: Endocrine, Pituitary, Thalamus, Kidney, Gonadotropin, Liver, Corresponding points selected based on the focus.

* Improving fatigue: Sympathetic, Kidney, Liver, Spleen, San Jiao, Anxious, Nervous Subcortex, Speed Recovered Fatigue. Bleed Ear Apex.

 

NUTRITION

* Increase the consumption of fresh fruits, vegetables, grains, seeds, and nuts.

* Eat more fish and fish oils, onions, garlic, olives, olive oil, herbs, spices, yogurt, fiber, and tofu or other soy products.

* Sea vegetables, such as kelp and dulse, replenish the body with minerals like magnesium, potassium, calcium, iodine, and iron.

* Ensure adequate intake of vitamin B complex to process and utilize energy.

* Decrease intake of alcohol, fats, and highly processed foods.

* Avoid the use of stimulants, such as coffee, caffeine, and high-sugar products.

* Food allergies or chemical hypersensitivity can drain energy and cause fatigue. Additional tests are necessary to rule out allergy and/or hypersensitivity.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Kidney yang deficiency: Consume warming foods such as chicken, lamb, scallions, sesame seeds, fish, baked tofu, soybeans, walnuts, eggs, lentils, black beans, lotus seeds, a little wine, ginger, cinnamon bark tea.

* Kidney yin deficiency: Consume cooling foods such as mulberries, apples, peaches, pears, fresh vegetables, mung beans, soybeans, tofu, soy sprouts, chrysanthemum flowers.

 

LIFESTYLE INSTRUCTIONS

* Get regular exercise and adequate rest.

* For relaxation and better sleep, take a warm bath for about 20 minutes before bedtime. Sea salt or Epsom salt can also be added.

* Engage in activities such as tai chi chuan [tai ji chuan], walking, or meditation that allow calming of the mind without creating stagnation or excessive fatigue.

* Avoid exposure to heavy metals such as lead, cadmium, aluminum, copper, and arsenic, all of which can suppress the immune system and cause fatigue. Those who have already been exposed should take Herbal DTX to eliminate these toxins.

 

CASE STUDIES

* M.H., a 66-year-old female patient, presented with tiredness, weakness, inability to exercise with desire to rest frequently, and some anxiety. Her blood pressure was 145/70 mmHg and her heart rate was 88 beats per minute. Laboratory results showed K 5 mmol/L, Na 140 mmol/L, Cl 103 mmol/L, CO₂ 26 mmol/L, and Anion gap 15.8 mmol/L. According to the results, high potassium signified adrenal stress, and high anion gap showed dysglycemia. The practitioner diagnosed this condition as Kidney qi deficiency with yin and yang deficiencies. Other objective findings were cold hands and feet. Adrenal + was prescribed at three capsules three times daily and as needed after exercising. The results were good. The patient reported that she was satisfied with the herbs and noticed the difference in energy it had given her. Submitted by N.H., Chatsworth, California.

* L.D., a 31-year-old female, presented with fatigue, dizziness, low body temperature, coldness, and muscle weakness. Her blood pressure was 100/60 mmHg and her heart rate was 65 beats per minute. Her Western diagnosis was hypotension and hypoglycemia. Laboratory result showed she had decreased thyroid activity and adrenal medullary insufficiency. The diagnosis was yang deficiency. She was prescribed Thyro-forte and Adrenal + at 2.5 and 1.5 grams per day, respectively. She did not receive any acupuncture. After two months, she felt much more energized and the dizziness was gone. She no longer felt cold. Submitted by W.F., Bloomfield, New Jersey.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Adrenal + is designed to treat patients who are “burned out,” with fatigue and lethargy accompanied by premature aging and a decline in mental acuity and physical performance. It contains herbs that stimulate the mind, improve physical strength, restore sexual prowess, and enhance the immune system.

        The endocrine system has a significant impact on the regulation of various glands in the body, including, but not limited to, the hypothalamus, pituitary, thyroid, parathyroid, the adrenal glands, gonads, pancreas, and paraganglia.[2] The imbalance of the endocrine system will affect the glands, and disorder of the glands will also affect the endocrine system. To properly address such conditions, this formula uses many herbs to regulate and restore the endocrine system and the glands. For example, Shu Di Huang (Radix Rehmanniae Praeparata) has been shown to increase plasma levels of adrenal cortical hormone.[3] Ba Ji Tian (Radix Morindae Officinalis) has a stimulating effect on the pituitary gland and the adrenal cortex, and its administration has been associated with an increase in plasma levels of corticosteroids.[4] Administration of glycyrrhizin and glycyrrhetinic, two active ingredients in Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle), clearly enhances the overall duration and influence of cortisone as demonstrated by various laboratory studies.[5] One clinical trial showed that patients with declining pituitary gland function were successfully treated by continuous use of Ren Shen (Radix et Rhizoma Ginseng) and Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) for two to three months.[6] Since the long-term use of Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) is sometimes associated with cellular accumulation of water, Ze Xie (Rhizoma Alismatis) is added for its diuretic action to alleviate this potential side effect.[7] Other herbs that affect and improve the endocrine system include Shan Zhu Yu (Fructus Corni), Du Zhong (Cortex Eucommiae), and Ba Ji Tian (Radix Morindae Officinalis).[8]^,[9]

        In addition to regulating the endocrine system, it is also important to restore optimal mental and physical functioning. Shi Chang Pu (Rhizoma Acori Tatarinowii) and Ren Shen (Radix et Rhizoma Ginseng) improve mental acuity. In laboratory studies, administration of Shi Chang Pu (Rhizoma Acori Tatarinowii) is associated with improvement of memory.[10] In clinical studies, use of Ren Shen (Radix et Rhizoma Ginseng) is associated with marked effectiveness in improving memory and learning ability.[11] In one study on mental retardation, 30 children with low IQ took a formula comprised of Ren Shen (Radix et Rhizoma Ginseng) and three other herbs and showed mild to moderate improvement in classroom performance.[12] Furthermore, Da Zao (Fructus Jujubae) and Ba Ji Tian (Radix Morindae Officinalis) improve physical performance. In comparison with placebo substances, both of these herbs showed significant capacity to increase body weight, muscle strength, and physical endurance.[13]^,[14]

        Furthermore, many herbs in this formula function to improve sexual and reproductive functions. Use of Gou Qi Zi (Fructus Lycii) is highly effective to improve low sperm count and poor motility.[15] Wu Wei Zi (Fructus Schisandrae Chinensis) has a stimulating effect on reproductive organs, increasing the weight of the testicles in males and inducing ovulation in females.[16] In another study, patients with impotence were treated with Ren Shen (Radix et Rhizoma Ginseng) with marked success. Out of 27 patients, 15 regained normal function, 9 had moderate improvement, and 3 showed no effect. Lastly, in one clinical study, 24 patients with low sperm count, treated with a preparation of Ren Shen (Radix et Rhizoma Ginseng), demonstrated an increase in sperm count in 70% of the patients, and an increase in sperm motility in 67% of the patients.[17]

        Since patients who are weak and deficient often have a suppressed immune system, herbs are included in this formula to strengthen the body and enhance the immune system. According to studies, use of a Rou Gui (Cortex Cinnamomi) preparation for five days increased white blood cell count by 150 to 200%, and use of Ren Shen (Radix et Rhizoma Ginseng) increased the total count of IgM.[18]^,[19] Additionally, Gou Qi Zi (Fructus Lycii) and Du Zhong (Cortex Eucommiae) increase non-specific immunity, as they promote phagocytic activity by the macrophages, and increase the total number of T cells.[20]^,[21]^,[22]

        In summary, Adrenal + contains herbs that have excellent effects of regulating the adrenal glands and balancing the endocrine system. It is a key formula to treat patients experiencing premature aging, declining mental and physical functioning, or who are simply “burned out” with fatigue, no energy, lack of interest, lack of drive and satisfaction.

 

COMPARATIVE ANALYSIS

Adrenal insufficiency or low adrenal functions are general terms used here to describe individuals who have premature aging or are “burned out,” with fatigue, no energy, lack of interest, lack of drive and satisfaction. These conditions affect overall health, and often lead to diminished mental and physical functions.

        Adrenal insufficiency technically and specifically refers to conditions such as Addison’s disease. Such serious conditions are often treated with various types of intravenous or oral adrenocortical hormones. Though effective, they often have a great number of side effects, including immune suppression, increased frequency of and decreased resistance to infections, decreased or blurred vision, filling or rounding out of the face, frequent urination, increased thirst, abdominal or stomach pain, acne, bloody or black (tarry) stools, headache, irregular heartbeat, menstrual problems, muscle cramps or pain, muscle weakness, nausea, pain throughout the body, sensitivity of eyes to light, stunting of growth (in children), swelling of feet or lower legs, tearing of eyes, thin and shiny skin, difficulty sleeping, unusual bruising, unusual increase in hair growth, unusual tiredness or weakness, rapid weight gain, and non-healing wounds. Therefore, unless the patients are diagnosed with the biomedical condition of adrenal cortical hypofunction, potent drugs such as adrenocortical hormones are not used.

        Adrenal insufficiency is used to describe the general signs and symptoms of qi, blood, yin, yang, and Kidney jing (essence) depletion accompanied by Spleen, Stomach, Heart and Kidney deficiencies. As described above, Adrenal + has excellent functions to regulate the endocrine system, stimulate the adrenal glands, and improve mental and physical functions. Though herbs do not treat specific and serious conditions such as Addison’s disease, they do offer excellent preventative and treatment effects for individuals who are “burned out,” with fatigue, no energy, lack of interest, lack of drive and satisfaction. Most importantly, herbal therapy has a significantly better safety profile in comparison with drug treatments.