Adrenal health. It’s a complex topic. Alternative health professionals often label vague miscellanea symptoms like fatigue, digestive complaints, achiness, sleep issues, etc., as “adrenal fatigue.”

However, “adrenal fatigue” as a diagnosis is not recognized by conventional medical standards (1). In fact, a systemic review concluded there is not enough evidence and too much variability to confirm the existence of such a disorder and concluded that “adrenal fatigue is still a myth” (2).

But such is the nature of science. New research suggests that a more fitting explanation of this panacea of symptoms classifies as “HPA axis dysfunction.” In a mathematical model of HPA axis function.

Researchers showed that the feedback nature of this system results in periods of growth and atrophy of the adrenal glands when exposed to prolonged stress rather than “fatigue” or “burnout” (3). The changes in adrenal mass and the subsequent changes to hormonal output and receptor function more appropriately elucidate the basis of “adrenal fatigue” and its symptoms.

Adrenal Cocktails – Clinically Validated?

Regardless of labels, there is certainly merit to clinical disruptions to adrenal hormones and the downstream effects they can cause. Many practitioners recommend an “adrenal cocktail” to restore balance to these issues. This is essentially a food-based approach that combines naturally rich sources of sodium, potassium, and vitamin C.

While there is no scientific basis for the use of “adrenal cocktails” in restoring HPA function, each of these nutrients is intimately involved in adrenal function, particularly via the hormone aldosterone.

Aldosterone

Aldosterone is a complex hormone secreted by the adrenal glands, which influences several metabolic pathways and systems. Its primary function is to retain sodium levels in the blood and excrete potassium in the urine via the kidneys.

Aldosterone is considered one of the “stress hormones” because it activates systems involved in the sympathetic (flight or flight) response. Major functions of aldosterone include:

  • Increases sodium retention and blood volume while simultaneously increasing urinary potassium excretion.
  • Increases blood pressure.
  • Activates sympathetic systems such as increasing heart rate, blood sugar/insulin levels, and alertness.

The concept of being a “stress hormone” might shed a negative light on this hormone, but its role in maintaining electrolyte balance is critical for life itself. This article reviews the intimate relationship between adrenal function, aldosterone, and potassium.

Potassium

The body maintains tightly controlled levels of potassium. Only 2% of total body potassium is in the serum (blood). The other 98% resides inside cells. It’s the most abundant intracellular cation in the body and is vital for maintaining life.

On the contrary, sodium is the most abundant extracellular mineral in the body. We can quickly begin to appreciate the role of aldosterone in regulating these two minerals for optimal cellular function. The intricate intracellular/extracellular balance of sodium and potassium is, by and large, how cellular functions take place and is at the basis of life itself.

Potassium is the quintessential ‘Goldilocks nutrient’. Too low levels (called hypokalemia), as well as too high levels (called hyperkalemia), can quickly become life-threatening. Thus, the body has several systems to keep ranges in check (4).

The potassium we eat from food is rapidly absorbed and could easily reach life-threatening levels if not for intelligent compensation.

  • The increase in blood sugar and insulin with eating causes a large portion of serum potassium to be taken into cells (5).
  • The rise in serum potassium levels stimulates aldosterone secretion, signaling the kidneys to pull potassium out of the blood (6).
  • The net result is balanced blood potassium levels.

Research findings suggest that aldosterone and potassium counterbalance one another. One study found that potassium supplementation in hypertensive men reduced blood pressure and other cardiovascular hemodynamics despite the increase in aldosterone (7).

The opposing effect of aldosterone and potassium seems to be important, especially in restoring balance to other minerals. While it has not been extensively explored in research (8), there are many anecdotal reports of magnesium supplementation causing symptoms like heart palpitations, sleep disruptions, and hyperactivity. This may, in part, be due to the fact that magnesium suppresses aldosterone (9, 10).

Low aldosterone production as a result of magnesium supplementation may prevent the body from efficiently balancing serum potassium levels in some people (11). Interestingly, high aldosterone has also been shown to result in magnesium deficiency (12, 13). Thus indicating a potential hierarchy in mineral maintenance. Restoring potassium balance first might best support people with more severe HPA axis dysregulation.

Supplements or food?

If you’re following a healthy diet rich in whole foods and responsibly raised animal products, you may be meeting the RDA of potassium intake. The RDA was previously 4,700 mg/d. The NIH has since reduced the number to 3,600mg/day for men and 2,600mg/day for women.

This change was likely due to the difficulty of achieving 4,700mg/day from food, as most were not meeting it. Thus, this should still be considered the ideal intake level for supporting optimal health. Supplementation is often required for most people to achieve this intake, but It is very important to note that supplemental potassium intake should be modest.

High doses of potassium cause gastrointestinal issues. The NIH suggests that supplements should not contain more than 99mg per capsule/tablet (4). This is based on studies from the 1960s linking potassium chloride present in medications to ulcers (14). This has not been observed with other forms of potassium supplements.

Nonetheless, starting low and slow is the best way to restore intracellular and extracellular potassium balance. Given the rapid spike in serum potassium that happens with food and the increase in aldosterone that accompanies this, lower supplemental levels have proven most beneficial for the majority of people (15, 16). This is especially important in people with kidney disease, as impaired excretion of potassium can cause hyperkalemia with supplementation, which can be life-threatening (4).

Solutions for Restoring HPA-axis Function

Regardless of the cause of adrenal imbalance – HPA-axis dysfunction, primary or secondary adrenal insufficiency, it poses an issue for health.

Hyperaldosteronemia, such as what occurs during the prolonged high-stress phase that initiates HPA-axis dysfunction or Cushing’s disease, can result in hypokalemia (low potassium) and hypernatremia (high sodium) (3). Both of which pose health risks

Adrenal insufficiency, whether primary or secondary or such as in the later phase of HPA-axis dysfunction, can result in hyponatremia and hyperkalemia as a result of chronically low aldosterone (17). Restoring HPA-axis function via normalizing adrenal mass and receptor function is vital to balancing health.

This is why our Whole C IQ contains both sodium from Celtic sea salt and a modest amount of potassium bicarbonate to support healthy aldosterone production and cellular electrolyte balance. The whole-food-based vitamin C packs dual benefits in that vitamin C itself is essential for both adrenal tissues and hormones (18) and for regulating aldosterone (19). The amla fruit that supplies vitamin C is also an adaptogen, which has been shown in thousands of studies to support the HPA axis (20).