Advanced Clinical Herbalism: The Endocrine System
Introduction to the Endocrine System
Our final organ system to be covered in this course is the endocrine system, which is likely
one of the most complex systems of the body- for here we are dealing with the vast network of
communication amongst hormones. In general, the body communicates via 2 different
mechanisms, the electrical impulses through the nerves and with hormones, both are vitally
important for optimal physiological and psychological functioning.
Endocrine balance has been a major focus in the natural health and products industry over the
last number of decades and is often seen as the root cause of all of our problems. While likely
not the root cause of all of our problems, it is shocking to see the radical shift in our endocrine
function as a species and the ill impacts it has on our health. The question is, is the endocrine
imbalance the cause of all the problems, or is it simply a byproduct of something much deeper,
much more invisible that is happening?
A majority of the issues concerning the proper function of our hormonal system lies in
environmental toxins and simply the stresses of modern life. Everything from xenoestrogens
found lining plastic water bottles, radiation fallout affecting thyroid function and living in a
vata deranged culture that places high value on intellectual development, fast paced lifestyle,
working hard, and burning the candle at both ends- we see that the endocrine system is often
the brunt of these subtle attacks upon the human organism.
As I said, the endocrine system is really complex, one can go pretty deep down the rabbit hole
and get all spun around in various metabolic pathways of synthesis, transformation and
excretion of these hormonal pathways. My goal with this lesson if to give you straightforward
teachings that help to define the structure and function of the various endocrine glands, their
corresponding hormones, the underlying energetics behind these systems, and some of the
common symptomatic pictures and conditions associated with them. Along with of course,
some materia medica. My major focus will be on the hypothalamus, thyroid, pancreas, and
adrenal glands- we already covered the sex glands under the male and female reproductive
system.
A major focus of this lesson is on the holistic treatment of chronic fatigue, as that is a major
issue many people deal with these days, as well as talking about adaptogens- since they are all
the talk of the town these days in the industry and everyone thinks they need to load up on
adaptogens to get healthy and live forever. By the end of this lesson you will see why that is an
“herban” myth and may actually make people feel worse.
There’s a lot here... enjoy =)
The Physical System
• Anatomy and Physiology: The main elements of the endocrine system include the various
glands of the body, as well as the hormones they manufacture and secrete. Glands in general
are organs which are secretory, the 2 primary types of which are exocrine glands which
secrete non-hormonal substances which leave the body, such as sweat glands, sebaceous
glands, salivary glands, and the gall bladder. These are glands which have ducts. The other
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Advanced Clinical Herbalism: The Endocrine System
are the endocrine glands, also called ductless glands, secrete hormones which remain inside
the body.
As mentioned above, the endocrine system forms one half of the bodies intricate methods of
communication. It achieves this end through the secretion of hormones from various glands,
which includes the hypothalamus, pituitary, pineal, thyroid, thymus, adrenals, pancreas,
testes, and ovaries. These are the bodies primary endocrine glands, because their primary
purpose is secreting hormones, but other organs secrete hormones as well, such as the heart
and kidneys. These hormones travel throughout the bloodstream until they reach their
targeted tissue site, where they bind to a particular type of receptor which accepts its signal.
This leads to specific chemical and physical alterations in the activity of the cells.
There are also other tissues and organs which produce hormones, but are not considered
endocrine glands per se. A few of these include adipose (fat) tissue, the small intestine,
stomach, kidneys and heart.
The nervous system forms the other half of this communication network, with
neurotransmitters being similar to hormones, though they reside specifically within the
nervous tissues and only communicate from the axon of one neuron to the dendrite or cell
body of the next. Together, the nervous and endocrine systems form a core regulatory
wholeness that governs much of our bodies physiological activity. Matthew Wood likes to add
to this the immune system, whose function is also to regulate and balance the internal
environment with the external- which the hormonal and nervous systems do as well.
It is often taught that the endocrine system functions as a sort of cascade, starting from the top
and moving down. It all begins with the hypothalamus, the “master gland” of the body, which
is constantly monitoring various elements of the body such as temperature, the quality of the
blood, immunological activity etc. It then sends it signals to the pituitary gland, which is like
the helper of the hypothalamus, the messenger, which sends the appropriate signals to the rest
of the system: kidneys, ovaries, testes, adrenals, thyroid and heart- the last of which is said to
be the center of the system which acts as a sort of medium. Obviously we see the thyroid and
adrenals have an especially powerful impact upon the heart. Below lists the different organs of
the endocrine system, their primary hormones and physiological functions.
• Hormones: Hormones are defined as chemical substances secreted by various cells into the
extracellular fluids, blood, and lymphatic system which travel long distances in the body to
regulate the metabolic function of other cells in the body. The two primary categories of
hormones are based on their base chemical structures- either from amino acids or steroidsmost of which are amino acid based. Amino acid based hormones are formed from amino
acid derivatives from dietary protein, whereas the steroid hormones are synthesized from
cholesterol. The only steroid hormones produced by major endocrine organs are the sex
hormones and adrenocortical hormones. Some others also include the eicosanoids, which
include the prostaglandin molecules responsible for inflammation. But these typically affect
local tissues near where they are secreted and don’t technically fit the textbook definition of
a hormone, which travel longer distances. In general, amino acid hormones are water
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Advanced Clinical Herbalism: The Endocrine System
soluble and act on the cellular membrane (except thyroid hormones), whereas steroid
hormones are fat/oil soluble and act within the intercellular space.
Hormones function through their binding to specific target cells. There are particular
receptors that fit those precise hormones, which have a specific predetermined effect. Some
target cells and receptors are located on specific tissues where that hormone has an affect- for
example ACTH only bind to receptors found on the adrenal cortex, whereas thyroid hormone
(T3) have receptors on every cell in the body, so it can generate the basal metabolic rate of the
cells. In this way, hormones act as molecular triggers, turning on and off specific cellular
functions. The effect of a hormone is dependent on 3 factors: 1) blood levels of the hormone,
2) the number of receptors for that hormone on the target site, and 3) the strength or affinity
of the bonding between the hormone and receptor. Receptors can alter in numbers, increasing
in number, called up-regulation, when there are rising blood levels of a particular hormone,
or become non-receptive, or down-regulate, when there is excessive exposure to a hormone
(like what happens in Type II Diabetes).
Hormones are generally signaled to release via three mechanisms: 1) humoral stimuli are
based on the constant monitoring of fluid levels of certain hormones, nutrients, etc. 2) neural
stimuli derive from impulses form the nervous system, like the stress response, and 3)
hormonal stimuli, likely the most common, means that certain hormones trigger the release of
other hormones, which we see being a main function of the hypothalamus-pituitary dynamic,
explored in detail below. This latter step is mediated by feedback-loop mechanisms, whereby
the blood is screened for relative amounts of certain hormones, and once they reach an ideal
state, a signal is sent to turn off the signal that triggered their release. In this way, the
endocrine core functions in cycles and loops.
• Hypothalamus: As mentioned above, the hypothalamus is commonly referred to as the
“master gland” of the body, who has a constant pulse on the internal state of the body,
primarily via screening the blood. It is located in the middle of the brain. It’s job is to
maintain that bodies dynamic state of homeostasis through various physiological
adjustments that it achieves through hormones as well as the nervous system. Some of it’s
primary functions include: adjusting internal temperature and the peripheral venting system
(pores of the skin), circulation of the blood to the surface or to the core, shivering, sweating,
fever, hunger and thirst. We can simply think of the 3 primary things needing balance in the
body as heat (sulfur), fluids (mercury) and electrolytes (salt). We can think of the
hypothalamus as sitting in the control tower with a birds eye view on the body, as well as its
external environment, in this way it functions to “govern the periphery” to quote Matthew
Wood. This can be likened to our physiological shield, which helps us maintain homeostasis
with our surroundings. The peripheral venting system is what is shifted during a fever, and
was a primary focus of traditional systems of medicine- a truly holistic approach- rather than
just being focused on killing a virus or a bacteria.
It also signals thinking and emotional regions of the brain that tell us to adjust ourselves to
maintain balance with the environment- such as thinking “it’s cold outside, I need a coat and
scarf.” We see it impacting both branches of the ANS- initiating shivering, shunting blood
flow and opening the pores of the skin via the sympathetic branch, which is also shown that
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Advanced Clinical Herbalism: The Endocrine System
when we get scared or nervous we start to shake and sweat. “Though it does not generate
emotions, the hypothalamus reinforces them with autonomic intensity. Thus, when emotions
are especially intense they are accompanied by shivering, pallor, blushing, sweating,
etc.” (Matthew Wood)
Because the blood is constantly being monitored by the hypothalamus, when there is an
excessive amount of toxins, metabolic waste products, or artificial hormones (xenoestrogens
for example) it gets “confused” and starts to secrete inappropriately. Thus our damp/
stagnation tissue state can actually lead to a degree of endocrine imbalance.
Matthew Wood also makes a very interesting observation on how traditional systems
medicine were aware of hypothalamic functioning, even though they likely didn’t know about
the little gland in the brain itself. The first is Samuel Thomson’s analogy of the “fountain of
life” and how the vital force and health is the radiation of the heat from the core out to the
periphery and that the body has developed mechanisms to maintain that regulation of
temperature. If it is deficient at the core, the fountain will not flow outwards with any force. If
something enters from the outside it can divert or block that flow. This is why he liked
diaphoretics so much. The other one Matthew discusses is the concept of the heart protector
in Chinese Medicine, or the pericardium, whose function is to protect the heart from
emotional intensity and invasion from external heat or cold- though primarily heat. Both of
these are achieved through the hypothalamus.
• Pituitary: I like to think of the pituitary gland as the “right hand man” of the hypothalamus,
it’s function being to receive the messages from the master gland (via hormones) and then to
send it’s own messages out to the rest of the physiology to enact the appropriate changes
that are needed. It’s as if the hypothalamus is preoccupied monitoring the entire system that
it can manufacture and release all of the hormones required- it needs a helper, which is the
pituitary.
This gland is divided into 2 primary lobes, which are called the anterior pituitary and the
posterior pituitary, named for their positions in relation to one another. For all intensive
purposes, they can really be seen as two completely different glands, for they have very
different functions and hormones that they communicate with. Let’s look at each of these
lobes and their primary hormones they work with.
• Anterior Pituitary: This lobe is located closer to the front of the body, which the word
anterior indicates. It secretes 5 basic hormones, 3 of which regulate primary endocrine
glands: thyroid, adrenal, and the gonads. These are variously referred to as the HPT
(Hypothalamic Pituitary Thyroid), HPA (Hypothalamic Pituitary Adrenal), and HPG
(Hypothalamic Pituitary Gonad) axes. The fourth hormone is HGH, or Human Growth
Hormone and the fifth is Prolactin, which stimulates lactation in women post childbirth.
Let’s look at these hormones in a bit more detail.
• Thyroid Stimulating Hormone (TSH): Also called thyrotropin, this hormone is released
by the anterior pituitary which binds to receptors on the thyroid gland signaling it to
produce it’s primary hormone called Thyroxine, which manifests in two forms called T3
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Advanced Clinical Herbalism: The Endocrine System
and T4. If the pituitary is deficient in it’s secretions of TSH, the thyroid will be low in
functioning and result in hypothyroidism. It is triggered into secretion by release of
hypothalamic Thyrotropin-Releasing Hormone (TRH).
• Adrenocorticotropic Hormone(ACTH): Also called, ACTH is specific for the adrenal
cortex, signaling them to manufacture and release glucocorticoid hormones (called
corticosteroid hormones). These are primarily cortisone and cortisol, which are
primarily anti-inflammatory in their actions and are used to balance the other side of the
adrenal function- described later. This is triggered by hypothalamic release of
Corticotropin-Releasing Hormone (CRH). This hormone has a daily rhythm, being
released in the morning shortly before waking. When the levels rise high enough, it has a
feedback loop and shuts down CRH and ACTH from secreting more.
• Human Growth Hormone (HGH): Also called somatotropin, this hormone is
responsible (as the name implies) for the development and maturation of our physical
body, as well as the regrowth of damaged tissues. It alters the protein and sugars in the
blood in order to nourish and feed the tissues, and interacts with the pancreas, skeletal
system, adipocytes, and carbohydrate metabolism. It does this primarily through
stimulating substances called Insulin-like Growth Factors (IGF’s). It is triggered and
inhibited by 2 hypothalamic hormones: stimulated by GHRH (Growth Hormone
Releasing Hormone) and inhibited by GHIH (Growth Hormone Inhibiting Hormone,
AKA somatostatin).
• Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH): These were
discussed for fully under the male and female reproductive systems. Essentially these are
gonadotropins which stimulate the reproductive system into maturity- primarily the
ovaries and testes. These also have an affinity for the adrenal glands, as they also
manufacture sex hormones.
• Prolactin: After childbirth, prolactin is secreted in order to stimulate the breasts to
produce milk to nourish the infant. It is triggered through the radical decrease in
estrogen and progesterone after removal of the placenta, suckling of the infant, as well as
psychological inputs (IE mothering instinct). When prolactin levels are high the rest of
the anterior pituitary hormones are low, which is an important factor in this gland. The
function of Prolactin in males is largely unknown.
• ACTH, FSH, LH, and TSH are all called tropins or tropic hormones, meaning that
they serve to stimulate other endocrine glands to release hormones.
• Posterior Pituitary: The posterior pituitary works with 2 primary hormones which have
radically different physiological effects than those secreted by the anterior pituitary. These
are vasopressin, or anti-diuretic hormone (ADH) and oxytocin.
• Anti-Diuretic Hormone (ADH) or Vasopressin: This hormone is manufactured in the
hypothalamus and stored in the pituitary for release. It’s function is to signal the kidneys
to reabsorb fluids and minerals back into the body- thus it is anti-diuretic. In this way
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Advanced Clinical Herbalism: The Endocrine System
the urine is able to concentrate much more readily and the body will be much more
prone to fluid retention. This is due to the influence of retained potassium. ADH is
released in response to excess dissolve solutes in the blood, low blood pressure, pain, and
drugs such as nicotine, morphine and barbiturates. Inhibition of ADH is caused by
excess alcohol and water intake, and diuretic drugs- (perhaps diuretic plants too?) A
deficiency is an aspect of diabetes, where there is copious urine release and extreme
thirst.
• Oxytocin: This interesting little hormone is called the “bonding hormone.” It is primarily
secreted during orgasm, childbirth, and uterine contractions during menstruation, it has
a contractive effect on smooth muscles, primarily in the breasts and uterus. It is said to
open the heart and create a sense of connection and bonding with ones partner during
orgasm, with the baby at delivery, as well as the good feelings associated with simple
social bonding. It is also indirectly suppressive to the secretions of ACTH (fight/flight,
cortisol response). The heart is quite sensitive to oxytocin and some say that it is actually
secreted by the heart as well, which would indicate why during those moments
(typically) ones heart feels open. This could also be the sensations we are receiving
during heart perception with plants and the merging of human and plant consciousness.
• Pineal: The pineal gland is a small pine cone shaped gland (hence it’s name) located in the
center of the brain. Much of the pineals endocrine function is a mystery because it is located
so deep in the brain, making analysis of it quite difficult. What we do know about it, is that
it secretes the hormone melatonin, which induces sleepiness that prepares the body to go to
bed. What’s fascinating about it, is that secretion of melatonin is dependent on our exposure
to light- meaning that it is suppressed when our eyes perceive light and it is secreted when it
is dark. This is why artificial lighting can disturb our sleep rhythms dramatically. Melatonin
is an amine hormone, synthesized from the amino acid tryptophan, which has a tryptamine
base similar to that of the neurotransmitter serotonin.
The other theorized compound produced in the pineal gland is Dimethyltryptamine (DMT),
one of the most universal and powerful psychotropic compounds found in nature. The theory
is that this “spirit molecule” is secreted from the pineal during experiences of ecstasy, mystical
illumination, near death experiences, astral projection, lucid dreaming, and UFO abduction
experiences. In many traditional esoteric and spiritual traditions, the pineal gland is related to
the 3rd eye (Ajna chakra) which represents the spiritual reality, visionary states of
consciousness, and in short, the “light at the end of the tunnel.” I find it quite interesting that
we all contain one of the most potent psychotropic compounds endogenously in our body, all
the time. Terrence McKenna theorized that in the evolution of consciousness, DMT will
gradually replace serotonin as a primary neurotransmitter opening up our consciousness to
other realities separate, but a part of, our physical one. The spiritual eye so to speak.
• Thyroid: The thyroid gland is a butterfly shaped gland located in the throat on the trachea
beneath the larynx. There are 2 cell types in the thyroid: follicle cells produce thyroglobulin
which attaches to iodine to form thyroid hormones, and parafollicular cells which produce
calcitonin. These 2 cell types and the hormones they produce have radically different
physiological functions, the first is to set the basal metabolic rate, and the second is the
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Advanced Clinical Herbalism: The Endocrine System
regulation of calcium metabolism. The former is stimulated by pituitary secretions of TSH,
which trigger the thyroid to manufacture and secrete thyroxine in the form of T4, which in
transformed into the more bioactive T3. Some also say that the thyroid secretes excess
iodine to help cleanse the blood, especially the blood entering the brain, as the gland is
juxtaposed next to the carotid arteries which feed the brain.
• Thyroid Hormone (TH): There are 2 primary forms of TH, thyroxine is called T4 and
triiodothyronine is T3, the latter being considered the more active form of TH. Most T4
is transformed into T3 at the target cells. This hormone impacts almost every cell in the
body, except the brain, spleen, testes, uterus and the thyroid gland. This is likely one of
the most important hormones in the body, for it sets the basal metabolic rate, which
determines how fast or slow the body metabolizes substances, nutrients and waste
products- remember metabolism is composed of anabolism (building up) and catabolism
(breaking down), the metabolic rate determines at what speed our body does this. This is
achieved by TH stimulating enzymes that regulate the oxidation of glucose which
increases our metabolic rate and heat production, as well as increases the number of
adrenergic receptors which impacts blood pressure. TH is an amalgamation of the amino
acid tyrosine and iodine minerals, each tyrosine holding 2 iodine molecules. 1 iodine
attached to tyrosine is T1, 2 iodines is T2, 2 tyrosines and 3 iodines is T3, and 2 tyrosines
and 4 iodines is T4- T3 and T4 are formed by coupling together T1’s and T2’s.
• Calcitonin: The second hormone generated by the thyroid is responsible for lowering
blood calcium levels when they become too high. This is an antagonistic effect of the
parathyroid hormone which is designed to raise blood calcium levels when they are too
low. It does this through 2 major mechanisms, the first is by inhibiting osteoclasts (cells
that break up bone) and inhibiting calcium from being released by the bone, and the
second is by promoting uptake of calcium into the mineral matrix of the bones.
• Parathyroid: There are 4 little parathyroid glands that rest alongside the thyroid, though
some people have more or less than 4. These little glands have a very straightforward
function which operates in nice juxtaposition to that of calcitonin release by the thyroid- in
fact, they are mutually antagonistic and balance on another. It main known function is the
secretion of Parathyroid Hormone (PTH) or parathormone.
• Parathyroid Hormone (PTH): This hormone sole function is to maintain the calcium
balance of the blood by increasing it’s levels. It is triggered to be released when blood
calcium levels drop below optimal levels. PTH acts upon 3 primary organs to effectively
raise calcium levels back to normal: the skeletal system, the intestinal tract, and the
kidneys. In the bones, it triggers osteoclasts to leech calcium from the bones and send it
into the blood, in the kidneys it triggers resorption of calcium, and in the digestive
system it increases its absorption through the intestinal lining. This latter action is highly
dependent upon Vitamin D, which is essential for optimal Ca absorption and
interestingly enough, PTH stimulates the conversion of Vitamin D into it’s active form
D3- which is done in the kidneys.
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Advanced Clinical Herbalism: The Endocrine System
• Adrenals: We now come to the famous (or infamous depending on how you look at it)
adrenal glands. As the name implies, ad-renal, means above the kidneys. These 2 upward
facing triangular shaped glands sit just on top of the kidneys, though have a very different
function than the kidneys themselves- I think of this pairing of organs is like the primal Fire
and Water of the body. Like the pituitary gland, each adrenal is like 2 endocrine organs in 1,
though where the pituitary has 2 lobes (anterior and posterior) the adrenals have an inner
and outer layer- called the medulla and cortex- respectively (I like to remember that the
medulla is in the middle). Because these 2 sides of the adrenals have such different
functions, I will describe them separately below. The adrenals primary function is to help
the body to cope with stress. From a medical perspective, stress isn’t just the feeling of stress
as we commonly use the word, but rather any shifting of physiology away from homeostasis.
This could be due to excess or lack of food, immunosuppression or excess immunity,
inflammation, exercise, too much or too little of something etc.
• Adrenal Cortex: The adrenal cortex forms the bulk of these little organs and manufactures
over 24 different steroid hormones using the base structure of cholesterol. These hormones
are collectively called corticosteroids, and because they are fat soluble, we find that the
adrenal cortex is rich in adipose tissue. There are 3 different layers of the adrenal cortex,
which produce 3 different types of hormones: 1) the zona glomerulosa produces
mineralcorticoids which maintain solid/liquid balance in the body, 2) the zona fasciculata
produces glucocorticoids and 3) the zona reticularis produces gonadocorticoids, or sex
hormones. Note there are many different types of hormones in each of these categories, so
for all intensive purposes we will look at the main categories of them and their functions.
• Mineralcorticoids: This class of hormones function to regulate the balance of fluids and
solids, primarily the electrolytes sodium (Na) and potassium (K). Na is the most
abundant electrolyte mineral within the extracellular fluids and is vitally important for
healthy cellular functioning, though in excess it can lead to fluid retention and high
blood pressure. The most common mineralcorticoid ((95% of all of them made) is
aldosterone, which functions to increase Na within the system. It achieves this by
stimulating the kidneys to reabsorb Na from the urine along with water, and to increase
secretion of K. This effectively increases blood pressure and blood volume. It is triggered
to release by different mechanisms: 1) decreased Na and increased K in the blood, 2)
decreased blood volume or blood pressure, 3) stress response received from the
hypothalamus, releasing CRH, triggering the pituitary to secrete ACTH to stimulate the
adrenal cortex. Increased K directly stimulates it, but decreased blood volume or
pressure signals the kidneys to secrete renin, which ultimately turns into angiotensin II
which triggers aldosterone release. It is inhibited directly by a hormone secreted by the
heart called Atrial Neural Peptide (ANP) which is secreted when blood pressure or
blood volume get too high. The effects of aldosterone are brief- about 20 minutes. Thus
the mineralcorticoids have a powerful impact upon the cardiovascular system, and we
actually see local secretion of aldosterone by cardiovascular organs. The MC pathway
we see the immune response, liver and kidney functions are heightened, and it generally
produces the pitta constitution.
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Advanced Clinical Herbalism: The Endocrine System
• Glucocorticoids: This class of hormones are often the ones that get all of the attention in
the health industry these days because they influence the bodies energy metabolism and
help us to resist adverse effects of stress. As the name implies, they assist the body to
maintain blood sugar levels (glucose) and maintain blood pressure through their impact
on the neuromuscular juncture of the vasculature, mainly through constriction. The 3
primary glucocorticoid hormones are cortisol, cortisone, and corticosterone, although
the only one secreted in significant amounts is cortisol- thus that is what we will focus on
here. These are triggered to be released by CRH from the hypothalamus, and ACTH
from the pituitary- as cortisol levels rise they have a negative feedback action on these
glands which turns off their secretions so cortisol levels can lower. It tends to peak in the
morning just before rising, and steadily declines towards the evening before we go to
sleep.
An important point here is that the sympathetic nervous system can override cortisol’s
inhibitory effect on the hypothalamus and pituitary and stimulate more cortisol to be released
under periods of acute stress. Cortisol has a handful of major physiological impacts, such as:
triggering gluconeogenesis which generates glucose from fats and proteins (as under stress we
need lots of sugars for the brain and muscles to fight or flee, raises blood sugar), and increases
vasoconstriction via enhancing epinephrines effects thus increasing blood pressure.
Additionally, it is our bodies primary endogenous anti-inflammatory compound- thus
chronic systemic inflammation increases cortisol dramatically. It also suppresses the immune
system, depresses cartilage and bone formation, and prevents vasodilation (effects of
digestion, liver, metabolism, blood pressure etc.).
• Gonadocorticoids: These are essentially sex hormones which are also produced in either
the ovaries in females and the testes in men. The adrenal cortex produces weak
androgens, primarily in the form of androstenedione and DHEA, which are converted
into testosterone and estrogen.
• Adrenal Medulla: The adrenal medulla is not so much like an endocrine gland actually, but
rather a bundle of nerve fibers which are directly tied into the sympathetic branch of the
autonomic nervous system. Its chromaffin cells are modified neurons that produce the
sympathetic neurotransmitter hormones of the catecholamine structure, principally
epinephrine and norepinephrine (also known as adrenalin and noradrenalin, respectively).
• Epinephrine/Norepinephrine: These are released when the body enters the fight, flight
or freeze stress response, triggering a cascade of physiological effects, primarily
activating the sympathetic nervous system, which raises blood sugar levels, increases
heart rate, constricts blood vessels, raises blood pressure, dilates the bronchioles (to get
more oxygen) and diverts blood flow from the digestive organs to the peripheryprimarily the brain and skeletal muscles. The adrenal medulla stores primarily
epinephrine, at 80%, and lower amounts of norepinephrine (20%)- for all intensive
purposes they have the same physiological effects. Norepinephrine is a more potent
impact on peripheral vasoconstriction, whereas epinephrine exerts a stronger influence
on bronchiole dilation, increasing metabolism, and increasing blood flow to skeletal
muscles. Unlike the adrenal cortex hormones, these catecholamines have a much shorter
duration of effects, primarily because they are working through the nervous system as
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Advanced Clinical Herbalism: The Endocrine System
neurotransmitters, whereas the glucocorticoids and mineralcorticoids have a longer
lasting effect. These hormones are derived originally from the amino acid tyrosine in the
following pathway: Tyrosine-->L-Dopa-->Dopamine-->Norepinephrine->Epinephrine. This metabolic pathway is mediated by different enzymes which are
necessary for these transformations to take place.
• Pancreas: This triangular shaped organ is located behind the stomach and is both an
endocrine and exocrine organ, meaning that it secretes both hormones as well as digestive
fluids that leave the body. The pancreas is unique in that it is not under direct influence of
the “higher ups” of the endocrine cascade (hypothalamus/pituitary), but is rather connected
primarily to the digestive system and is responsible for the regulation, distribution and
storage of blood sugar. That being said, it is influenced by secretions of other endocrine
glands, primarily the adrenals. It is the organ that is the most sensitive to the foods we eat,
as it has the capacity to read the quality of nutrients in the food, and secrete the appropriate
enzymes to digest them. Pancreatic hormones are produced by cellular clusters called the
Islets of Langerhans, which produce glucagon (alpha cells) and insulin (beta cells). These
hormones represent a polarity in terms of energy storage in the form of sugar and are highly
sensitive to the bodies blood sugar levels and detects when we are fed or fasting.
• Glucagon: This hormone is responsible for elevating blood sugar levels by signaling the
liver to metabolize glycogen into glucose where it is sent into the blood stream when
blood sugar is low. It also creates glucose from proteins and fats, a process mentioned
above called gluconeogenesis (literally “generate new glucose”), which also occurs
during secretion of cortisol from the adrenal cortex. This process is also stimulated
during sympathetic nervous system activation, as blood sugar is greatly needed in such a
state. Glucagon is suppressed when blood sugar levels are high, when insulin is detected
in the blood, and by somatostatin release from the pituitary (also known as GHIHGrowth Hormone Inhibiting Hormone). This latter hormone suppresses gastric
secretions and somatotropin (HGH) release.
Glucagon is directly tied in to cortisol levels, which makes the liver more receptive to the
glucagon signal. Thus, those who have low cortisol levels from “burning out their adrenals”
tend to have hypoglycemic drops in between meals since they are not able to maintain
adequate levels of blood sugar via glucagon’s action. This is often accompanied by
carbohydrate cravings in order to feed the body with sugars more consistently- not an ideal
method, as it can lead to an excess of insulin and lead to insulin resistance and ultimately Type
II Diabetes. This should make sense, as when the body is under stress it needs more sugars,
thus epinephrine and cortisol help to stimulate glycogen metabolism to feed the system with
the glucose it needs to function.
• Insulin: The function of insulin is anti-pathetic to that of glucagon- it effectively lowers
blood sugar levels by binding to the cellular membranes to open up the channels so
sugars can exit the blood stream and enter the cells to be used as fuel. It does this
especially to muscle and fat cells. Because blood glucose levels are already high, it
directly inhibits formation of glucose by inhibiting glucagon and thus glucose production
from protein and fat and the snipping apart of glycogen to glucose in the liver. Once
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insulin binds to the cell membrane, not only do the channels open to let the sugar into
the cells, but it also stimulates the oxidation of glucose for the production of ATP
(Adenosine Triphosphate), or cellular energy, helps join glucose molecules to form
glycogen stored in the liver, and convert glucose to fat. This makes sense, as the body is
sensing it is in a fed state and wants to use some that energy now, but also store some for
later in the form of fat and glycogen so that some of it can be used later during a fasting
state. This sugar is turned into LDL cholesterol where it deposits in the lining of the
arteries, abdomen, and hips, primarily.
Insulin is not only triggered for release by rising blood sugar levels, but also by secretions of
acetylcholine by the parasympathetic nervous system (remember that one is associated with
digestion), as well as rising plasma levels of amino and fatty acids (indicating presence of
nutrients). We also want to think about other hormones that increase blood sugar levels- such
as cortisol, epinephrine, thyroxine, growth hormone, and glucagon. These all indirectly
stimulate insulin into action because they all raise blood sugar levels. Insulin works in
conjunction with somatostatin (GHIH) to lower blood sugar levels. Remember GHIH is the
inhibitor for growth hormone (GH), the latter of which increases blood sugar levels.
An important point here is that 3 primary hormones govern the secretions of insulin and
glucagon (aside from regular food consumption), these are: epinephrine, cortisol, and growth
hormone (secreted by the pituitary). Matthew Wood mentions, that these “actually favor three
basic constitutional conditions in the organism. High GH and IGF-1 occurs when there is
increased activity, muscle mass, inflammatory tendencies, lower insulin but higher blood sugar
usage; it produces the pitta constitution. High cortisol favors higher insulin levels, which
promotes fat production and storage, and therefore tending towards the kapha constitution.
High adrenaline levels favor the vata type. Since the three doshas are related to the six tissue
states we already have a good ground plan for discussing pancreatic syndromes.”
• Other Hormonal Organs: The following organs also have endocrine effects and produce
hormones, although they are not generally considered a primary part of the endocrine core
because they have other major physiological functions.
• The Heart: The is directly tied into the hypothalamus and other regulatory centers of
the brain, though it’s primary hormonal secretions is Atrial Natriuretic Peptide (ANP)
which signals the kidneys to excrete sodium and increase urine output. It also inhibits
aldosterone release from the adrenal cortex. Thus it helps to lower blood pressure.
• Intestinal Tract: The lining of the GI tract contains cells called enteroendocrine cells
which secrete a wide variety of hormones that regulate the digestive process, serotonin
and other amines, and other nervous system based neurotransmitters.
• Placenta: During pregnancy the placenta secretes steroid and protein hormones which
influence pregnancy, such as estrogen, progesterone, and Human Chorionic
Gonadotropic (hCG).
• Kidneys: These secrete erythropoietin which stimulates the bone marrow to
manufacture red blood cells, as well as renin which ultimately turns into angiotensin II
which stimulates adrenal cortical secretion of aldosterone mentioned earlier.
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• Skin: The skin produces cholecalciferol which is needed to synthesize Vitamin D from
the rays of the sun. While called a vitamin, it really functions like a hormone, and is
vitally important for calcium absorption and deposition into the bones.
• Adipose Tissue: Fat cells release leptin when they uptake glucose during a high blood
sugar state which binds to the CNS and reduces appetite.
Pathological Patterns and Tissue States
While the various endocrine glands and their hormones have a predominance towards
producing certain tissue states, a good general model to view endocrine imbalance is to see the
dynamics of dominance, excess and deficiency. Dominance could be seen as the constitutional
type that is produced by that particular pathway exemplifying itself more than the others.
This creates a particular strength and weakness in the physiology. We will look at the
different constitutional types different endocrine dynamics produce.
Excess would be either a particular hormone is secreted in excess or the receptor is highly
sensitive to its signal- in either case, the hormone has an excessive impact upon the system. In
deficiency, the hormone is either secreted in too little amounts, or the receptor site has become
insensitive to it and does not generate the post binding effect- like what occurs with Type II
Diabetes. Deficiency can also occur if there is an issue with the fluids in the body that the
hormones travel through- seen as either dryness or stagnation.
Thus for our pathological patterns, I will go through each endocrine organ and mention their
expressions of excess and deficiency, which lends us insight into the 6 tissue states through
that model. This is all information I learned from Matthew Wood and will quote him
vigorously through this section, as he says things much better than I most of the time. Some of
the endocrine organs though will be discussed in detail under materia medica by common
symptoms, primarily the thyroid and pancreas.
• Hypothalamus
• Excess: Excess of the hypothalamus can be seen as fever in essence, but more
specifically the “febrile mechanism overwhelmed” (MW). Here we see the heat/
excitation tissue state, see discussion on fever to get a sense of its picture under the
Immune System lessons.
• Deficiency: Here we see the hypothalamus is unable to read the quality of the blood
effectively, and has someone lost its control over the system. Matthew describes this
state the best. “Fluctuating temperature, emotions, toxins, and physical stress can
distune the hypothalamus. When it is under-functional there will be an oversensitivity to
external impressions, both emotional and environmental. If it is cold outside, people are
too cold, if hot, too hot. They sweat too much or too little. At the same time the internal
environment will be off. The hormones controlling the pituitary, thyroid, adrenals, and
gonads are secreting insufficiently or erratically. Internal temperature may rise and fall.
The female cycle will be irregular. Since the kidneys are controlled by hormonal
secretions from the anterior and posterior pituitary, water levels and excretion may
fluctuate. These irregularities may cause nervousness and anxiety, resulting in rising
adrenaline levels. The sympathetic response is not usually exhausted, but
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overstimulated.” His primary remedies here are: Eleuthero (Eleutherococcus senticosus),
Vitex (Vitex agnus-castus), and Pulsatilla (Anemone pulsatilla).
“Taking a lesson from these and other remedies, we learn that hypothalamic-pituitary
remedies have distinctive signatures. Siberian Ginseng and Vitex both have fivefold leaves
that look like a hand (analogous to cinquefoil and marijuana). This is usually an indication for
protection against outside interference – the hand indicating one’s calling or work and also
inference from others. Another important signature is a soft, billowy, cloud-like quality. We
see this in the flowers of vitex and the soft, downy, flowers of pulsatilla. ‘Cloud medicine’ is
associated with the ability to go through the keyhole, through little psychic and physical
openings. This is a picture of the endocrine system, which must penetrate throughout the
nooks and crannies of the entire body.” -Matthew Wood
• Pituitary:
• Excess: Overactivity in the pituitary can be a cause of some headaches, which is
typically when the pituitary is working overtime trying to compensate for deficiencies in
the thyroid gland or the ovaries (menstrual headache). Basically the gland swells and
pushes up against the bones and creates pressure.
• Deficiency: In the anterior pituitary, what we primarily see is that when prolactin levels
are high, the other 4 pituitary hormones are low (ACTH, HGH, TSH, GSH). “In this
condition there is a tendency to deposition of fatty tissue everywhere about the body,
resembling ‘baby fat.’ Shoulders are rounded, curves are lost, the face is large compared
to the body size, the knees are sometimes fat and there tends to be a somewhat childlike
expression to the face. Infertility may occur in women. There tends to be a generalized
lymphatic congestion with low immunity and tendencies to colds and allergies. The
mind tends towards idealistic thoughts about helping others.” (Matthew Wood) There
will also typically be a lack of period, or at least painless period, lack of bleeding,
irregular, intermittent, sterility and/or impotence. Matthew’s remedies here are
Fenugreek (Trigonella foenum-graecum) and Queen Anne’s Lace (Daucus carota).
With the posterior pituitary, we see the following dynamics: “When secretion of vasopressin
(antidiuretic hormone) from the posterior pituitary is low, water and potassium are not
reabsorbed from the tubules of the kidneys back into the bloodstream, resulting in a watery,
profuse, clear urine. Due to the loss of potassium, the cells and tissues are less able to hang on
to water, so there are also tendencies to excessive sweeting, diarrhea, expectoration, menstrual
bleeding, and general ‘leakage’ of fluids. Such loss of fluids tends to result in low energy,
exhaustion, dampness, and coldness. Cellular activity, including catabolism and reproduction
decline, High blood sugar increases as the cells are less active.... The skin becomes thin, soft,
and sensitive from lack of reproduction of epidermal cells at a high rate. The blood vessels
can be seen more easily through the transparent skin. Sex drive is diminished.” (Matthew
Wood) This is a great description of the damp/relaxation tissue state.
In Chinese Medicine this would be classified as kidney yang deficiency- the yang not holding
in the yin- hence the frequent urination, low energy, fatigue, and lack of sex drive (often from
sexual excess). To continue with Matthew, “If loss of fluids and electrolytes continues for too
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Advanced Clinical Herbalism: The Endocrine System
long, so much potassium will be lost that the fluids will become acid and calcium and
magnesium will be lost. The nerves and muscles will not be able to relax. When the nervous
system is overstimulated the cerebral cortex becomes overactive to provide nutrition by
raising blood sugar levels and encouraging a hot digestive tract.” His two major remedies here
are Sumach (Rhus typhina, R. glabra, R. aromatica) and Lemon (Citrus media)
• Thyroid: Thyroid pathologies are discussed under common symptoms and materia medica
under hyperthyroidism and hypothyroidism.
• Adrenals:
• Excess: We will see different states generated by excessive secretions of the various
hormonal pathways in the adrenals.
• Mineralcorticoid: Excess mineralcorticoid secretions, primarily aldosterone, lead to
high blood pressure and edema due to excessive sodium retention and potassium
loss- the latter of which can lead to neuromuscular weakness because they depend on
potassium for proper functioning. Accordingly to Matthew Wood, it creates a
constitutional pattern more prone to inflammation, heightened immunity, fever and
cardiovascular disease. “The characteristic symptoms of excess MC dominance
include: general irritability, hyper excitation, tension or depression, impulsive and
unstable behavior, aggressiveness, inflammation, pounding of the heart, high blood
pressure, fatigue, anxiety, trembling, neuromuscular tension, grinding of the teeth,
restlessness, excessive movement, increased sweating and urination, diarrhea, loss of
excess of appetite, indigestion, premenstrual tension, neck and back pain, increased
use of legal and illegal drugs, alcohol, and tobacco, and accident proneness.” (MW)
This tends to lead to the pitta constitution. He recommends remedies that will cool
off the excessive heat, relax the tension and tonify and strengthen the constitution.
Remedies here include: Solomon’s Seal (Polygonatum multiflorum), and Agrimony
(Agrimonia eupatoria).
• Glucocorticoid: Glucocorticoid excess, or cortisol excess, results in a multitude of
physiological issues, such as high blood sugar, loss of muscle and bone tissues, water
and salt retention, high blood pressure, edema, and redistribution of fat to the
abdomen and behind the neck. This is commonly called Cushings syndrome. The
glucocorticoid pathway of the adrenals is the anti-inflammatory side, which also
depressed the immune response, slows down lymphatic filtering, overexcites the GI,
lowers the cells ability to respond to thyroxine, and raises blood sugar. “If this side
becomes too dominant it creates a large appetite, good digestion, high blood sugar
levels, weight gain, type II diabetes, lymphatic stagnation, toxin and mucous build
up, and water retention. This whole constellation of problems has been recognized as
a source of chronic disease named “Syndrome X” by its discoverer, Dr. Gerald
Reaven.” (Matthew Wood) We also call this insulin resistance. He notes that this
leads to the classic “bear constitution.” This leads to the kapha constitution, and
what the old doctors called “bad blood syndrome. The main remedies Matthew uses
here are Yellow Dock (Rumex crispus), Turkey Rhubarb (Rheum palmatum), and
White Peony (Paeonia officinalis). I would suggest general alteratives as well as
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Advanced Clinical Herbalism: The Endocrine System
Licorice (Glycyrrhiza glabra) to help preserve endogenous cortisol and build up the
adrenals.
• Epinephrine: When the adrenal medulla is overly active in its secretions of
norepinephrine and epinephrine, we will see an excess fight/flight response, with
increased metabolism, high blood sugar due to quick release of sugars but with a
longer term reflex hypoglycemia, low appetite and poor digestion, rapid heart rate,
sweating, nervousness, anxiety, hypertension, and an overall feeling of being stressed
out. This has a profound impact upon the nerves and is ultimately rather debilitating
and can lead to burnout. Dominance of the adrenal medulla pathway leads to the
vata constitution, or what the old doctors called “neurasthenia.”
• Deficiency: A deficiency in adrenal function is commonly called Addison’s disease,
which is essentially hyposecretion of the adrenal cortex and thus lowered glucocorticoid
and mineralcorticoid hormones. It tends to produce low body weight, low blood sugar,
high potassium and low sodium, excess urination, low blood pressure, fatigue, and
chronic inflammation and pain.
The adrenal patterns are summarized below, adopted from Matthew Wood’s work:
Adrenal Medulla
Adrenaline Pathway
Adrenal Cortex
Glucocorticoid Pathway
(GC)
Mineralcorticoid Pathway
(MC)
epinephrine, norepinephrine cortisol, cortisone
aldosterone,
desoxycorticosterone
Anxiety, nervousness, fear
Suppresses inflammation
Supports inflammation
Easily frightened, startled
Syntoxic (coexists with
toxins)
Catatoxic (facilitates
detoxification)
Reduced appetite, weight
loss
Increased blood sugar,
hyperinsulinemia, type II
diabetes
Increased minerals in blood,
aggravation from salt
Increased alertness, mental
activity, insomnia
ACTH increases from
anterior pituitary
HGH increases
Increased blood pressure
and risk of heart disease
Decreased aggressiveness
Increased aggressiveness
Increased blood sugar
acutely, and hypoglycemic
between meals
Can lower blood pressure or
raise blood pressure,
depending on MC state
Thirst, dropsy, fluid
accumulation, increased
blood pressure and
vasoconstriction
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Advanced Clinical Herbalism: The Endocrine System
Adrenal Medulla
Vata constitution
Adrenal Cortex
Lymphatic and white blood
cell atrophy (depressed
immunity)
Heart and kidney
enlargement- heart attack,
stroke, nephritis, arthritis
Increases feelings of wellbeing, buoyancy, heightened
perception, artistic capacity,
mental activity, overactivity,
insomnia, depression
Nervous excitation follow by
sleep
Weight loss, weakness and
fatigue
Eclampsia (HBP in
pregnancy) and PMS
Kapha constitution
Pitta constitution
• Pancreas: We will look at the pancreas under diabetes and hypoglycemia later.
Evaluation Criteria
Evaluation methods for the endocrine system are primarily based on blood analysis of relative
hormone levels. This is probably the best way to really see what is going on in regards to the
state of the endocrine system. That being said, there are some simple analysis methods we can
take in order to see what might be going on.
A few tests for the thyroid. Take the temperature underneath the armpit immediately upon
waking. Normal temperature here is between 97.8-98.2 F- anything above that would indicate
hyperthyroid and anything under that hypothyroid. Note that this does not work in women
during ovulation when the temperature is naturally higher due to higher estrogen levels. From
Karyn Sanders via Margi Flint, “When the back of the neck is open the thyroid
opens.” (Karyn Sanders) “I ask the client ‘What feels better, tipping your head forward or
backward?’ Imbalance leaning towards hypo is better backward, hyper feels better
forward.” (Margi Flint). Some more from Margi, “Hit ankle nerve on Achilles tendon, strong
reflex is hyperthyroid, low reflect is hypothyroid. Paint iodine, the size of a quarter, onto inner
arm between elbow and wrist f it is absorbed quickly you need iodine, slowly you don’t. Ask,
“Have you been in a car accident or had a blow to the neck?” The seat belt may have hit the
thyroid gland on impact.”
Like a few of our other systems, there are not technically specific positions on the tongue that
correspond to the specific endocrine glands. But from the descriptions above and below, there
are some particular tongue indications we can look to in order to get a sense for the
underlying tissue states. For example, hypothyroid patients will often have a thick coating on
the tongue due to low metabolism unable to fully “combust” cellular waste products and
toxins thus accumulate. Someone with hyperadrenalism will have a shaky and quivering
tongue upon sticking it out, and may have excess dryness as well.
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The pulse on the other hand we do have positions for. Here we are looking at the 2 kidney
positions, both of which are on the proximal positions (closest to the shoulder) on both wrists.
On the right wrist we have the position for Kidney Yang, or the state of the Fire Element, in
the superficial position. On the left wrist we have the position for Kidney Yin, or the state of
the Water Element, in the deep position. In the simplified system the proximal positions on
both wrists just relate to Kidney Water (left) and Kidney Fire (right), without paying
attention to superficial or deep. We are essentially observing the state of the endocrine system,
core vitality, and the essence or Jing in these pulse positions. When they are absent, difficult to
find, or weak there may be some sort of deficiency there.
The Energetic System
The endocrine system, as we have seen, is a vast and complex dynamic within the organism
and as such it is so with its energetic manifestations. Each of the endocrine organs is said to
correspond with one of the energetic centers in the chakra system, which we have already
studied in depth during the Year 1 Evolutionary Herbalism Program (see those notes for
details). But in short, these are the general correspondences:
Chakra
Endocrine Gland
General Function
Sahasrara (crown)
Hypothalamus/pituitary
Master control
Ajna (third eye)
Pineal
Sleep, dreaming, visioning
Vishuddha (throat)
Thyroid
Metabolic rate
Anahata (heart)
Thymus, heart
Immunity, various
Manipura (solar plexus)
Adrenals
Stress response
Svadhisthana (naval)
Pancreas, testes, ovaries
Digestion, reproduction
Muladhara (root)
Adrenals*
Stress response
*In short, the adrenals are typically corresponded to the muladhara chakra because this center
is about our physical preservation and survival, and the adrenals are activated whenever there
is a threat to our survival. Although they are not physically located near the chakra, this is the
primary gland associated with this area- being at the root of the spine, there isn’t really any
other gland in that area, aside from the gonads which truly correspond to the 2nd.
From our astrological perspective, we have many correspondences here, depending on how
deep one wants to go into it. From a general perspective, we can look at simply the individual
glands themselves, but to more in depth, one could break down each individual hormone and
make correspondences to them as well.
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Advanced Clinical Herbalism: The Endocrine System
Endocrine Gland
Planetary Ruler
Sign Ruler
House Ruler
Hypothalamus
Uranus, Jupiter
?
?
Pituitary
Uranus, Jupiter
Scorpio, Uranus in
Aries
8th
Pineal
Neptune
Pisces, Neptune in
Aries
12th
Thyroid
Mercury, Uranus,
(Venus?)
Taurus and to some
extend Scorpio
2nd and 8th
Thymus
Venus
some say Gemini and perhaps the 2nd and
Scorpio....
8th
Adrenals
Mars and Jupiter
Libra (I would add
Aries)
7th
Pancreas
Venus, Jupiter
Cancer and Virgo
4th and 6th
Gonads
Venus and Mars
Scorpio
8th
We can see a theme here that Scorpio plays a central role in rulership of the endocrine system
because it is said to rule the “ductless glands,” which are the endocrine glands. This is
obviously a pretty general correspondence. This is likely due to the esoteric traditions
regarding the ductless, or endocrine glands, as having a primary mental and spiritual function
rather than a physical one. Of course, much of the classic medical astrology literature was
written by those in esoteric traditions, as well as the fact that for the most part what we now
know about the endocrine system is still really new. There are many mysteries associated with
these glands that we still do not fully understand.
We can also think of some of the energetics and symptomatic pictures associated with some of
the excesses and deficiencies of each endocrine organ. For example, hyperthyroid could be
seen as an excess of Uranus, Mercury and Mars- stimulating nervous energy. Hypothyroid
could be seen as Saturn, Jupiter and the Moon- depressing metabolism and fluid
accumulation. Hyperadrenalism could be seen also as excess Uranus, Mercury, Mars. Blood
sugar imbalances and diabetes could be Jupiter and Venus- excess consumption of sugar.
These are just a few examples to get you thinking about the corresponding imbalances of the
endocrine glands and their hormones along with potentially underlying planetary influences.
Primary Herbal Actions
If we are looking at all of the various endocrine organs and hormones listed here, it’s hard to
compile a specific list of actions that are specific for all of them. We see there are certainly
actions that are specific for certain endocrine organs, and specific plants which are specific to
them but don’t display actions that are particularized to that gland. So, this list of actions is
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Advanced Clinical Herbalism: The Endocrine System
relatively loose, but our first and foremost primary action here all the way around would be
our adaptogens.
• Adaptogen: This is likely the most popular and well known herbal action in the modern
alternative healthcare world these days. It’s a relatively new definition for herbs (1964),
developed by Russian scientists studying Eleuthero (Eleutherococcus senticosus) and noticing
it’s wide range of actions that were not easily defined by more traditional herbal actions.
What we see in adaptogenic herbs is that they have a non-specific action that increases the
bodies natural resistance to stressors. This could be external stressors from the environment,
or internal stressors triggered by exercise, diet, lifestyle factors, and the stresses of modern
life. They are also said to have a normalizing influence upon the physiology. These are quite
vague descriptions....
Because of their specificity for the stress response, many adaptogens are said to have an
impact upon the hypothalamic-pituitary-adrenal axis (HPA). Thus they are often regarded as
primary remedies for the treatment of the endocrine system. They do not block the stress
response per se- which would be impossible- but rather they tend to bring balance to the
sharp peaks and valleys in energy and mood from stress. In this way they “smooth out the
rough edges.”
This is the old textbook definition of adaptogens, developed by scientists in the 1960’s. The
newer research on adaptogens refined by the scientists Panossian, Wikman, and Wagner, state
that there are in fact only 3 plants (!!) that meet the classical definition of an adaptogen:
Eleuthero (Eleutherococcus senticosus), Rhodiola (Rhodiola rosea), and Schizandra (Schisandra
chinensis). This is interesting, as it seems that more and more herbs are being regularly added
to the “adaptogen” list. They also question the statement that adaptogens are “normalizing” to
the physiology of the body as well as to the relative safety of their use, which is generally
thought of as being completely 100% safe for everyone to take. If we think of an herb like
Panax ginseng, we see that it is not normalizing! It’s a highly stimulating warming plant, very
contraindicated for people with hot constitutions and a lot of energy. The new definition,
much shorter and to the point, is that adaptogens are herbal preparations that can increase
resistance to stress. Paul Bergner adds to that, in the short term.
The mechanisms by which adaptogens achieve this are largely unknown, though theories
about from modulating hormonal output and metabolism, adjusting blood glucose levels, liver
metabolism, nervous and immune system activity, and altering cognitive function. This is an
extremely diverse herbal action with a wide variety of plants that are all quite distinct from
one another, with their own unique specific indications, energetics, and affinities. This is our
closest western term for in China they consider “chi tonic herbs,” which are used to build up
deficient constitutions that are weak, tired, fatigued, and lethargic.
That being said, it is extremely important to understand that adaptogens are not “free
energy.” If someone is severely and chronically fatigued, an adaptogen will usually not be
curative and if not specifically indicated can actually do harm. These must be given within a
greater context of treatment including dietary and lifestyle adjustments, rest therapy, specific
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Advanced Clinical Herbalism: The Endocrine System
nutrients etc.- a recovery protocol. If we do not do this adaptogens can in fact facilitate
someones burnout.
Most people have heard that adaptogens build your adrenals. But what the scientific research
shows is that they don’t, and actually some herbs make adrenal burnout worse! This is
because they give you more energy by turning off the brake that your body usually presses
down that says “stop,” but you keep going and pushing yourself, called overreaching. This
was true of Eleutherococcus. One trial showed Rhodiola to be stabilizing to cortisol levels and
Schizandra has been shown that short term cortisol effects are reduced, but the longer term
response was increased. This is not supporting the adrenals, it is pushing them to work
harder!
In both China and India, where the concept and therapeutic use of tonic herbs was developed
and refined, we see that these herbs were used for very particular people, for very particular
lengths of time (usually short term), and with specific cautions associated with their use.
These cautions have all been neglected by most westerners who are familiar with the concept
of adaptogen (which is really a scientific model) and not with using tonic herbs from a holistic
standpoint.
One of the problems that I’ve noticed many herbalists do is learn information about 1 plant
called an adaptogen, and then automatically apply what they learned about that one plant and
think all adaptogens do that! For some reason people start to loose sight of the differentials
from herb to herb. Paul Bergner states it well: “ Each herb should be investigated for its own
effects, side effects, contraindications, and mechanisms, and utilized for its uniqueness.
Ocimum, Chaga mushroom, Schisandra, Shatavari, and Cordyceps have very little in common other
than being traditionally-described as tonics.” What’s important is that we choose an
appropriate adaptogen that matches the underlying constitution and energetics of the person
being worked with.
I’d like to quote Paul Bergner, whose way of talking about this herbal action completely
revolutionized the way I think about them. “The term adaptogen is not well defined by science
outside of tonic effects, ignores the possible consequences of overstimulation, of masking
effects, rebound effects after use or abuse, and promotes overgeneralization both in
contemporary herbal literature and in scientific writings on the concept. The term adaptogen
should be abandoned in favor of the categories of Tonic or Rasayana herbs in traditional
systems.”
The reason he makes this statement is that inherent within the way in which adaptogens are
taught makes them less applicable within a clinical context. “The now-discarded portions of
the original definition give rise to elements of “magical thinking:” a plant will give energy or
improve fatigue without any costs to the system or necessity to modify the lifestyle, it will
increase performance without any clinical rebound effect, and will “normalize” the system
without driving the balance in one direction or the other. These ideas readily lead to misuse of
tonic herbs with consequences to the patients that may range from minor to grave.” (Paul
Bergner)
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Advanced Clinical Herbalism: The Endocrine System
We will discuss adaptogenic materia medica separately from common symptoms later. Some
standard examples of adaptogens are: Ashwaganda (Withania somnifera), Chinese Ginseng
(Panax ginseng), American Ginseng (Panax quinquefolius), Rhodiola (Rhodiola rosea), Schizandra
(Schisandra chinensis), Spikenard (Aralia racemosa, A. californica), Devil’s Club (Oplopanax
horridus), Holy Basil (Ocimum sanctum), Cordyceps (Cordyceps sinensis), Reishi (Ganoderma
lucidum), Licorice (Glycyrrhiza glabra), and Codonopsis (Codonopsis pilosula), among others.
• Nervine: Nervine materia medica is discussed in detail under the Nervous System lessons.
These are indicated especially for people with heightened stress responses via either the
adrenal medulla pathway, hyper cortisol secretions, or hyperthyroid. They could also be
indicated for excess pituitary secretions triggering the thyroid or adrenals. I consider
nervines to be a primary herbal action for the treatment of stress, fatigue, and many
endocrine imbalances because the nervous system is directly tied in to the hormonal cascade.
• Alterative: Whereas nervines can be seen as specific for the hyperactive endocrine issues
(hyperthyroid, hyperadrenalism etc.), the alteratives can be considered specific for the
hypoactive endocrine imbalance, such as hypothyroid, glucocorticoid dominance, and
pancreatic/insulin/blood sugar disorders. These all contribute to lowered metabolism,
stagnation within the fluids and tissues, and an overall need for detoxification. For the
thyroid, the iodine containing alteratives are specifics, like Kelp and Bladderwrack.
• Circulatory Stimulant: Like alteratives, circulatory stimulants are indicated for the low
energy endocrine states prone to stagnation. They essentially need more Fire to move the
blood, cleanse and detoxify the tissues, and keep everything moving along.
Materia Medica by Common Symptoms
• Hyperthyroid: This condition is in essence a heat/excitation pattern. Either there is too
much thyroxine being produced by the thyroid, or for some reason the cells are highly
sensitive to its influence. Either way, the net effect is a heightened metabolism which leads
to sympathetic excess in the nerves. Matthew Wood notes that whereas hyperadrenalism
leads to excess thinking in the mind, hyperthyroidism has it’s impact on the enteric brain
and impacts not the mind, but the gut level instincts- leading to a certain degree or
irrationality. They can sometimes look like a hunted animal, as the fight/flight response is
consistently engaged and the nerves are constantly on edge.
If we think of the cells being overly excited and stimulated, they need a constant supply of
sugars, nutrients, and oxygen, which leads to overstimulation of the digestive tract,
respiration, and circulation of the blood. Hence rapid heart beat, hyperacidity in the stomach,
asthma, heart palpitations, and over stimulation of the sympathetic nervous system. The
person will typically feel hot, sweaty, and want to stay active. It’s almost as if they are on a
constant direct to bloodstream drip of caffeine!
A most common manifestation of hyperthyroidism is called Grave’s disease. What we see here
is antibodies in circulation that mimic TSH, which thus constantly stimulate the thyroid to
secrete T3 and T4. This creates an excessively high metabolic rate: profuse sweating, rapid
heart rate, heart palpitations, nervousness, anxiety, tension, and weight loss. Another
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symptom is called exophthalmos, which is protrusion of the eyeballs due to edema and
formation of fibrous tissue behind the eyes. This is what gives that “hunted animal look” that
Matthew mentions.
Standard medical treatment of hyperthyroidism is surgical removal of the thyroid or
destroying highly active thyroid cells with radioactive iodine. Because the root is based on
antibodies that are somehow mimicking TSH, this is often considered an autoimmune diseasethus our elimination diet and food allergen protocol because of major importance here. When
thyroxine levels are high, metabolism is too hot, leading to heat/excitation tissue states, along
with wind/tension, pitta dynamics. Excess parathyroid function is rare, and usually due to a
tumor. We primarily see skeletal weakness and kidney stones due to constant leeching of
calcium from the bones.
Symptoms are commonly worse in hot weather, from caffeine, lack of sleep, and better with
cold, sedation, relaxation. The pulse will always be rapid and they will typically display heat
signs. While it’s easy to think most hyperthyroid people will be skinny, some are overweightpotentially due to sympathetic excess shutting down the digestive system. Our basic herbal
approach includes nervine trophorestoratives, sedatives and hypnotics, and cooling bitters.
Below are some common remedies used in the treatment of hyperthyroidism- though they are
not technically curative, rather they help in symptom management. Many of our hyperthyroid
remedies are in the Lamiaceae (mint family) and are the cooling, sedative, relaxing mints.
• Lemon Balm (Melissa officinalis): This is a well established remedy for managing
hyperthyroid symptoms. We looked at it in more detail under the Nervous System
lessons, but I’ll mention it again briefly here. It’s a highly indicated remedy for it is sour
and cooling to excess heat and excitation in the tissues, and a gentle calming agent for
the nerves. Specifically though, Melissa exercises it’s nervine action upon the heart and
has specific applications for heart palpitations. It’s nervine sedative qualities are gentle
enough to be used throughout the day without creating marked drowsiness, yet it is
strong enough to settle the nerve, strengthen and nourish them, and relax tension around
the heart and mind.
• Bugleweed (Lycopus virginicus): This is our 2nd primary remedy with extensive use in the
treatment of hyperthyroid, making it direct specific remedy. It is another one of our
cooling bitter mints, like Skullcap, Wood Betony, and Motherwort, to be juxtaposed to
the more aromatic mints. It’s cooling properties make it of benefit here for hyperthyroid,
as it cools and calms overly excited tissues- especially in the circulatory system,
respiratory system and intestinal tract. The bitter tonic properties exerts an influence
upon the enteric brain, so derailed by hyperthyroid, calming any inflammation and
stimulating digestion, which can often be lacking in function due to excessive
sympathetic stimulation. It is a sedative like Motherwort and Lemon Balm with a
specific affinity for the heart, easing palpitations, tightness in the chest, and angina, as
well as has a toning effect upon the vasculature. Matthew says it is best when the pulse
is “rapid and tumultuous” and the person is in constant fight/flight mode, looking like a
hunted animal, eyes bulging and darting this way and that.
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• Motherwort (Leonurus cardiaca): We have seen this remedy pop up numerous times,
under the cardiovascular system, nervous system, female reproductive system, digestive
system, and now again under endocrine. While this remedy is not curative for
hyperthyroid, it certainly can make the symptoms palliated to the point the person feels
much better. We see it’s specificity here in regards to its actions on the heart, as a nervine
sedative for heart palpitations. It is likely one of the most bitter plants I’ve ever tasted,
just chewing the fresh leaves or drinking tea sends shivers down my spine just thinking
about it! The signature on the plant is the rhythmic distribution of the leaves and flowers
up the stalk, indicating equality of rhythm- this applies not only to the beating of the
heart, but the rhythm of the menstrual cycle as well. It has numerous applications in
menopause, helping to cool hot flashes, clear the liver of excess androgen waste
products, and settle the nervousness that can often accompany it.
• Eleuthero (Eleutherococcus senticosus): This was one of the plants that brought in a
completely new understanding of herbal medicines through the western paradigm, and
invented the word “adaptogen.” Many consider it an amphoteric remedy, meaning that it
can be applied in all manner of endocrine imbalance- hyperthyroid or hypothyroid in
this case. It is thought to have this action because it has an influence on the
hypothalamus, especially because this plant has been shown to modulate peoples ability
to adjust to their external environment- a job regulated physiologically by the
hypothalamus. I would exercise some caution in using it with hyperthyroid people
though as it can be slightly warming- though adding some of it to a formula full of the
intense bitters mentioned so far would likely balance that out just fine. With
hyperthyroid, the adrenals are often overstimulated due to the sympathetic excess, thus
this remedy helps to settle the nerves, build the adrenals, and take off some of the
burden. It is said to work best when there is weakness and exhaustion. Many herbalists
recommend giving this remedy by default whenever there is expected endocrine
burnout, but that may be too general of a statement. It is also really important to mention
that all of the above indications should be given in small to moderate doses of Eleuthero.
Strong standardized extracts and concentrated products have been shown clinically and
scientifically to be very stimulating- so exercise caution here with hyperthyroid.
• Blue Vervain (Verbena hastata): This is another one of our strong bitter nervine remedies
which sedates excess heat and calms and settles the nerves. I have found it to be useful
for people with various types of nervous habits- picking at skin, biting the nails, twirling
the hair (see also Equisetum)- as it takes the vital force from the head and brings it down
not to the solar plexus like Stachys, but into the pelvic region.
• Hypothyroid: This can occur due to a number of causes. One would be a deficiency in
either the hypothalamic release of TRH (Thyrotropin Releasing Hormone), pituitary release
of TSH, or an inability for the thyroid to produce adequate amounts of TH. The latter can
occur to a number of factors such as iodine or tyrosine deficiency (the latter being relatively
uncommon unless one is severely protein deficient), or when there is damage to the thyroid
gland itself, which often occurs from radioactive iodine damaging the cells that manufacture
thyroxine, or by an autoimmune reaction which destroys the cells.
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If hypothyroid is due to a lack of iodine, people get what is called goiter, a swelling in the
thyroid due to accumulation of colloid that cannot be actively turned into hormones. In our
modern world of iodized salt, this is relatively rare. Often we will see high levels of TSH
because there is low TH and the pituitary is trying to get the thyroid to secrete more- but it
can’t make it! This high TSH causes more colloid to form making the swelling worse, and the
cells ultimately burn out and atrophy.
When thyroxine is deficient, metabolism is low, leading to bad blood syndrome because the
Fires of the body are burning low and waste products are not fully “combusted,” the body
becomes slow, sluggish, overweight, toxic, and prone to infection. It essentially leads to a
damp/stagnation tissue state, “toxemia” and a desperate need for alteratives. This was a major
indication from the old doctors, and actually “bad blood” was pretty much equated with
hypothyroidism. The blood becomes impure from excessive accumulation of metabolic waste
products, immune factors, blood sugars and such leading to chronic skin conditions.
Heart rate is often diminished and circulation to the periphery is shunted leading to cold
hands and feet. Due to poor blood flow, we see that the tissues begin to starve because they
are not getting the nutrients they need to thrive. The cells are thus undernourished, but the
person is overfed and gains weight. Water collects in the tissues and cells and often leads to
edema. The damp accumulation makes bacteria thrive much easier leading to chronic
infections slow to recover from. This all gives the hypothalamus a more difficult time to
adequately screen the blood and make the adjustments it needs to because it’s cluttered with
too much stuff. In Ayurveda, this is ama accumulation due to a lack of agni, and represents
the need for increased gastric and metabolic Fire. People feel tired, sluggish, slow, heavy,
languid, and fatigued both physically and mentally. This overall congestion in the body and
mind can also lead to increased deposition of materials in the blood vessels, high blood
pressure, and increased risk for heart disease. Many people associated hypothyroidism with
sugar cravings.
Deficiency of parathyroid is usually from trauma to the neck or thyroid surgery and results in
muscle twitches, convulsions, loss of sensations, and can lead to respiratory paralysis and
death. This is all due to major calcium deficiency, and can also be due to major longstanding
magnesium deficiency (a major nutrient required for PTH secretion). If the thyroid is truly
deficient, we can see a lack of calcium in the bones, teeth, hair, skin and nails.
Most deficient thyroid pathologies are due to inflammation of the thyroid, often autoimmune
in nature. Another major issue in our modern world is the affects of nuclear fallout, which
oftentimes contains radioactive iodine. For people that are already iodine deficient, the thyroid
will readily take up any form of iodine that is presented to and the radioactive property of it
readily destroys thyroxine producing cells. This is where we see the necessity to either
supplement potassium iodine, or incorporate kelp and other seaweeds into the diet which
contain iodine.
If the thyroid is deficient because of the pituitary not adequately stimulating it, we must
address the pituitary. If the pituitary is healthy, but thyroid is low, this is true hypothyroidism
and is often indicated when there is an excess secretion of TSH from the pituitary, but a low
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Advanced Clinical Herbalism: The Endocrine System
level of T3 and T4 in the general circulation. Full blown hypothyroidism is called myxedema,
which means “mucous swelling.” What we will primarily see here is a lowered metabolic ratethe bodies Fire Element is deficiency, and Earth and Water predominate. This leads to feeling
cold, constipated, thick dry skin, puffy eyes, lethargy, foggy thinking and an overall kapha
type constitutional picture.
• Black Walnut (Juglans nigra): This is traditional remedy used in the southeast for goiter,
as the black hulls contain iodine- that area was commonly called “the goiter belt” as they
were severely iodine deficient. Black Walnut is a commonly prescribed remedy for
parasites and various types of infections, of which it is useful for, but it has uses far
beyond that. We see it specifically for the damp and cold tissue states, as it’s taste is
bitter and astringent, helping to detox and dry up damp accumulations. It has a
particular affinity for cleansing the colon as well as excess toxins from the bloodstream.
This partly a humoral effect and partly a pharmacological effect, as iodine has a direct
antimicrobial action. Phyllis Light states that this remedy directly activates the thyroid,
stimulating the metabolism in the cells. To quote Matthew, “This improves circulation,
removes deposits in the arteries, lowers blood sugar, decreases hyperinsulinism, removes
stagnant water, mucous, and toxins from the system.” Sounds pretty specific to me!
• Chickweed (Stellaria media): This humble little plant is an ideal hypothyroid remedy for
its action as an alterative specific for the Water Element in the body, as well as
facilitating in the metabolism of lipids. This is important, for in hypothyroid conditions,
there is often an excess of fat deposition within the tissues, making it ideal for the
prevention of arteriosclerosis and heart disease. As a diuretic, it drains excess fluids from
the tissues and it’s lymphatic actions help to decongest stagnations. It is considered an
emollient, meaning that it helps to soften tissues that have turned hard, likely doing so by
helping in removing deposits from the arterial walls, moving stagnant fluids, and getting
the liver to function properly. It enhances the nutrition to the cells, partly by enhancing
digestion, partly removing blockages and stagnancies in the intercellular fluid that
prevent nutrients from entering the cells.
• Cleavers (Gallium aparine): While commonly seen as a lymphatic and diuretic remedy, we
can see the usefulness of Cleavers in treatment of hypothyroid symptoms. But it also has
a special affinity for the throat, as indicated by it’s Venusian planetary ruler (Venus rules
Taurus who governs the throat and thyroid). It is often used specifically for lymphatic
swellings around the neck and throat and clears old infection from the lymphatics.
Remember, hypothyroid tends towards lymphatic stagnation and swelling as well as
persistent infection. Matthew claims it has a direct action on the thyroid, though I am
unfamiliar with any mechanism of this, other than the energetic perspective. It is
relatively similar to Chickweed in its actions, though with stronger influence on the
lymphatics, and less an influence on the cardiovascular system and fat metabolism.
• Blue Flag (Iris versicolor): This strong alterative remedy has a primary affinity for the
liver, gallbladder, and other secreting glands of the digestive apparatus. It’s a potent
bitter tonic, but also detoxifying remedy- specifically for those with excess sugar
cravings and Type II Diabetes, of which it is a specific. Matthew notes it being used for
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Advanced Clinical Herbalism: The Endocrine System
constantly shifting moods- high blood sugar- low blood sugar, excitement-depression,
sympathetic excess-parasympathetic excess.... essentially a shifting between extremes.
We could see this as fluctuations in thyroid output, with surges of T3 and T4 stimulating
the system which gets burned out thereafter. The purple colored flower indicates its
usefulness in treating stagnation of fluids within the system, particularly blood, but also
lymph. This is important, since the digestive system is typically hypo-functioning and
foods are not properly digested, absorbed, and their waste products not eliminated. Thus
Blue Flag is differentiated here from Cleavers and Chickweed in that it stimulates our
exocrine glands along with the endocrine glands, thus enhancing digestion as a bitter
tonic.
• Kelp (Fucus vesiculosus): This herb from the sea is often considered a specific remedy for
hypothyroidism, but it’s important to know that it is really only indicated when there is a
deficiency in iodine. Most people in the western world don’t have iodine deficiency due
to the fact that table salt is commonly iodized. This is why goiter is so rare these days. If
there is no iodine deficiency then it is not the most ideal remedy- but only if we look at it
through iodine lens. We also see that all of the sea vegetables/herbs are extremely high in
other minerals and nutrients. With hypothyroid, there is often nutrient deficiencies that
go alongside it, and supplementing with an herb like Kelp can definitely help to get some
more nutrition into someone. Capsules are probably the best way to make people
compliant, as the average Jane or Joe won’t likely enjoy the taste of seaweed. A good
way to get it in people is to cook it into soup broths or sprinkle it onto food mixed with
sesame seeds like a gomasio. The other situation that might make it worth using is if
someone is in a known area of radiation fallout, where there is radioactive iodine floating
in the air. Here we definitely want to work with the sea veggies since they will
competitively bind to the thyroid receptors and protect them from radioactive poisoning.
• Poke (Phytolacca decandra): Like Blue Flag, Poke is another strong lymphatic alterative,
with a specific affinity for the breast area. It cleanses and detoxifies the system. But
remember it is strong, so only use low doses- 1-3 drops is usually more than enough.
“The Phytolacca patient is pokey, sluggish, exhausted, fatigued, and indolent. They are
often large and fleshy, with large glands and breasts and dry skin.” (Matthew)
• Nettle leaf (Urtica dioica): Lastly we come to Nettles. I think this is a major universal
remedy for both hyper and hypothyroidism. It works on the latter because, like the other
herbs mentioned, it drains fluids out the kidneys, cleanses and detoxifies the blood and
lymph, and helps the liver metabolize metabolic wastes. It stimulates circulation,
diuresis, and dealing with nitrogenous waste products from proteins. Conversely, it also
helps to bring good nutrition to the cells with all of its rich content of minerals,
chlorophyll, amino acids, and vitamins. For hyperthyroid, we see it being calming to
excessive heat/excitation in the tissues as a pretty strong inflammation modulator, and
also providing bulk nutrition to an otherwise “starved” system. This remedy is not often
mentioned as a thyroid medicine, but I remember Matthew mentioning the herbalist
Robin Rose Bennet giving Nettles to someone who had their thyroid surgically removed
and it regrew. Herbs... are.... amazing!!
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Advanced Clinical Herbalism: The Endocrine System
• Other herbs that could prove beneficial for other symptoms of hypothyroidism would be
our circulatory stimulants like Cayenne (Capsicum annum), Rosemary (Rosmarinus
officinalis), Prickly Ash (Zanthoxylum americanum), Ginger (Zingiber officinale), and
Turmeric (Curcuma longa); herbs to support the cardiovascular system such as Hawthorn
(Crataegus monogyna), Yarrow (Achillea millefolium), Garlic (Allium sativum), and Ginkgo
(Ginkgo biloba); and herbs to support the nervous system, more our trophorestoratives
like St. John’s Wort (Hypericum perforatum), Mugwort (Artemesia vulgaris), and Milky
Oats (Avena sativa). Adaptogens may also be an indicated action, especially if there is
extreme fatigue and deeper level endocrine burnout.
• Hyperadrenalism: We can also think of this as adrenal stress, or excess in the adrenal
medulla and it’s secretions of epinephrine and norepinephrine. As mentioned, this leads to a
hyperactive sympathetic nervous system and all of it’s accompanying symptoms: rapid heart
rate, high blood pressure, blood diversion from the core to the periphery, dilation of the
bronchioles, sweating, and the feeling of stress! It is possible for people to be in this state of
being consistency and it becomes their dominant adrenal pathway. This is a very similar
state to hyperthyroidism, discussed above- thus all of the materia medica mentioned above is
applicable here. This is an important thing to remember because most people out there feel
like if they are stressed all the time all they need is adaptogens, but really what they usually
need more is nervines and trophorestoratives. The adaptogenic remedies are really only for
when the people reach full blown endocrine burnout, or adrenocortical deficiency. We want
to prevent them from getting there by giving nervines.
One of the ways Matthew distinguishes the hyperthyroid from the hyperadrenal person is that
the thyroid type is irrational and they operate more from the emotions, where as the adrenal
type is overly rational and mental. He also notes that it is no such thing as adrenal medulla
deficiency- that the nervous and epinephrine response is inexhaustible- what does get worn
out is the cortex which also gets worked hard in order to balance the excess stress placed on
the system by the sympathetic nervous system. Sometimes people in a hypothyroid state end
up relying more heavily on their adrenal glands to compensate and end up in a
hyperadrenaline state. This is why some hypothyroid people don’t seem to have the kapha
type constitution one would expect, and are on the thin and dry side.
Our remedies here include: Lemon Balm (Melissa officinalis), Skullcap (Scutellaria lateriflora),
Milky Oats (Avena sativa), Blue Vervain (Verbena hastata), Chamomile (Matricaria recutita),
Hops (Humulus lupulus), and pretty much the rest of the nervine materia medica. Adaptogens
can be applied, but we want to apply them only if they have reached a degree of deficiency in
the adrenals. Adaptogenic materia medica will be discussed in its own section.
• Adrenocortical Deficiency: As mentioned above, it is technically possible for the adrenal
medulla to become deficient. But when it is in a state of excess, the epinephrine constantly
activating the sympathetic nervous system causes a reflex in cortisol secretions to help
buffer that stress response. This is what most people these days call “adrenal burnout,” but a
more precise turn would be endocrine burnout, for as we have seen all of the endocrine
glands are intimately connected, and perhaps the pituitary is unable to secrete as much
ACTH, or the thyroid is taking a hit from all of the stress as well. Thus we want to maintain
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Advanced Clinical Herbalism: The Endocrine System
our holistic perspective and not just tunnel in on the adrenals. It’s really really important to
understand the just because someone is fatigued and tired all of the time doesn’t mean their
adrenals are “burned out.” It takes a long time for adrenocortical deficiency to develop and
most of the time people have nervous system burnout before their adrenals are totally wiped.
It’s important to remember that the hormones synthesized in the adrenal cortex are formed
from cholesterol, therefore low fat diet fads are dangerous for the endocrine system as we
don’t have the fundamental unit to build these hormones.
This state is where Matthew recommends “oily bear medicines” to help build up lipid
metabolism through enhancing their digestion, absorption, and assimilation, thus “fattening up
the kidneys.” “The oily bear medicine, as well as other dietary oils, keep up the
parasympathetic/GC side of the adrenals, so that the high energy level of adrenaline living can
be maintained and grounded.” (Matthew Wood) I find it interesting that most of these
remedies are roots, which the bears eat after coming out of a long winter of hibernation and
need to fatten themselves up.
I’ve thought about this classification of remedies quite extensively, especially in regards to
their treatment of the adrenal glands- since they not remedies often discussed for this. What I
have realized is that it is really looking at the core energetics and underlying dynamics around
adrenal fatigue- which is that they are fatty oily organs, whose hormones are generated from
cholesterol and fats. That “adrenal burnout” is really a manifestation of the dry/atrophy tissue
state- thus it should be treated with moistening remedies that contain oils. This remedies not
only help with overall lipid metabolism, but have an energetic affinity for these fatty glandstheir actions are more indirect than direct. I would also mention that we don’t just want to
help someone maintain their adrenaline based living, but give them nervines as well to settle
that excessive sympathetic stimulation. This state would also be treated with our adaptogens,
which will be discussed in their own section later.
• Burdock (Arctium lappa): The word arctium comes from the Greek word for bear and
lappa means to clutch, thus Arctium lappa means “clutched by the bear.” This Jupiter
plant is one of the top remedies for adjusting the oil balance in the body- it’s absorption
from the GI via it’s impact on the liver and gallbladder, it’s distribution throughout the
body, regulation of the sebaceous glands on the skin etc. It can be seen as an amphoteric
in this regard, helping people that are dry get more oily, and for folks that are already
too oily to utilize them better and detox. But in general, it is said to be most specific for
the thin, dry atrophic type constitutions with dry flaky skin, dryness in the intestines
leading to constipation, and a stagnant liver. The main classification of Burdock is that it
is an alterative, with a particular affinity for the liver, blood and skin, also with some
actions on the kidneys- though the seeds are more diuretic and diaphoretic than the
roots. Thus we see Burdock (and most of these remedies actually) do not necessarily
have a direct impact on the adrenals, but rather support the entire physiological
mechanisms behind their functioning.
From an energetic or spiritual perspective, I think of Burdock as embodying the Earth
Element in a super powerful way. People that tend towards adrenal fatigue or medulla/
sympathetic excess are ungrounded, flighty, nervous and in a vata state, which is ultimately
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Advanced Clinical Herbalism: The Endocrine System
volatilizing the Earthly elements of the body. Burdock instills a sense of groundedness, peace,
steadiness, and strength that is often truly needed by people in this state.
Another important action of Burdock is its high content of inulin and mucilage which are
prebiotic for the intestinal tract. These help to feed the beneficial gut flora and strengthen the
digestive response. In someone who is hyperthyroid or has high adrenalin, the gut takes a
serious blow as it’s entire process is essentially shut down. Due to a decrease in gastric
secretions it can become dry and atrophic, more prone to infection, and hypersensitive and
inflammatory. When we see epinephrine dominance, one of the impacts is relaxation of the
gastric tissues, as well as the urinary tract and uterus. Prolongation of this response can lead
to potential leaky gut syndrome.
• Angelica (Angelica spp.): While this is a specific discussion on Angelica, we can also think
of its fellow Apiaceae cousins such as Osha (Ligusticum porteri) and Lomatium (Lomatium
dissectum) as also being bear medicines- of course Osha and Lomatium have both been
called Bear root by many people throughout time. These are all pungent, warming, oily
and aromatic roots with an affinity for the circulatory and respiratory systems. Osha and
Lomatium are typically considered strictly respiratory medicines- though here we see
they may have applications elsewhere in the body. These are all “imaginal” plants,
represented by the hollow stems, which is a signature for conducting our consciousness
into the other world- opening up the higher sensory faculties and our visioning
capacities. All of these plants are also bitter, which combined with the aromatic
properties greatly enhances digestion. The pungent qualities help to circulate the blood,
which is how Osha was used in TCM- not even used for the lungs (though it’s a different
species). They are all specific for thin dry people as well as heavy wet people. I find these
plants helping in assisting us in opening up our imaginations to new ways of living, of
breaking old patterns, of dreaming in a new life that is more integral and in balance. The
oiliness of these plants, like Burdock, is said to assist in lipid metabolism and building
the adrenal cortex.
• Spikenard (Aralia racemosa): Like the remedies mentioned above, Spikenard is another
oily, pungent, and slightly sweet root. As a member of the Araliaceae (Ginseng family)
we may assume it has actions on the cortical side of the adrenal functioning like most
other members of this family (American Ginseng, Chinese Ginseng, Devil’s Club). It has
a particular affinity for people with blood sugar spikes and dips, helping to maintain an
even keel. The roots have a longstanding use in the treatment of the respiratory system,
especially cold and damp conditions with thick heavy stagnant mucous. Spikenard is
also said to be a strengthening remedy for thin, weak and debilitated constitutions (vata)
that need more power and tonification in the nerves. It has a longstanding traditional use
in the treatment of the female reproductive system giving a pelvic region affinity. I find it
useful when the solar plexus is weak with a poor hunched over posture and sense of
laxity in the tissues of the pelvic region.
• Licorice (Glycyrrhiza glabra): The name for this plant comes to us from the Greek
physician Dioscorides, Glycyrrhiza meaning “sweet root.” This is one of the most
universal remedies of Chinese medicine, though has also been used extensively in the
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Advanced Clinical Herbalism: The Endocrine System
west. While the root itself is now brown and furry, the seed pods are- similar to Burdock
seeds. Whereas the above remedies are primarily pungent and oily, we note that Licorice
is sweet and neutral in regards to temperature- perhaps leaning on the cooling side as it
is so potently anti-inflammatory. Because of this moistening property, it is considered a
yin tonic- building the primal Waters of the body to temper the Fires. This is it’s
demulcent property and one of the ways it is cooling. The other is more biochemical- the
roots contain triterpene compounds with a similar structure to the adrenal cortex
hormones which are anti-inflammatory- primarily cortisol.
Science has also shown us that Licorice not only helps build cortisol, but also preserves the
half-life of what is already in circulation. This means that it prevents cortisol from being
metabolized and broken down as quickly, which spares the adrenals from needing to make
more. This is a theoretical statement that many herbalists make, but whether it is scientifically
true is unclear. Because cortisol is our bodies natural anti-inflammatory, by sparing it and
increasing its half life, our body is under its influence for longer and thus helping to reduce
inflammation. That being said, it may over the long term maintain high levels of cortisol,
leading to excess in the glucocorticoid side of the adrenal axis. This gives Licorice an
extremely broad range of applications.
David Winston gives us some specific indications, “I frequently use it for people with adrenal
insufficiency who have symptoms of fatigue, tiredness upon waking up in the morning,
elevated cortisol and blood sugar levels and frequent colds. Because it is an
immunomodulator, licorice can be used to stimulate immune system function in people with
cancer and chronic fatigue immune deficiency syndrome and reduce excessive immune
response in people with autoimmune disease (rheumatoid arthritis, lupus, scleroderma) and
allergies (animal dander allergies and allergic asthma).
It is of great benefit to those diseases due to dryness and excess inflammation. With primary
affinities for the digestive system and respiratory system, it has benefit in many irritable bowel
conditions, leaky gut syndrome, ulcerative colitis, and general mucosal membrane dryness.
I’ve used it extensively in this regard, as well as for general dry respiratory conditions of
which it is premier in its actions. It also exhibits strong hepatoprotective properties, of which
it combines nicely with Schizandra and Milk Thistle.
There is a caution in its use though. While we see it’s actions on the glucocorticoid side of the
adrenal cortex, it also exerts an influence on the mineralcorticoid side as well, increasing the
level of aldosterone which leads to water preservation (another way it is good for dryness) but
also retention of sodium. All of this can lead to heightened blood pressure- thus never give this
remedy to someone with high blood pressure or on blood pressure medication. These effects
are due to the constituent glycyrrhizin, which is removed from many commercial extracts to
improve its safety.
We see Licorice has many other impacts upon the different organ systems of the body. It is a
valuable expectorant in dry lung conditions, one of best herbs for stomach ulcers and acid
reflux, it builds core immunity, facilitates in liver detoxification, and has been shown to be
directly antiviral. It is also commonly used in various herbal formulations to “harmonize” the
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formula, that is, to balance any drying humoral effects of the formula as well as improve its
palatability and thus compliance.
From King’s Dispensatory, he states “Liquorice root is emollient, demulcent and nutritive. It
acts upon mucous surfaces, lessening irritation and is consequently useful in coughs, catarrhs,
irritation or the urinary organs, and pain of the intestines in diarrhoea. It is common
administered in decoction, sometimes alone, at other times with the addition of other agents
and which is the preferable mode of using it.” I wanted to mention this quote because in his
monograph he doesn’t mention anything about it being used for endocrine burnout, and he
also states that using in formula is the preferred method of administration.
Paul Bergner notes that this is not an herb to used daily and persistently in high doses.
Traditionally it was always used in small amounts in formulas. If someone is taking high
amounts in decoctions or tinctures, they may exhibit the high blood pressure side effects due
to excess aldosterone secretions mentioned above. He states that Licorice does not build the
adrenal glands, and sites a few cases where consistent long term used ended up leading to long
term burnout (adrenals, thyroid, gonads). Standard tincture dosages are said to be relatively
insufficient for its tonic effects, traditional preparations are powders or decoctions in amounts
of 3-10 grams.
• Contraindications: It is highly contraindicated in people taking steroid drugs as well as
high blood pressure medication, or for people who have high blood pressure but aren’t
on medication. Because it is a moistening plant, excess mucous and kapha constitutions
should generally avoid it.
• Solomon’s Seal (Polygonatum multiflorum): This remedy was discussed at greater length
under the musculoskeletal system, though I mention it here because it is a remedy
Matthew discusses under the treatment of mineralcorticoid excess and glucocorticoid
deficiency. That state tends to produce someone who is hyperinflammatory with an
excess of musculoskeletal tension. The neuromuscular system tends to become deficient
in this state as the body looses potassium, making it more prone to cramping, and the
constitutional state being pitta has an affinity for the muscles as well. As cortisol
becomes deficient, it is exceedingly difficult for the body to modulate any inflammation
that is occurring. Thus, Solomon’s Seal is not just a demulcent, emollient and tonic for
the connective tissues and joints, with a humoral cooling effect, but also may have a
biochemical anti-inflammatory effect through helping the adrenals to build up more
cortisol output.
More remedies will be discussed for the adrenals below where we will cover adaptogens.
See fatigue.
• Type II Diabetes: The primary pattern associated with the pancreas and insulin is diabetes.
This can occur from either an excess of pancreatic activity due to long term consistent high
levels of blood sugar (from excess sugars in the diet), or a deficiency in the pancreas’ ability
produce insulin. Over an extended period of time of excess insulin secretions, the cells
eventually become insensitive to it- as if they are overworked and get tired- and their
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binding doesn’t have the proper effect of opening the cell gateway to let in the blood sugar.
So blood sugar levels stay high, telling the pancreas to secrete more insulin which doesn’t
have it’s effect and the cycle continues on and on. This is the pattern associated with Type II
Diabetes.
With blood sugar levels staying high, the fight/flight response is triggered because the tissues
and cells themselves think they are starving. This triggers the release of more hyperglycemic
hormones (epinephrine, cortisol etc.) which raises blood sugars even more through breaking
down proteins and fatty acids into sugars. Blood fats rise. Sugar is excreted through the urine.
Blood pH drops and becomes highly acidic due to the formation of ketones from the excess
fatty acid metabolism. Ultimately, this can kill you.
This is a very interesting disease because essentially the body thinks it is starving, even though
the system is flooded with nutrients (or at least in the form of sugar). Before the diabetes
pattern develops, excess secretion of insulin from the pancreas can produce hypoglycemia, or
low blood sugar, because the sugars are cleared so quickly from the bloodstream. This triggers
all of the hyperglycemic hormones to be released, which triggers a stress response (as the
body thinks its starving again) leading to anxiety, nervousness, tension, weakness, tremors
and cramping. There can be poor concentration and foggy thinking because the brain isn’t
getting any glucose, which is its primary fuel.
To think through the effects of high blood sugar, I like to think of the difference between a
bottle of water and a bottle of simple syrup. If the blood is supposed to be the consistency of
the water, diabetic blood is the consistency of syrup. It is sticky, gummy and thick. When the
blood is like this, it is exceedingly difficult for nutrients to pass through the capillary beds,
into the extracellular fluid and into the cells. Toxins also have a hard time making their way to
the organs of elimination.
“Cellular life is depressed, since the cells are stuck full of glycogen and cannot take up new
sources of energy. Low thyroid often develops as cellular metabolism goes down, leading to
poor peripheral circulation and unhealthy skin. The extremities are especially imperiled. The
peripheral nerves become lifeless and lose sensation. Vascular tissue is more irritated,
cholesterol is laid down more quickly and bacteria becomes involved in destruction of the
vessel walls, resulting in cardiovascular disease. Wounds heal slowly and can more easily
become gangrenous. Thus, diabetics start loosing their toes and feet. Diabetes personifies the
depressed tissue state.” (Matthew Wood)
Deficiency in the pancreas would be hyposecretion of insulin. Blood sugar levels rise, but the
pancreas is unable to secrete insulin and thus the blood sugar levels stay high. This is
associated with Type I Diabetes, where the cells themselves are receptive to insulin, it’s just
that there isn’t any or enough there to open up the gates to let it into the cells from the blood.
Type I Diabetes is due to destruction of the Isles of Langerhan in the pancreas. I’ve heard
reports of this occurring from injuries which directly bruise the pancreas, as well as
potentially autoimmune reactions. My father had Type I Diabetes and contracted it as a
young child after being heavily vaccinated. This is called “insulin dependent diabetes” because
people are dependent on an insulin pump to provide them with the hormone.
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Advanced Clinical Herbalism: The Endocrine System
Type II Diabetes was classically called “adult onset” because it was more common in adults.
But we can’t really call it that anymore, as a greater number of children are developing it
through such high sugar diets and lack of exercise.
Here are some remedies that can be used along with those lifestyle changes to support
common symptoms associated with diabetes.
• Goat’s Rue (Galega officinalis): This is one our primary herbs from Europe which is
specific in the treatment of type II diabetes. It’s primary actions are as a diuretic and
diaphoretic, regulating and dispelling damp accumulations in the body which are
common to this condition, of which the bitter and astringent tastes are also beneficial for
on an energetic level. The bitterness helps to kindle the digestive fire and enhance
absorption of nutrients. But most specifically it has been shown to increase the
sensitivity of the cells to insulin, making it’s binding more effectively open the cellular
channels to let glucose in from the blood and into the cell to be utilized for energy. In
this regard, it is a hypoglycemic agent, and should be used with caution if someone if
currently taking diabetic medications, as it can interact with them. According to the
British herbalist and Ayurvedic practitioner Anne McIntyre, Goat’s Rue “reduced blood
sugar by decreasing insulin resistance; decreases absorption of glucose from the gut and
reduces glucose formation in the liver, and increases uptake and utilization of glucose in
fat and muscle cells. Clears ama from the rasa & rakta dhatus (plasma and blood,
respectively).” On a side note, it also one of our great galactagogue remedies, increasing
milk production in lactating women. Because of it’s effects on stimulating glucose
production from fat and muscles, as well as it’s impact on lactation, it is possible it is
acting on the higher regulatory centers in the brain (hypothalamus/pituitary).
• Devil’s Club (Oplopanax horridus): This is another remedy which has some research
behind it showing that it has an impact on insulin metabolism and re-sensitizing the cells
to it’s influence, thereby lowering blood sugar levels. It has also been said to help
decrease people’s sugar cravings. It is pungent and sweet in taste, indicating it’s ability to
stimulate the blood and circulation and warm up a cold constitution, and the sweet taste
indicates a nourishing, tonic and building effect upon the overall system. It is in the
Ginseng family (Araliaceae) and contains similar steroidal saponins which are often
thought to be the primary constituents related to their adaptogenic effects. While not
much is written on this plant, save for the handful of primarily northwest herbalists that
work with it, many claim it to be adaptogenic in its properties- making it useful for states
of debility, weakness, low energy, fatigue, and chronic infection. It has a great deep
acting effect on the immune system, helping to restore the core energy behind it’s proper
functioning, and is extremely valuable for chronic respiratory conditions that don’t fully
clear up- for that post sick feeling of weakness and the annoying cough that just won’t go
away. Devil’s Club will quickly restore health and vitality with a simple 20 drop dose
three times a day. I’ve seen this work multiple times.
There’s a lot I could say about this plant, as it’s one of my own personal deepest plant alliesboth physically and spiritually. It is a plant of Mars, and instills a deep sense of protection,
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Advanced Clinical Herbalism: The Endocrine System
strength and courage though strengthening the manipura chakra, or the solar plexus. It is great
for thin, weak, emaciated, atrophic people with poor energetic boundaries, low will power,
and lack of strength on a physical and mental level. The root bark is the primary part used,
and tends to invoke a particular heightened state of consciousness and awareness, especially
when walking through the woods. Everything seems a bit more... alive. I consider it a
profoundly visionary psychotropic plant, but I have very sensitive nerves- not quite on par
with our standard visionary plants like Ayahuasca or Peyote, but rather like Calamus root or
Elderberry- one of those plants with a very strong spirit that you feel immediately when in it’s
presence.
Because Devil’s Club helps with the solar plexus and thus our will power, personal strength
and confidence, I find it assists with the spiritual/energetic side of diabetes as well as the
physical. Often people that develop this disease have poor energetic boundaries, knowing that
they shouldn’t eat the chocolate cupcake with sprinkles, but abandoning themselves for the
temporary pleasure of sweetness. Working with this plant over the long term helps people to
maintain and strengthen their contact with the higher self, the wisdom voice, and to have the
remembrance and will power to strive to live in greater accordance with that part of the self.
Sometimes change takes a lot of energy, and often people are just too wiped out and tired all
the time to want to make the effort. Oplopanax instills the vitality and strength required to
make lasting change in our lives to move us further on the path of walking in alignment with
our True Self.
• Sweet root (Osmorrhiza occidentalis): This plant is also referred to as Sweet Cicely. It has a
distinct smelling/tasting root, a cross between Licorice and Anise, with a sweet and
aromatic pungent flavor. This indicates it being a highly useful plant for the vata
constitution, as it moistens, lubricates, softens and builds up dry atrophic tissues, and
also warms up the system, moves the blood, and stimulates digestion. Like the other 2
remedies mentioned above, it re-sensitizes the cells to insulin and helps in the cellular
absorption of glucose from the blood. It is Matthew Wood’s #1 remedy for diabetes. It
also has impacts upon other side effects from diabetes, most notably the peripheral
neuropathy that accompanies it. Sweet root has helped with sore eyes, poor vision, and
numbness in the feet and lower legs- all things which are common in diabetics. Of
course, no plant will cure diabetes, but we can sure help to manage the symptoms
associated with it while people correct their diet and lifestyle, which are the only ways it
can be reversed- at least with type II diabetes. It is a sweet carminative, which is useful
in digestive problems, used similarly to Fennel or Anise- as it has very similar volatile oil
constituents. Through warming the GI, circulating the blood, and making not only the
cells but also the tongue more sensitive to sugar, it has far reaching benefits for diabetic
conditions. But, it can also be used in any situation of peripheral neuropathy, numbness,
and nerve pain- thus it has a certain anodyne action.
• Rosemary (Rosmarinus officinalis): This is another one of our specific remedies used for
the many complications associated with diabetes and insulin resistance. While it does not
seem to re-sensitize the cells to insulin as Sweet Root, Devil’s Club, and Goat’s Rue, it
does have far reaching impacts on the issues with circulation, digestion, liver
detoxification, peripheral neuropathy, and troubles with the eyes. These are all due to
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Advanced Clinical Herbalism: The Endocrine System
the pungent nature of Rosemary which brings about a stimulation to circulation as well
as overall metabolism, helping to the body to rid itself easier of excess sugars and fats.
We can think of diabetes as an ama disease, to use Ayurvedic terminology, and
Rosemary is a pungent aromatic that helps to relieve these stagnations, warm up and
kickstart the metabolism, cleanse and open the channels, and stimulate the nerves which
are deadened due to lack of oxygen and nutrients.
This plant as we have seen throughout this course has a multitude of far reaching actions and
applications, from the digestive system, liver and gallbladder, to the cardiovascular and
nervous systems. Thus it protects the heart and circulation from oxidative damage, adjusts
cholesterol, and lowers triglycerides- all problems associated with diabetes. In fact, a majority
of diabetic people have a radically increased risk of heart and cardiovascular disease. Because
of it’s dietary root, anything that supports digestion is indicated, with a primary need for
increased warmth.
Rudolph Steiner said Rosemary is one of the most specific plants in the treatment of diabetes.
He taught that Rosemary essentially builds up the ego and strengthens the sense of self by
activating the Fire Element within the organism. According to him, diabetes is an issue
associated with incomplete incarnation of the soul into the body, which the person
unconsciously attempts to attain by eating an excess of sweet foods which correspond to the
Earth Element. Essentially, they are trying to ground down and in, but not in the right way.
Rosemary assists in the soul to fully incarnate into the body and supports a persons sense of
self-awareness.
• Holy Basil or Tulsi (Ocimum sanctum): This is another one of our universal medicines
that comes from the Ayurvedic tradition. The vast spectrum of uses of Tulsi could be an
entire book unto itself! This is one of our nervine mints. The aromatic oils have an
affinity for digestion, the nerves, and stimulate circulation. The polyphenols and
flavonoids exert a potent antioxidant effect and protect the circulatory system from
oxidative damage, and the oils circulate the blood easier, helping to cleanse and protect
the vasculature. Tulsi lowers high levels of cholesterol and triglycerides. It is said to
cleanse excess doshas from the plasma (rasa) and blood (rakta) tissues (dhatus). Caffeic
acid derivatives similar to those found in Rosemary lend it an anti-inflammatory action
as well. Studies have shown it to protect the nerves, brain, liver, and cardiovascular
system from oxidative diseases, radioactive stress, and high glucocorticoids. Like the
first 3 remedies, Holy Basil is considered a hypoglycemic agent, facilitating in the
lowering of blood sugar levels. As a nervine, it a broad spectrum of applications in
nervousness, anxiety, insomnia, melancholy, and for treating peripheral neuropathy. A
placebo controlled study found it to lower blood sugar levels in diabetics by over 17%,
which is pretty remarkable!
It is commonly considered an adaptogen, helping the body to resist environment and internal
stressors. In Ayurveda it is a rasayana, or rejuvenative tonic, helping to strengthen the body
and mind, enhancing ojas and prana. “Holy Basil is classified as a rasayana, an herb that
nourishes a person’s growth to perfect health and promotes long life. For perhaps three
thousand years, holy basil has been considered one of India’s most powerful herbs. The daily
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Advanced Clinical Herbalism: The Endocrine System
use of this herb is believed to help maintain the balance of the chakras (energy center) of the
body. It is acclaimed as possessing sattva (energy of purity) and as being capable of bringing
on goodness, virtue and joy in humans.” (David Winston)
It’s effects upon the nervous system and the mind are quite remarkable. It is an excellent
remedy for brain fog, or “mucous in the brain,” when people can’t think clearly and feel like
their head is stuffed with wool. By increasing cerebral circulation, it perks up the senses, feeds
the brain with fresh oxygen and nutrients, improves memory and sharpens perception. I’ve
used it in combination with Wood Betony (Stachys betonica), Ashwaganda (Withania
somnifera), and Schizandra (Schisandra chinensis) for chronic Cannabis smokers who said they
felt much clearer in their mind. It has a sort of dual effect on the nerves. On the one hand it’s
helpful for depression and cloudy thinking, and on the other it’s great for vata derangement
where people are all anxious, nervous and scattered all over the place in their minds. It brings
about a calm, peaceful, serene sense of clarity that is quite distinct and noticeable, even after a
single dose (depending on how sensitive you are). But, I will note that some people find that it
makes them feel a little spacey, myself being on of them and can’t really take it during the day
too much as I get a sense of floating from it. Nice for meditation and prayer though.
• Blue Flag (Iris versicolor): We’ve covered this strong plant in a few other lessons, but I
wanted to mention it again here as it is one of Matthew’s specific plants for treating
diabetes, or even just simple sugar cravings. It is a strong pungent bitter root, which
stimulates all of the exocrine secreting organs of the digestive system: pancreas, stomach,
liver, gallbladder and intestines. It is also said to act on the thyroid gland, which I’ve
never used it for, but it makes sense as the roots carry the signature similar to Calamuslooks just like a vocal chord where the thyroid rests (also chewing the fresh root goes
straight to the throat!). “Iris is indicated when there is lack of secretion from the
digestive and metabolic organs, leading to hypoglycemia, constipation (from lack of
bile), atrophy, low thyroid, and type II diabetes. Rather than going down into a
depressed, cold condition, Iris favors a more irritable, nervous situation, alternating with
exhaustion and hypoglycemia. It is indicated in cases where there is fluctuation between
hypo- and hyperactive secretions. Thus, there are sometimes symptoms of
hypthyroidism and hyperadrenalism mixed in with atrophy, exhaustion, and depression.”
(Matthew Wood) With a primary action of bitter and alterative, it is an important
remedy for insulin resistance and diabetes, which tend towards the toxic and stagnant
side of the tissue state spectrum, which always needs detoxification.
• Bilberry and Blueberry (Vaccinium spp.) These 2 berries have a long standing historical
use in diabetes, and both are similar enough in their actions that I will cover them
together. Like most berries, these are indicated for oxidative stress in the tissues along
with the heat/excitation tissue state. They have a strong affinity for the cardiovascular
system, reducing heat, inflammation, and protects the capillaries and vasculature from
damage. They have a particularly strong affinity for the eyes, which is one of the primary
ways in which they are used. Because the eyes are serviced by very small capillary beds,
nestled around the complex caverns of the facial bones, it is a relatively difficult area to
get blood flow too. Also because the beds are so small, they are some of the first to go
when blood sugar levels stay too high for too long. The sour and astringency helps to
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Advanced Clinical Herbalism: The Endocrine System
cool down the heat, and tighten, tonify and strengthen the weakened vessels. They are
often used for people with hypoglycemic tendencies, and are especially useful for thin,
dry/atrophic, vata type constitutions. Herbalist David Winston uses solid extracts of
Blueberry to treat heightened autoimmune reactions and allergies with great success.
• Also of great importance in general are circulatory stimulants, adaptogens to build the
adrenals if needed, digestive remedies (bitters and carminatives) and alteratives to keep
the channels of elimination open and flowing.
• For type II diabetes, no herb can cure it- but it can successfully be reversed through
appropriate dietary modifications. Those these are often the people with addictive habits
to their foods and dietary coaching can prove difficult. Be steadfast, and encourage your
clients to be that way too.
• Another important point with diabetes is to never take a type I diabetic off their
insulin. You will kill them if you do. This is an irreversible disease. But we can help them
manage their symptoms.
• Fatigue: This is probably the most common complaint amongst modern humans living in the
western cultural paradigm. I can’t tell you how many thousands of people have come up to
me while working our booth at various events across the country that complain about their
energy levels and feeling fatigued all the time. Who can blame them? Our society has built
itself up in a way that forces most people to work long hours, not get enough or quality
sleep, and live high stress lifestyles because it’s difficult to simply make ends meet. For some,
fatigue gets far beyond simply “feeling tired” often, or having a hard time getting out of bed,
but can get to a point where it is debilitating and affecting their quality of life dramatically.
Fatigue is often accompanied by not just low energy levels, but also changes in their
immunity, nervous system and cognitive function, musculoskeletal system and pain
response, digestive function, as well as psychological wellbeing.
A major point I want to make here while discussing fatigue is that it is alarmingly common
these days for people to equate fatigue with “adrenal exhaustion.” Someone goes to an
herbalist, says they are tired, and get handed a bottle of adaptogens with no questions asked,
and are told that more is better, to stay on it for years, it will increase their lifespan, and all of
their problems will magically disappear. Well, maybe not the last part, but it always feels like
that’s the way adaptogens are discussed. What I would like to do here briefly is outline some
of the implications with fatigue and things that can be easy to overlook, which can be a major
health issue for your client if you fail to address them.
It is estimated that roughly 50% of patients that go to the doctor with complaints of fatigue
have a deeper illness at play- whether that be diabetes, cancer, Lyme’s disease,
hypothyroidism, autoimmunity, alcohol or drug abuse, HIV, allergies, heart failure,
fibromyalgia, or lupus, among others. Or, it could be something as simple as an accumulated
effect of lack of sleep or nutrient deficiencies. The point is, we don’t want to assume that
everyone is walking around with adrenal burnout just because they are tired more than they
would like to be.
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Advanced Clinical Herbalism: The Endocrine System
I can remember talking to dozens and dozens of people that approach me at an event asking
me for herbs to give them more energy. While not in the most ideal situation to do a full intake
and interview, I still take the time to ask some questions of people since I don’t want to give
them something that either isn’t going to work, or more importantly isn’t indicated. I always
ask them how much sleep they get at night, and most of the time people respond saying they
get on average 4-6 hours of sleep a night- some being that way for years. I usually hand them
a bottle of sedative and hypnotic nervines and trophorestoratives and tell them to get at least 8
hours of sleep a night and they will feel more energy. Some are grateful. Many are
disappointed I didn’t have some new fancy fad herb or formula to magically fix their problems
without any necessity for lifestyle adjustment.
“It is a therapeutic error to fail to make appropriate differential diagnosis as to the cause of
fatigue, then stimulate the system while allowing an underlying pathology to progress.” (Paul
Bergner) This is a really powerful state, and so very critical. If someone comes to us because
they are tired and we just give them an adaptogenic formula, more often than not, they will
feel more energy. They’ll start waking up less tired, not crashing so much during the day, and
genuinely feel better. But oftentimes we are enabling them to live an unhealthy lifestyle,
and push themselves beyond their normal limits. On top of that, this could be masking a
deeper issue. What if that person is tired because their thyroid is deficient? What if they have
fibromyalgia or cancer? These things cannot be overlooked.
Fatigue has become such a commonplace reason people go to the doctor these days that it
even as a medical term for it- Chronic Fatigue Syndrome. This is generally defined as fatigue
lasting for 6 months or longer without any known medical condition at its root. Paul Bergner
says “it is an artificially constructed diagnostic entity without an objective reality,” like so
many other “diseases” of the modern world like Seasonal Affective Disorder. Much of the
time, as mentioned above, it is due to certain nutrient deficiencies, sleep debt, or chronic stress
leading to a state of endocrine burnout. Note I say endocrine burnout, not adrenal burnout,
because it is impossible to separate one endocrine gland from the rest of the cascade. If
someone is chronically stressed and activating their fight/flight response, they need nervines
more than they need adaptogens most of the time.
Hans Selye created a 4 stage model of fatigue that is useful to understand it on a deeper level.
Stage 1 fatigue is the normal tiredness we feel at the end of a normal days worth of activity
and is replenished from a good nights sleep. Stage 2 is excessive fatigue from aberrations from
our normal activity- such as staying up too late or intense physical overexertion (exercise etc.)
Here we see there are marked physiological and psychological changes that occur that impact
our immune, nervous and endocrine systems, and our ability to make proper judgement, have
mental clarity, and make good decisions. Complete recovery typically takes only a few days to
weeks of rest. Stage 3 is the same, though the recovery period is prolonged from days, to
weeks or months. In Stage 4, we reach full endocrine burnout, which can take months to
years to recover from- late stage atrophy of the endocrine organs may never recover. There is
a loss of function in the hypothalamus and pituitary axis to the thyroid, adrenals, and
reproductive organs. There is a lack of rebound from rest.
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Advanced Clinical Herbalism: The Endocrine System
This provides a useful model for understanding where someone is at with their fatigue. The
key element here is that in any of the stages, the primary therapeutic strategy is rest therapy
and recuperation. You can usually tell what stage someone is at after they engage in rest
therapy for a period of time- once their energy bounces back to normal, you can tell what
stage based on how long it took them to bounce back.
When we are thinking about someone’s energy, we often immediately think of the adrenals.
But the adrenals are not responsible for our core energy levels, just our immediate stress
response. Energy is produced at the cellular level within the mitochondria of all cells in the
body. This production is called the Krebs, Citric Acid, or TCA Cycle, and generates the 1
singular molecule used for energy at the cellular level: ATP (Adenosine Triphosphate). Thus if
we are thinking of energy, we should rather think of whether we are generating enough ATP
or not, rather if the adrenals are “burned out.” Without going into depth on the entire cycle,
basically what we see is that the 3 primary forms of fuel from our diet: protein, carbohydrate,
and fat, ultimately turn into a compound call Acetyl CoA, which is the base material that
feeds this production of cellular energy.
A very important point is that the requirements for transforming our baseline nutrients into
Acetyl CoA is the B-vitamins. They are necessary to, prepare amino acids, glucose, and free
fatty acids into the baseline compounds that enter the TCA cycle. This is what technically
classifies a B-vitamin, preparing our foods for generating cellular energy. The cycle itself
requires other basic co-factors and enzymes that spin the wheel, primarily amino acids, and
some vitamins and minerals. If we do not have the proper baseline nutrients to feed into this
cycle, we will be tired!
To break for a moment into a little bit more of a philosophical speculation.... If we look at the
Krebs Cycle, what we see is that we have 4 primary things which are turned into Acetyl Coa
that enters the cycle: Protein (amino acids), carbohydrates (glucose), fats (free fatty acids),
and ketones (which are used for energy during fasting states). These 4 compounds translate
into the 4 Elements quite nicely: fat is Earth, carbohydrate is Water, protein is Fire, and
ketones are Air. These all come together to form Acetyl CoA, the Ether Element which feeds
the cycle.
After the cycle is complete, there are 3 primary metabolic byproducts: carbon dioxide, water,
and ATP, which correspond to the Mercury, Salt, and Sulfur Principles, respectively. Thus
here we see on the molecular level the formation of the 3 principles from the 5 Elements.
What is even more interesting (to me at least), is that when you break the ATP molecule it
releases a photon of light- turning it to ADP. The breaking of that phosphate bond releases
light. Phosphorous is related to the Morning Star or Venus, who shines the light of the Sun
brighter than any other planet. Thus, we are literally run by photons, or molecules of light.
Okay just wanted to throw that out there! Now back to the practical side of things....
The other critical factor when assessing fatigue is if someone is getting enough sleep at night.
Most people do not get enough sleep, and just by getting people to sleep better you can
improve their quality of life drastically. Like diet, sleep can often be a difficult thing to assess
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Advanced Clinical Herbalism: The Endocrine System
with people, as many do not really know how many hours they get at night. A good clinical tip
is to not ask how many hours of sleep someone gets, but rather what time they get up in the
morning and what time they typically go to bed at night. Then ask, “how long does it take to
fall asleep?” Then ask, “when you don’t wake up/go to bed at that time, what time do you do
those things? What causes you do stay up later or get up earlier?” These are some good
questions to ask that give you an understanding of someones circadian rhythm.
Here is a list of things you can suggest to your client to help them reestablish a healthy sleep
pattern (from Paul Bergner and NAIMH)
1. Select a time to get to bed in order to get 8.5-9.5 hours of sleep. Ideally before 11 pm, and
getting to bed no later than 1 am. Have people set an alarm to remind themselves to go to
bed.
2. Engage in light outdoor activity in the afternoon. No intense physical exercise in the
evening
3. 20 minute naps in the afternoon is acceptable, though no longer.
4. Eat dinner ideally 5-6 hours before bed, but at least 3 hours is necessary.
5. Do not engage is intense mental activity for 2 hours before bedtime
6. Turn off bright lights after sunset and have dim to low lighting in the evenings, especially 1
hour before bedtime.
7. 45-90 minutes before bed take a neutral bath (not hot!! 92-97 F) Stay in for at least 15
minutes. Add Lavender oil to the bath with peaceful music.
8. Take a dose of a hypnotic sedative formula 30-60 minutes before bed.
9. Get horizontal 30-60 minutes before bed and do some light journaling or reading (no TV!)
10. At bed time, take another dose of the herb formula. Turn off all lights.
11. If woken up before 8.5 hours, roll over and go back to sleep. If you can’t fall back asleep,
take another dose of the herb formula.
12. Eat a substantial breakfast with an abundance of protein.
I provided this as a handout that you are free to use for your clients. Usually doing this
consistently will reestablish a healthy circadian rhythm within 3 days. Anyone with fatigue
should be given this protocol before administering any stimulating adaptogenic herbs. If
someone is consistently not getting enough sleep, they accumulate what is called “sleep debt,”
which ultimately has a draining affect on the nerves and endocrine function. It is essential that
people catch up on their sleep consistently to prevent accumulated effects of sleep debt.
Other factors that should be considered with the fatigued patient is their relative protein
intake. Amino acids act as co-factors for many of the enzymatic reactions in the TCA cycle
and thus energy production. The new science on protein is showing that the standard RDA is
not high enough to optimal physiological functioning, and most people get less than 50% of
the protein intake they should get in their diet. One of the best ways to get people more
energy is to change their breakfast!! Too many people skimp on breakfast, and the old saying
is true that it’s the most important meal of the day.
The clinical herbalist and Ayurvedic practitioner Todd Caldecott routinely prescribes patients
with fatigue, stress, anxiety and nervousness to simply eat lamb stew for breakfast and has
had close to a 100% cure rate- no herbs used at all! Generally, eating 25-35 gams of protein at
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breakfast is recommended. I know, I know, that sounds like a lot, but that’s what the magic
number has shown to be to reduce carbohydrate cravings throughout the day and improve
energy levels. The new RDA of protein for people is .35 grams per pound of bodyweight. The
science has also shown that there no clinical harm in eating an excess of protein.
Other nutritional dynamics to consider is potential iron deficiency in women, vitamin D
deficiency (essential for ATP production), caffeine consumption, and whether someone holds
a vegan or vegetarian diet, which even though many see it as a myth- it is true that many (not
all) do not get ample amounts of protein in the diet. Studies on the amino acid carnitine
showed that 52% of vegans were deficient in carnitine, whereas 18% of lacto-vegetarians were
deficient, and 3% of omnivores were. This amino acid is responsible for shuttling fatty acids
into the mitochondria to be utilized for energy, and is common used for people that want to
“burn fat for energy.”
A useful model for looking into the underlying energetics of the fatigued patient comes to us
from Chinese Medicine. In general, fatigue is a form of deficiency. But the sense of fatigue
could be due to various underlying types of deficiencies, which in it’s most basic expression in
TCM would be Yin (water) and Yang (fire), as well as looking at Chi and Blood. Chi and
Yang are sympathetic to one another, as are Blood and Yin, thus each set of pairs has similar
signs and symptoms and also has some differences.
What you will often see with Chi and Yang deficiency would be pale skin, low energy,
depression, low voice, weak digestion (low gastric fire), and an enlarged tongue. With Chi
deficiency one would specifically see shortness of breath, loose stool, dribbling urine and a
weak pulse, whereas Yang deficiency would essentially be chi deficiency with cold signs: cold
hands and feet, aggravation from cold, clear copious urine, loose stool, slow pulse and darker
colored tongue.
With Blood and Yin deficiency, you would see thin deficient frame (emaciated), dizziness,
heart palpitations, insomnia, spots before the eyes, thin coating on the tongue, and a thin
thready pulse. Blood deficiency will be paleness of the skin, lips, tongue, and numbness. Yin
deficiency would be a red flushed face, hot hands and feet, dry mouth, night sweats, dry and
red tongue, rapid pulse and night sweats.
Hopefully this lends some insight into fatigue on a more in depth level than taking the
approach of loading people up on “adrenal herbs.” This previous section holds some important
points that enable you as a clinician to effect major and profound changes in someones health.
Adaptogenic Materia Medica
Before I jump into the adaptogenic materia medica, I want to make a few more statements
about them. What we see in China and India, that these types of herbs were never given to
someone for the complaint of simple fatigue, there was always a specific pattern that they
looked for in order to administer them. Also, most of these remedies are not “normalizing” as
they are often described as being- rather, they move the vital force in specific directions.
Traditionally these types of herbs were not give over the long term, only for about 4-7 days.
They should always be given in accordance with lifestyle adjustments that are rational for
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improving energy, like sleep and adequate nutrition. I also feel it is integral to give people an
idea of what any side effects might look like so they know if/when they should stop.
In general, most of these herbs are contraindicated unless there are signs and symptoms of
deficiency, from a Chinese perspective, of Blood, Chi, Yang, or Yin. Traditionally it is not
recommended to take any type of tonic herb when there are acute symptoms- such as a cough,
cold, acute infection or something of that nature. If someone is overly tonified, that is
constricted, tense, in a state of excess, or has cramping you generally don’t want to give them
these herbs, or if they feel aggravation from taking the herbs. In Chinese Medicine, typically
tonic herbs are divided into 2 primary categories: those for tonifying Chi and Yang, and those
for tonifying Blood and Yin. We can also think of these as stimulating adaptogens and more
restorative adaptogens, the latter category being less stimulating to energy.
Lastly, Paul Bergner provides the follow list of the right use of tonic herbs and adaptogens:
• To break a viscous cycle of poor appetite in a deficient patient
• To break a viscous cycle of low energy and will power in a deficient patient
• As an adjunct to other herbal treatments in the deficient patient
• To assist in the fatigue that may accompany positive lifestyle changes such as caffeine
withdrawal or the induction phase of a ketogenic diet
• In the fatigue of serious chronic disease such as cancer
• Given with attention to traditional indications and contraindications
• To support normal activity, not to drive unnatural levels of performance.
• To support recovery phase after long term periods of stress or athletic performance
• After addressing the possible causes of the deficiency, and in the context of correction of
the root causes
• Use is a moderate dose with attention to any developing overstimulation
• As a short term intervention, with frequent reevaluation or regular breaks
• Eleuthero/Ci Wu Jia (Eleutherococcus senticosus): This remedy was formerly called
“Siberian Ginseng,” though that name has fallen out of favor as this plant is not technically a
Ginseng and has rather different effects, although it is in the same family, the Araliaceae.
Another primary difference with this remedy is that it needs to be used in much higher doses
that both American and Chinese/Korean Ginseng. In Traditional Chinese Medicine, the
outer layer of the rootbark was peeled off and used for arthritis pain, the main root being
discarded, which is the part primarily used today in modern herbalism. This remedy came
into popularity during the time of WWII as developed by the Soviets and their research
done on adaptogenic herbs to help soldiers in the war.
Thus it’s important to know that this herb is not a classic tonic herb, especially from Chinese
Medicine- there it wasn’t started to be used until the 1990’s! Though there they primarily use
it to strengthen Spleen chi, which in short is the digestive faculty. Some of the primary actions
of this remedy is that it is a stimulant, in the sense that you feel a lot of energy both physically
and mentally, and as such can raise blood pressure, and heart rate. This would be ingestion of
the strong Russian Pharmacopia type extractions, which could be considered provings for
what it is useful for in lower doses. Most standard products on the market today (that aren’t
mega-concentrations) are much more mild and less likely to cause overstimulation. In fact, it
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has been shown to help relieve angina symptoms, lower LDL and triglycerides, as well as
stress induced high blood pressure. Thus as we can see, the dosage is very specific on how this
herb works. It also has been used to strengthen core immunity in cancer patients, or simply
people who tend to get sick a lot throughout the winter months. It is warming energetically
and can be contraindicated for people with heat signs or hot constitutions.
This herb is often promoted for promoting athletic performance to enhance endurance and
stamina, those the scientific studies behind this use have been said to have not been well
designed and the results not trustworthy. Other studies have shown that people using
Eleuthero in conjunction with their exercise practices showed biochemical markers for
athletic burnout, which is said to be high levels of cortisol and low levels of testosterone. This
is often by the athletes pushing themselves too far and overreaching their bodies natural
capacity.
Eleuthero, as with most of the adaptogens, is best used in moderate doses for short periods of
time when someone is in a state of fatigue. Remember, we don’t want to use it to enable people
to overreach their bodies natural capacities for too long. Thus it is for supporting normal
activity and the recovery phase. This is the way I like to think of when to use adaptogens
primarily is to promote the bodies restoration and recovery, not as a means for stimulating and
pushing it too hard. It is best given in conjunction with other therapies such as rest adequate
sleep, and nervine trophorestoratives.
An important thing to understand about this remedy, is that all of the research done in Russia
was on 1:1 extracts of the plant- most products available today are done in 1:5 or so ratios
which are for many considered not to be a strong enough preparation to convey its medicinal
virtues- at least those which are noticeable. Also they use a much lower concentration of
alcohol, which is around 30% alcohol, as opposed to 50-70%. Standard dosage is 2-15 mL a
day in Russia (2 mL is about 2 dropperfuls).
• Contraindications: heat signs and insomnia, musculoskeletal or psychological tension,
excess phlegm
• Side Effects: Overstimulation, irritability, heart palipitations, stuck energy, tension, neck
tension, insomnia, rebound crash lasting up to 2 weeks after 1-2 weeks of daily
administration. Headache, hypertension and insomnia.
• Schizandra/Wu Wei Zi (Schizandra chinensis): This is probably one of my personal
favorite adaptogenic plants. Called the “5 flavor berry,” upon close inspection of the taste
one will notice a conglomeration of sweet, salty, pungent, bitter and sour. These 5 tastes in
Chinese medicine correspond to the 5 major organ systems, all of which this remedy acts
upon. While not considered a taste in Chinese Medicine, it is also remarkably astringentwhich is very important to keep in mind when administering this remedy, especially if you
are thinking of giving it to a dry client. I like to thin of Schizandra in a couple different
ways: 1) a strong astringent for damp/relaxation, 2) a lung tonic, 3) hepatoprotective and
liver detoxification, 4) immune tonic, 5) nervous system relaxant, 6) enhances mental acuity.
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The intense astringency of the berries makes it quite ideal for the damp/relaxation tissue state,
especially when the kidneys are weakened passively leaking fluids out. In China, they say the
kidneys are connected to the lungs and help them to fully inhale air- when they are weak the
lungs are unable to do this. I have found it quite useful for shallow breathing in myself, as well
as clients who can’t take a deep breath because of too much congestion in the lungs and
because they just feel too weak. It’s one of the main remedies I like to give to smokers and
combines quite nicely with Mullein leaf and Licorice.
Research has shown Schizandra to have profound impacts upon the liver, showing
hepatoprotective and anti-inflammatory properties, as well as enhancing liver based
detoxification. This makes it useful for people exposed to toxic chemicals that may damage the
liver, or at least be difficult for them to metabolize, as well as helping to regenerate lost liver
cells to degenerative diseases like hepatitis or cirrhosis. For this it combines very well with our
western Milk Thistle seed.
The impact of Schizandra on the nervous system can be a bit confusing, depending on who
you study. Scientific research has been conducted showing that it is a direct sympathetic
stimulant, increasing heart rate, body temperature, insomnia, and overall nervous excitability.
Yet in TCM it was used to calm the shen, and was thus used for heart palpitations,
nervousness and anxiety. Personally, I have experienced more of the latter effects myself and
tend to think of it that way rather than as a stimulant- but I tend to work with lower doses.
Matthew Becker states that a small dose of Schizandra before bed promotes restful sleep and
pleasant dreams. I find it useful for “astringing the mind,” when the thoughts are scattered
and all over the place and needs direction, focus and clarity.
It’s important to know that in China Schizandra is rarely given by itself and is typically
administered as a part of a formula- likely because it has such strong energetics and effects
that we would want to modulate it in certain ways to have the desired effects. I find it
combines very nicely with nervine sedatives and trophorestoratives like Milky Oats (Avena
sativa), St. John’s Wort (Hypericum perforatum), and Skullcap (Scutellaria lateriflora). While it
has 5 flavors, sour (and astringent) is the most prominent. To reduce this excess in the plant,
the berries can be soaked in water overnight, strained and rinsed. Do this 2-3 times and then
they can be dried, powdered, or tinctured to reduce the astringency. This makes it much more
palatable and not as imbalancing. It’s interesting that some people classify it as being a
warming remedy, but my experience of it is that it is cooling (and I am really sensitive to hot
plants), which would go along with most of our other sour berries (Hawthorn, Rose hips,
Blackberries, Strawberries, Raspberries etc.)
The traditional method of preparations in the Russian Pharmacopia is a 1:5 or 1:6 ratio
tincture in 95% alcohol, of the dried fruits, BID. They would also use .5-1.5 g of powder, BID
or a decoction at a 1:20 ratio taken in doses of 5 oz BID.
• Contraindications: Conditions of excess, heat, or at onset of acute symptoms. Though as I
mentioned above, the heating quality of Schizandra is a bit confusing to me, as it seems like
another sour cooling berry. When I take the tincture or chew the berries and take a deep
breath, it feels noticeably cool.
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• Side effects: dry astringency, overstimulation, insomnia, overexcitability, tension (I would
note these side effects are in higher doses, low doses I find are helpful for these symptoms).
Side effects primarily due to the excess astringency of the berries. This can be relieved by
soaking the berries in cool water over night, pouring it off and then tincturing it, or making
tea.
• Ashwaganda (Withania somnifera): This is one of major rasayana, or rejuvenative tonic,
herbs used throughout the Ayurvedic tradition of India. The name translates to “the smell of
a horse,” as the roots have a rather unique odor, which also refers to the fact that it is said to
instill the strength and vigor of a stallion. Interestingly enough, it was also used throughout
the southern Mediterranean, Egypt, and the east coast of Africa. Dioscorides called it
“sleepy nightshade,” which is where it gets it’s species name somnifera, which means sleep
inducing. (This is also the species name for the unrelated plant Papaver somniferum, the
Opium Poppy.) It is in the nightshade family and thus relates to tomatoes, potatoes, tobacco,
and many other plants in this highly diverse family of foods, medicines, poisons, and
psychotropics.
It is traditionally used to help build up ones energetic reserve, strengthen the nervous system,
focus the mind, and enhance libido. It not only energetically strengthens the sexual reserve,
but also physically- in men it increases sperm count and mobility. I like to think of it as being
specific for men who have sexual difficulties or frustration due to nervous exhaustion or
because of sexual overextension which has drained the vital reserves (which is well
documented in the Chinese tradition).
This plant, in a similar way to Schizandra, has mixed effects upon the nervous system- in one
sense it is a stimulating energy tonic and in other ways it is a calming nervine sedative. Both
properties are due to different chemical compounds in the plant which exhibit these effects.
On the relaxant sedative side, it has been shown to have an affinity for GABA (Gamma
Amino Butyric Acid) receptors, which have a relaxant effect- Valerian and Crampbark also
effect these receptors. This is why I absolutely love this plant. On the one hand it helps build
up energy, but on the other it does it is a sort of indirect way by simply helping someone sleep
better, which is really the best way to get someone to not feel fatigued! Paul Bergner sums it
up well when he states, “Ashwaganda is one of the very best herbs for breaking the cycle of
exhaustion causing insomnia, and then the insomnia causing further exhaustion.”
I find it is best for people that are exhausted and totally drained, yet they have signs of wind/
tension: anxiety, nervousness, heart palpitations, insomnia, and feeling stressed out in general.
In this regard I have combined it with great success with nerve trophorestoratives and
sedatives like Milky Oats (Avena sativa), Skullcap (Scutellaria lateriflora), Passionflower
(Passiflora incarnata), and Lemon Balm (Melissa officinalis). A formula with those 5 herbs is like
nervous exhaustion heaven!! The power of Ashwaganda is that it is not quite as strong as
some of the other adaptogens, and thus less likely to over stimulate someone, making it more
effective for long term use.
It has been studied in regards to its effects upon the thyroid gland, which it has been shown to
stimulate, thus making it a possible great remedy of choice for hypothyroidism. Energetically
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it is a nice match too since it is warming and often hypothyroid people run on the cold side
and feel tired and run down. It has also been extensively used for muscle and joint pain,
fibromyalgia, rheumatoid arthritis, anemia (it contains iron, only powders will work here...
maybe spagyrics?), immunodeficiency, cancer, and various autoimmune conditions.
I have found personally in my own work with this plant (both taking and administering it)
that it is much less likely to cause the overstimulation that you get with other adaptogens like
Eleuthero, American Ginseng, or Asian Ginseng. Though some people do experience agitation
from using this plant and it actually making it difficult for them to sleep, which something one
should really keep their eye on when administering it. If this happens it is the wrong plant and
it should be changed for a different remedy.
Traditionally it was used in amounts of about 3-6 grams of powder mixed in milk. It tinctures
quite nicely in a 50/50 alcohol to water tincture.
• Contraindications: heat signs- though it is not nearly as warming as Eleuthero or the
Ginsengs. The traditional method of preparation as a milk decoction likely reduced this
heating effect. It can also be combined with cooling plants, Shatavari is traditional,
which would also balance this heating property. Nightshade sensitivities. Powders may
not be best for men, especially if their iron levels are normal or high. It is also
contraindicated in people using barbiturate sedatives (valium class of drugs), as it can
potentiate or decrease their effects. Note some herbalists have used it to help get people
off those drugs.
• Asian Ginseng/Ren Shen (Panax ginseng): This is probably the most famous of the
Chinese tonic herbs, and was generally considered to be one of the primary representatives
of the adaptogenic category. But, under the modern definitions of the word, it really doesn’t
fit the category, as this is likely the most stimulating of all of the adaptogens. Panax ginseng
became very popular in the west as an “energy” herb, as was quickly marketed as such
generating a multi-million dollar industry. Unfortunately, many people took this herb as a
sort of caffeine replacement and have experienced some of the side effects associated with
inappropriate use. I was taught that if you are taking enough Ginseng to feel stimulated you
are either taking too much or more likely it is not indicated for you. In Chinese Medicine,
this plant was generally not taken by anyone under the age of 40, as it is not indicated until
there is a certain degree of yang and chi deficiency. Oftentimes people in the west who want
to take Ginseng are those whom it is most contraindicated, primarily yang/pitta type
individuals wanting more energy for some reason or another.
So what are it’s indications? The first and foremost is deficiency of kidney yang, which
manifests as impotence, low back pain, weakness in the knees, frequent urination, coldness,
and generalized coldness (pale complexion) as well as fatigue related shortness of breath and
quiet voice. Basic fatigue is not enough of an indication for its use. We should see someone
who is pale, weak, and overall deficient.
The thing that’s important to understand about Ginseng, is that it is directly increasing the
amount of vital force in someone’s body. This might sound all fine and dandy, but the problem
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with this is that oftentimes people already have an excess of chi or energy in the body, or that
it gets stuck in certain areas or organ systems. If there’s already enough energy in the system
and it’s stuck somewhere, and you add more energy to the system, it’s going to aggravate the
signs and symptoms associated with that stuck energy. Thus it is contraindicated in any
situations where there is any form of stagnation.
Like many of the other adaptogens, it is also reputed to have an amphoteric action on the
immune system, primarily in the treatment of fatigue related immunodeficiency diseases like
cancer. There has been some studies done on people with type II diabetes showing
improvement of symptoms, as well as people with Addison’s disease (complete adrenal
exhaustion). As a stimulant, it has cardiovascular effects as well, lowering cholesterol and
triglycerides, preventing arteriosclerosis and thus heart disease.
An important distinction amongst Asian Ginseng is the different forms in which it is availableprimarily what is called the white and red forms. White Ginseng is just plain old Ginseng root
dried, hence it looks like. Red Ginseng on the other hand has the small root hairs stripped off
of it, and then steaming and drying it in the sun. The Red Ginseng, as we might assume, has a
more pungent and stimulating property than the white.
• Contraindications: heat signs, hypertension, insomnia, intolerance of hot weather,
abdominal bloating, “excess and stuck energy,” muscular tension, any of the side effects
listed below. It is also contraindicated in people taking blood thinners (warfarin), as well
as blood sugar medications, and MAOI antidepressants.
• Side Effects: Overstimulation, irritability, dry mouth, fidgeting, blurred vision,
headache, decreased appetite, irritability, nose bleeds, dizziness, stuck energy, tension,
neck tension, insomnia, rebound crash lasting up to 2 weeks after 1-2 weeks of daily
administration. Heart palpitations, headache, hypertension and insomnia.
• Codonopsis/Dang Shen (Codonopsis pilosula): I wanted to briefly mention this remedy
because it is a primary substitute for Ginseng in Chinese Medicine with relatively similar
properties and contraindications. Commonly called “poor man’s Ginseng,” Codonopsis is a
much cheaper option, as Ginseng is pretty expensive, with similar uses- though it is
generally much more mild in terms of its heating and stimulating properties. Because it is
weaker in its actions this plant is typically used in higher amounts that Ginseng, and that is
its strength!! Also worth mentioning is that it is much more moistening and tonifying to yin
than Ginseng.
It is especially useful for people with weakened and deficient digestion, as it strengthens
spleen chi, restores the appetite and improves the overall digestive function. It was classically
attributed to be a Blood tonic as well, as modern studies reveal that it indeed increases red
blood cell count and thus applications in pale, thin, weak and anemic individuals. It would be
appropriate to use it with Ashwaganda in powders for this.
As for extraction, some people like to make simple tinctures out of it at a 1:4 or 1:5 ratio. But
others like to prepare a very concentrated decoction which is preserved with alcohol. This is
the form I have taken and like it quite a bit. I have not found Codonopsis to be over
stimulating in anyway, nor have experienced it to aggravate any heat patterns (and I can tend
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to run a bit on the hot side). It is commonly used in formulation, ideally with Licorice
(Glycyrrhiza glabra).
• Contraindications: Heat signs, though it is much more mild in terms of its heating
properties, closer to warm than hot. Excess iron in the blood. All the same side effects
and contraindications listed under Asian Ginseng apply here.
• American Ginseng (Panax quinquefolius): This plant was used by literally every indigenous
tribe that had access to it, often held in very high regard both as a physical and spiritual
medicine. It grows along the east coast of the US and was a major part of trade during the
Revolutionary War. Like it’s cousin Asian Ginseng, this is considered a stimulating tonic
herb, though unlike Panax ginseng, this plant is cooling and has the benefits of being a
moisturizing yin tonic. Thus, our American Ginseng is much more suitable for the dry/
atrophic, vata type constitution that needs more yin, especially in the lungs and kidneys.
This cooling and moistening property of American Ginseng is one of the best guiding lights
for its proper use. I tend to often think of it primarily as a moistening agent for the mucosal
membranes, a property which not that many herbs can do, sometime of great benefit to
many people in our modern culture who don’t drink enough water and are chronically
dehydrated. The neurasthenic person is often dehydrated, especially of oils, or at least loss of
water which makes the nerves unable to function as well.
Like most adaptogens, it is indicated for fatigued, worn out, tired, deficient people with a
relative degree of endocrine burnout. Dark circles under the eyes, elevated cortisol and
epinephrine, and difficulty sleeping. Like Asian Ginseng, it was used by the Eclectic
physicians primarily as a digestive aid, giving the GI enough energy to properly assimilate
nutrients from food and stimulate a sluggish digestive system as a bitter tonic. It was
traditionally prepared as a decoction, though in the mountains it was often stuffed in jar with
some corn alcohol poured on top of it. The best preparations are lower percentages of alcohol,
around 30% or so in mid range doses of 10-20 drops. Many of the traditional American
herbalists state that it is best used over a longer term period of time
• Contraindications: cold signs and abdominal bloating
• Rhodiola (Rhodiola rosea): This plant has also been called the “arctic rose” or “rose root,”
and has a long standing historical folk use in Tibet, Siberia and Scandinavia. This is likely
one of the most studied adaptogens by the Russians (other than Eleuthero), as well as the
Germans, Chinese and Swedish. I find that this remedy is extremely stimulating, much more
so than many of the other adaptogens discussed (except the Ginsengs). It is primarily used
as a nootropic stimulant, meaning that it helps clarify and focus the mind, increase
circulation to the brain, and stimulate the nervous system. In this regard, it has a lot of
research and usage for depression, poor memory, ADHD, and other cognitive disorders.
One of the first things most people note immediately after taking Rhodiola is that it is
extremely astringent and drying. This humoral effect is one that should not be overlooked
when administering it. Because it is so stimulating and drying, we see that it is best used for
people with the kapha constitution, which matches many of the major uses anyways
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(depression, sluggishness, fatigue, mental exhaustion, foggy thinking etc.). In general it is
recommended to not take this plant late in the afternoon as it will commonly generate
insomnia, and many people experience anxiety, nervousness, sweating, and even heart
palpitations.
Of course we can see the physiological effects of being such a strong stimulant potentially
leading to some of these side effects, but I wonder how much of it would be humorally related
as well. As we have seen, the nerves must be kept moist with oils in order to function properly,
as does the adrenal cortex. Perhaps because Rhodiola is so incredibly drying, it is simply severely
aggravating the vata constitution.
• Contraindications: nervousness and anxiety, insomnia, dry tissue state or constitution.
Not a good remedy for vata constitutions- best for kaphas. It should not be used by
people with manic mental states, bipolar disorder, or are particularly paranoid.
• Side Effects: anxiety, sympathetic overstimulation, dry mouth, heart palpitations,
insomnia, panic attacks, triggering of PTSD.
• He Shou Wu (Polygonum multiflorum): This classic herb from the Chinese pharmacopia
was for some reason started to be called “Fo-Ti” in the west, which is basically a completely
made up term, hence the Chinese name He Shou Wu will be used. This name translates to
“black haired Mr. He.” As the story goes, Mr. He was an ill elderly man who had no
children, though desperately wanted some. After consuming the root for a period of time it
is said his hair turned from grey to shiny black and his wife gave birth to children.
Interestingly enough these are symptoms associated with a degree of endocrine burnout
(premature greying hair and infertility).
On a chemical level, this remedy contains anthraquinone glycosides, similar to what is found
in our stimulant laxative plants like Senna or Cascara. In order to reduce this laxative effect,
the roots are often prepared by cooking them in black bean juice, which also makes the roots
look black, like Mr. He’s hair. It has a sweet, bitter and warming property, making it an ideal
remedy for vata constitutions, as it promotes fluid generation and warms up cold tissues. The
bitterness lends to its use for the liver and gallbladder and digestive strengthening virtues.
In TCM it was traditionally used to strengthen blood and yin deficiency, and it’s
accompanying symptoms mentioned above (dizziness, ringing in the ears, low back pain etc.).
It also has an impact on the nervous system and may have far reaching abilities to help
strengthen the nerves in degenerative nerve diseases like Lyme’s, MS and Alzheimer’s. Many
note it improves mental cognition, cerebral circulation, and mental focus and clarity. The
other major use is for men with low libido, low sperm count and poor sperm motility, and
higher doses can indeed cause a pretty strong acute sexual excitation.
• Contraindications: cold digestion, excessive mucous, diarrhea
• Side effects: Diarrhea and loose stool from the stimulant laxative effects
• Astragalus/Huang chi (Astragalus membranaceous): This is a pretty well known herb these
days used by so many western herbalists that we have essentially adopted it into our system.
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Advanced Clinical Herbalism: The Endocrine System
But, we have to remember that there are some specific dynamics around this herb that have
been discovered by the Chinese that cannot be abandoned. I mention this from the
beginning here because I see this herb used incorrectly a lot and want to make sure you
know it’s proper use.
In the west we primarily think of it as an immunomodulator for people that have deficient
immunity and get sick a lot. The problem with this, is that then people think “oh it’s good for
my immune system” and then start taking it when they get sick. This is the problem when we
take herbs out of their traditional context and forget the energetics. First and foremost, it is
said to be a tonic to both blood and chi, which is a unique aspect of the remedy. According to
the Chinese, Astragalus strengthens wei chi, which is the energy that circulates between the
skin and the muscles and functions as a protective mechanism- a sort of shield. This
corresponds to the immunity of the skin- which as we noted earlier is under hypothalamic
regulation- the opening and closing of the pores and sweating response. (Whether Astragalus
impacts the hypothalamus or not I am unsure).
We can think of the wei chi as this protective mechanism that keeps “bad things out.” But the
problem is, once something gets in and you start taking Astragalus you are actually trapping
that pathogen, or cold, in the body and driving it deeper into the tissues. I heard once that
Astragalus actually strengthens the cell membranes, which would be like a microcosmic
reflection of what it does to the whole body itself. The point, don’t take this plant when you
are sick, but rather when you are healthy to keep you that way. If you think of a fever, you
want the pores to be open so you can freely sweat, but Astragalus will effectively keep the
pores closed to maintain the body heat potentially raising the fever even more but moving
opposite to the direction the vital force is trying to move. Paul Bergner says it is a “chronic
tonic,” meaning it is meant to be used in the long term for chronic immunodeficiency, as
opposed to for acute and peripheral immune stimulation.
Energetically it is a warming remedy, and is traditionally used to warm up a cold, deficient
person in the winter who has poor digestive faculty (spleen chi deficiency). Not only does the
warming quality keep you warm, but through strengthening the wei chi it helps to prevent cold
from entering the body. It also has a nice moisturizing property in the respiratory system and
strengthens lung chi- which is actually responsible for generating wei chi (lungs are similar to
immunity in Chinese Medicine). Because of it’s effects on immunity, it has been research for
immunodeficiency syndromes and cancer.
The spleen chi deficiency pattern is important to consider here as well. Sometimes people feel
fatigued and deficient because they don’t have the capacity to fully digest, assimilate, and
metabolize the nutrients from their food. Thus, don’t just pigeonhole Astragalus into the
immune system category, but remember that it is a key herb for strengthening digestion and
absorption, and can be an important remedy for those who have low energy levels and chronic
fatigue juxtaposed to low immunity and digestive insufficiency.
• Contraindications: heat signs. Pitta constitutions. Acute infection or disease.
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Advanced Clinical Herbalism: The Endocrine System
• Reishi (Ganoderma lucidum): This medicinal mushrooms comes to us from Chinese
Medicine, where it is called Ling zhi, which means “spirit plant,” (even though it’s a
mushroom). Yet we find that there are different species of Ganoderma growing in the forests
of the Pacific Northwest and Northeast, primarily Ganoderma oregonensis, G. tsugae, and G.
applanatum. I will note that most Reishi that is in herbal commerce is commercially grown in
laboratories and not gathered from the wild. It is my opinion that the wild Reishi contains
an intelligence and spirit that will not be found by those grown under strict laboratory
conditions- whether they have higher “active” constituent profiles or not.
It was classically called “the mushroom of immortality,” and was held in high reverence by the
Chinese mystics, sages, healers, and emperors. This is one of the most classic shen tonics in
Chinese Medicine, which is said to be stored in the heart and represents the state of the mind
and emotions- quite similar to the concept of Mercury of the 3 Philosophical Principles of
Alchemy. They say that when someone’s shen is disturbed, they have anxiety, tension, stress,
bad dreams, insomnia, lack of clarity and poor memory. These symptoms are all addressed by
Reishi in a potent and powerful way, among other uses.
The primary actions of Reishi are first and foremost, bitter tonic, which are due to the
triterpenes. A long decoction of the mushroom indeed yields a quite bitter tasting beverage,
which also has some warming properties to it. This bitter property also reveals that it has an
impact upon the liver, of which it is a superior hepatoprotective, on par with Milk Thistle to
protect the liver from oxidative damage and facilitate it’s rejuvenation and restoration. It has
been studied extensively in Japan and China in this regard. Bitters in general tend to have a
downward bearing action on the vital force, meaning that it brings the energy from the head,
brain, and mind down and in- excellent for vata derangement and scatteredness, which would
be a disturbance of the shen. It moves the awareness from the mind down into the heart- a
spiritual bitter.
But most of the research on Reishi has been on it’s immunomodulating actions. It has been
shown to increase the activity and count of monocytes, T-cells, and macrophages in those that
are immunodeficient, and yet decreasing excessive inflammation and immunity in those which
are hyper-reactive or autoimmune. Thus it is an immune amphoteric. Due to this action it has
boatloads of research done on it for the treatment of cancer, immunodeficiency diseases, and
the related fatigue that goes along with it. It is also considered a superior lung tonic and used
for bronchitis, especially in the elderly when it has gotten to the point of being debilitating.
Herbalist Matthew Becker calls Reishi one of the great “wisdom remedies.” This category he
says are those plants which act directly upon our consciousness and instill a sense of peace of
mind and open up our consciousness to higher levels of awareness, initiate our personal
growth and psychological development. “Reishi is believed to lead you into deeper states of
inner knowledge, wisdom. You are able to go deeper inside yourself. It is the premier herb for
people that want to meditate or have a spiritual practice. The calm that it gives you is unlike
any other calm I know.... Take Reishi every day and you will be a different human person, a
permanent realignment with a deeper part of yourself.” (Matthew Becker)
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Advanced Clinical Herbalism: The Endocrine System
He also mentions that it is one of our other calming adaptogens, and as such it works very
well with Ashwaganda and Schizandra. While it has an impact upon the nervous system as a
nervine, it is not a majorly calming remedy like our normal sedatives and hypnotics- rather it
tends to produce a state of peace. It is useful for treatment of insomnia, primarily due to
people.
Lastly I want to mention preparation. What we see in most of the medicinal mushrooms is a
polarity in their chemistry, some of which are water soluble (polysaccharides responsible for
their immunological effects) and some of which are alcohol soluble (the bitter triterpenes).
Traditionally, they were prepared as long decoctions and drank as a tea. What the modern
method of extraction is called is “dual extraction.” This is simply making a high alcohol
tincture, and a strong decoction and combining them. An important consideration here is that
the ratio of alcohol extract and water extract needs to be just right, as high percentages of
alcohol will cause the polysaccharides to precipitate, or fall out of solution. Thus they should
be recombined at no higher than 30% alcohol, and the alcohol extract should be poured into
the water extract. If you pour the water into the alcohol, that first bit of polysaccharides that
hit the high proof alcohol will immediately fall out of solution. If you pour the alcohol into the
water, you are gradually increasing the ratio of alcohol to water and preventing that from
happening.
• Shatavari (Asparagus racemosus): The word “shatavari” translates to “she who has one
hundred husbands,” an indication of it’s affinity for the female reproductive system and as a
sexual/libido tonic. This has also been translated as “cures 100 disease,” indicating it’s vast
spectrum of application. Shatavari has been used in the Ayurvedic tradition for thousands of
years and is a truly incredible plant. Although it is often referred to as a female medicine, it
has it’s applications in the male system as well. The first and foremost important thing to
understand about Shatavari, is that unlike many of the other adaptogens, it is a cooling and
moistening plant. This is important because many of the remedies discussed are quite
warming and drying energetically- so this is a highly suitable plant for the pitta constitutions
that are hot, and the vata constitutions that tend to be on the dry side. Shatavari is said to be
the female equivalent of Ashwaganda, and they indeed formulate quite well together- as one
is warming and drying, and the other is cooling and moistening. In China Asparagus is not
considered a specific for women and is used for both sexes- although it is a different species.
It directly stimulates prolactin and thus has an effect on the anterior pituitary gland. Whether
this is the mechanism or not, it has been used as an effective galactagogue to facilitate milk
production and flow in lactating women. It has a soothing, cooling demulcent property which
is beneficial for tissues which are emaciated, dry and atrophic. It has an especial affinity for
the female reproductive system as mentioned, but also the genitourinary tract- especially
when the tissues are hot, dry, tense and inflamed. This is also true of our standard food
asparagus. The soothing demulcent property also has applications in the respiratory system.
From a Chinese perspective, it is a premier yin tonic.
It is indeed a great herb for people who are deficient, tired and lethargic in need of core vital
strengthening, specifically when there is low libido, infertility and general dry tissue states
which leads to fatigue, nervousness and anxiety. I find it to be quite pleasantly and gently
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Advanced Clinical Herbalism: The Endocrine System
calming to the nerves, I find it somewhat similar to Reishi promotes a peaceful state of mind,
rather than a direct sedation like a sedative or hypnotic nervine. I like it combined with Milky
Oats in this regard.
• Contraindications: cold signs and excessive moisture.
Nutritional Factors
Below are some fundamental nutrients to consider when treating certain endocrine organs and
treating fatigue:
• Magnesium (stabilizes adding 3rd phosphate onto ADP to make ATP)
• B-vitamins (always take a complex)
• Essential fatty acids
• Zinc
• Vitamin D
• Iodine (for iodine deficient thyroid cases)
• Complete protein (provides co-factors for neurotransmitter and hormone production)
• Meat (contains iron for anemic women)
• Eating a protein rich breakfast
Cruciferous vegetables have been shown to depress thyroid function. Thus they are
specifically indicated for hyperthyroid, and contraindicated for hypothyroid. This includes
foods like: kale, spinach, broccoli, cabbage, Brussels sprouts, cauliflower, turnips, mustard
greens... avoid soy products all together.
Lifestyle Factors
Below is a list of lifestyle factors that can contribute to fatigue (from Paul Bergner)
• Sleep debt
• Disordered digestion, including foot intolerance (eating a food intolerance triggers a
stress response)
• Suboptimal protein in the diet
• Insufficient food/protein early in the day
• Deficiencies in magnesium, B-vitamins and zinc
• Vitamin D deficiency
• Iron deficiency (most common in women)
• Essential fatty acid deficiency
• Lack of moderate exercise most days
• Over exercise relative to nutrient intake
Soy protein has been shown to trigger autoimmune reactions in people with thyroid disease,
thus for people with diagnosed thyroid issues screen for potential soy allergens or
hypersensitivities.
Materia Medica
Warming Adaptogens (Yang Tonics)
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Advanced Clinical Herbalism: The Endocrine System
Asian Ginseng (Panax ginseng)- The red form is the hottest, the white form is less so.
Eleuthero (Eleutherococcus senticosus)
Cordyceps (Cordyceps chinensis)
Schizandra (Schisandra chinensis)
Ashwaganda (Withania somnifera)
Astragalus (Astragalus membranaceous)
Devil’s Club (Oplopanax horridus)
Cooling Adaptogens
Reishi (Ganoderma lucididum)- though it is slightly warming too....
Shatavari (Asparagus racemosus)
Peony (Paeonia lateriflora)
Ophiopogon (Mai Men Dong)
Goji (Lycium chinensis)- somewhat neutral, though anti-inflammatory and antioxidant...
American Ginseng (Panax quinquefolius)
Rhodiola (Rhodiola rosea)- slightly cooling though quite stimulating
Licorice (Glycyrrhiza glabra)- neutral to cool
Moistening Adaptogens (Yin Tonics)
American Ginseng (Panax quinquefolius)
Astragalus (Astragalus membranaceous)
Asian Ginseng (Panax ginseng)*
Shatavari (Asparagus racemosus)
Ho Shou Wu (Polygonum multiflorum)
Codonopsis (Codonopsis tangshen)
Ophiopogon (Mai Men Dong)
Goji (Lycium chinensis)
Devil’s Club (Oplopanax horridus)*
Licorice (Glycyrrhiza glabra)
*Although it is moistening it is not considered a yin tonic. For Oplopanax it depends on when
it was harvested (spring or fall- autumn harvest is more moist)
Drying Adaptogens
Pretty much all of the warming adaptogens are also drying, but Schizandra (Schisandra
chinensis) and Rhodiola (Rhodiola rosea) are extremely astringent and drying.
Rehmannia (Rehmannia glutinosa)
Angelica/Dong Quai (Angelica sinensis)
Astragalus (Astragalus membranaceous)
Peony (Paeonia lateriflora)
Ho Shou Wu (Polygonum multiflorum)
Blood Tonics*
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Advanced Clinical Herbalism: The Endocrine System
*Blood deficiency in Chinese Medicine does not always equate to our western definition for
anemia. Blood deficiency is usually associated with the following symptoms: emaciation, pale
complexion, pale tongue, little to no coat on the tongue, weak thready pulse, dizziness on
standing, spots before the eyes, heart palpitations, and insomnia.
Asian Ginseng (Panax ginseng)
Astragalus (Astragalus membranaceous)
Codonopsis (Codonopsis pilosula)
Eleuthero (Eleutherococcus senticosus)
Reishi (Ganoderma lucidum)
American Ginseng (Panax quinquefolius)
Licorice (Glycyrrhiza glabra)
Chi Tonics
Hyperthyroid
Motherwort (Leonurus cardiaca)
Lemon Balm (Melissa officinalis)
Bugleweed (Lycopus virginicus)
Skullcap (Scutellaria lateriflora)
Blue Vervain (Verbena hastata)
Eleuthero (Eleutherococcus senticosus)
Quaking Aspen (Populus tremuloides)
Sarsaparilla (Smilax officinalis)
B-vitamins
Magnesium
EFA’s
Cruciferous vegetables
Black Walnut (Juglans nigra)
Bladderwrack (Fucus vesiculosus)
Chickweed (Stellaria media)
Burdock (Arctium lappa)
Queen Anne’s Lace (Daucus carota)
Ashwaganda (Withania somnifera)
Cleavers (Galium aparine)
Blue Flag (Iris versicolor)
Poke (Phytolacca decandra)
Nettle leaf (Urtica dioica)
Kelp
B-vitamins
Selenium (Brazil nuts)
Avoid cruciferous vegetables
Hypothyroid
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Advanced Clinical Herbalism: The Endocrine System
Pancreas/Insulin Resistance/Diabetes
Goat’s Rue (Galega officinalis)
Devil’s Club (Oplopanax horridus)
Holy Basil (Ocimum sanctum)
Rosemary (Rosmarinus officinalis)
Blue Flag (Iris versicolor)
Bilberry/Blueberry (Vaccinium spp.)
Sweet root/Sweet Cicely (Osmorrhiza occidentalis)
Dandelion (Taraxacum officinalis)
Prickly Ash (Zanthoxylum americanum)
Alteratives in general are indicated
Circulatory stimulants are indicated
Dietary shifts are key, herbs are only supportive
Simple Formulations
Hypothyroid Formula*
Black Walnut (Juglans nigra)
Chickweed (Stellaria media)
Burdock (Arctium lappa)
Nettle leaf (Urtica dioica)
Queen Anne’s Lace (Daucus carota)
20%
20%
20%
20%
20%
Equal parts. Add Bladderwrack or Kelp if there are nodules on the thyroid or goiter.
*This formula comes to us from Phyllis Light and has been used by many herbalists with great
success.
Hyperthyroid Formula*
Bugleweed (Lycopus virginicus)
Motherwort (Leonurus cardiaca)
Skullcap (Scutellaria lateriflora)
Hawthorn (Crataegus monogyna)
40%
25%
25%
10%
*From David Hoffman
Adrenaline Excess Triplet
Lemon Balm (Melissa officinalis)
Skullcap (Scutellaria lateriflora)
Milky Oats (Avena sativa)
33%
33%
33%
Fatigue Formula*
Eleuthero (Eleutherococcus senticosus) 1:1
Licorice (Glycyrrhiza glabra)
Schizandra (Schisandra chinensis)
Damiana (Turnera diffusa)
25%
25%
25%
25%
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Advanced Clinical Herbalism: The Endocrine System
*This comes from the NAIMH clinic in Boulder, CO. Suggested use in 20-30 drops 2-3 times
a day.
Immune Tonic Triplet*
Codonopsis (Codonopsis pilosula)
Astragalus (Astragalus membranaceous)
Licorice (Glycyrrhiza glabra)
60%
20%
20%
*From Paul Bergner
Stress Formula with Anxiety
Ashwaganda (Withania somnifera)
Shatavari (Asparagus racemosus)
Gotu Kola (Centella asiatica)
Skullcap (Scutellaria lateriflora)
Milky Oats (Avena sativa)
20%
20%
20%
20%
20%
Blood Sugar Balance*
Goat’s Rue (Galega officinalis)
Devil’s Club (Oplopanax horridus)
Holy Basil (Ocimum sanctum)
Rosemary (Rosmarinus officinalis)
Nettle (Urtica dioica)
Oregon Grape (Mahonia aquifolium)
Blue Flag (Iris versicolor)
20%
20%
20%
17%
10%
10%
3%
*This is the Organic Unity formula Sweetness and works very well. Be cautious if taking
hypoglycemic drugs. To be used in conjunction with dietary and lifestyle changes.
Daily Core Nutritional Protocol For Fatigue
• B-Complex Vitamin (or use a multivitamin with an adequate B complex)
• 5000 IU of Vitamin D (up to 50,000 IU a day in severely deficient people, for 1-2 weeks)
• 600-1200 mg Magnesium (in divided doses, increases ATP production)
• 1000 mg EPA supplement (essential fatty acid)
• 25 grams of protein with breakfast
• Daily Nervine Trophorestorative Formula
• Nighttime Hypnotic Formula
• No less than 8 hours of sleep per night, 10-12 hours of rest therapy on weekends
Reassess someones energy levels at 6 weeks. If this has been followed completely and no
improvements are seen, assess for underlying serious diseases and potentially use an
adaptogenic formula.
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