Condition
Hypoadrenalism
Hypoadrenalism, or adrenal insufficiency, happens when the adrenal glands make too little cortisol, because they are damaged (Addison's disease) or because the pituitary sends too little ACTH to switch them on. Among supplements, DHEA and salt have the strongest support, both moderate, though one small DHEA trial found no clear difference in body fat. Diagnosis stands on firmer ground: a cosyntropin test detected primary cases with about 97% sensitivity.
- Supplements studied
- 1
- Medicines and peptides
- 1
- Graded outcomes
- 5
- Trials
- 1
- People studied
- 20
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Body Fat No effect | NoneNo effect | 20 people | ||||
| Testosterone | Improves (the measure goes up) | 3 studies | 40 people | |||
Studies that measured testosterone
| ||||||
| Serum DHEA | Improves (the measure goes up) | 2 studies | 20 people | |||
| Growth Hormone | Improves (the measure goes up) | 1 study | 20 people | |||
Studies that measured growth hormone | ||||||
| IGF-1 | Improves (the measure goes up) | 1 study | 20 people | |||
| Glycemic Control | Improves (the measure goes up) | 20 people | ||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 20 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 20 people | ||||
| Serum T3 | Improves (the measure goes up) | 20 people | ||||
| Total cholesterol | Improves (the measure goes down) | 20 people | ||||
Prescription medicines and peptides studied, for context
Cosyntropin (Cortrosyn/Synacthen)
- Cortisol Stimulation: changes; see studies
- Safety Profile: improves
- Diagnostic Sensitivity (Primary AI): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cortisol Stimulation Normal response: cortisol ≥18 mcg/dL (500 nmol/L) at 30-60 minutes. Reliable stimulation of adrenal cortex in healthy individuals. | Changes; see studies | Large effect | 10 studies | |||
| Safety Profile Less immunogenic than natural ACTH. Rare hypersensitivity reactions. Well-tolerated diagnostic procedure used for decades. | Improves (the measure goes up) | Large effect | 7 studies | |||
| Diagnostic Sensitivity (Primary AI) 97% sensitivity at 95% specificity for primary adrenal insufficiency. Meta-analysis of multiple studies confirms high diagnostic accuracy. | Improves (the measure goes up) | Large effect | 6 studies | |||
| Diagnostic Accuracy (Secondary AI) 57-61% sensitivity for secondary AI. Better for ruling in than ruling out. Low-dose (1mcg) may be superior (AUC 0.94 vs 0.85). | Improves (the measure goes up) | Moderate effect | 6 studies |
Key findings
- Body Fat
The Hypoadrenalism (Adrenal Insufficiency) Supportive Care protocol
2 primary supplements · 6 supporting supplements
- Vitamin C500–1,000 mg daily in divided doses
- Vitamin B5 (Pantothenic Acid)500–1,000 mg daily
Studies cited
18 studies from PubMed
- Examining aldosterone plasma concentration alterations post-ACTH stimulation in healthy subjects: a systematic literature review and meta-analysis on ACTH's role in aldosterone secretion.
- Cortisol levels in blood and hair of unanesthetized grizzly bears (Ursus arctos) following intravenous cosyntropin injection.
- Cosyntropin for the Treatment of Refractory Postdural Puncture Headache in Pediatric Patients: A Retrospective Review.
- Pitfalls in the interpretation of the cosyntropin stimulation test for the diagnosis of adrenal insufficiency
- ACTH Stimulation Tests for the Diagnosis of Adrenal Insufficiency: Systematic Review and Meta-Analysis
- Is the cosyntropin test redundant in the acutely ill patient suspected of adrenal insufficiency? A case report and literature review.
- Normal hypothalamic-pituitary-adrenal axis by high-dose cosyntropin testing in patients with abnormal response to low-dose cosyntropin stimulation: a retrospective review.
- A dose-response and meta-analysis of dehydroepiandrosterone (DHEA) supplementation on testosterone levels: perinatal prediction of randomized clinical trials.
- Androgens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiency
- Effects of dehydroepiandrosterone (DHEA) supplementation on hormonal, metabolic and behavioral status in patients with hypoadrenalism
- Effects of dehydroepiandrosterone supplementation on cognitive function and activities of daily living in older women with mild to moderate cognitive impairment
- Effect of acute DHEA administration on free testosterone in middle-aged and young men following high-intensity interval training
- Lack of dehydroepiandrosterone effect on a combined endurance and resistance exercise program in postmenopausal women
- Effects of dehydroepiandrosterone vs androstenedione supplementation in men
- Effects of a betaine-containing toothpaste on subjective symptoms of dry mouth: a randomized clinical trial
- Betaine-containing toothpaste relieves subjective symptoms of dry mouth
- Safety and effectiveness of topical dry mouth products containing olive oil, betaine, and xylitol in reducing xerostomia for polypharmacy-induced dry mouth
- Evaluation of the clinical efficacy of a betaine-containing mouthwash and an intraoral device for the treatment of dry mouth