[Article References]

In this article, we’ll dig deeper into how to increase testosterone levels with the best testosterone supplements.

Before going through the testosterone supplement list, it’s absolutely critical for the essential nutrients listed below them are covered.

These testosterone supplements have an indirect relationship and/ or very specific relationship to certain underlying causes, such as low DHEA levels.

Specifically, magnesium, vitamin D, and zinc are the primary supporters of testosterone levels.

[Related Article: How to Lose Weight By Lowering Appetite]

The need for sufficient micro-nutrient levels to support healthy testosterone levels cannot be overstated.

Finally, consider the other micronutrients, most notably boron, D-aspartic acid, and vitamin C, along with the others.

Testosterone boosting foods and certain lifestyle strategies can play a major role in testosterone levels, as we will discuss in a future article.

If one is dealing with symptoms of low testosterone, they should have testosterone levels checked.

For otherwise healthy individuals, aside the core micronutrients, these testosterone supplements will deliver extremely limited if any benefit.

[Related Article: The Top 9 Science-Backed Blood Sugar Supplements]

#1 Myo-Inositol

Myo-inositol increases testosterone levels, and sperm count. It normalizes the metabolic profile of patients with metabolic syndrome while increasing insulin sensitivity without adverse effects to other markers.

Reduced testosterone levels have been directly associated with metabolic syndrome, most notably obesity, as the decrease is perhaps caused by the conversion of androgens to estrogens, through aromatization of peripheral fat.

Elevated SHBG levels are the cause of male infertility. Decreased testosterone is one of the predicting factors for the onset of insulin resistance, type 2 diabetes, and metabolic syndrome.

Testosterone therapy alone is ineffective for male infertility. Either myo-inositol or inositol works well for this purpose.

#2 Maca

Lacking any testosterone or other hormone, instead, maca causes the body to produce and regulate hormones, which promotes a healthy hormonal balance. To be clear, research shows maca does not boost overall serum testosterone levels.

Invariably, maca’s energizing effects on men lead us to believe it has a beneficial endocrine system effect on both men and women. For these reasons, researchers believe maca supports free testosterone levels.

While maca may also improve fertility and mood, it shines above all others as a libido booster for men and postmenopausal women. Black, red, and yellow maca work well for this purpose.

#3 DHEA

DHEA increases testosterone by 200% in middle-aged men and by 180% in young men in a small study. With the best and most extensive research, 50 to 100 mg DHEA raises testosterone 20% across a range of studies. We also see elevated free testosterone levels in middle-aged men with prevention in high-intensity interval training declines.

Like most testosterone supplements, DHEA appears to be of benefit and maybe only beneficial for middle to older aged men with low DHEA levels. As with Tribulus Terrestris and horny goat weed, DHEA shows a libido benefit for postmenopausal women.

#4 Tongkat Ali (Longjack)

Along with other proven benefits, Malaysian ginseng, Tongkat Ali increase testosterone levels by as much as 37%, while lowering cortisol levels up to 16%.

In rodent and in vitro studies, Tongkat Ali outperforms tamoxifen, a prescription estrogen-blocking medication. Tongkat Ali can contain heavy metals and should be properly screened and tested by the vendor.

#5 Ashwagandha (KSM-66)

This Indian form of ginseng increases testosterone levels as much as 22% in studies while lowering cortisol, fat, sleep, and anxiety levels. Ashwagandha also increases sperm quality, and strength, and exercise performance.

#6 Panax Ginseng

Ginseng increases sperm count and motility, total and free testosterone, DHT, FSH, and LT, while also lowering prolactin levels in one research study.

The 3 Key Critical Testosterone Boosting Nutrients

Magnesium

Taken at bedtime with zinc, ZMA, magnesium increases free and total testosterone levels in both active and non-active individuals. We see a larger effect on active individuals versus non-active individuals.

Vitamin D

In one study, just 3,300 IU of vitamin D, doubles their vitamin D levels with testosterone levels rising by 20%. Vitamin D is synergistic with magnesium and boron.

Zinc

The influence of zinc on testosterone levels are well supported, and more so in the case of deficiency. Zinc also delivers exercise and sports recovery along with alleviating low testosterone levels from high-intensity exercise. Magnesium with zinc at bedtime, ZMA is a popular supplement.

3 Notable Testosterone Boosting Nutrients

Boron

Free testosterone levels rise 25%, while estradiol, interleukin, and C-reactive proteins drop 50%, promoting more free testosterone binding with blood proteins, after just one week of 6 mg boron.

D-Aspartic Acid

This pituitary gland and testes amino acid regulates the release and synthesis of luteinizing hormone, (LH), and testosterone in both humans, as one study shows it doubles male sperm count. D-Aspartic Acid appears to only deliver benefits in otherwise infertile men.

Vitamin C

Vitamin C can support testosterone by protecting the testes from oxidative stress.

6 Other Testosterone Boosting Nutrients

• Calcium
• CoQ10
• Selenium
• Vitamin A
• Vitamin B9
• Vitamin E

7 Other Testosterone Boosting Supplements

Caffeine, creatine, mucuna pruriens, shilajit, coleus forskohlii, royal jelly, shweta musali (Chlorophytum borivilianum).

*Limited and mixed results show licorice to lower testosterone levels. Use DGL for licorice supplements, if there is a concern.

*Phosphatidylserine acts similar to ashwagandha in cortisol and testosterone actions.

*Tribulus Terrestris and horny goat weed are only found to increase libido in postmenopausal women.

*Pregnenolone might be able to indirectly boost testosterone levels through cortisol reduction.

Conclusions on Testosterone Supplements

Hormone levels should be monitored through routine blood tests every 6 to 12 months.

To support healthy testosterone levels, one should look to diet and nutrient intake along with their overall health and wellness.

We’ll explore the lifestyle strategies one can use to boost testosterone levels in part 2 of this series.

What’s your favorite testosterone supplement?

Your Friend in Health,

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

The 6 Top Science-Backed Testosterone Supplements was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

[Article References]

[Related Article: The Top 6 Supplements for PMS and PMDD]

Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting women of reproductive age.

While the causes of PCOS are complex, insulin resistance and hormone regulation are the top factors.

Some might manage and ease symptoms through supplements for PCOS and lifestyle changes, but the approach should be customized according to PCOS type and symptoms.

The 3 Types of PCOS Symptoms

1. Abnormal Periods (Less than 9 per year and/ or heavy periods lasting over 35 days)
2. Polycystic Ovaries (Enlarged and failing ovaries)
3. Increased Androgen Levels (Male hormones resulting in excess body and facial hair and heavy acne.)

Other PCOS Symptoms:

Dandruff, depression, high blood pressure, high-stress levels, infertility, low libido, pelvic pain, sleep disturbance, and skin allergies.

The 3 Causes of PCOS

1. Chronic Low-grade Inflammation
2. Heredity
3. Insulin Resistance

The 4 Types of PCOS

1. Insulin-resistant PCOS. (Most common type of PCOS due to metabolic issues and diet.)
2. Pill-induced PCOS (2nd Most common type of PCOS due to birth control pills.)
3. Hidden-cause PCOS (Thyroid, iodine, zinc deficiency causes.)
4. Inflammatory PCOS (Vitamin D deficiency and inflammatory food causes.)

The Top 5 PCOS Supplements

Supplements can assist with PCOS-related hormone regulation, insulin resistance, and inflammation.

As always, it’s important to use the best PCOS dietary supplements backed by science.

#1 Inositol

At the top of the list of best supplements for PCOS, with over a dozen research studies, inositol is a key nutrient that can help improve insulin resistance.

Also, the top choice for PMS and PMDD, inositol has been found to promote fertility in some PCOS cases.

Dose:

Lower myo-inositol or inositol doses in the 200 to 4,000 mg range appears to improve fertility in women with PCOS, while 2,000 to 4,000 mg doses appear to be effective in improving testosterone levels and insulin sensitivity. Much larger doses in the 12,000 to 18,000 mg range are needed to affect mood-related symptoms.

#2 Berberine

Berberine is an AMPK-stimulating Chinese medicine plant, which performs as the most reliable insulin resistance supplement.

With over 500 studies, some researchers believe berberine is comparable to the anti-diabetic medication, Metformin.

Taking berberine prior to meals can boost your metabolism, lower insulin while balancing your endocrine response.

Dose:

500 mg taken with or up to 30 minutes prior to each meal.

#3 Curcumin

Curcumin acts both as an insulin improving supplement and as an anti-inflammatory agent.

Beneficial for PCOS, because in addition to improving insulin sensitivity and antioxidants, curcumin has also proved itself effective for depression and hormonal issues.

Dose:

1,000 to 2,000 mg of a high absorption curcumin taken in divided doses with a fatty meal for a minimum of 6 weeks.

#4 NAC (N-acetyl-cysteine)

In multiple studies, NAC shows potent PCOS effects due to its notable antioxidant actions.

NAC can lower insulin resistance, testosterone levels while improving fertility, period normalization.

Dose:

600 to 1,800 mg daily in divided doses taken at least 6 weeks.

#5 Chasteberry (Vitus agnus-castus)

Also effective for PMS and PMDD, chasteberry is a traditional plant used for reproductive conditions and normalizing menstruation cycles.

Containing a number of phytoestrogens, chasteberry decreases testosterone by aromatizing testosterone and converting it into estradiol.

Dose:

500 to 1,000 mg taken for at least 3 months.

Top 10 Notable PCOS Supplements

Alpha-lipoic acid

A traditional option for insulin issues, alpha-lipoic acid is often combined with berberine, another top blood sugar supplement.

Ashwagandha

Ashwagandha presents itself as the top option for anxiety, cortisol, and stress-based PCOS.

Cinnamon

Cinnamon extract is a popular option for insulin resistance in women with PCOS.

Evening Primrose Oil

Evening primrose oil is popular for period pain and irregular menstruation, along with improving cholesterol and oxidative stress.

L-Carnitine

Carnitine supplements can help PCOS patients improve ovulation, pregnancy rates, and cholesterol.

Maca

Maca root is a traditional fertility and libido-enhancing plant which may balance hormones, reduce cortisol levels, and alleviate depression.

Probiotics

Probiotics can play a key role in treating PCOS, by lowering inflammation and regulating sex hormones such as androgen and estrogen.

Saffron

Saffron appears to be the top supplement for depression-related PCOS, and is also effective for PMS and PMDD.

Tribulus Terrestris

Tribulus might stimulate ovulation, supporting healthy menstruation, and lower the number of ovarian cysts.

Other PCOS Supplements

Salacia reticulata, aloe, licorice root, melatonin, quercetin, holy basil, fenugreek, fennel, stinging nettle, horsemint, benfotiamine, garden peony (Chinese peony), red raspberry leaf, ginger, rosemary, feverfew, partridge berry, mugwort, and false unicorn root, black cohosh, wood betony, red clover flower, alfalfa, flaxseed, soy, and hops.

Top 7 PCOS Vitamins and Minerals

In following the best PCOS diet, make sure you are getting sufficient amounts of the following nutrients in your daily meals and/ or dietary supplements.

1. B-vitamins: (Especially B6, B9, B12)
2. Vitamin D: Critical to your endocrine system, vitamin D deficiency is common with PCOS and may improve irregular periods and ovulation.
3. Magnesium: Along with copper insufficiency, low magnesium levels contribute to PCOS insulin resistance
4. Copper: Along with magnesium insufficiency, low copper levels contribute to PCOS insulin resistance.
5. Omega-3’s: These key fatty acids can promote menstrual regularity and lower abdominal fat.
6. Zinc: As a critical fertility and immune-stimulating mineral, zinc can help with body hair growth and alopecia.
7. Chromium: Helping with body mass index, chromium can assist with insulin resistance.

Others: Calcium, CoQ10, iron, selenium, vitamin A, vitamin E.

Top 8 PCOS Strategies

1. Keep a healthy weight
2. Maintaining a healthy weight can help decrease insulin resistance.
3. Exercise balance
4. Maintain sleep hygiene
5. Lower stress levels
6. Avoid endocrine disruptors
7. Acupuncture
8. Take vitamins, minerals, and supplements

Conclusions on PCOS Supplements

More so than just taking PCOS best supplements, we want to look at lifestyle and other factors.

Keep an eye out for the following when overcoming PCOS.

• Progestin making pregnancy more difficult.
• Systemic enzyme therapies
• Supplements promising “cure-all” and “instant results”.

What’s your favorite PCOS supplement?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

The Top 5 Supplements for PCOS was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

How to Support Your Most Underrated Organ

[Article References]

[Related Article: The Top 9 Science-Backed Gastrointestinal Supplements]

As a critical digestive system organ, our liver is a workhorse which we rarely pay attention to.

We tend to ignore our liver, provided it is healthy and properly working.

Playing a role in multiple detoxification actions, our liver cleanses the blood, fights infections, helps digest our food, while storing energy.

When damaged, our liver regenerates, or grows back, unlike our heart or stomach, or other organs.

Despite this, our liver remains vulnerable to damage and injury from an array of factors.

Our risk for liver disease is determined by our diet, environment, and genetics.

When our liver is not working properly, it can lead to serious illness and in some cases death.

In this article, we’ll explore the top science-backed supplements for liver support.

Symptoms of Liver Disease

A tender abdomen and a yellow cast, or jaundice, in the skin, could mean liver disease which falls into these categories:

1. Infections: hepatitis A, B, C, D, and E, all caused by viruses.
2. Fatty liver: diabetes and obesity-related cirrhosis.
3. Autoimmune liver disease: because of the immune system attacking the liver.
4. Alcohol-related Liver Disease: due to the overconsumption of alcohol.
5. ‘DILI’ (drug-induced liver injury): because of medications, including supplements, and acetaminophen.

Top 3 Liver Enzyme Supplements

When a blood test shows elevated liver enzymes, this often indicates inflammation or damage to liver cells.

Aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT), are the most common liver enzymes.

#1 Coffee

Coffee is associated with decreasing levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), and alkaline phosphatase (ALP).

This effect is supported across numerous studies and is supported in both decaf and regular coffee consumption.

Researchers confirm this suggests a chemical in coffee other than caffeine may support the liver.

Those drinking the largest amount of daily coffee show the lowest levels of abnormal liver enzymes.

Dose

1 to 4 cups, with 3 to 4 cups showing the best results.

#2 Vitamin E

Vitamin E when used in doses exceeding 300 IU for 6 months appears to considerably improve liver enzymes.

We find a notable decrease in ALT and γ-GPT in those with non-alcoholic fatty liver (NAFLD), sometimes exceeding 50%, across several studies.

There is no effect or benefit in otherwise healthy subjects.

Dose

300 to 800 IU taken over 1 to 6 months in multiple studies shows as effective.

#3 Tauroursodeoxycholic Acid (TUDCA)

TUDCA is a reference drug for liver enzymes, as liver enzyme decrease associated is quite strong, and consistent across many research studies.

Dose

1500 mg daily performs as the best dose over a period of 2 to 6 months across the studies, with 500 mg being the minimum effective dose.

Other Liver Enzyme Supplements

Spirulina, curcumin, fucoxanthin, resveratrol, pterostillbene, TMG, artichoke extract, garlic, gynostemma pentaphyllum, hesperidin, L-carnitine, melatonin, picrorhiza kurroa, hibiscus, L-cysteine, Korean black raspberry.

Top 3 Liver Cancer Supplements

The following supplements have shown the greatest reduction in the risk of developing liver cancer.

#1 Curcumin

In addition to protection against breast, colorectal, lung, and prostate cancer, curcumin performs as effective against liver cancer.

Stimulating apoptosis of cancer cells, curcumin acts as an antiproliferative agent, with anti-angiogenic action, preventing tumor growth and recurrence.

Curcumin has been proven to decrease chemotherapy side effects.

Delivering a synergistic anticancer action, curcumin acts at the molecular level, affecting multiple tumorigenesis metabolic pathways.

Promoting healing along with anti-inflammatory, antioxidant, and anti-infective action, curcumin with its natural phytocompounds offers notable anti-cancer protection with enormous promise as an adjuvant remedy to treat liver cancer.

The most recent studies show curcumin inhibits the growth of cancer cells through the PI3K/AKT/mTOR signaling pathway.

Dose

Studies use up to 2,000 mg of bioavailable curcumin. Curcumin should be taken with a fatty meal to improve absorption.

[Related Article: The Best Curcumin Types: Quality Matters]

#2 Coffee

Coffee, the magical bean shows a reduction of 38% with 2 to 3 cups of coffee per day, with a 41% liver cancer risk reduction with over 4 cups per day.

Other studies support a liver cancer risk reduction to 72% in those consuming 4 cups or more daily.

Interestingly, we see a gender difference with a larger benefit for women with a 54% reduction at 3 cups of daily coffee a day.

Another study concludes coffee consumption of over 3 cups is associated with a lower risk of chronic liver disease, liver cancer, liver cancer recurrence, and liver disease mortality after liver transplantation in both those with and without a history of liver disease.

Across many studies, daily coffee consumption promotes a 40% reduction in the risk of liver cancer versus non-coffee drinkers.

Dose

2 to 4 cups or more daily. Decaffeinated coffee shows a lesser benefit over caffeinated coffee for liver cancer in some studies, although some researchers believe the benefits are comparable.

#3 Vitamin E

Much like coffee, vitamin E has many studies supporting its role in liver protection and support.

Chronic liver disease and cirrhosis are established risk factors for liver cancer

Recent evidence shows higher doses of vitamin E consumption can protect against liver cancer.

This association is supported in those with family histories of liver disease, along with those who do not have a family history of liver disease.

Dose

400 IU d-alpha-tocopherol daily. Choose a natural vitamin E supplement. Natural vitamin E is listed as D and not DL, which indicates synthetic vitamin E.

Other Liver Cancer Supplements

Choline, betaine.

Top 3 Fatty Liver Supplements: (Alcohol or Nonalcoholic Fatty Liver Disease)

Representing liver stored triglycerides, with which excessive accumulation, higher liver fat results in fatty liver (alcohol or non-alcoholic), potentially leading to liver cirrhosis.

#1 Choline

More evidence continues surfacing, showing choline deficiency along with high sugar, especially high fructose corn syrup diets might be the biggest risk factor in the development of non-alcoholic fatty liver disease.

Betaine is extremely important for liver support as well.

Dose

550 mg for men and 450 mg for women. A single egg contains 164 mg of choline. Choline is also found in a variety of vegan sources such as fruits, vegetables, nuts, and beans. Krill oil is roughly 34% choline. Lecithin is approximately 10% choline. Algae oil also contains choline, while it along with lecithin and forms of choline are phosphatidylcholine, which supports acetylcholine, a critical neurotransmitter.

#2 Coffee

In nonalcoholic fatty liver disease studies, those reporting consumption of two or more cups of coffee daily, show notably less liver damage than those who drank little or no coffee.

Dose

2 to 4 cups

#3 Curcumin

Curcumin performs in multiple recent studies as highly effective for fatty liver.

Dose

Studies use up to 2,000 mg of bioavailable curcumin. Curcumin should be taken with a fatty meal to improve absorption.

[Related Article: The Best Curcumin Types: Quality Matters]

Other Liver Fat Supplements

Spirulina, fucoxanthin, omega-3’s, TMG, vitamin E, L-cysteine, zinc.

Top 3 Hepatitis Supplements

#1 Coffee

The review of multiple studies concludes coffee drinking is associated with a substantially lower risk of chronic liver disease.

In comparison with non-coffee drinkers, 2 to 3 cups of daily coffee is correlated with a 46% lower risk of chronic liver disease death, while more than 4 cups daily is associated with a 71% reduction.

We find support for coffee in both the treatment of hepatitis B and hepatitis C.

We find hepatitis studies showing coffee consumption in association with a lower hepatocellular carcinoma risk.

Dose

2 to more than 4 cups.

#2 Cordyceps

Cordyceps, the medicinal mushroom provides a powerful supplement to treat chronic hepatitis B and C.

Studies show cordyceps as combined with other medicinal mushrooms, along with the antiviral drug, lamivudine, as effective in the treatment of hepatitis B.

Cordyceps improves liver function in patients with posthepatic cirrhosis.

Dose

3 to 4.5 grams twice daily, with traditional indications for use at 5 to 10 grams daily.

# 3 Curcumin

Curcumin performs in multiple recent studies as effective against hepatitis B.

Dose

Studies use up to 2,000 mg of bioavailable curcumin. Curcumin should be taken with a fatty meal to improve absorption.

[Related Article: The Best Curcumin Types: Quality Matters]

Others Hepatitis Supplements

Milk thistle, spirulina, folate, iron, vitamin A, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K, artichoke extract, curcumin, zinc, licorice, probiotics.

Top #1 Acetaminophen and Alcohol User Supplement

Some research suggests the use of NAC (N-Acetyl Cysteine) to assist the liver in metabolizing reasonable doses of acetaminophen and alcohol.

Dose

500 mg twice daily. Taken 30 minutes prior to alcohol and not while using alcohol.

[Related Article: Biohacking Alcohol for Health and Harm Reduction]

Top 3 Supplements for Liver Damage (Cirrhosis)

#1 Keto Diet

While not a supplement per se, a recent study shows a great fibrosis reduction after 1 and 2 years of a ketogenic diet of 30 daily carbohydrates.

In this non-random, non-blind control trial, we find substantial benefits for obese patients with liver disease.

Dose

We can conclude lowering sugar intake along with correcting a choline deficiency is effective for liver disease.

#2 Choline

Choline deficiency promotes liver damage.

More evidence continues surfacing, showing choline deficiency along with high sugar, especially high fructose corn syrup diets might be the biggest risk factor in the development of non-alcoholic fatty liver disease.

Betaine is extremely important for liver support as well.

Dose

550 mg for men and 450 mg for women. A single egg contains 164 mg of choline. Choline is also found in a variety of vegan sources such as fruits, vegetables, nuts, and beans. Krill oil is roughly 34% choline. Lecithin is approximately 10% choline. Algae oil also contains choline, while it along with lecithin and forms of choline are phosphatidylcholine, which supports acetylcholine, a critical neurotransmitter.

#3 Coffee

Effective for cirrhosis, liver cancer, liver enzymes, along with hepatitis B and C, and fatty liver disease, coffee is not to be overlooked in the prevention and treatment of liver disease.

Coffee reduces the risk of liver conditions, including fibrosis (scar tissue) and cirrhosis, and can delay liver disease progression in some patients.

Consuming caffeine releases a chemical paraxanthine, slowing the acceleration of fibrosis-related scar tissue.

High daily coffee consumption can notably lower the risk for hepatic cirrhosis compared to no daily coffee consumption.

The data from nine previous studies with over 430,000 subjects shows drinking two additional cups of coffee a day is connected with a 44% reduction in risk of liver cirrhosis.

Dose

4 or more cups.

Other Liver Damage Supplements

Milk thistle, TMG, curcumin, vitamin E

Top 12 Ways to Keep Your Liver Healthy

• Don’t consume alcohol to excess.
• Don’t consume pain medication to excess.
• Avoid sex drugs and needle-sharing which promotes the transmission of hepatitis C.
• Safe sex as hepatitis B (and even possibly C) can be transmitted through sexual contact
• Wash your hands when dealing with food as hepatitis A and E are food-borne diseases.
• Supplements can carry serious liver risks, especially when consumed in excess.
• Review your medications and supplements with your doctor and/ or pharmacist to lower the risk of drug interactions and liver toxicity.
• Keep a healthy weight.
• Exercise at least 3 times weekly.
• Lower simple sugar (carbohydrate) intake, especially HFCS
• Take vitamins and minerals, while consuming sufficient dietary choline.
• Drink caffeinated or decaffeinated coffee.

Top 12 Vitamins and Minerals for a Healthy Liver

• Betaine (Most critical)
• Choline (Most critical)
• Folate
• Iron
• Selenium
• Vitamin A
• Vitamin B-12
• Vitamin C
• Vitamin D
• Vitamin E
• Vitamin K
• Zinc

Other Liver Supporting Supplements

These supplements can act as liver supporting supplements.

Garlic, dark chocolate, cocoa, cacao, lemon balm, licorice, uridine, grape seed extract, pine bark, beans, berries, cinnamon. clove, pycnogenol, sweetheart, milk osteopontin, rosemary, Boswellia, burdock, melatonin, quercetin, artichoke extract, TMG, glycine, holy basil, wormwood, chamomile, astragalus, reishi mushroom, stone breaker, Schisandra, Guduchi, dandelion root, gynostemma pentaphyllum, hesperidin, melatonin, picrorhiza kurroa, resveratrol, pterostilbene, wild tam Mexican root, yellow dock root extract, hawthorn berry, chanca piedra, green tea, matcha tea, black tea, white tea, SAMe, NAC, picrorhiza kurroa, glycine, sulforaphane (broccoli sprouts), apple cider vinegar, coconut vinegar, MCT oil, taraxacum officinale, asteracantha longifolia, calcium-D-glucarate, eclipta alba, brassica vegetables, hops (Xanthohumol Hops), amla, Guduchi, Schisandra, berberine, fenugreek.

Supplements Which Can Cause Rise in Liver Enzymes

We always want to ask, are liver supplements safe?

These are the supplements to keep an eye on.

Hoodia gordonii, Andrographis paniculata, Tribulus territories, green tea extract (doses over 800 mg), kava (only with non-Noble strains), pennyroyal, Artemesia, atractylis gummifera, bush tea, callilepis laureola, chaparral leaf (creosote bush, greasewood), comfrey (Symphytum officinale), crotalaria, germander, gordolobo herbal tea, heliotropium, Jin-Bu-Huang, kombucha mushroom (tea), Ma-Huang (Ephedra sinica), margosa oil, mate (Paraguay) tea, mistletoe, nutmeg (if taken in large doses), pennyroyal (squawmint oil), tansy ragwort (variation of Ragwort), sassafras, Senecio aureus, senna, skullcap, Symphytum, valerian root (due to interactions), kratom (rare cases reported with excessive intake.)

Conclusions on Liver Supplements

Much like supporting our kidneys, using the top liver detox supplements is a worthy goal for all health optimizers.

When looking at liver health supplements, we should pay attention to the critical basic micronutrients, most notably choline.

Watch excessive sugar intake.

And don’t be afraid to enjoy some daily coffee, even decaffeinated if need be.

What’s your favorite liver supplement?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

The Top 3 Science-Backed Liver Supplements was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

[Article References]

[Adrenal Fatigue: Part 1 of 2]

“Adrenal fatigue”, medically referred to as “adrenal insufficiency”, occurs when the adrenal glands are hyporesponsive, or under-responsive to brain signaling for hormone secretion.

What happened is “adrenal fatigue”, which has become a buzzword to represent an array of symptoms due to insufficient adrenal gland activity.

While abnormal actions can occur at other points, we need to look beyond the adrenal glands.

The Hypothalamus, a brain region, in stress detection response, releases corticotropin secreting hormone, (CRH) which acts on the pituitary gland.

The pituitary releases adrenocorticotropic hormone (ACTH), which acts upon the adrenal glands, which are located on top of our kidneys.

The Hypothalamus-Pituitary-Adrenal axis, or the HPA Axis, is the result of the inner workings of these three organs.

[Related Article: The Top 9 Science-Backed Anti-Anxiety Supplements]

[Related Article: The Top 9 Science-Backed Nervous System Supplements]

Primary adrenal insufficiency or Addison’s disease is when the adrenal glands under-react to release ACTH or are damaged.

With adrenal insufficiency, the hypothalamus and pituitary gland are operating normally, but the adrenal glands are not producing sufficient cortisol and dehydroepiandrosterone.

An ACTH-stimulation test taken by an endocrinologist can diagnose this condition, with the primary pathology being less cortisol secretion and synthesis.

When either the hypothalamus releases less CRH, or the pituitary releases less ACTH, in stress response, we call this secondary adrenal insufficiency.

This is a signaling issue, as the adrenal glands work normally, yet are not receiving the signal to produce more hormones.

CRH is not easily detected, while ACTH is readily evaluated in a blood test.

Tertiary adrenal insufficiency is also the name we use for CRH deficiency.

This process is not a single action or event, and instead a catch-all term to represent lower hormone production due to dysregulation of the endocrine system.

So we can see “adrenal insufficiency’ is HPA axis dysregulation resulting in lower hormone release affecting energy and mood.

Function of the Adrenal Glands

The endocrine system, as one of our 13 bodily systems, is a network of hormone-producing glands.

As part of our endocrine system, we have two adrenal glands sitting on top of each of our kidneys.

• Blood pressure control
• Burning fat and protein
• Creating hormones
• Glucose regulation
• Stress management

Adrenal Insufficiency Symptoms

• Body hair shedding
• Fatigue and weakness
• Lightheadedness
• Low blood pressure
• Low or loss of appetite
• Weight loss

Adrenal Insufficiency Causes

• Anxiety
• Diet
• Diseases (Such as Addison’s disease and Cushing's disease)
• Drugs (Including Pharmaceuticals)
• Stress

Drugs Which can Cause Adrenal Insufficiency

• Aminoglutethimide
• Dexamethasone
• Hydrocortisone
• Ketoconazole
• Megestrol
• Metyrapone
• Mitotane
• Prednisone

Cortisol

Produced by the adrenal glands, cortisol is the body’s primary glucocorticoid, a steroid hormone.

When our body detects a threat, such as a loud horn, our brain releases a hormone called adrenocorticotropic hormone (ACTH).

Known as our fight-or-flight stress response, our adrenal glands are triggered to release adrenaline and cortisol.

Rising cortisol levels can stimulate new releases of energy and strength.

This is our natural and protective threat response process.

Suppressing unneeded and counterproductive functions, cortisol is the trigger maintaining control of our fight-or-flight response.

Adrenal Insufficiency: (Fight-or-Flight Response Symptoms)

• Body aches
• Chronic fatigue
• Depression
• Diarrhea
• Digestive issues
• Hair loss
• Hyperpigmentation
• Lightheadedness
• loss of appetite
• Low blood pressure
• Muscle weakness
• Nausea
• Nervousness
• Stomach pain
• Unexplained weight loss

When we experience a threat, our nervous system reacts by releasing stress hormones, adrenaline, and cortisol, springing our bodies into action.

Our heart races, muscles tighten, blood pressure spikes, breathing gets shallow, while our senses come into focus and sharpen.

Cortisol Release

• Digestive system suppression
• Growth process suppression
• Immune system response suppression
• Reproductive system suppression

Adrenal Gland Hormones

• Aldosterone
• Androgenic steroids
• Cortisol
• DHEA
• Epinephrine
• Norepinephrine

Actions of Adrenal Gland Hormones

• Blood pressure regulation
• Circadian rhythm
• Diurnal energy levels
• Immune system
• Inflammation
• Metabolism

The bulk of cortisol binds to corticosteroid-binding globulins, which prevents its binding to glucocorticoid receptors.

Cortisol must be freed, as in the case of testosterone, what counts is the amount of free cortisol.

As we connect an array of health conditions with inflammation, chronic suppression diminishes the immune response.

This could explain the connection between chronic stress and the increased risk of getting sick.

The Two Primary Stress Response Systems

Researchers believe there are two major body systems regulating our stress response.

Both of these systems arise from the hypothalamus, a forebrain region.

Playing a direct role in physical stress response, the autonomic nervous system is divided into the parasympathetic nervous system and the sympathetic nervous system.

As our bodies experience stress, the sympathetic nervous system promotes what we call the “fight or flight” response.

The parasympathetic nervous system, promoting “rest-and-digest” activity, can counterbalance the fight-or-flight actions of the sympathetic nervous system, as a part of our cholinergic system.

The other proposed stress pathway is the sympathomedullary system, where signals are sent to the adrenals to release adrenaline and norepinephrine

The HPA Axis

The hypothalamic-pituitary-adrenal axis, HPA axis, represents the interplay between our adrenal glands, hypothalamus, and pituitary gland.

While the adrenal glands are located on top of the kidneys, the hypothalamus and pituitary gland are found just on top of the brainstem.

We believe the HPA axis manages longer-term stressors, as the sympathomedullary system handles acute stressors.

Both of these can experience imbalance from stress, as other brain regions and pathways can likewise be affected by this.

These three glands comprising the HPA axis release these three hormones:

CRH (Hypothalamus)->ACTH(Pituitary)->Cortisol (Adrenal)

Blood cortisol is a standard stress response measurement, however, several other markers have also looked at how stress affects our body.

It’s important to realize our stress response involves an array of other potential drivers, such as our unique individual biochemistry, the physical environment, our overall health, and our genetic code.

Cortisol Tests and Treatment

Exceedingly high or low cortisol levels can indicate an adrenal gland disorder.

Disorders of the adrenal glands can cause bodily harm if left untreated.

While blood tests are the standard, saliva, or urine can also be used for cortisol testing.

Standard cortisol testing represents variable and transient effects.

Alternative cortisol tests such as hair cortisol tests can be more reliable of longer-term levels, when based on continuously monitored or multiple-day cortisol testing.

Labs use varying measuring ranges, with the deemed normal range varying from lab to lab.

The normal blood range at 8 a.m. will be in the range of 6 to 23 micrograms per deciliter (mcg/dL).

There is also a less active form of cortisol, called cortisone.

High Cortisol Levels can Indicate

• Excessive ACTH release because of a pituitary gland tumor or excessive growth
• Excess cortisol production because of an adrenal gland tumor
• Tumor elsewhere involved in cortisol release

Low Cortisol Levels can Indicate

• Addison’s disease, occurring when adrenal gland cortisol production is too low
• Hypopituitarism, occurring when adrenal gland cortisol production is too low because the pituitary gland is not correctly signaling for release.

24 Strategies to Lower Cortisol

1. Acetylcholine Supplements (Theoretical)
2. Butyrate/ SCFA’s (Dairy products or supplements. Dietary fiber: fruit and starch)
3. Caffeine Elimination/ Reduction (Green tea and cocoa in moderation)
4. Carbohydrate Elimination/ Reduction (Especially Simple Carbs)
5. Cold Therapy (2–5 minute cold shower)
6. Deep Breathing (Wim Hof breathing)
7. Electronics (Reduction at nighttime)
8. Exercise (Also HIIT. Not to excess in exertion or time)
9. Fasting (Intermittent and prolonged)
10. Fried and Processed Foods Elimination
11. GABA Supplements (Theoretical)
12. Gum Chewing (Lowers salivary cortisol)
13. Hypnosis (Also self-hypnosis)
14. Laughter
15. Massage
16. Meditation/ Yoga/ EFT
17. Music
18. Protein
19. Socializing (Family and friends)
20. Sugar Restriction
21. Sufficient Sleep
22. TMS/ tDCS/ PEMF (All promising yet unconfirmed)
23. Vagus Nerve Therapy/ EFT
24. Vegetables

Conditions which can Block Adrenal Glands

These conditions should be diagnosed and treated to promote healthy adrenal gland function.

• Anemia
• Autoimmune Diseases
• Anxiety and/ or depression
• Cardiovascular issues
• Diabetes
• High stress lifestyle/ environment
• Infections
• Irritable bowel syndrome (IBS)
• Kidney or liver disease
• Lung issues
• Sleep Apnea

Diet for Adrenal Fatigue

The best diet for adrenal fatigue involves proper hydration along with a whole food diet.

To follow a diet for adrenal fatigue, eating on a consistent schedule is a key target.

In maintaining the best diet for adrenal fatigue, limiting the intake of the following foods appears to deliver the best results.

• Alcohol
• Artificial sweeteners
• Caffeine
• Fast food
• Fried food
• Processed food
• Soda
• White flour
• White sugar

*The ketogenic diet has been found to raise cortisol from small to high amounts across three different research studies.

Conclusions on Cortisol and “Adrenal Fatigue”

So, even though the complementary approaches may reduce the symptoms, the biology is completely misunderstood.

One potential issue with this approach is that the patient’s immune system can be overactive, and most of the listed supplements are immune stimulants.

So not understanding our biology can have negative consequences in how we treat diseases.

Like many difficult conditions needing more than basic medical care, finding a naturopathic doctor or functional medicine specialist is an increasingly popular method for solving more difficult conditions such as adrenal fatigue.

What’s your favorite anti-stress supplement?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

Is Adrenal Fatigue Real? was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

[Article References]

Before exploring what science tells us about how to handle a cold or flu, we need to better understand the difference between the cold, coronavirus, and the flu.

What is the Difference Between Allergies, Cold, Coronavirus, and the Flu?

The Common Cold

The common cold typically causes head symptoms, along with a mild-to-moderate phlegm-producing cough

When one has a cold, they will commonly experience a stuffy, runny nose, sneezing, along with congestion.

The Flu (Influenza A or B)

Flu symptoms happen 1 to 4 days after infection, with a sudden onset, with a milder to a moderate and dry cough.

The flu is more often associated with body aches, chills, headache, and loss of appetite compared to COVID-19.

Coronavirus (COVID-19)

With a much longer incubation period and a gradual symptom onset, COVID-19 more often causes respiratory complications and shortness of breath versus the flu.

COVID-19 symptoms typically take 5 days, within a range of 2 to 14 days, with more severe and pervasive dry cough.

Seasonal Allergies

Occurring in the Spring, seasonal allergies are affected by one’s surrounding environment.

*** (Allergies, cold, and flu can aggravate asthma, which can lead to shortness of breath. The coronavirus can lead to shortness of breath on its own.)

Flu Symptoms vs Coronavirus Symptoms

COVID-19 symptoms, less common with the flu:

• Runny/ stuffy nose
• Shaking with chills
• Shortness of breath/ difficulty breathing
• Sore throat
• Sudden loss of taste or smell

*Symptom combinations — COVID-19 possibility comes with two or more symptoms present, while any single common flu symptoms are an indicator of the flu.

[Related Article: Are You Ready for COVID-19?]

[Related Article: How to Block Viruses with Zinc and Zinc Ionophores]

[Related Article: The Top 9 Science-Backed Immune System Supplements]

What is the Common Cold?

Generally self-diagnosable, the common cold is caused by viruses that will pass with a healthy immune system.

The symptoms of the cold are not caused by the infection, and instead, our body’s immune system fights it off.

Colds produce a mild-to-moderate cough with phlegm, along with aches, fatigue, and fever being mild and rare.

How Long Does the Cold Last?

With a gradual onset, the cold lasts 7 to 10 days.

How Long Are You Contagious with the Common Cold?

The cold is contagious 1 to 2 days prior to symptoms and lasts 5 to 7 days after presenting symptoms.

One is contagious with the cold as long as symptoms are present, sometimes up to 2 weeks.

What is the Cause of the Common Cold?

The cold is caused by over 200 different viruses, with 100 different human rhinoviruses (HRVs) producing about one-third of colds.

What are the Symptoms of the Cold?

The symptoms of the common cold are typically above the neck.

Common

• Aches and pains (mild)
• Nasal congestion and postnasal drip
• Runny/ stuffy nose
• Sneezing
• Sinus pressure
• Sore throat (Usually the first symptom)
• Watery, itchy, red eyes
• Cough (mild to moderate with phlegm)

Sometimes

• Body aches
• Fatigue (mild)
• Fever (mild, short, and rare)
• Headache (rare)

When Should I go to the Doctor for the Cold?

Always seek medical attention when you have a fever exceeding 101.3°F, breathing complications, persistent fever, and sore throat, or prolonging sinus pain, or headaches.

If a child is experiencing a fever greater than 100.4°F, cold symptoms greater than 3 weeks, or extensively severe symptoms, they also need medical attention.

What is the Flu (Influenza)

The flu, or seasonal influenza, is a common respiratory infection caused by a virus affecting our lungs, nose, and throat.

How Long Does the Flu Last?

With a fast and furious onset, the flu can last from 5 to 7 days.

How Long Are You Contagious with the Flu?

Most are contagious with the flu for about 1 day prior to symptoms.

Older adults and children seem to be most contagious during the initial 3 to 4 days, remaining contagious for about 7 days.

Those with weak immune systems, including babies and the elderly, can be contagious for longer durations.

What are the Symptoms of Flu?

Common

• Aches and pains
• Cough (typically dry)
• Fever
• Headaches

Sometimes

• Diarrhea (with children)
• Fatigue
• Runny/ stuffy nose
• Shortness of breath/ breathing difficulty
• Sore throat (sometimes)

When Should I go to the Doctor for the Flu?

We should take children to the emergency room for flu symptoms when they experience rapid breathing or difficulty breathing, bluish skin, fever, rash, become unresponsive, or are not consuming fluids.

The CDC also recommends that one should go to the ER, when their flu symptoms ease and then return, especially with fever and coughs.

What is COVID-19/ Coronavirus?

COVID-19 is a respiratory disease caused by a new coronavirus strain, SARS-CoV-2

Four other coronavirus strains are common to humans, all of which cause cold-like symptoms.

Some of what we know about the virus remains under further investigation.

How Long Does the COVID-19/ Coronavirus Last?

The average duration of illness is about 2 weeks after initial symptoms, with more severe cases lasting 3 to 6 weeks.

While symptoms can begin in as little as 2 days after infection, they usually begin after 4 days and can take up to 14 days to occur.

Unlike the flu with a rapid onset, the disease progression is more similar to the common cold, with a gradual onset.

How Long Are You Contagious with COVID-19/ Coronavirus?

It’s possible for one to spread the virus for 2 days prior to symptoms while being contagious for 10 days after symptoms present themselves.

When one is asymptomatic or after symptoms resolve themselves, they can remain contagious for 10 days after a positive COVID-19 test.

What are the Symptoms of COVID-19/ Coronavirus?

Common

• Fatigue
• Fever
• Cough (usually dry)
• Shortness of breath/ breathing difficulty

Less Common

• Aches and pains
• Chills
• Diarrhea
• Headache
• Loss of smell/ taste
• Runny/ stuffy nose
• Sore throat

*Upper respiratory symptoms associated with the common cold, such as a runny/ stuffy nose and sinus congestion, are uncommon in COVID-19, whereas they are common with the cold.

When Should I go to the Doctor for COVID-19/ Coronavirus?

According to the CDC, if symptoms worsen, becoming severe, one should seek medical attention.

This includes difficulty breathing, prolonged pressure and, or pain in the chest, confusion, inability to stay awake, or bluish face or lips.

What are Allergies?

Nasal issues such as a runny nose can occur when spring arrives.

This could indicate a cold, but also one could be experiencing seasonal allergies, which can occur with the seasons or year-round.

Airborne pollen from an array of plants is the most common allergy cause in the spring.

Pollen is nearly invisible to the eye but can wreak havoc on your body’s immune system.

Our body’s immune system releasing antibodies to fight off these allergens.

This releases histamines triggering symptoms such as itchy eyes or runny nose.

These allergy symptoms can be increased with high pollen counts on windy days.

• Cough
• Fatigue (less common)
• Headaches less common)
• Itchy nose, eyes, throat, sinuses, and ear canals
• Runny or stuffy nose
• Shortness of breath
• Sneezing
• Watery eyes

[Related Article: Histamines: Friend or Foe? DAO and Beyond]

The Top Science-Backed Supplements for the Cold and Flu

This article will focus on the top science-backed supplements and strategies for beating the cold and flu.

For supplements and strategies on seasonal allergies and the coronavirus, please see the links above.

#1 Vitamin D

Vitamin D is the rising supplement star of 2020, as the data suggests sufficient vitamin D levels can be protective against acute respiratory tract infections.

Increasingly, we recognize vitamin D affects how much of the virus enters cells, while also regulating the effects on our inflammatory response.

We can associate low vitamin D levels with worsening immune function and increasing acute respiratory infection rates.

It is well-documented low vitamin D levels across countries with lower sunlight levels, and genetically levels are both associated with increased rates of acute respiratory tract infections.

A recent meta-analysis of double-blind placebo-controlled studies involving over 11,000 participants, worldwide and across diverse demographics shows people with deficient vitamin D levels experience an 18–60% reduction of risk in acute respiratory tract infections when taking vitamin D supplements at the onset of symptoms.

Those with adequate vitamin D levels get a lower benefit with a 0–23% reduction of risk in developing an acute respiratory tract infection.

We can estimate every hour of direct UV sunlight exposure can raise vitamin D levels 10 ng/ mL, the equivalent of taking 1,000 IU in the oral form.

Some such as the elderly and those with inflammatory conditions and metabolic disease may need higher vitamin D levels.

Dosage Details:

Sufficient magnesium, another common micronutrient deficiency is needed to absorb oral vitamin D. A good daily option is a vitamin D3 supplement including vitamin K2. Vitamin K is needed with higher doses of vitamin D. Many are now suggesting taking 5,000 IU of vitamin D daily, with some even taking as much as 10,000 IU of vitamin D.

#2 Zinc

Required for the development and growth of cells that manage our immune response, zinc is also an essential structural enzyme and protein component needed for healthy immune function.

Supporting our immune system against infections, zinc is a mineral that can inhibit viral replication in our nasal epithelium, along with lowering inflammation of the respiratory tract.

Superoxide dismutase, a zinc-containing antioxidant enzyme, protects our immune cells from reactive oxygen species, (ROS), as they are produced to destroy pathogens during our immune response.

Cell studies show zinc can inhibit rhinovirus attachment within the nasal cavity lining while slowing respiratory viruses replication in the body.

Zinc acetate or gluconate lozenges taken within 24 hours of symptoms can lower the duration and severity of symptoms.

Readily dissolving and releasing localized zinc ions, zinc acetate and gluconate lozenges can support the throat and nasal cavity in fending off infections.

George Eby holds a USPTO patent for zinc lozenges as the cure for the common cold.

Zinc can cause major organ distress, so we should only use high doses as needed, with up to 180 mg doses found safe for 1 to 2 weeks of use.

Nasal sprays, swabs, and zinc gels do not have proven benefits while carrying risks of permanent or temporary loss of smell and taste.

Dosage Details:

For prevention, a high-quality two-a-day multivitamin and along with dietary zinc is the best strategy. Higher zinc doses can harm the kidneys and liver. For best results, beginning within 24 hours of initial symptoms, sucking on and not chewing zinc lozenges every 1 to 3 hours can provide significant symptom relief.

If one develops severe side effects, such as severe headache or stomachache, as they should discontinue use. One should avoid additives containing formulations such as certain amino acids, citric acid, and magnesium stearate which can worsen cold symptoms.

#3 Pelargonium Sidoides

Containing prodelphinidins, which can block pathogens attaching to the throat and lungs Pelargonium sidoides, is a plant we know as umckaloabo or South African geranium.

With fewer studies on the cold and flu, Pelargonium sidoides has been historically used in the treatment of acute bronchitis.

One human study displays the potent anti-cold and anti-influenza effects of Pelargonium sidoides.

With dry and hoarse coughing symptoms, Pelargonium sidoides can lower the severity and duration of these symptoms, when taken at initial onset.

We see two times the symptom reduction, and over two times the rate of cure, in those taking elderberry.

While Pelargonium sidoides is effective in treating infections, it does not appear to prevent the occurrence of infections.

Dosage Details:

Pelargonium sidoides studies use EPs 7630, a patented 8 to 10:1 extract. A 7630 syrup is also available as taken by ¼ teaspoon, three times daily in research studies. Another option is EPs 7630 hydroalcoholic extract at 1 teaspoon, three times daily. In the powder form, 720 mg taken three times daily is used.

#4 Elderberry

Elderberries, (Sambucus nigra) are a popular medicinal adaptogenic plant widely used in Egyptian, Mediterranean, and Native American cultures.

Animal as well as human cellular studies showcase the antiviral properties of elderberries, most specifically inhibiting influenza, the flu.

While human studies were not well-designed, we find consistent results across them showing elderberry supplementation within 24 hours of initial symptoms leads to mild-to-moderate flu outcomes.

With the rise of the coronavirus, we have witnessed some warnings that elderberries could further complicate a cytokine storm.

These warnings are based on a single elderberry supplementation study exhibiting cytokine effects, with cytokines being a critical and natural immune system response.

While more applicable to the coronavirus, in severe flu cases, cytokine storms can promote lung inflammation, and sometimes death.

As a cytokine storm is a severe immune overreaction to invading pathogens, the article outlines how Sambucol Elderberry antiviral properties can activate a healthy immune system through increasing inflammatory cytokine production.

While it would seem improbable low to even moderate elderberry use could promote a

cytokine storm, it is unclear if large elderberry doses during severe symptoms could cause adverse outcomes.

As always, one should always discuss supplement use with their physician.

Limited evidence leads us to believe taking elderberry as a short-term preventative measure might lower the risk of a cold.

Dosage Details:

Do not use raw elderberries because of their toxicity. Take elderberry when symptoms arrive and continue until resolved. Popular flu products add elderberry to zinc lozenges and appear to be a good option.

Elderberry is also available in capsules, with 700 to 900 mg of elderberry extract used in 3 to 4 divided doses. In Sambucol syrup form, study participants take 1 teaspoon (5 mL) four to five times daily.

#5 Vitamin C

As a water-soluble essential vitamin, vitamin C, or L-ascorbic acid is a popular dietary supplement because of its antioxidant properties, safety, and low price.

Able to act as an antioxidant and pro-oxidant, depending on the body’s needs, vitamin C is a versatile vitamin.

As vitamin C isolates free radicals, its levels are restored by antioxidant enzymes.

Our immune cells produce reactive oxygen species, (ROS), to eliminate pathogens, while vitamin C protects these cells from pathogenic damage.

While the evidence does not appear to show basic vitamin C lowering cold and flu frequency in a healthy population in past studies, it is clear vitamin C lowers symptoms of the cold by 8–14%, depending on the age, for all when taken at the beginning of a cold, or for ongoing preventative measures.

These benefits increase to 50% for athletes and those under physical stress or individuals with insufficient vitamin C levels.

This leads us to investigate whether a high dose or mega dosing of vitamin C can be more effective.

Many suggest megadosing vitamin C between 5 to 10 grams is more effective.

One study shows those taking 1 gram vitamin C hourly for the first 6 hours, and three times daily could effectively relieve and prevent cold and flu symptoms.

Observational cancer studies show greater benefits of vitamin C administered intravenously, while newer vitamin C formulations are in liposomal form for greater bioavailability.

For those who suffer from allergies, vitamin C can lower histamine levels by directly removing the histamine molecule.

Dosage Details:

For basic coverage 1 to 2 grams of vitamin C, L-ascorbic acid in divided daily doses. Choosing vitamin C in a non-GMO form can make sense. It is unclear whether a high dose of vitamin C can cause kidney stones. One recent study shows in 2% of participants, and those predisposed to kidney stones, experiencing kidney stones with a high dose of vitamin C. If one has a history of kidney stones, they can consider not exceeding 1 gram of vitamin C daily.

According to the Linus Pauling Institute, little scientific evidence supports any type of oral vitamin C being better absorbed over others. As the debate continues over “natural” vitamin C versus L-ascorbic acid, they further assert there is no difference in the effects of “natural” vitamin C and L-ascorbic acid.

Top 10 Notable Cold and Flu Supplements

Oregano Oil

Cell studies show oregano oil delivers potent antiviral activity, as it has traditionally been a plant for fever and respiratory symptoms.

Carvacrol from oregano is more effective on certain viruses, while oregano oil performs more effectively against respiratory viruses, including the flu.

Multivitamin/ Mineral

An array of vitamins and minerals such as vitamins A and E, selenium, and iodine, and many more can help support the immune system and immune response.

Taking a quality two-a-day can help cover basic micronutrient needs.

Zinc Ionophores

Black seed oil, green tea, quinine, stinging nettle, cinchona, and quercetin have been shown to possess zinc ionophore actions.

This means they can transport zinc into the cells, allowing it to help the immune system fight off infection.

Melatonin

It is a potent scavenger against the coronavirus in multiple studies.

Protective against viral infections, melatonin appears to be a cold and flu supplement to consider.

Pterostilbene (Other Polyphenols)

Pterostilbene, a natural blueberry compound, is arguably one of the strongest and best-absorbed polyphenols.

Recent research suggests it might be effective against respiratory viruses.

Garlic

Garlic presents itself as a promising cold and flu preventative supplement through increasing the availability of white blood cells.

Whether raw or aged garlic extracts, this supplement is one to consider for those who are often sick as its clinical value appears to be prevention and not the improvement of symptoms once sick.

Medicinal Mushrooms: (Chaga, Cordyceps, Lion’s Mane, Maitake, Reishi, Shitake)

The top medicinal mushrooms show strong actions to support the immune system’s actions.

We will await more studies for a better understanding of the dose and other factors.

Astragalus

In a head-to-head comparison, astragalus in one study more notably activates T-cells above the more well-studied echinacea.

The study used 1.23 grams of daily astragalus.

Bee Products: (Raw Honey, Manuka Honey, Pollen, Propolis, Royal Jelly)

Bee products also might be a valuable tool in immune support.

Some studies show the immune protection from these various different bee byproducts.

Echinacea

Echinacea shows antiviral activity in cell studies against viruses that have membranes, such as the rhinovirus, herpes simplex, influenza A and B, coronavirus (previous strains), and respiratory syncytial virus.

There are more than 10 echinacea studies on the common cold with mixed and inconsistent small symptom reductions along with unclear effective doses, active compounds, or even which symptoms are lowered.

Other Cold and Flu Supplements

NAC, spirulina, chlorella, ginger, glutamine, stinging nettle, quercetin, turmeric, cloves, (eucalyptus, peppermint, and rosemary essential oils), acacia fiber, acai berry, alpha-lipoic acid, Ang 1–7, Andrographis paniculata, berberine; (barberry, Bidens pilosa, goldenseal, Oregon grape root), boneset, chickweed, cinnamon, cordyceps, curcumin, red sage (dan shen), Dong Quai, frankincense, ginkgo Biloba, hawthorn, hesperidin, hesperetin, honeysuckle. Horse chestnut, Korean red Panax ginseng, kudzu, noni leaf, oats, oat fiber, olive oil, olive leaf, prebiotics, probiotics, psyllium fiber, red root, resveratrol, reishi mushroom, rosmarinic acid, rosemary, soluble fiber, weeping forsythia, Chinese skullcap, Japanese knotweed, licorice root, Rhodiola Rosea.

Conclusions on Cold and Cough Remedies

A lot of these symptoms across these diseases are similar, which makes sense to not rule out COVID-19 and to always err on the side of caution first and foremost.

Public health officials agree, children below the age of 5 should not be given cold medicine, while children under 6 months old should only be given acetaminophen, and not ibuprofen or aspirin.

Cough and cold medicines will not prevent or shorten sickness but could provide some symptom relief.

Saline nasal drops and sprays can help with stuffiness and congestion.

Saltwater gargle, throats sprays, and lozenges can relieve sore throats.

Receiving plenty of rest and fluids is important.

Many advocate drinking warm liquids and honey, while others advocate using saunas and heat therapy.

A vaporizer or humidifier might provide additional relief.

The following is what I do when I feel a sickness coming on, as I try to respond immediately, staying on this protocol for several days.

Vitamin C: 1 gram every 30 minutes, watching for stomach rumbling.

Vitamin D3/ K2: 40,000 IU, and sometimes much higher.

Multi-vitamin: a high-quality 2-a-day complete vitamin.

Extra magnesium: magnesium is needed to efficiently absorb oral vitamin D3.

Zinc lozenges: 200 mg for 3 days. If it is the flu, then I’ll use zinc with elderberry lozenges.

Zinc Ionophores: black seed oil, cinchona bark, (restless legs the OTC med), green or matcha tea, quercetin are all options. I typically use matcha tea.

Melatonin: 40 mg at bed. Works well with vitamin C.

Heat therapy: I’ll take plenty of infrared saunas and hot showers while avoiding cold exposure. UV sunlight can help as well.

With heavy fluid consumption, I have plenty of hot drinks and raw honey.

In avoiding high protein meals and simple sugars, nuts, and seeds, dairy is also important to avoid.

Making it a point to eat more than normal, the typical daily intermittent fasting is not the best strategy when sick.

What are your favorite cold and cough remedies and supplements?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

Allergies vs the Cold vs Coronavirus vs Flu? was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

[References to this Article]

As a skin condition occurring when our hair follicles close up from dead skin cells and oil, acne causes blackheads, pimples, or whiteheads.

Medically, acne is called acne vulgaris, a type of skin disease with blackheads, inflammation, rashes, red skin, whiteheads, and even deep lesions.

While most common amongst teenagers, acne can affect individuals of all ages.

[Related Article: The Top Science-Backed PMS and PMDD Supplements]

Like a game of Whack-A-Mole, as one acne bump heals and goes away, another can take its place.

Even though acne can be chronic, effective treatments for acne are widely available.

Acne can create emotional distress and as well as scar our skin.

The earlier one begins their acne treatment, the better the outcome.

There are many factors that can cause acne, including bacteria, hormonal shifts, hyperkeratinization, inflammation, diet, and other lifestyle actions.

Acne Types (Classified by Severity)

• Mild Acne: low amounts of inflammatory acne, or only non-inflammatory acne, or both.
• Moderate Acne: greater amounts of inflammatory acne, occasional nodules, hard and painful acne, or both, with some amount of scarring.
• Severe acne: large amounts of inflammatory acne, nodules, or both, and with heavy scarring. Treatment-resistant after 6 months, and/ or that which causes emotional distress.

Typically occurring on our body parts with sebaceous glands, our tiny oil-producing hormonally influenced glands.

We find these glands on our back, chest, face, neck, and upper arms.

What Causes Acne? (Four Causes)

Bacteria

A bacterium that grows on our skin is called Propionibacterium acnes (P. acnes).

With acne, this bacterium grows abnormally leading to alteration of sebum, follicular hyperkeratinization, inflammation, and skin damage.

Excessive Oil Production (Sebum)

High amounts of oil production or sebum caused by sebaceous glands, inflammation, follicular hyperkeratinization, and bacterium promote acne.

Follicular hyperkeratinization, or abnormal sebaceous glands and upper hair follicle skin cell exfoliation is the main cause of acne.

Inflammation (Diet)

Despite some researchers suggesting the role of diet on acne is overstated, we have powerful evidence dietary changes can promote notable acne improvement.

Oil and Dead Skin Cell Clogging Hair Follicles

Acne occurs when our hair follicles close up due to dead skin cells and oil buildup. This causes blackheads, pimples, or whiteheads.

Acne Symptoms

• Blackheads: Clogged open pores.
• Cystic Lesions: Pus-filled painful lumps below the skin.
• Nodules: Painful large lumps below the skin.
• Papules: Tender, small reddish bumps.
• Pimples: (Pustules or papules containing pus at the top.
• Whiteheads: Clogged closed pores.

What is the Best Diet for Acne?

Research shows us changing our diet can produce notable acne improvements.

The best diet for acne is a whole-food-based diet while avoiding dairy, highly processed foods, and simple sugar-based foods.

Acne Promoting Foods to Avoid

• Milk and Dairy: milk, cheese, yogurt. (This relationship might be overstated.)
• Processed Food: chips, fast food, frozen meals, microwave meals, sugar cereals, white bread, and other simple sugar-based carbohydrates.
• Sugar Drinks and Snacks: cake, candy, cookies, soda, sugar, sweetened juice, and others.

Nutrients for Acne

• B Vitamins (High dose B-12 injections can also inflame acne.)
• B5 (Large doses of 5–10 grams of daily B5 shows significant improvements in 2 months.)
• Chromium (400 mcg of chromium appears to improve skin cell metabolism.)
• Omega-3’s (Mixed evidence and some might experience negative effects.)
• Probiotics (Lactobacillus acidophilus was one of the first to treat acne.)
• Selenium (400 mcg selenium appears to show some benefit.)
• Vitamin D (Best evidence with a strong deficiency correlation with impressive results at 5,000 IU daily.)
• Zinc (Also effective along with vitamin D, at 30 to 150 mg in divided daily doses after 3 months.)

*The Linus Pauling Institute cautions men on using in excess of 200 mcg of daily selenium.

*Vitamin C is extremely important for collagen and skin, hair, and nail support.

*Vitamin E can support dry skin.

Lifestyle Changes for Acne Improvement

• Alcohol
• Diet: (Benefit through lowering or eliminating simple sugars, carbohydrates.)
• Skincare
• Sleep
• Smoking
• Stress (Does not cause acne, but it can worsen it.)

Acne Myths

1. Chocolate (Non-dairy cocoa/ dark chocolate won’t promote acne.)
2. Cosmetics (Oil-free makeup will not promote acne).
3. Hygiene (Excessive cleaning and scrubbing can worsen acne.)

Acne Risk Factors

• Age. Most commonly found in teenagers because of androgen production during puberty.
• Dairy and dairy byproduct consumption, such as casein and whey.
• Genetics. If both parents had acne, one is likely to experience it.
• Greasy or oily substances, from skin contact with oily lotions and creams.
• Hormonal changes during pregnancy or midlife, notably in women, can also increase acne.
• Women also experience acne later in life-related to hormonal fluctuations during pregnancy, premenopause, and when using hormonal birth control
• Medications: corticosteroids, lithium, testosterone. (This acne type is distinct from acne vulgaris.)
• Skin friction or pressure.
• Stress. Can worsen acne despite not directly being a cause.

Which Acne Treatment is Best? The Top Acne Supplements

#1 Vitamin B3 Niacinamide

The most well-studied acne supplement is vitamin B3, in a 4% niacinamide, also called nicotinamide gel form.

Niacinamide gel performs equal to 1% clindamycin antibiotic gel in acne severity improvement while performing superior to clindamycin in oily skin types.

Also available is a topical cream with the niacinamide metabolite, 1-methyl niacinamide (0.1–0.5%), which shows effectiveness for burns and eczema, besides acne.

Results:

With 8 weeks of twice a day daily use, 4% niacinamide gel can be equally effective to 1% clindamycin gel, while we see some initial results in as little as 1 to 3 weeks.

#2 Green Tea

Polyphenol-rich green tea appears to be a potent anti-acne compound.

Matcha green tea might even deliver more benefits because of its higher polyphenol content.

Results:

A study shows 1,500 mg of green tea extract for 4 weeks, significantly improving acne lesions. We have issued cautions with daily green tea extracts over 800 mg, because of rare reports of liver toxicity. Drinking matcha tea might be a safer long-term option.

#3 Inositol

Inositol appears to deliver the best results for women with PCOS.

Inositol or Myo-inositol is a vitamin-like type of sugar, which performs at the highest level for acne, anxiety, fertility, and panic attacks in those with PCOS.

Acne was eliminated in one research study in over half of its participants.

Results:

We see results in three months, with full benefits realized after six months using 2,000 mg per day. They used no placebo control group in this study. One important side note is we see the range of use as high as 4,000 mg for physical PCOS conditions, with much higher dosages used for mood-based PCOS symptoms.

#4 Milk Thistle (Silymarin)

Milk thistle or silymarin is a top liver support supplement.

Results:

Taken at 210 mg daily, milk thistle shows a 53% reduction in total acne count after 2 months of use.

#5 NAC (N-Acetyl-Cysteine)

The amino acid N-acetyl-cysteine, (NAC) used for liver health, detoxification, and mood benefits, appears to be a solid acne supplement.
We see a 50% reduction in total acne count with the use of NAC.

Results:
The one small NAC study used 1200 mg per day of NAC, with results appearing after 8 weeks, as these effects show continued improvement.

Acne Supplements (Notable Others)

Barberry, (Berberis vulgaris L.)

Barberry’s antibacterial and anti-inflammatory actions notably lowers acne lesions in some studies.

Cannabidiol (CBD)

Also, with antibacterial and anti-inflammatory actions, CBD is found lowering inflammation and improving sebum production in test-tube studies on human skin cells.

Resveratrol

Resveratrol in a cream form more than halved the rating scores of acne, but the acne count reductions were less than 10%.

Vitex agnus-castus, (Chasteberry)

Limited evidence shows chasteberry lowers acne prior to menstruation because of its hormonal action on estrogen.

Conclusions on Acne Supplements

For acne treatment, we want to understand what causes acne in our own body.

Because, when we look at which acne treatment is the best, this will further help us select the right one.

Once again we are reminded of the importance of using a high-quality two-a-day multivitamin.

We can see how our chosen lifestyle may improve or worsen the expression of the physical conditions we experience.

What’s your favorite supplement?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

How to Have Bright, Clear, Glowing Skin was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

[References to this Article]

Related Article: Part 2

Is adrenal fatigue real?

The technical and incomplete answer is no.

Adrenal fatigue is not a medically recognized condition.

Instead, it is a catch-all buzzword representing symptoms of adrenal gland dysfunction.

We’ll explore how to address what is actually happening in part two.

And as we mention this, we’ll use the phrase “adrenal fatigue” in this article for referential purposes only.

In part one, we’ll explore how to lower or raise cortisol using the top cortisol supplements for adrenal fatigue.

[Related Article: The Top 9 Science-Backed Anti-Anxiety Supplements]

[Related Article: The Top 9 Sleep Supplements for Insomnia]

[Related Article: The Best Adaptogenic Supplements]

So, let’s get started on how to lower or raise cortisol using the top science-backed supplements.

What is Cortisol: The “Flight-or-Fight” Hormone

As a steroid hormone regulating several core body processes, including metabolism and immune response, cortisol plays a critical role in managing our body's stress response.

Too much or too little cortisol can cause us problems and promote chronic stress and disease.

The following conditions can be caused by high cortisol, and some of these conditions can also cause high cortisol levels.

What are the Symptoms of High Cortisol

• Cognitive Disorders
• Flushed and Round Face
• Frequent Urination
• High Blood Pressure
• Increased Thirst
• Low Sex Drive
• Metabolic Disease
• Mood Shifts (Anxiety, Depression, Irritability)
• Muscle Weakness
• Osteoporosis
• Rapid Weight Gain (Abdomen, chest, and face, along with thin arms and legs)
• Skin (Bruises and purple stretch marks)
• Sleep Disorders

What are the Symptoms of Low Cortisol?

• Darkening of Skin Regions
• Dizziness (Upon standing)
• Fatigue
• Low Blood Pressure
• Mood Changes
• Muscle Weakness
• Weight Loss
• Untreated insufficient cortisol levels can pose a potentially life-threatening condition.

Cortisol Supplements for Adrenal Fatigue (Micronutrients)

Before we get into adrenal fatigue recovery, we want to look at the micronutrients which are involved in adrenal and cortisol support.

We want to ensure the adequate intake of the following key micronutrients.

1. B-1
2. B-5
3. B-6
4. B-9 (Folate)
5. B-12
6. CoQ10
7. Magnesium
8. Omega-3's (Cod liver oil, fish oil; algae oil or krill oil might be superior omega-3's.)
9. Potassium
10. Selenium
11. Vitamin C
12. Vitamin E
13. Zinc

B5, magnesium, omega-3, potassium, vitamin C, and zinc are the most critically important.

Top 5 Cortisol Supplements for Adrenal Fatigue

Adaptogen plant supplements perform best in research studies for cortisol lowering effects.

#1 Ashwagandha

Ashwagandha, “Indian Ginseng”, is the popular adaptogen plant supplement for anxiety, sleep, metabolic health, hormones, reproductive health, stress, along with an array of others.

While it has clinical support for anxiety and sleep, ashwagandha’s strongest proven action is lowering chronic stress and high cortisol levels.

Traditionally celebrated as a nerve tonic, Ashwagandha is a sacred plant in Ayurvedic medicine.

Ashwagandha improves stress, happiness, and cortisol levels in multiple research studies.

KSM-66 (5%) and Sensoril (10%) are the two types of Ashwagandha supplements.

Some report KSM-66 as a stimulating daytime Ashwagandha, with Sensoril as a calming nighttime Ashwagandha, and others report opposite invariable effects or no varying effects amongst the two.

Dosage:

Studies use a standardized Ashwagandha extract of 300 mg, two times per day, with daily doses up to 1 gram seen as safe. Users should be aware a small subset of males seem to report sexual and long-term negative serotonin-type side effects referred to by a new term, Post-SSRI Sexual Dysfunction, (PSSD). It is both fat- and water-soluble and effective with or without food.

#2 Phosphatidylserine

As a naturally occurring fat, phosphatidylserine exists in high concentrations in our nervous system and brain.

Phosphatidylserine lowers ACTH and cortisol levels following a stress test in clinical studies.

In other studies, phosphatidylserine improves mood and calm in those undergoing stressful situations.

Phosphatidylserine is the only supplement approved by the US Food and Drug Administration, FDA, to treat cognitive decline and dementia.

The total content of all phospholipids, such as lecithin and algae and krill oil, is 3% phosphatidylserine, along with phosphatidylcholine and phosphatidylinositol.

Dosage:

The effects of phosphatidylserine only performs at doses of 300 to 400 mg, and not with higher dosages.

#3 Rhodiola Rosea

Rhodiola Rosea is an adaptogenic cold climate, high altitude plant, delivering anti-stress and anti-fatigue benefits.

As an MAO-A and MAO-B inhibitor, which makes Rhodiola Rosea a believed antidepressant and ADHD supplement, while possibly offering mild anxiety benefits.

Acting on acetylcholine, dopamine, norepinephrine, and serotonin, it also lowers primary inflammatory cytokines, IL-1, IL-6, and TNF-alpha.

While the studies showing Rhodiola Rosea’s anti-stress actions are of poor quality, they demonstrate potent and rapid anti-stress actions.

Rhodiola Rosea has two listed active compounds; rosavins and salidrosides.

Salidrosides support the HPA axis, the hypothalamus, and adrenal and pituitary glands, which maintains our stress response.

Dosage:

Common Rhodiola extracts are 1% salidrosides and 3% rosavins or 5% salidrosides. 400 to 600 mg per day of standardized Rhodiola Rosea extract is the typical dose.

#4 Ginkgo Biloba

Ginkgo biloba is the world’s oldest cognitive-enhancing plant, and similarly one of the oldest and well-studied supplements

As another reliable adaptogenic plant, ginkgo Biloba offers an array of benefits.

In combating stress, ginkgo significantly lowers systolic and diastolic blood pressure, improving central and peripheral blood flow, while also boosting mood and cognition.

Ginkgo Biloba's actions support the ACE2 enzyme, along with acting as a vasodilator.

Effective for some types of anxiety, depression, ginkgo Biloba also provides a disputed benefit for cognitive issues such as dementia and ADHD.

The notable ginkgo Biloba effects on cardiovascular issues due to elevated cortisol are clear.

It now appears ginkgo Biloba can improve sleep disturbed by high cortisol levels.

Dosage:

240 mg EGb or standardized extracts are taken before bedtime is shown to improve sleep, through believed cortisol lowering actions. Other studies show it being used at 120 mg twice a day for cardiovascular blood flow support.

#5 Bacopa Monnieri

As another adaptogenic plant, bacopa monnieri lowers stress and depression in small research studies.

Offering evidence as a memory enhancer, bacopa monnieri also lowers cortisol.

Specifically, in animal studies, bacopa improves memory loss due to acute and chronic stress.

In other animal studies, bacopa improves symptoms of depression and anxiety.

We know stress causes blood and brain chemistry changes.

As cortisol rises in the blood, norepinephrine levels rise in the brain causing dopamine and serotonin to drop.

One animal study shows bacopa addressing and normalizing this stress response reaction in the brain.

With this limited evidence, bacopa could lower depression and stress through neurotransmitter balancing, while improving inflammation and oxidative stress in the brain.

Dosage:

We see 300 to 450 mg standardized bacopa extracts used as the typical dosage across research studies.

Rising Star: Lion’s Mane

Much like bacopa, quality lion’s mane, human studies are few.

The widely popular medicinal mushroom lion’s mane is used for cognition (brain fog), depression, focus, memory, Parkinson’s, depression, sleep, and lowering anxiety, cortisol, and stress.

While quality studies have been lacking to support its uses, lion’s mane is the recipient of exciting research on nerve growth and regeneration in its believed BDNF promoting actions.

Paul Stamets, a mycologist, suggests his research will show lion’s mane improves cognition along with psilocybin and niacin, thus influencing neurogenesis, the growth of new neurons forming in the brain.

This could deliver for those with brain and nervous system issues and degenerative neurological diseases.

Imbalances in nerve growth factor (NFG) and myelin, (nerve fiber insulation), can increase the incidence of neurological diseases such as Alzheimer’s and multiple sclerosis.

A human study shows lion’s mane improving focus while lowering anxiety.

Researchers believe lion’s mane is a stimulant of NFG and brain-derived growth factor (BDNF) and improving these targets can increase cognition and memory through the production of new neurons.

Lion’s mane appears to increase and decrease the following pro-inflammatory cytokines: AP-1, IL-1-beta, IL-6, IL-8, NF-kb, SOD, and TNF-alpha.

As IL-1, IL-6, and TNF-alpha are the key pro-inflammatory cytokines affecting HPA-axis dysfunction and high cortisol levels, it will be important to better understand this relationship.

Dosage:

Standardized extracts of 500 to 3,000 mg per day in divided doses. As with Ashwagandha, some users report Post SSRI-Sexual Dysfunction with lion’s mane.

Adrenal Supplements (Low Cortisol, Low Blood Pressure)

• 5-HTP
• Caffeine
• Cordyceps (Another adaptogenic rising star)
• Licorice (Most well-supported and used)
• Yohimbe

Adrenal Supplements (Top 9 Notables)

L-Theanine:

We see less stress from individuals taking 200 mg theanine in research studies.

Lavender Essential Oil:

Lavender performs with cortisol decreases in the aromatherapy form.

Maca:

Cortisol reductions were seen in postmenopausal women.

Mucuna:

Mucuna shows a lowering of cortisol in chronically stressed men.

Omega-3's:

Benefits are seen with Omega-3'd for ADHD, depression, and other cognitive and mood disorders caused by stress.

Prebiotics:

Dietary fiber can lower high cortisol levels in healthy individuals.

Saffron Essential Oil:

Cortisol lowering effects are seen with women only.

Tongkat Ali (LongJack) (Eurycoma):

Cortisol reductions noted in chronically stressed individuals.

Vitamin C:

Exercise-induced spikes with pro- or anti-inflammatory actions at 500 to 1,500 mg. (This might translate to cortisol lowering effects for those on the Ketogenic diet and intermittent fasting.)

Adrenal Supplements (Others)

Black seed oil, DHEA, curcumin, lemon balm, melatonin (night time), l-lysine, SAM-e, alpha-lipoic acid, St. John’s wort, lecithin, probiotics, phosphatidylserine, maca, astragalus, eleuthero, NAC, Tribulus Terrestris, holy basil, Panax ginseng, Schisandra, butyrate, magnolia bark, hops, Chinese skullcap, kava, valerian, taurine, salvia sclarea, TMG, theaflavins, agmatine, rose essential oil, tyrosine, DLPA, cocoa, cacao, dark chocolate, green tea, black tea, matcha, garlic, wild salmon, berries, chamomile, alpha-GPC, CDP-choline.

Adrenal Fatigue and Cortisol Supplements Conclusions

As is the case with most other conditions, the insufficiency or deficiency of micronutrients should be addressed first and foremost when using cortisol supplements for adrenal fatigue.

We want to understand what is happening at the level of root causes.

Do we have high or low cortisol levels?

Are we experiencing high daytime cortisol levels, causing us debilitating stress?

Or are we experiencing high nighttime cortisol levels, which is disturbing our sleep?

Addressing the root cause of medical conditions is where we can create the most meaningful and lasting change.

Join us for part two, as we examine adrenal and cortisol lifestyle optimization strategies.

What’s your favorite anti-stress supplement?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

Is Adrenal Fatigue Real? was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

Improve Your Overall Health with Better Sleep Now!

[References to this Article]

The National Institutes of Health (NIH), estimates about 30 percent of people experience sleeping problems, with 10 percent of people having an impairment of their daytime function.

It’s estimated that about 25 percent of people have acute insomnia lasting a few days to a month annually.

[Related Article: Sleep Like a Baby, with the Top Science-Backed Insomnia Supplements and Strategies Part 1 of 2]

[Related Article: The Top 9 Science-Backed Anti-Anxiety Supplements]

Sleep Affects Our Overall Health

1. How Improper Sleep Negatively Affects You
2. Cardiovascular Health
3. Cognition and Focus
4. Inflammation
5. Insulin (Resistance vs Sensitivity)
6. Muscle Growth

How Much Sleep Do We Need?

According to the Sleep Foundation, healthy adults need between 7 and 9 hours of sleep.

While a newborn needs 14 to 17 hours of sleep, the amount of sleep we need declines as we age, until 65 years or older, we need 7 to 8 hours of sleep.

Similarly, studies show excessive sleep over nine hours nightly can contribute to disease states.

The Sleep Foundation also tells us the seven to nine hours of sleep rule is a “rule of thumb” and getting one hour more or less within this range is acceptable depending on the individual.

The American Academy of Sleep Medicine (AASM), and Sleep Research Society (SRS), also suggest the average individual needs a minimum of 7 hours of sleep to optimize overall health.

What is a Short-Sleeper?

“The new research trend is raising questions that are harder than they first seem. How do you know when someone has gotten enough sleep? Enough for what?,” Michael Grandner, director of the Sleep and Health Research Program at the University of Arizona School of Medicine.

One percent of people are “short-sleepers”, which means they get 4 to 6 hours of sleep and report feeling refreshed upon waking.

Another 39% of people are short-sleepers who report feeling otherwise fine, except relying on caffeine and napping to get through their day.

As the one percent are considered true short-sleepers, scientists believe they possess a genetic mutation affecting their circadian rhythm, called DEC2, also promoting a notably higher tolerance for pain.

While the questions might be clearer than answers, we are finding growing reasons to believe our sleep patterns might be genetically predetermined.

We discover more researchers echoing short-sleepers should not pretend they are long-sleepers and vice versa.

Why Do We Wake Up in the Middle of the Night?

With waking in the middle of the night, we are conditioned to automatically believe this is the sign of poor sleep.

And we need to once again remind ourselves, “not so fast.”

Most people wake up one to two times in the middle of the night.

We wake at 3 am or thereabouts as this is the time we transition from deep sleep into lighter sleep.

If we are in bed at 11 pm, four hours later, we’ve completed our deep sleep and are shifting into prolonged light sleep periods, called rapid eye movement, or REM.

I Wake Up at Night to Urinate — Is this Normal?

Studies show waking to urinate is normal.

In fact, over two-thirds of men and women over the age of 70 urinate at least once, with up to 60 recent waking to urinate two times a night.

One in three adults over the age of 30 urinate twice nightly.

Technically, nocturia is the waking to urinate one or more times per night.

The reality is nocturia tends to be more invasive with two or more bathroom trips with significant interruption of sleep.

As we focus on how nocturia diminishes sleep quality, the relationship can likewise be inverse with poor sleep being a root cause of nocturia.

Despite it typically affecting those over the age of 60, nocturia can occur at any age, from an array of causes.

Nocturia could also indicate a serious underlying condition such as diabetes.

In men, often an enlarged prostate or benign prostatic hyperplasia (BPH), closing off the urethra serves as the cause of nocturia.

How Long is Normal to Fall Asleep and Fall Back to Sleep?

Normal sleep latency means it is normal for it to take 10 to 20 minutes to fall asleep once we get into bed.

Similarly, if it takes over 20 minutes to fall back asleep after waking in the middle of the night, this might be the sign of a sleep disorder.

The 9 Common Sleep Disorders

1. Excessive Sleepiness
2. Excessive Sleepiness (From Obstructive Sleep Apnea)
3. Insomnia
4. Narcolepsy
5. Non-24 Hour Sleep-Wake Disorder
6. REM Sleep Behavior Disorder
7. Restless Legs Syndrome
8. Shift-Work Disorder
9. Sleep Apnea

What is Insomnia?

1. Acute or Adjustment Insomnia: Most common lasting a few days to a month.
2. Behavioral Insomnia: Childhood
3. Chronic Insomnia: Long-term insomnia, typically from lifestyle and underlying health.
4. Maintenance Insomnia: Difficulty staying asleep or waking too early.
5. Onset Insomnia: Difficulty falling asleep or sleep latency.

Insomnia is the most common sleep disorder.

Stress and worry about family, finances, health, school, and work are typical underlying causes of chronic insomnia.

The Sleep Foundation shows 10% to 30% of adults have chronic insomnia.

In other studies, we find the estimates in the 50% to 60% range.

We also see insomnia affecting 30% to 48% of older people.

Sleep Cycle Stages

A Full Night’s Sleep

We cycle through these 5 sleep stages four to five times nightly.

Stages 1 and 2: Light Sleep

Starting our sleep cycle, light sleep is the transitional sleep stage into deeper sleep stages.

Our muscles relax during light sleep, as our breathing and pulse slow, in a state wherein we can wake easily.

• Muscles Release and can Twitch
• Pace of Respiration Decreases
• Pulse Decreases
• Temperature Decreases

Stages 3 & 4: Deep Sleep

Deep sleep is the restorative and rejuvenation sleeping stage.

We experience muscle growth and tissue repair, along with waste removal from the brain.

In this stage, you have difficulty waking up and are disoriented or groggy if awoken.

• Blood Pressure Decreases
• Blood Circulation Increases out to the Muscles
• Cellular Repair and Tissue Growth
• Hormonal Repair (Release of Growth Hormone (GH))
• Removal of Waste Products from the Brain
• Slow Brain Wave Activity

Stage 5: Rapid Eye Movement (REM) Sleep

The re-energization of our minds occurs during REM sleep.

REM promotes dreaming, learning, memory consolidation, and problem-solving.

The length of REM time generally declines with aging.

• Acceleration of Brain Activity
• Genitalia Blood Flow Increases
• Immobility of Body Prevents the Acting out of Dreams
• Regulation of Body Temperature Pauses
• Respiration Increases
• Pulse Increases
• Vivid Dreams (Lucid Dreaming)

We experience more Non-REM (NREM) sleep or dreamless sleep, in our earlier sleep cycles, whereas we undergo more REM sleep in our later sleep cycles.

When we enter the last sleep cycle, our body might bypass NREM deep sleep in transitioning into REM.

Neurotransmitters Involved in our Sleep-Wake Cycle

Primaries:

1. Acetylcholine (Promotes REM sleep)
2. Dopamine (Inactivates melatonin)
3. GABA (Sleep as the major inhibitory neurotransmitter)
4. Glutamate (Primary excitatory neurotransmitter)
5. Norepinephrine (Fight-or-flight response: Sleep interrupter)
6. Serotonin (Similar actions as norepinephrine)

Others:

1. Adenosine (sleep-promoting neurotransmitter. Caffeine is an adenosine blocker.)
2. Corticotropin-Releasing Hormone (CRH) (Peptide stress-response hormone)
3. Cortisol (Steroid adrenal gland hormone made for stress and homeostasis.)
4. Growth Hormone-Releasing Hormone (GHRH) (Promotes Slow-Wave Sleep)
5. Melatonin (Sleep-Wake Cycle: Higher levels at night. Levels drop as we age)
6. Orexin (Arousal and wakefulness)

Better Sleep Solutions

1. Avoid alcohol and caffeine at night
2. Block bluelight (Add blue-blockers to screens and/ or wear blue-light-blocking glasses)
3. Cold shower (1–2 hours before bedtime)
4. Consistent bedtime
5. Cool room (Cooler rooms promote sleep)
6. Darkroom (Block all light. Apply black electrical tape on all electronics)
7. Earlier bedtime and dinner time (Small bedtime snacks may help some)
8. Lower nighttime light exposure (2 hours before bedtime)
9. Lower noise
10. Relax (Wim Hof breathing, music, meditation, self-hypnosis)

Sleep Accessories

1. Black Electrical Tape (For electronics and light cracks)
2. Blackout Paper (For windows; Tinfoil can be optimal for those sleeping during the day.)
3. Blue-Light-Blocking Glasses
4. Ice Pack to Cool-Down
5. Fan for Bedroom
6. F.lux (Blue-light-blocker for the desktop)
7. Mobile Phone Blue Light Blocking App
8. Oura Ring
9. Sleep Mask (360 light blocking) and Soft Foam Ear Plugs
10. Sleep Tracking App
11. The Right Bed and Pillow
12. Tiny Melatonin Friendly Flashlight (Such as Blocklite)

*Some report taping their mouth shut with electrical tape to promote nasal breathing.

Nasal breathing strips can open nasal passages to promote improved nasal breathing.

What’s the best way to take a nap?

Much like caffeine, many use naps as a daytime strategy.

Research shows us there is a more effective method of napping.

Short: Nap for 10 to 20 minutes.

Early Afternoon: Naps after 3 p.m. can disturb nighttime sleep.

Restful Environment. Napping cool, dark, quiet spaces can be helpful.

Sleep Disorder Treatments

• Cognitive-Behavioral Therapy
• FDA-Approved Sleeping Devices: (Sleep apnea devices)
• Medications: (Sedative-hypnotic drugs, sedative-antidepressants, antihistamines, sleeping pills, benzodiazepines, and others.)
• Sleeping-Aids (See the Previous Chapter)
• Sleep Hygiene Counseling
• Sleep-Restriction Therapy
• Stimulus-Control Therapy
• Sleep Supplements (See Part 1)

Promising New Insomnia Therapy: Triple Chronotherapy

Triple chronotherapy, or adjunctive triple chronotherapy, is emerging as an interesting and more importantly promising insomnia and sleep disorder treatment.

Already found more effective than exercise for depression, triple chronotherapy is undergoing testing with initially promising results on bipolar disorder, anhedonia, PTSD, along with even more severe sleep disorders, such as narcolepsy.

Triple chronotherapy combines total sleep deprivation (wake therapy), sleep phase advance, and bright light therapy.

We believe triple chronotherapy might restore the circadian rhythm, or sleep-wake cycle, along with dopamine and serotonin function.

Historically, white lamp therapy has been the primary first-line treatment for seasonal affective disorder, (SAD).

The effectiveness of white lamp therapy for SAD, a type of winter depression, is undeniable, however, it is ineffective for other types of depression and insomnia.

We are finding bright light therapy, while still equally effective for SAD as white light, might also be effective for insomnia and other sleep disorders along with an array of mood disorders.

Bright light therapy involves 20 minutes of sun exposure upon waking.

Blue light therapy machines have been found to be the next best option to natural sunlight, with studies using them for 30 to 90 minutes within the first two hours of waking.

One study actually suggests red light therapy could be effective in anxiety treatment, however, this is very much in its early stages.

Triple chronotherapy can be a bit tricky and is typically done under medical supervision.

The Truth About Insomnia Medications, and Other Drug Treatments of Insomnia

A recent warning from the Harvard Medical School tells us many insomnia medications used for treatments of insomnia, both over the counter and prescribed, contain drug actions which can be detrimental to our brain health.

The most common insomnia medications are antihistamines, and the evidence supporting their use as treatments of insomnia is not strong.

More researchers are sounding the alarm against insomnia medications, such as benadryl, Unisom, ZzzQuil, and others, with suggestions they decrease sleep quality, lead to drug tolerance, and increase the risk of developing dementia.

The drug mechanism of these insomnia medications are not treatments of insomnia and instead just promote drowsiness.

Those with cardiovascular disease, hypertension, and respiratory conditions should avoid these insomnia medications altogether.

Insomnia medications also may trigger central nervous system reactions leading to tachycardia, or high pulse rate.

According to Harvard Medical School, those with kidney or liver issues and older adults should avoid these insomnia medications due to increased risk of adverse effects.

If we must use insomnia medications, we should aim for no more than two weeks of use.

Common Medications which Can Disturb Sleep

• Anti-arrhythmic (Heart rhythm)
• Beta-blockers (Blood pressure)
• Clonidine (Blood pressure)
• Corticosteroids (Asthma and inflammation)
• Diuretics (Blood pressure)
• Cold, Cough, Flu Medications (Alcohol)
• Headache and Pain Medications (Caffeine)
• Nicotine
• Sedative Antihistamines (Allergies and colds)
• SSRIs (Anxiety or depression)
• Stimulant medications (ADHD/ ADD)
• Theophylline (Asthma)
• Thyroid hormone (Hypothyroidism)

*This is not a complete list. Verify any medications you are taking have not been found to cause sleep disturbance.

Conclusions on Sleeping Problems and Strategies

With all health conditions and once again, in the case of fixing sleeping problems, we want to look for the underlying cause of the sleep disturbance.

It might be possible our sleep is genetically predetermined, with individual needs varying.

Some might even believe they are experiencing sleeping problems when they are in fact perhaps not.

We want to remind ourselves as health optimizers, when we analyze our sleeping, we want to compare ourselves to ourselves and not others, because we are all different.

Triple chronotherapy is interesting as an insomnia and sleep disorder treatment protocol and worthy of much deeper attention.

What’s your favorite sleep supplement?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

How to Sleep Like a Baby, with the Top Science-Backed Insomnia and Sleep Strategies — Part 2 of 2 was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

[References to this Article]

Today 50 to 70 million Americans have sleep disorders, while one in three reports not sleeping well.

In this two-part series, we’ll explore how we can sleep better, using the top science-backed supplements, sleeping tools, and strategies.

In part one, we’ll go through the best sleep supplements based on science.

So let’s get started, shall we?

Sleeping Problems: Sleepless at Night

Sleeping problems leaving us sleepless at night leaves us vulnerable to an array of long-term health issues.

The following are health conditions due to sleeping problems, keeping us in chronic disease states.

1. Cardiovascular Health
2. Cognition and Focus
3. Inflammation
4. Insulin (Resistance vs Sensitivity)
5. Muscle Growth

The Best Supplements for Insomnia: (Sleeping Pills vs. Supplements for Sleep as Treatments of Insomnia)

A recent Harvard Medical School report warned long term use of common sleeping pills and other sedative medications such as benzodiazepines, antihistamines, anticholinergics, and others as treatments of insomnia, can cause significant damage to the brain.

According to Harvard and other researchers, sleeping pills, antihistamines, and other sedatives used as treatments of insomnia, have been linked to the acceleration of dementia.

Sleeping pills and other sedative medications deliver an anticholinergic mechanism of action.

What this means is sleeping pills block acetylcholine, our primary neurotransmitter involved with alertness, focus, learning, memory, and muscle activation.

So as always as health optimizers, we ask, is there a safer, smarter, better way instead of sleeping pills?

[Related Article: The Top 9 Science-Backed Anti-Anxiety Supplements]

[Related Article: Free Yourself From Depression with The Top 9 Supplements and Strategies]

Can health supplements for sleep work as sleeping pills?

#1 Melatonin: (Circadian Rhythm Supplement)

Melatonin is produced from the amino acid tryptophan and the neurotransmitter serotonin, which means it’s a metabolite.

Produced in the pineal gland, melatonin is a circadian rhythm or sleep-wake cycle hormone, regulating our sleep-wake cycle.

As we rise in the morning, melatonin levels drop, as the sun sets or even as we turn down the lights, our melatonin production increases.

Our circadian rhythm is responsive to our surrounding environment, as in the sun setting or rising and artificial lighting.

Blue light receptors in our retina influence neural pathways in our bodies due to our interaction with light, both natural and artificial.

Melatonin is one of the key regulators of our circadian rhythm, as produced in the pineal gland when not interfered with by blue light.

In the oral form, melatonin can treat insomnia, improving sleep latency and sleep quality when our sleep-wake cycle is interrupted.

Safe for children and the elderly, and also popular for treating jet lag, melatonin is a popular and versatile health supplement.

Recent studies show the potent antioxidant and antiinflammatory actions of melatonin to be effective in protecting and supporting the heart, brain, stomach, along with other major organs, causing many to suggest taking larger doses in the 5 to 10 mg range.

Melatonin continues receiving spotlight as a popular COVID-19 therapeutic for the immune system for its protective effects against the coronavirus as a home therapeutic and in the hospitals.

While some researchers believe melatonin levels gradually drop as we age, other researchers believe cancer, dementia, some mood disorders, severe pain, type 2 diabetes, nighttime light exposure, excessive stress, and smoking are greater factors in suppressing melatonin production.

Dosage:

Do not use melatonin during the day, especially those with or prone to bipolar disorder. Those with inflammatory conditions, such as rheumatoid arthritis, should watch high dose melatonin intake above 10 mg.

Take 0.3 mg, or 300 mcg, before bed. Some suggest anywhere from 30 minutes to 2 hours prior to sleeping. Increase the dose weekly by the same amount or by .5 mg, 500 mcg until you find the lowest effective dose.

Time-release melatonin is said to more closely resemble our natural sleep cycle and may help with staying asleep. Those who have trouble with only falling asleep can consider melatonin in a fast dissolve form.

#2 Kava, (Nature’s Xanax)

As some claim it can replace or help with alcohol substitution, kava is a traditional sedative beverage of the South Pacific indigenous people.

Once popular worldwide prior to fear-based, FDA-led attacks on kava safety in the 90s all but collapsed the kava market, sending former kava buyers running for the hills.

As kava is making a resurgence today, it is being embraced due to its non-habit forming yet potent sedative effects and benefits.

Kava is currently being investigated for its role as a possible treatment for alcohol, tobacco, and other drug addictions.

The case could be made that kava is the true number one supplement for sleep and insomnia.

Also, the top option for stress and anxiety, kava reduced stress and improved sleep quality in a study involving stress-induced insomnia.

Kava is also effective in a study of individuals experiencing sleeping issues due to anxiety, restlessness, and tension.

The sedative effects of kava are due to blocking of calcium and sodium ion channels, increasing GABA-A activity, and inhibiting monoamine oxidase B (MAO-B).

Kava also increases the actions of dopamine and noradrenaline.

Unique in causing reverse tolerance, this means tolerance is initially experienced with kava, causing a user to need to use it several times, prior to realizing full benefits.

Dosage:

Use only 100% certified root extract, as kava stem-and-leaf products have been linked to rare cases of liver toxicity. Kava can cause interactions and should generally be used with caution, especially with other GABA and serotonin acting compounds. For more information on dosing and how to take kava, see our in-depth kava article.

[Related Article: How to Kava: Nature’s Xanax]

#3 Lavender: (Supplement or Aromatherapy Essential Oil)

Lavender is unique in its effectiveness as both an aromatherapy essential oil and a supplement for both anxiety and insomnia.

As its traditional use is as an aromatherapy essential oil, lavender promotes its effects based on its relaxing scent.

The challenge with aromatherapy essential oil studies is the difficulty in establishing a double-blind study, causing the study quality to be lower quality.

More recent lavender studies have tested oral lavender supplements on anxiety and sleep, with promising results as we see sleep quality improving with insomniacs and those with generalized anxiety.

There is also reason to question whether lavender would also be effective with increasing sleep quality in otherwise healthy individuals.

Lavender has been shown to improve anxiety, stress, and lower intrusive repetitive sleep-interfering thoughts.

It is important to note, lavender sleep and insomnia studies are more recent using a proprietary extract called SilexanTM, which we see improving anxiety, sleep duration and sleep quality.

One word of caution on lavender, which might end up serving to be a typical overstatement we often see in the supplement world, however it is worth keeping in mind.

We have limited evidence to suggest lavender may have hormonal effects on boys and girls.

While one study shows lavender causing no interaction with estrogen-based birth control, we still feel caution is best advised, and topical and oral lavender supplements should be avoided by boys and girls.

In rare cases wherein reactions have occurred, the side effects such as gynecomastia, enlarged breasts in males, has reversed itself when lavender use has ended.

We also have limited evidence of antiandrogenic and estrogenic actions with lavender and tea tree aromatherapy essential oils.

If lavender causes tender breasts, terminate its use immediately.

While it is believed topical lavender causes allergic reactions, this is likely due to a chemical additive called linalyl acetate.

Lavender might be synergistic with lemon balm.

Dosage:

80 mg of SilexanTM, a lavender oil standardized to contain the active component linalool at 25 to 46%, 30 minutes prior to bedtime. If no benefits have occurred in two weeks, one can increase to 160 mg as the maximum dosage. Lavender can also be used in aromatherapy essential oil form burned with candles, heated, placed in an essential oil diffuser, placed on a bandana or scarf, or taken with a hot bath. Research studies test lavender aromatherapy essential oils with essential oil diffusers using 30 minutes of exposure.

#4 Hops, Passionflower, and Valerian (The Three Sisters of Sleep)

Named “The Three Sisters of Sleep”, hops, purple passionflower, and valerian when taken together, have been found to be effective at raising GABA, our primary calming neurotransmitter.

The trio of hops, purple passionflower, and valerian can promote calm and relaxation to increase sleep quality.

Hops, purple passionflower, and valerian have been found in one study equally effective as the prescription medication zolpidem, otherwise known as Ambien in sleep quality improvement.

In Germany, this hops, purple passionflower, valerian formula is the number one prescribed sleep medication.

Hops, purple passionflower, and valerian are also effective as anti-anxiety plants due to their same effects on GABA.

A new form of hops called xanthohumol hops is raising attention in recent studies and could eventually be considered the more potent form of hops for sleep and anxiety sedative effects.

Dosage:

Hops, passionflower, and valerian can be purchased as a combination formula supplement.

#5 Lemon Balm, (Valerian Synergy)

Lemon balm, or melissa, performs with notable effects on anxiety and insomnia in the research studies.

We see an improvement with insomnia in 85% of subjects, with anxiety and insomnia in a small study.

In another sleep study involving menopausal women with insomnia, we see lemon balm with or without valerian improving sleep quality.

Another study shows the same valerian and lemon balm combination improves sleep quality in children.

Lemon balm improves sleep through increasing GABA activity in the brain.

Studies on lemon balm, with or without valerian, are few and smaller, and the usual more studies are needed can be issued here, however the evidence thus far has been promising.

Dosage:

The lowest effective lemon balm dose is 300 mg. The optimal lemon balm form is with standardized rosmarinic acid. Some suggest effects improve with increased dosage with 1200 mg increasing effects up to three-fold. We also see lemon balm used in tea and aromatherapy essential oil forms.

#6 Glycine, (Also in Magnesium-Glycinate Form)

Some researchers believe the daily intake of glycine, a semi-essential amino acid, might be insufficient in some.

While glycine supplements have not been found to improve sleep quality or reduce the time to fall asleep, subjects report experiencing a notable increase in feelings of rest the next day.

In mild sleep deprivation cases, glycine supplements can increase sleep quality, while improving fatigue reporting along with overall well being the next day due to enhanced sleep.

Glycine is often combined with magnesium as magnesium-glycinate and is popular amongst those with sleep and anxiety conditions.

Dosage:

3 grams one hour prior to bedtime is the dose we see in studies.

#7 Magnesium, (Sleep Promoting for Deficient Levels)

Magnesium is an essential mineral we find with high modern insufficiency and deficiency rates.

Needed for an array of actions in the body and brain, magnesium is recognized as the “calming mineral.”

Magnesium supplements show sleep quality improvement in those with poor sleep quality, with no available studies to show the effects of magnesium on otherwise healthy individuals.

Dosage:

We see 500 mg of magnesium used in research studies. Many use magnesium in the magnesium-glycinate form to obtain the calming benefits from both supplements.

#8 Theanine, (Sleep Quality for ADHD)

L-theanine, an amino acid found in green tea, promotes sleep quality in those who experience sleep disturbance from hyperactivity, such as ADHD.

Sleep duration and sleep latency, however, do not show improvement with l-theanine supplements.

Effectiveness of l-theanine is increased in animal studies, when it is combined with GABA supplements.

Other studies show l-theanine promotes relaxation and focus.

Dosage:

200 mg two times daily. Suntheanine might be more effective, but we cannot confirm this.

#9 Ginkgo Biloba, (Sleep Quality for Depression)

Ginkgo biloba, the world’s oldest cognitive enhancing plant, might also promote sleep.

Ginkgo biloba might increase sleep efficiency, which means less waking in the middle of the night, which might be attributed to its flavonoid actions.

No REM sleep enhancement is seen with ginkgo biloba supplements.

There might be a better effect of ginkgo biloba supplements on individuals with depression.

Animal studies show promising results with ginkgo biloba supplements as well.

Dosage:

240mg Egb-761 taken 30 to 60 minutes prior to bedtime with best results occurring after four weeks of use.

Vitamin and Mineral Micronutrients for Sleep Optimization

1. B-complex (Esp B3, B5, B6, B9, B12) (Best taken earlier in the day.)
2. Calcium
3. Iron
4. Magnesium
5. Vitamin C
6. Vitamin D
7. Vitamin E
8. Zinc

*Neuropathy has been reported with daily vitamin B6 over 200 mg. The Linus Pauling Institute recommends 100 mg as the maximum daily B6 dosage.

Notable Other Sleep Supplements

5-HTP, Chamomile (Apigenin), Niacin/ Niacinamide, Pyrroloquinoline quinone (PQQ), Red Clover Extract, Rhodiola, Tryptophan

Other Sleep Supplements

Ashwagandha, saffron, rhodiola rosea, blue lotus, GABA, trimethylglycine (TMG), magnesium-glycinate, taurine, magnesium-taurate, cannabis (THC), apigenin, black seed oil, niacin B3, niacinamide B3, inositol, lecithin, phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylserine (PS), phosphatidylinositol (PI), CBD, vitamin C, vitamin D, omega-3 (cod liver oil, fish oil, algae oil, krill oil), sceletium tortuosum (Kanna), Panax ginseng (earlier in the day), catnip, magnolia, ornithine, N-acetyl-cysteine (NAC), tart cherry, kiwifruit, oleamide, palmitoylethanolamide (PEA), picamilon, phenibut, kratom (increases insomnia in some).

Sleepless at Night: Conclusions on Sleep Supplements

As always, consider and cover any micronutrient deficiencies first and foremost, before looking at other treatments of insomnia.

Stay tuned for part two in which we will review the science-tested sleep strategies which can help optimize our sleep quality.

What’s your favorite sleep supplement?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

Sleep Like a Baby, with the Best Supplements for Sleep and Insomnia Strategies Part 1 of 2 was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.

Reducing PMS and PMDD Pain and Discomfort with These Top 6 Science-Backed Health Supplements

[References to this Article]

[Related Article: Top 5 Supplements for PCOS]

For all the women out there, and the men who interact with them.

“May You Menstruate In Peace.”

Premenstrual syndrome (PMS) affects 20 to 32 percent of women with moderate-to-severe symptoms, while premenstrual dysphoric disorder (PMDD) is a more rare condition.

As a series of unpleasant mood and physical symptoms, PMS generally begins every month in a usual pattern.

These emotional and physical changes experienced with PMS can range from barely noticeable to intense.

While PMS and PMDD cannot be prevented, lifestyle strategies and supplements have been shown to reduce the severity and duration of PMS and PMDD symptoms.

PMS Symptoms

• Abdominal Pain
• Acne
• Anxiety
• Bloating
• Cramps
• Constipation
• Depression
• Diarrhea
• Emotional Outbursts
• Fatigue
• Food Cravings (Sugar)
• Headaches
• Hot Flashes
• Irritability
• Light or Sound Sensitivity
• Mood Swings
• Sadness
• Sleep Cycle Changes
• Tender Breasts

Premenstrual Dysphoric Disorder, (PMDD), Severe PMS

Premenstrual dysphoric disorder (PMDD), is the name given to severe PMS, affecting 3 to 8 percent of women.

PMDD is a new condition which we can find in the latest Diagnostic and Statistical Manual of Mental Disorders, (DSM-5).

PMDD Symptoms

• Binge Eating
• Bloating
• Crying Spells
• Depression
• Extreme Anger
• Extreme Anxiety
• Insomnia
• Lack of Interest in Daily Activities
• Painful Cramping
• Panic Attacks
• Severe Mood Swings
• Suicidal Thoughts
• Trouble Thinking or Focusing

PMS and PMDD: Possible Causes

1. High Estradiol (Estrogen)
2. High Luteinizing Hormone (LH)
3. High Progesterone
4. Iron Deficiency
5. Low Calcium, Magnesium, Manganese Levels
6. *Other Hormones Testosterone (Mixed Evidence)

(DHEA, DHEA-S, Follicle-Stimulating Hormone (FSH), Prolactin)

13 PMS and PMDD Strategies (How to Ease PMS Symptoms)

1. Balancing diet with a variety of fruits and vegetables.
2. Consuming a calcium-, iron-, magnesium-, and manganese-rich whole food diet.
3. Hydrate with plenty of water and electrolytes, (not Gatorade), to ease bloating.
4. Stopping smoking.
5. Lowering alcohol intake to one drink daily.
6. Lowering salt and simple carb intake prevents swelling. Swap simple carbs for complex carbs.
7. Sleeping and optimizing sleep to at least eight hours nightly to combat fatigue.
8. Exercising to decrease bloating, stress, and improve mental health. Aerobic exercise is best supported for physical PMS symptoms.
9. Using diuretics prevents bloating and water weight. Natural diuretics include dandelion, horsetail, parsley, cilantro, hibiscus, green tea, black tea, coffee, cocoa, and carraway.
10. Lowering stress through meditation relaxation techniques, including meditation, cognitive-behavioral relaxation therapy, cognitive-behavioral therapy, and self-hypnosis.
11. Practicing yoga is shown in several studies to relieve physical PMS pain symptoms.
12. Using acupuncture is seen in multiple studies relieving physical PMS pain symptoms.
13. If all else fails, pain medication, such as ibuprofen or NSAIDs such as aspirin, can be considered. Please consider the serious risk of gastrointestinal bleeding with long term NSAID use. Pay special attention to omega-3’s mentioned later in this article.

[Related Article: Pain Relief with The Top 9 Science-Backed Anti-Inflammatory and Pain Supplements]

***Recent evidence suggests contrary to generic PMS advice from the past, lowering caffeine intake is not associated with the improvement of PMS symptoms. As caffeine is a diuretic, we can hypothesize caffeine elimination might be a counterproductive PMS strategy. In support of general health, current evidence shows up to 4 daily servings of caffeine remains optimal for those who are not sensitive to the effects of caffeine. Low caffeine content cocoa or green teas could also be tested.

PMDD Treatment

Estrogen and progesterone levels can cause changes in PMDD symptoms.

Recent research believes serotonin is a more likely first-line PMDD treatment over hormonal treatments.

Interestingly, as in the case for anxiety, antidepressant SSRI drugs have been found to be more effective for PMDD than for depression.

The good news is we have found several safe natural antidepressant supplements which raise serotonin equal to SSRI drugs, without the short- and long term adverse SSRI side effect risks.

[Related Article: The Top 9 Science-Backed Natural Antidepressant Supplements]

Common PMDD Exams

• Complete Blood Count
• Gynecological Exam
• Liver Function Test
• Physical Exam
• Psychiatric Test

Family or personal histories of major depression, substance abuse, trauma, or stress can further complicate PMDD.

Treatment for PMDD varies. Your doctor may recommend:

The only FDA-approved birth control pill to treat PMDD symptoms is drospirenone and ethinyl estradiol tablet (Yaz).

As with PMS, cognitive-behavioral therapy (CBT), has shown to be helpful for PMDD, along with the other strategies outlined in the PMS and PMDD strategies section.

The Top 6 PMS and PMDD Supplements

#1 Chasteberry (Vitex Agnus Castus Extract)

Chasteberry or vitex agnus castus extract consistently performs in studies with notable PMS symptom improvements.

With well over 10 research studies, chasteberry offers the best evidence of PMS symptom improvement, as we find clear agreement on this conclusion across all of them.

Chasteberry improves an array of PMS symptoms including anger, breast pain and tenderness, constipation, depressed mood, irritability, migraines, and swelling.

By decreasing prolactin, chasteberry restores healthy estrogen levels.

Through lowering progesterone levels, chasteberry improves estrogen to progesterone ratios.

And these two notable adjustments of hormonal levels is what likely promotes significant PMS symptoms.

Chasteberry also shows mild improvement for anxiety, cramps, depression, insomnia, and irritability.

Dosage:

Study doses are seen as 8, 20, and 30mg, and while both the higher doses outperform the 8mg dose, we find no differences between the 20 mg and 30 mg doses. Full PMS symptom improvement occurs after 6 cycles.

#2 Inositol

Myo-inositol supplementation appears to be effective in reducing dysphoric and depressive symptoms during PMS.

Inositol performs as perhaps the single best PMS mood related option, reducing PMS symptoms and improving mood.

Inositol is also proven as a top choice for Polycystic Ovary Syndrome, (PCOS) for both mood and physical symptoms.

While it does have general support for depression, inositol performs much better as a top anti-anxiety supplement for women, most notably with PMS, PMDD, or PCOS, as it is even effective for panic attacks.

While inositol is a sugar, it has been shown to modestly reduce blood sugar levels and improve insulin sensitivity.

Finally, we see strong support for inositol for acne, entirely eliminating acne in 3 to 6 months, however, this may likely only apply to women with PCOS.

Dosage:

Inositol takes up to 6 cycles for best PMS effects to occur. We generally need higher dosages in the 12 to 18 gram range for mood-related symptoms, as lower doses in the 3 to 6 gram range can help physical PMS symptoms. Look for either myo-inositol or inositol on the label. It can mix easily in coffee or a favorite beverage.

#3 Saffron (Most Especially for PMDD)

Saffron, also highly effective for depression and appetite suppression, performs equally well for PMS symptoms over the course of two menstrual cycles.

This is not surprising, as one of the oldest saffron uses is for PMS treatment.

Even the smell of saffron in just 20 minutes, significantly lowers PMS symptoms, while improving period irregularity.

In addition to serotonin, we believe saffron serves to lower cortisol, the stress hormone.

Dosage:

15 mg standardized extract taken twice daily. Benefits improve over the course of two cycles.

#4 Curcumin

The most recent research shows curcumin significantly reduces overall PMS symptoms, four times as much as placebo, because of its believed anti-inflammatory and mood boosting mechanisms of actions.

We have strong evidence in support of curcumin for depression in other studies.

Curcumin prevents a drop in brain-derived neurotrophic factor, BDNF levels, which means the plant can fight inflammation, in effect lowering the severity of psychological and physical PMS symptoms.

Dosage:

As curcumin is an adaptogenic plant, it is often found to take up to two months in some cases to realize any initial benefits. Use a bioavailable type of curcumin taken with a meal with fat and black pepper in divided doses. Studies use a total of 200 mg of curcuminoids per day in divided doses for 7 days before and 3 days after the onset of menstrual bleeding, with full benefits achieved after 3 menstrual cycles.

#5 Ginger

Ginger performs equal to nausea medication in a variety of studies for a variety of conditions.

It should be no surprise, ginger performs well for PMS symptoms, in which we see behavioral, mood, and physical improvement.

Dosage:

500 mg 7 days prior to menstrual bleeding and up to 3 days after as benefits increase over three cycles.

#6 Melissa (Lemon Balm)

Mainly psychological, with some evidence of physical benefits, studies show PMS symptom improvement with lemon balm.

In anxiety and sleep studies, we do have better support for the use of lemon balm, so this is perhaps where it could be most effective with respect to PMS benefits.

Dosage:

Typically 1200 mg. One study shows 500 mg twice daily. Best results seen in mood.

Micronutrients: (Essential PMS Vitamins and Minerals)

Boron

Some improvement in severity of pain and duration of menstrual cramps occurs with boron supplementation. Dosage is 88.5 mg of sodium tetraborate or 10 mg of elemental boron for 2 menstrual cycles.

Calcium

Shown to relieve anxiety, depression, pain, and swelling due to PMS, studies seem to agree high dose calcium can reduce mood- and pain-based PMS symptoms.

500 to 1000 mg calcium daily is often best taken with B6. For optimizing overall health magnesium should always be balanced with calcium intake. We feel high dose calcium should be a final, not first option due to cardiovascular concerns.

Omega-3’s (Krill and Vegan Algae Oil Might be Superior to Fish Oil)

Krill oil and fish oil reduce mood- and physical-related PMS symptoms in studies, with benefits increasing in time. Omega-3’s might be more effective for cramps than ibuprofen. A couple studies show krill oil to be more effective on day 45 and even more on day 90 head to head versus fish oil. See comments below on lecithin, for an explanation on the better performance. 1 gram of krill oil, twice daily 8 days prior to the menstrual cycle for 90 days is what we see as performing best in studies. Fish oil dosage is two times that of fish oil, because of lower absorption rates.

Magnesium

Magnesium, a calming mineral for smooth tissue relaxation and essential for efficient absorption of oral vitamin D, shows a moderate PMS symptom reduction. Magnesium is also used as a key cofactor in many core body and central nervous system functions. It is apparent magnesium effects are best with vitamin B6. We see magnesium dosages of 250 mg with 50 to 100 mg vitamin B6 used in studies.

B1, B-6, and Folic Acid/ Folate (B-Complex)

Studies show both folic acid B9 and 50 to 100 mg of B6 are effective in lowering physical and psychological PMS symptoms. Effectiveness seems to increase with calcium and magnesium, as we believe they promote cycle regularity and healthy hormones. B-vitamins support the liver in detoxification, as the liver eliminates excess estrogen. High estrogen levels, or “estrogen dominance”, can be a significant cause of PMS symptoms such as irritability.

Dosage:

As b-vitamins “work best as a team,” we suggest a methylated b-complex, which are now included in high-quality multi-vitamins. Taking a two-a-day can allow for better absorption. We see 50 to 100 mg of B6 in studies. 100 mg of vitamin B1 is the study dosage. 500 to 1,000 mg of calcium might best improve results along with 250 mg of magnesium. A high-quality multi-vitamin can also deliver much needed iron and manganese.

Vitamin D and Vitamin E

Vitamin E performs as more effective for mood related PMS symptoms, with Vitamin D appearing more effective for physical PMS symptoms. We see a variance in vitamin D results, however for general health, new studies appear to show we generally need higher vitamin D intake. Studies use 2,000 to 7,000 IU and the vitamin D dosage, with vitamin E doses between 200 to 400 IU. We suggest a D3/ K2 combo, as K2 keeps D3 in the bones and out of the arteries.

Zinc

As zinc plays a role as a NMDA-antagonist, which means it blocks excessive, neurotoxic, and mood disturbing glutamate in the brain, it is not a surprise to see notable psychological benefits, and maybe even physical improvements in those with zinc deficiency. We see improvement increase over time with studies using 30 to 220 mg of zinc, with no observable difference with the higher dosage range.

***Lecithin

As a classic health supplement containing phosphatidylserine (PS), phosphatidylcholine (PC), and phosphatidylinositol (PI), lecithin is expected to be confirmed as effective for treating PMS and PMDD symptoms, most notably regularity. Studies appear to be using 1,200 mg of soy lecithin. We recommend sunflower-derived Non-GMO lecithin instead. Lecithin also appears to be effective for liver detoxification, cholesterol, and digestive health, along with menopause- and PMS-related fatigue. We will watch for further conclusions to see if lecithin is effective because of its phosphatidylserine (PS) content, or it is more effective than isolated PS, because of its other two compounds.

Notable Other PMS and PMDD Supplements

Brewer’s yeast, Saint John’s wort, Ginkgo biloba, Royal Jelly, Tryptophan, Fennel, Phosphatidylserine (PS), Valerian, Evening Primrose Oil.

Conclusions on PMS

The effects of micronutrients on PMS and PMDD symptoms most reflect correcting common modern day nutrient insufficiencies and deficiencies.

The modern western diet reminds us once again of micronutrient insufficiency and deficiency, especially b-vitamins, vitamin D, magnesium, and omega-3’s are increasingly common and widespread.

[Related Article: 5 Core Essentials: The Basic 5 Health Supplements]

We can find even greater nutrient deficiency such as iron, iodine, folate, vitamin A, and zinc, in the developing world.

Caffeine intake might be helpful contrary to previous cookie cutter advice.

We have some science-backed supplements which can provide further support based on specific needs.

Chasteberry has by far the clearest and best evidence for use as a PMS and PMDD supplement.

Be patient, as most PMS supplements seem to take 1 to 3 cycles, and some even six months prior to getting full benefits.

If further support is needed for PMDD in the form of serotonin, we suggest consideration and discussion of a safer science-backed serotonin-boosting supplement first, such as saffron, prior to moving onto an SSRI.

Getting back to focusing on the basics, seems most appropriate in reclaiming our health.

With PMS and PMDD, once again there is no exception to this rule of thumb looming large above and all around us.

What’s your favorite PMS supplement?

Your Friend in Health

Mark Stein

[Get The Essential 3 Sugars and Fat for Every Health Optimizer]

“A PMS Dream Come True!” How to Get Hormonal Consistency. was originally published in OptimizeBetter on Medium, where people are continuing the conversation by highlighting and responding to this story.