[h=3]Alternative Approach to Hypercortisol-Induced Sleep Problems[/h]An effective way to manage chronically elevated cortisol levels is to ensure that the adrenal glands are supported by proper nutrition. Vitamin B6, vitamin B5 (pantothenic acid), and vitamin C often become depleted with prolonged hyperactivity of adrenal gland activity and increased production of cortisol.21 These nutrients play a critical role in the optimal functioning of the adrenal gland and in the optimal manufacturing of adrenal hormones. Levels of these nutrients can be diminished during times of stress. For instance, urinary excretion of vitamin C is increased during stress, which is evidence of vitamin C “dumping.” Consequently, additional symptoms may develop with these nutritional deficiencies. Observations and a rich tradition of anecdotal writings and reports supporting this claim have shown that deficiencies in pantothenic acid results in fatigue, headaches, and insomnia. L-tyrosine and L-theanine support the adrenal glands by supporting NE production and are beneficial in combating fatigue and anxiety symptoms related to stress.22,23 In addition, the cortisol feedback mechanisms are dependent on adequate amounts of calcium, magnesium, potassium, manganese, and zinc.24 Therefore, supplementation of these nutrients along with other supporting agents, such as L-tyrosine and L-theanine, may help ameliorate some symptoms as well as assist in proper HPA axis functioning.
Ashwagandha (Withania somnifera), also known as Indian ginseng, has been shown to reduce corticosterone, a glucocorticoid hormone present in amphibians, reptiles, rodents, and birds that is structurally similar to cortisol.25,26 An array of clinical trials and laboratory research also support the use of ashwagandha in enhancing mood, reducing anxiety, and increasing energy.27-30
Magnolia (Magnolia officinalis), was studied in a randomized, parallel, placebo-controlled study in overweight premenopausal women and resulted in a decrease in transitory anxiety, although salivary cortisol levels were not significantly reduced.31Magnolia has been demonstrated to improve mood, increase relaxation, induce a restful sleep, and enhance stress reduction.32 In an unpublished study conducted at the Living Longer clinic, Cincinnati, Ohio, a proprietary blend of Magnolia officinalis and Phellodendron amurense was shown clinically to normalize the hormone levels associated with stress-induced obesity. It was demonstrated that this combination lowered cortisol levels by 37 percent and increased DHEA by 227 percent.
Phosphatidylserine (PS), also known as lecithin phosphatidylserine, is known to blunt the rise in cortisol and ACTH following strenuous training and significantly reduce both ACTH and cortisol levels after exposure to physical stress.33,24 Phosphatidylserine also has been shown to improve mood.35,36
Another approach to improving sleep is targeting GABA activity. Increasing GABA activity will decrease LC, PVN, and resultant HPA axis activity. One method to support GABA functioning is to decrease glutamate signaling. Glutamate and GABA activity oppose each other; therefore, decreasing glutamate activity will support healthy HPA axis activity. L-theanine is a glutamate receptor antagonist and has been shown to decrease brain NE levels secondarily to increasing GABA levels.37,38 Interestingly, N-acetylcysteine (NAC) is a known precursor for cysteine, necessary for the synthesis of glutathione,39,40 but also has been shown to decrease glutamate levels. NAC decreases glutamate by enhancing the activity of a cystine/glutamate antiporter. Glutamate is regulated by a cystine/glutamate antiporter that exchanges extraceullular cystine for intracellular glutamate.41 Ultimately, the actions of this antiporter serve to lessen synaptic glutamate levels. Furthermore, glutamate is involved in immune-cell signaling to increase dendritic cell maturation following the exposure to antigens. To address elevated glutamate at its source, evaluation of intestinal permeabilities, food sensitivities/allergies, and bacterial and/or viral infections need to be considered due their relationship to dendritic cell maturation via increase antigen presence.42
4-amino-3-phenylbutyric acid is a synthetic amino acid sold as a nutritional supplement that crosses the blood-brain barrier and is a GABA agonist.43 Like many other GABA agonists, 4-amino-3-phenylbutyric acid can promote sleep by stimulating sleep-promoting centers in the brain. It also supports healthy cortisol levels by inhibiting the LC release of NE into the PVN.
Rhodiola rosea is an adaptogenic herb that modulates cortisol.44 It reduces catecholamine release and prevents catecholamine depletion from the adrenal glands. In addition, research that was conducted in Russia indicates that it may stimulate opioid receptors,45which in turn can reduce NE excitability in the PVN and HPA axis activity.46
Many traditional botanicals (eg, American ginseng, ashwagandha, Asian ginseng, astragalus, cordyceps, reishi, eleutherococcus, holy basil, rhodiola, schisandra, maca, licorice and common nutritional supplements (eg, phosphatidylserine, L-theanine, 4-amino-3-phenylbutyric acid, NAC) have been utilized for their stabilizing effects on the HPA axis. Combination/multi-ingredient formulations are common in a whole-system approach to restoring HPA axis dysfunction, whether to increase or decrease cortisol levels.