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Hey everyone, it's Mikki here. You're listening to Mini Mikkipedia on a Monday. And today I want to chat about natural supplements. When people ask me about herbs or about supplements, i.e. not medications, there's almost this sort presumption, or they assume, that if they're natural, they're going to always be safe. So the supplements I want to chat about today, they are...

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Once they deal with stress, and of course I get asked about these a lot, but sometimes these natural supplements that are specifically designed to help with stress might actually be working a little bit too well. So if you've been taking something like ashwagandha, rhodiola or other adaptions to manage stress, this episode can be really helpful actually to determine whether this is happening for you. So it's no surprise that particularly with this influx of

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information on perimenopause and menopause, the wellness industry really has exploded with supplements marketed for stress, cortisol management and adrenal support. If you walk into any health food store and all scroll through social media and you will see countless products promising to balance your stress hormones naturally and because they are quote unquote natural, many people just assume they're inherently safe or you can't really overdo it. However, these supplements work precisely because they really do affect

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physiological systems in the body. The same mechanisms that make them potentially helpful also mean they need to be used thoughtfully. So first up let's address the natural misconception. Natural does not mean without effects or impossible to overuse. Digitalis, the heart medication, comes from foxglove which is a natural plant. Aspirin comes from willow bark. Opioids come from poppies.

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The fact that something comes from nature tells us nothing about whether it's appropriate for every person in every situation. And when we take supplements that lower cortisol or affect our stress response, we're intervening in one of the body's most fundamental systems, and that's the HPA axis. So the HPA axis, the hypothalamic pituitary adrenal axis, is your body's central stress response system. So, the simplified version.

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Your hypothalamus in your brain senses stress. It signals your pituitary gland. This tells your adrenal glands to produce cortisol and other stress hormones. The system is supposed to ramp up when you need it and calm down when you don't. It isn't just about stress. It affects your immune system, blood sugar regulation, blood pressure, inflammation, sleep-wake cycles, and way more. The concern with certain supplements is that they suppress or dysregulate this axis.

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That might be exactly what you need if you genuinely have elevated cortisol from chronic stress. But if your HPA access is functioning normally, or especially if it's already underactive, further suppression can cause problems. So today I'm going to walk through five major supplements that can affect your HPA access and we'll cover what it is and why people use it, what the research shows, how it works in your body, and any potential benefits and important concerns

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and who should be cautious. First up Ashwagandha. Ashwagandha or Wathania somnifera is one of the most important herbs in Ayurvedic medicine where it's been used for thousands of years. It's classified as an adaptogen which theoretically helps your body adapt to stress. The name literally means smell of a horse in Sanskrit because both of its scent and because it's traditionally associated with strength and vitality.

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And in recent years, it's become one of the most popular supplements in the Western market for stress management, sleep and anxiety. So there are multiple systematic reviews and meta-analyses showing that ashwagandha can reduce cortisol levels and improve stress and anxiety scores in human trials. A 219 systematic review found that ashwagandha significantly reduced cortisol levels compared to placebo across multiple trials.

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We're seeing reductions in the range of 11 to 32 % in stress population. And studies also show improvements in anxiety, stress perception, sleep quality, testosterone levels in men for some studies, and potentially thyroid function improvements as well. The typical doses used in research are 300 to 600 milligrams of a standardized extract daily, often split into two doses.

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Ashwagandha appears to work through multiple mechanisms. It contains compounds called oethanolides that may modulate GABA receptors and GABA is our calming neurotransmitter. It may influence the HPA axis directly. It has inflammatory properties. It may affect thyroid hormones. And most studies are around 8 to 12 weeks long. We don't have robust long-term safety data. And the key question is whether ashwagandha is normalizing an overactive stress response

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or whether it could suppress a normal or underactive one. And so people who need to be particularly thoughtful about ashwagandha are people with thyroid conditions. Ashwagandha may increase thyroid hormone levels, which could be problematic for hyperthyroidism, pregnant and breastfeeding women, people on immunosuppressants, as it may enhance the immune function, people who take sedatives or medications for anxiety, because these may have potential additive effects,

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and people with already low cortisol. So this includes people with diagnosed adrenal insufficiency or those who are chronically fatigued and potentially have HPA access dysfunction. So while ashwagandha has legitimate research supporting its use for stress and anxiety in the short term, more is not better and natural stress support can absolutely be overdone. So definitely check in with your natural practitioner, health practitioner like a naturopath to assess whether you still need it and potentially take breaks from it.

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So licorice root is probably familiar to you as a flavouring or of course a candy almost, but it is used medically in Chinese, Ayurvedic and Western herbalism for centuries. In traditional medicine, it's used for digestive issues, respiratory conditions and as a harmonising herb that's often combined with other herbs. In the supplement world, you'll see it marketed for adrenal support, often with claims that it supports healthy cortisol levels.

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Here's where licorice root is different from everything else we're discussing. So its effects on the cortisol metabolism are well established and can cause real documented problems. Licorice root contains glycyrrhizin, which inhibits an enzyme called 11-beta-hydroxysteroid dehydrogenase type 2. That's very long. This enzyme normally converts cortisol to cortisone, which is an active form in your kidneys.

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When you inhibit this enzyme as what licorice root does, cortisol levels effectively increase in certain tissues and this can lead to a syndrome called pseudoaldosteronism. When you inhibit this enzyme, cortisol levels effectively increase in certain tissues or remain elevated and this can lead to a syndrome which mimics having too much aldosterone, which is a hormone that regulates sodium and potassium. And this isn't theoretical, it's clinically documented.

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And regular consumption of licorice can cause high blood pressure, low potassium levels, fluid retention, and in severe cases, dangerous heart rhythm problems. And it's even had warnings issued from associations like the FDA, and particularly regarding black licorice candy and licorice tea. So the effects are dose dependent. Eating a piece of licorice occasionally is not the problem, but

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Regular consumption of licorice supplements, certain licorice teas consumed daily, products with high glycyrrhizine content can absolutely cause issues and relatively quickly. So we're talking weeks, not years. And I've had a client who was just about put on high blood pressure medication until the doctor asked her about her licorice tea consumption and it was revealed she was drinking six cups a day. Getting off that licorice tea absolutely resolved everything.

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So DGL, which is a supplement, or deglycerinated licorice, has that glycerin removed and it doesn't have these effects. That's used for digestive issues and doesn't affect cortisol metabolism. So people who should strictly avoid regular licorice root, anyone with high blood pressure, anyone with heart conditions or arrhythmias or kidney disease, anyone taking diuretics, as licorice can worsen potassium loss.

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anyone on blood pressure medications, pregnant women, and even healthy people shouldn't use licorice fruit supplements long term without medical supervision. So this is the one supplement on our list where we have strong documented evidence of clinical harm from regular use. And the paradox is that it is often marketed for adrenal fatigue when it actually increases cortisol effects rather than supporting healthy cortisol production. So if you are taking licorice fruit regularly, talk to your healthcare provider and monitor your blood pressure and potassium levels.

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So our third supplement is phosphatidylserine, PS, and this is a phospholipid. It's a type of fat molecule that's a normal component of cell membranes, particularly abundant in brain cells. You get some from food, particularly organ meats, though modern diets are generally low in it, and your body also synthesizes it. As a supplement, phosphatidylserine has been studied for cognitive function, particularly in aging populations, but it is also marketed specifically for cortisol management.

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particularly in athletes and fitness enthusiasts who are concerned about cortisol's effects on muscle recovery and potentially sleep. So multiple randomized controlled trials have shown that phosphatidylserine supplementation can blunt the cortisol response to physical and psychological stress. A frequently cited study gave participants 400 or 600 milligrams of phosphatidylserine before exercise

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stress tests and found significant reductions in cortisol response compared to placebo. Other studies have shown similar effects with psychological stressors. There's also research on phosphatidylserine for cognitive function, particularly in older adults, showing some improvements in memory and cognitive processing. The mechanism here might be related to maintaining healthy cell membrane function in the brain rather than anything to do with cortisol. So research typically doses

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300 to 800 milligrams a day and often 400 milligrams as a standard dose. The supplement is generally derived from soy or sunflower lethacin and here's what we need to consider. Blunting your cortisol response to stress in the lab setting demonstrates that PS affects the HPA axis, but is that beneficial or problematic? For an athlete dealing with over-training and chronically elevated cortisol, moderating that response could theoretically be helpful. For someone who's cortisol

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cortisol response is already appropriate, do you want to it? Cortisol serves important functions, mobilizes energy during stress, regulates inflammation, supports immune function, helps you wake up in the morning. And the concern is that chronic suppression of your cortisol response could make it harder for your body to mount an appropriate response to stress or could contribute to HPA access downregulation. Well, I have suggested people try PS

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when they wake up in the middle of the night, if they feel that sort of elevated stress response, at that dose of about 400 milligrams, we do still need to be cautious. So if you have symptoms suggesting low cortisol, chronic fatigue, difficulty waking, low blood pressure, dizziness, if you're taking other cortisol-lowering supplements, if you're on medications that affect cortisol or HbA access function, or if you have a diagnosed adrenal insufficiency, you do want to be cautious with this.

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Peas does have good evidence for affecting cortisol response to stress, but whether or not that's beneficial depends entirely on the context. It's probably not something to take just because or long term without a specific reason. And if you are using it, periodic breaks make sense and paying attention to how you feel, particularly in your energy levels, stress response and recovery is super important. So rhodiola rosia is an adaptogenic herb that

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is again recommended in a stress response. It grows in cold mountainous regions of Europe and Asia and it's been used in traditional medicine in Russia and Scandinavia for centuries, traditionally for increasing physical endurance, preventing fatigue and improving mental performance. It's popular in the West as a supplement for stress, fatigue, exercise performance and cognitive function.

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The research on rhodiola is mixed, which is important to acknowledge. So there are studies showing benefits and studies showing no significant effects. Where it shows benefits suggests rhodiola may reduce fatigue scores in a stress-related fatigue, improve attention and cognitive performance under stress, reduce cortisol response in some studies, and potentially improve depression symptoms in mild to moderate depression. However, many studies have methodological limitations.

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small sample sizes, short duration, lack of ability to replicate. The quality of rhodiola extracts also vary significantly between products, which makes interpreting research difficult. Rhodiola contains active compounds called rosavins and silydricides, and the proposed mechanisms of how it works includes that it modulates stress response proteins,

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potential effects on neurotransmitters such as serotonin, dopamine, norepinephrine, possible HPA access modulation and antioxidant effects. And truthfully, we don't fully understand how rhodiola works and individual responses do seem to vary quite a bit. And the dosing and standardization is a bit tricky because these products are standardized quite differently. Some are standardized to rosavins and some are standardized to the

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cilidricides and the ratios vary. So research that uses doses ranging from 200 to 600 milligrams daily of these various extracts. The most commonly cited standardization is 3 % to the rosavans and 1 % to the cilidricides, reflecting the natural ratio of the root. So the primary concern with long-term rhodiola use is that

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If it does lower cortisol and modulate the HPA axis, we don't have good long-term safety data because again, most of these studies are 4 to 12 weeks. Some people report feeling stimulated or jittery from rhodiola, while others find it calming. This suggests individual variation in response to it, possibly related to the baseline neurotransmitter levels or stress states. Some practitioners recommend taking rhodiola in the morning rather than the evening if you find it stimulating.

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and cycling it, so using it for a month or two and then taking breaks. So you do want to be cautious with rhodiola if you have bipolar disorder, as there are some case reports of some manic episodes, if you are on antidepressants or anti-anxiety medication because of potential interactions, if you have autoimmune conditions, which have, there's that theoretical immune stimulation, or if you're pregnant or breastfeeding.

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So, Rodeola does have traditional use history and some research support, but the evidence is less robust than Ashwagandha and individual responses vary. So, it's probably best used short term for specific situations like acute stress or demanding periods rather than as a long term daily supplement. Quality definitely matters as well, so getting that natural practitioner support for a good brand is really important. And finally, we've got Holy Basil or Tulsi.

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So holy basil is considered sacred in Hinduism and has been used in Ayurvedic medicine for thousands of years. It's not the same as the basil plant that you use in your cooking, though they are of course related. In traditional use, it's considered an adaptogen and is used for stress, respiratory issues, metabolic support, and as a general promoter of health and longevity. So the research on holy basil is interesting, but it is preliminary.

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So most studies are small or conducted in animals. There are some clinical trials, however, and the research that's been done shows potential benefits for reducing stress and anxiety, lowering cortisol, improving metabolic markers like blood sugar and lipid profiles for cognitive function and immune modulation. However, whilst there are randomized clinical

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Trials showing that holy basil has reduced anxiety and stress symptoms and show trends towards cortisol reduction. Not all research replicates these findings. And preclinical or animal research also shows it can work in multiple mechanisms affecting neurotransmitters, anti-inflammatory action and potential HPA access modulation. But there's a challenge with holy basil as well. There is significant variation in products. The active compounds include

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Ursulic acid, rosmarinic acid and eugenol, but standardisation varies widely between manufacturers. Traditional use involves fresh and dried leaves consumed as a tea or in whole plant form. Modern supplements are typically extracts and it's unclear if they're equivalent to the traditional preparation. Research studies have showed doses ranging from 300 to 2000 mg daily often split into multiple doses.

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Traditional use often involves consuming the fresh leaves or tea multiple times daily. So the primary concerns are there's limited long-term safety data in humans, the potential effects on blood clotting. These are theoretical based on the eugenal content. Possible blood sugar lowering effects, which could be problematic for people who might take medications, may affect fertility and potential HPA excess suppression with chronic use. Again, that's theoretical.

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You need to exercise caution if you are pregnant or trying to conceive. You have bleeding disorders or on anticoagulant medication. You are taking any medications related to diabetes. You have existing low cortisol or HPA access dysfunction, or you're having surgery. Again, this is that theoretical bleeding risk. So you want to discontinue two weeks before. So whilst Holy Basil has traditional use history and some preliminary research support,

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the evidence base is just not that strong for some as some of the adaptogens. So it's probably best used periodically rather than continuously. And as with all of the adaptogens, the question is whether you actually need cortisol lowering or stress hormone modulation. So here's what I want you to take away from this. Whether these supplements are helpful or problematic depends entirely on your individual context. If you genuinely have elevated cortisol from chronic psychological stress,

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documented with testing, then something like ashwagandha might be appropriate for a period of time while you address the underlying stresses. If you're taking these supplements because you feel tired, assume you have adrenal fatigue, you could actually be making things worse if your cortisol is already low. And just briefly, adrenal fatigue is not a recognised medical diagnosis, but it is what people understand out there on and sort of that social context. The theory is that chronic stress can wear you out your adrenals, leading to low cortisol.

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So while HPA access dysfunction is real and can occur, it is more complex than your adrenals being fatigued. And the concerning thing is that many supplements that are marketed for adrenal support without any testing or whether someone actually has elevated or low cortisol. And taking cortisol-lowering supplements for fatigue when you might already have low cortisol could worsen the symptoms. So if you're considering supplements that affect the HPA access, particularly if you're taking them long-term, you need to consider testing your cortisol levels

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before starting with a practitioner, which can be done through blood tests, but timing matters because we have this cortisol awakening response half an hour after we rise. Salivary cortisol across the day can show the daily rhythm and may be better. But of course, through the Dutch test, you can do a 24-hour urine cortisol. And the most informative is often a four-point salivary cortisol test showing your rhythm throughout the day in addition to that urine cortisol.

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Definitely want to work with a knowledgeable practitioner, so someone who understands HPA access function and can help you interpret results in the context. This is often a naturopath, a functional nutritionist or a functional doctor. You definitely want to monitor your symptoms, so pay attention to energy, sleep, your stress response, blood pressure and overall wellbeing. If you feel worse, that is information, remember that. And to take periodic breaks.

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So consider cycling them and taking periodic breaks of around two to four weeks to allow HPA access to function without intervention. So just don't get caught in that more is better trap. And there's a tendency in the wellness culture to stack multiple supplements thinking that combining adaptogens will create some sort of synergistic super effect. But if you're taking ashwagandha and rhodiola and holy basil,

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and phosphatidylserine, you're potentially multiplying the cortisol-lowering effects, which isn't necessarily beneficial. Start with one thing at a time, add a modest dose, and actually evaluate whether it's helpful or before adding more. So these supplements, as I said, can interact with medications, such as blood pressure medication, sedatives and anti-anxiety, thyroid medications, diabetes medication.

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immunosuppressants and anticoagulants. I did just want to mention that again. So if you're on these medications or have chronic health conditions, these supplements aren't just herbs, they're bioactive compounds that can interact with your medications and conditions. And most of these supplements don't have adequate safety data for pregnancy or breastfeeding either. Also, the supplement industry is not well regulated. So there is significant variation in the active compound content, any contamination with heavy metals or substances.

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and the accuracy of labeling. So using products from reputable manufacturers who do third-party testing, look for NSF, USP, or consumer lab verification does matter. Also, remember that if you have some stress response that you're trying to combat, behavior and addressing that stress response is going to be way more important than any supplement, which can help supplement an already good routine. So before reaching for supplements, consider sleep.

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Nothing affects your HPI access function more than chronic sleep deprivation. Stress management like mindfulness, therapy, boundary setting, time management, meditation, exercise, both too much or too little can affect cortisol, blood sugar regulation, eating regularly, a good protein dose as I always talk about, finding balance here is super important, and social connection and purpose.

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These have profound effects on stress physiology and really thinking about your relationships with people and those around you is super important. And of course addressing psychological trauma. Sometimes chronic stress has roots that need therapeutic attention. Supplements might be a useful tool, but they work best as part of this comprehensive dose. So natural does not mean harmless. And context is everything. Definitely.

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Test where possible to see whether you truly could do with using an adaptogenic herb and always choose a quality supplement and get some support from a practitioner on this. More is not always better in lifestyle first and foremost because supplements cannot replace adequate sleep, stress management and healthy living. And work with knowledgeable practitioners, especially if you have complex health issues or you're on medications.

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So the rise of adaptogenic and stress supplements reflects something real for sure. Many people are dealing with chronic stress and are looking for support. But we need to approach these tools with respect for their effects and thoughtfulness about whether they're appropriate for our individual situations. I don't want to scare you away from these supplements that might genuinely be helpful, but I just want to encourage a more nuanced, informed approach when we're making decisions based on understanding rather than marketing claims.

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So if you want any more information on these supplements, highly recommend going to examine.com. They are an independent research base which looks at all of these supplements and you can just do a quick search to get a broad overview of what's going on. Hopefully that's helpful. One final message. I have my webinar this Wednesday 1pm and 7pm New Zealand time.

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fat loss in the festive season. If there's ever a time to be stressed it is around this time and often people are stressed around their food and of course filling in their exercise. So I'm going to talk you through some really effective strategies to help you navigate the festive system. So we'll put links in the show notes to sign up. Would love to see you. Any questions around this DM me. I'm on Instagram threads and X @mikkiwilliden, Facebook @mikkiwillidennutrition or head to my website mikkiwilliden.com
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Alright team, you have a great day. See you later.