When we find ourselves overstressed over a long period of time, adrenal fatigue or ‘burnout’ can occur. Our adrenal gland is responsible for producing hormones in response to stress. After an excessive amount of stress, our adrenal gland gets exhausted.
This exhaustion leads us to feel even more overworked and tired. Adrenal dysregulation can involve either insufficient levels or excessive amounts of cortisol.
Many traditional Chinese herbs can influence cortisol to help return to proper adrenal regulation. Additionally, acupuncture therapies can support our body’s response to stress.
Sini Decoction and Adrenal Regulation
In 2014, a randomized controlled trial evaluated the Sini decoction in comparison to a control group and a group that received a corticoid. The Sini decoction included monkshood, dried ginger, and honey-fried licorice. The corticoid utilized was hydrocortisone, cortisol directly given to the body.
The researchers administered the therapies for 7 days and collected adrenocorticotropic hormone (ACTH) and cortisol levels before the study, 3 days after the therapies, and 14 days after the therapies. ACTH is the precursor to cortisol in the body and therefore can indicate future cortisol synthesis.
The study found no significant difference in ACTH levels between the corticoid and Sini decoction group. The groups that received the corticoid or the Sini decoction behaved similarly and had higher cortical levels in comparison to that of the control group.
Therefore, the study suggested that the Sini decoction can improve adrenal dysregulation.
Researchers in 2019 investigated Shui Qie’s effect on stress-relief through a randomized controlled trial. Shiu Qie is also commonly known as ashwagandha.
Over 60 days, 60 adults were randomly assigned to receive either a placebo or 240 mg of standardized Shiu Qie extract once a day. To measure their stress, participants had their cortisol levels collected and they also completed the Hamilton Anxiety Rating Scale (HAM-A) and the Depression, Anxiety, and Stress Scale-21 (DASS-21).
Ahswagandha intake was found to produce a greater reduction in cortisol compared to placebo. Additionally, the ashwagandha supplementation was associated with a statistically significant reduction in the HAM-A scale. These findings suggest that Aswagandha’s reduction in cortisol helped regulate the participant’s stress level.
Panax Ginseng & the HPA Axis
Cortisol is regulated through communications between the hypothalamus, the pituitary gland, and the adrenal gland. This pathway is referred to as the HPA axis. Through modulation of this axis, herbs can regulate cortisol as well as other stress-related hormones. For example, hyperactivity of the HPA axis leads to elevated blood cortisol levels.
Panax ginseng, a well-known Chinese herb, can act as a supportive tool for mood and stress regulation. And much of the research on this role is focused on the HPA axis.
A review in 2019 collected current research focused on Panax ginseng’s mechanism of action as an antidepressant. Modulation of the HPA axis can help relieve depression as well as other mood disorders.
The summary noted that mice that received ginsenosides extracted from Panax ginseng not only had improved sleep but had lower cortisol levels in blood serum. In a normal 24-hour cycle, cortisol should be the lowest at night to help support sleep. The researchers suggested that by lowering the cortisol levels, the ginsenosides helped calm heightened cortisol levels that might have been disrupting sleep.
Researchers in an animal study in 2012 directly evaluated the effect of ginsenoside Rg1 on cortisol levels after inducing stress in mice. Ginsenoside Rg1 is a major constituent of Panax ginseng thought to carry neuroprotective effects.
In comparison to controls, the mice that received the ginsenoside had reduced cortisol levels during the mild stress and increased brain-derived neurotrophic factor (BDNF). BDNF is a protein that helps promote the growth and health of nerve cells and is often negatively correlated with cortisol levels.
Acupuncture to Reduce Cortisol and Support Sleep
To explore the underlying mechanism of how acupuncture benefits patients with chronic insomnia, researchers in a randomized controlled trial in 2021 measured plasma cortisol levels after acupuncture therapies in comparison to a control.
These therapies included either acupuncture or electroacup2uncture at four therapeutic points. The control group received acupuncture or electroacupuncture, however, at three points that were not related to chronic insomnia relief.
The study randomly divided the 60 patients to either receive the control or therapeutic acupuncture for three sessions a week for four weeks.
Compared to before the treatment, plasma cortisol levels in the treatment group were significantly down-regulated while plasma melatonin levels were up-regulated in comparison to those in the control group. Cortisol is a hormone that can disrupt sleep when down-regulated while melatonin is a hormone that helps support sleep onset.
Through this hormone regulation, therapeutic acupuncture was thought to help support the patients’ sleep.
The study additionally measured scores on the Pittsburg sleep quality index (PSQI) and fatigue severity scale (FSS) to evaluate sleep quality and daytime fatigue. Compared with before the therapies, the PSQI scores and total FSS scores decreased significantly in the therapeutic group, suggesting chronic insomnia relief.
Patient receiving acupuncture
A randomized controlled trial in 2021 also exploring cortisol levels in patients with chronic insomnia, compared acupuncture to Estazolam tablets. Estazolam is a prescription sedative medication prescribed for insomnia.
The researchers randomly divided 60 patients into an observation group or a control group for 4 weeks. The observation group received acupuncture once every other day, 3 times a week while the control group received Estazolam tablets (1 mg) before bed every night.
The researchers measured serum GABA, serum cortisol, and PSQI ratings. GABA is a relaxing neurotransmitter that can be supportive of sleep.
The study found acupuncture to be similarly effective as Estazolam for PSQI ratings. The serum GABA levels were higher and the serum cortisol levels were lower in both groups after the four weeks.
Therefore, this study shows that acupuncture is equally as effective as Estazolam for chronic insomnia relief.
Patient receiving acupuncture
The research above shows that Traditional Chinese medicine, through both herbs and acupuncture, directly helps reduce stress and stress-related conditions by directly affecting the main stress hormone, cortisol. While lowered stress levels are substantial to support traditional Chinese medicine, blood labs noted in this article is further proof that traditional Chinese medicine works!