Adrenal Glandular

• Support for stress response system
• Potential improvement in energy and resilience
• Support for adrenal hormone production

• May support healthy inflammatory response
• Potential improvement in stress tolerance
• Support for immune function during stress
• May help maintain healthy cortisol rhythms

Adrenal glandular supplements contain dried and processed adrenal tissue from animals, typically bovine (cow) or porcine (pig) sources.

These supplements provide a complex mixture of adrenal-specific proteins, enzymes, hormones, and nutrients that may support adrenal function through multiple mechanisms. Unlike prescription adrenal medications that contain standardized amounts of specific hormones (like hydrocortisone), glandular supplements provide a broader spectrum of adrenal constituents in their natural ratios, though at significantly lower and less standardized concentrations.

Disclaimer: Adrenal glandular supplements are not standardized medications and should not be used as a replacement for prescribed adrenal hormone therapy in diagnosed adrenal insufficiency without medical supervision. The following information is based on traditional use, limited research, and manufacturer recommendations rather than definitive clinical evidence.

Individualization: Optimal dosage varies significantly based on individual factors including current adrenal function, stress levels, body weight, age, health status, and specific product formulation. Working with a healthcare provider familiar with glandular supplements is strongly recommended.

Monitoring: Regular monitoring of adrenal function through appropriate lab testing and symptom tracking is essential when using adrenal glandular supplements, particularly for those with existing adrenal conditions.

Potential Underdosing Signs: Persistent fatigue despite supplementation, Continued poor stress tolerance, No improvement in other adrenal fatigue symptoms, Continued abnormal cortisol patterns

Potential Overdosing Signs: Feeling wired or overstimulated, Difficulty falling asleep or staying asleep, Increased anxiety or restlessness, Elevated blood pressure, Heart palpitations, Irritability or agitation, Headaches, Digestive disturbances

Response To Adverse Effects: If signs of overdosage occur, reduce dosage immediately or temporarily discontinue use and consult a healthcare provider. Severe symptoms warrant immediate medical attention.

Potency Variations: Significant variations exist between products in terms of processing methods, source materials, and actual adrenal tissue content. Product-specific dosing guidelines should be followed when available.

Whole Adrenal Vs Cortex Only: Products containing whole adrenal gland include both cortex and medulla components, potentially providing broader support but also more stimulating effects. Cortex-only products focus more on cortisol support and may be less stimulating.

Proprietary Blends: Many adrenal support formulas contain proprietary blends with multiple ingredients. The adrenal glandular component may represent only a portion of the stated blend weight.

Quality Factors: Higher quality products typically specify the exact source (bovine or porcine), processing methods, and ideally provide some standardization information. These factors may influence appropriate dosage.

Limited clinical research exists on optimal dosing of adrenal glandular supplements. Most recommendations are based on traditional use, clinical experience, and manufacturer guidelines rather than controlled clinical trials. Individual response varies significantly, emphasizing the importance of personalized approaches and appropriate monitoring.

The bioavailability of adrenal glandular supplements is complex and varies significantly based on processing methods, formulation, and individual physiological factors. Unlike pharmaceutical adrenal medications with established bioavailability profiles, glandular supplements contain a diverse array of components with different absorption characteristics. Research

specifically examining the bioavailability of adrenal glandular supplements is limited, making much of the information in

this section based on general principles of protein and nutrient absorption combined with limited specific data.

Adrenal glandular supplements have a moderate safety profile when used appropriately, but carry specific risks if misused or used by certain populations. Unlike prescription adrenal medications, over-the-counter adrenal glandulars typically contain lower and less standardized amounts of adrenal hormones. However, they still contain bioactive components that can affect adrenal function and stress response. Safety concerns include potential effects on existing adrenal conditions, quality control issues, and risks associated with self-treatment of adrenal disorders.

The safety profile is further complicated by significant variability between products and limited regulatory oversight.

Common:

Uncommon:

Rare But Serious:

Absolute:

Relative:

Children:

• Not recommended
• Children’s endocrine function is particularly sensitive and critical for proper development. Diagnosed adrenal conditions in children should be managed by pediatric endocrinologists with prescription medications.
• No clinical studies evaluating safety in children; theoretical concerns about effects on growth and development.

Pregnant Women:

• Contraindicated
• Adrenal function changes naturally during pregnancy, and self-supplementation could interfere with this delicate balance, potentially affecting maternal and fetal health. Diagnosed adrenal conditions during pregnancy require careful medical management.
• No clinical studies in pregnant women; known risks of both adrenal insufficiency and excess to maternal and fetal health.

Breastfeeding Women:

• Not recommended
• Adrenal components may pass into breast milk, potentially affecting infant adrenal function. Diagnosed adrenal conditions during breastfeeding should be managed medically.
• Limited data on transfer to breast milk; theoretical concerns about effects on infant adrenal function.

Elderly:

• Use with caution, preferably under medical supervision
• Age-related changes in adrenal function, metabolism, and increased likelihood of underlying medical conditions or medication use that could interact with adrenal supplements.
• Limited specific studies in elderly populations; known increased sensitivity to hormonal fluctuations with age.

Individuals With Adrenal Conditions:

• Use only under medical supervision, if at all
• May interfere with treatment and monitoring of existing adrenal conditions. Potential for unpredictable effects in autoimmune adrenal disorders.
• Limited clinical studies; theoretical concerns based on known adrenal physiology and pharmacology.

Individuals With Cardiovascular Disease:

• Use with caution, preferably under medical supervision
• Adrenal hormones affect heart rate, blood pressure, and fluid balance. Even small changes may impact cardiovascular health in those with existing conditions.
• Limited specific studies; known effects of adrenal hormones on cardiovascular function.

Individuals With Psychiatric Conditions:

• Use with caution, preferably under medical supervision
• Adrenal hormones influence mood, anxiety, and stress response. May exacerbate certain psychiatric conditions or interfere with psychiatric medication effects.
• Limited specific studies; established connection between adrenal function and mental health.

Manufacturing Variability:

• Significant variations exist between products in terms of processing methods, source materials, and actual adrenal tissue content.
• Inconsistent potency may lead to unpredictable effects or dosing errors. Some products may contain more active adrenal hormones than others despite similar labeling.
• Choose products from reputable manufacturers with transparent quality control practices. Look for third-party testing certification.

Contamination Risks:

• As animal-derived products, adrenal glandulars carry potential risks of contamination with pathogens, heavy metals, or other substances.
• [“Prion diseases (e.g., BSE or ‘mad cow disease’) from bovine-sourced products”,”Bacterial contamination during processing”,”Heavy metal accumulation from source animals”,”Pesticide or drug residues from animal husbandry practices”]
• Select products that specify testing for contaminants and source animals from countries with strong regulatory oversight of animal husbandry.

Hormone Content Variability:

• The actual hormone content in over-the-counter glandular supplements can vary significantly between products and even between batches of the same product.
• Unpredictable hormone exposure may lead to adverse effects or treatment inconsistency.
• Choose products that provide information about hormone content testing or standardization processes.

Adulteration Concerns:

• Some products may be intentionally or unintentionally adulterated with pharmaceutical compounds to enhance perceived effectiveness.
• Addition of synthetic corticosteroids or stimulants that are not declared on the label.
• Purchase only from reputable manufacturers with good quality control practices and third-party testing.

Before Starting:

• Assessment of adrenal function through appropriate testing (morning cortisol, DHEA-S, etc.) to establish baseline
• Comprehensive health evaluation to identify any contraindications or special considerations
• Review of current medications for potential interactions
• Blood pressure measurement
• Basic metabolic panel including electrolytes and glucose

During Use:

Warning Signs Requiring Attention:

• Significant increase in blood pressure
• Heart palpitations or irregular heartbeat
• Severe anxiety, agitation, or mood changes
• Unusual fatigue or weakness
• Significant sleep disturbances
• Dizziness or lightheadedness
• Unusual swelling or fluid retention
• Significant digestive disturbances
• Signs of allergic reaction

Known Risks:

Unknown Risks:

• Long-term effects on HPA axis regulation
• Potential impacts on other endocrine systems over time
• Effects of chronic exposure to non-hormone adrenal components
• Long-term consequences of variable hormone exposure from inconsistent products
• Potential for development of antibodies to animal adrenal components

Risk Mitigation Strategies:

• Use the lowest effective dose
• Implement cycling protocols (e.g., 5 days on, 2 days off, or periodic breaks of 1-2 weeks every few months)
• Regular monitoring of adrenal function
• Physician supervision, particularly for long-term use
• Address underlying causes of adrenal stress rather than relying solely on supplementation
• Gradually taper dose when discontinuing after long-term use

Vs Prescription Adrenal Medications:

• Prescription adrenal medications generally offer more predictable safety profiles due to standardized hormone content and established clinical guidelines for use and monitoring.
• [“Prescription medications contain standardized, higher amounts of specific adrenal hormones with established safety profiles”,”Glandular supplements typically contain lower, variable hormone content but may include other bioactive components”,”Prescription medications are subject to stricter quality control and regulatory oversight”,”Glandular supplements may contain a broader spectrum of adrenal constituents with less predictable effects”,”Prescription medications have clear guidelines for monitoring and dose adjustment”]
• Diagnosed adrenal insufficiency requiring hormone replacement should be treated with prescription medications. Glandular supplements may be considered for mild support or as complementary therapy under medical supervision.

Vs Herbal Adaptogens:

• Herbal adaptogens (like ashwagandha, rhodiola, holy basil) generally have better established safety profiles for long-term use compared to adrenal glandulars.
• [“Adaptogens work primarily by modulating stress response systems rather than providing hormones or hormone precursors”,”Adaptogens typically have more research on long-term safety”,”Glandular supplements may provide more direct support but with potentially greater risk of hormonal effects”,”Adaptogens generally have fewer contraindications and drug interactions”]
• Adaptogens may be more appropriate for long-term stress support and prevention, while glandulars might be considered for shorter-term, more intensive support under appropriate supervision.

Between Animal Sources:

United States:

• Dietary supplement
• FDA regulates as food products, not drugs. Manufacturers are responsible for ensuring safety but pre-market approval is not required.
• Cannot make claims to diagnose, treat, cure, or prevent disease. Limited to structure/function claims.
• Must comply with dietary supplement Good Manufacturing Practices (GMPs) and adverse event reporting requirements.

International Variations:

• Generally regulated more strictly, often as medicinal products requiring authorization rather than as food supplements.
• Regulated as Natural Health Products, requiring pre-market authorization and product licenses with specific safety and efficacy evidence.
• Regulated as complementary medicines with requirements for listing or registration depending on ingredients and claims.

United States:

• FDA’s MedWatch program for voluntary reporting of adverse effects from supplements.
• www.fda.gov/medwatch or 1-800-FDA-1088
• Product name, manufacturer, lot number, symptoms experienced, timing of symptoms, other medications/supplements being taken.

Classification: Adrenal glandular supplements are typically regulated as Listed Complementary Medicines on the Australian Register of Therapeutic Goods (ARTG)., Must be listed on the ARTG before they can be legally marketed. Listing involves self-assessment against criteria rather than pre-market evaluation.

Permitted Indications: Can only make claims from a list of permitted indications approved by the Therapeutic Goods Administration (TGA). No specific indications for treating adrenal disorders are permitted for listed products., Must hold evidence to support any claims made, though this evidence is not evaluated before listing.

Quality Standards: Must be manufactured according to the PIC/S Guide to Good Manufacturing Practice., Ingredients must comply with standards in the British Pharmacopoeia, United States Pharmacopeia, or other recognized pharmacopoeias when applicable.

Animal Sourcing Regulations: Subject to strict controls on animal-derived ingredients, particularly for bovine-sourced materials, with requirements for documentation of country of origin and TSE/BSE risk minimization.

Classification: Depending on specific composition and claims, adrenal glandular supplements might be classified as either ‘Foods with Health Claims’ or ‘Quasi-drugs’., Requires approval from the Ministry of Health, Labour and Welfare before marketing, with different pathways depending on classification.

Market Presence: Limited availability compared to Western markets, with stricter regulation of animal-derived products and health claims.

Claim Restrictions: Very limited permitted health claims, with no claims related to adrenal hormone function or disorders allowed without drug approval.

Molecular Characteristics: Adrenal glandular supplements contain a complex mixture of proteins, peptides, potential trace hormones, and various nutrients. The stability of these components varies significantly, with proteins and peptides being particularly susceptible to degradation through various mechanisms. Adrenal hormones (if present in trace amounts) have varying stability profiles, with steroid hormones being relatively stable in solid form but catecholamines being more prone to degradation. The overall stability profile is influenced by the specific processing methods used and the resulting composition of the final product.

Degradation Pathways:

Degradation Products: Degradation can produce a variety of products including denatured proteins, peptide fragments, amino acids, oxidized derivatives, and various breakdown compounds. Some degradation products may retain partial biological activity, while others may be inactive or potentially reactive. The specific profile of degradation products depends on the initial composition and the conditions of storage and processing.

Natural Sources

Processing Methods

Commercial Forms

Quality Considerations

Sourcing Recommendations

Sustainability Considerations

Scientific evidence for adrenal glandular supplements is limited, consisting primarily of preclinical research, traditional use, and clinical experience rather than robust clinical trials. While the physiological importance of adrenal hormones and nutrients is well-established, research specifically examining the efficacy and safety of over-the-counter adrenal glandular supplements is sparse. Most available studies focus on prescription adrenal medications rather than glandular supplements. The limited evidence that does exist suggests potential benefits for supporting adrenal function in some contexts, particularly for stress-related fatigue and adrenal insufficiency symptoms, but is insufficient to make definitive claims about efficacy for specific conditions.

Quality research is particularly lacking regarding standardization, bioavailability of active components, and long-term outcomes.

Conventional Medical Perspective: Mainstream medical organizations generally do not recommend adrenal glandular supplements due to insufficient evidence, concerns about quality control, and availability of well-studied pharmaceutical alternatives for diagnosed adrenal conditions. The Endocrine Society does not recognize ‘adrenal fatigue’ as a medical diagnosis and does not endorse over-the-counter adrenal support supplements for treatment of adrenal disorders.

Integrative Medicine Perspective: Some integrative medicine practitioners utilize adrenal glandular supplements as part of comprehensive approaches to stress-related conditions, particularly for subclinical adrenal dysfunction or as complementary support alongside conventional treatment. The Institute for Functional Medicine acknowledges potential benefits while emphasizing individualized assessment and monitoring.

Research Community Perspective: Researchers generally acknowledge the limited evidence base while noting some promising preliminary findings that warrant further investigation. Consensus exists on the need for larger, longer, and more rigorous clinical trials.

Large-scale, long-term randomized controlled trials examining efficacy and safety, Studies with standardized, well-characterized glandular preparations, Research on bioavailability and pharmacokinetics of various adrenal glandular components, Comparative effectiveness research against other adrenal support approaches, Studies examining effects in specific populations (elderly, athletes, those with specific stress-related conditions), Research on optimal dosing and administration protocols, Investigation of potential synergistic effects with other nutrients or adaptogens, Long-term safety studies, particularly regarding effects on natural adrenal function, Research clarifying the clinical relevance of concepts like ‘adrenal fatigue’ and establishing standardized diagnostic criteria for stress-related adrenal dysfunction