Positive Health Online

Described by a child in an exam howler modern man is a 'knackered ape'. The shocking results of Britain's largest ever survey of 22,000 city dwellers[1] revealed that 76 per cent of people are frequently low in energy, waking up tired and loading in stimulants. More than half of those surveyed use tea, coffee, cigarettes and sugary snacks including chocolate to wake up and keep going throughout the day.

Although they work in the short term, these stimulants throw the body's sensitive balance of blood sugar, hormones and neurotransmitters right off track. The result is poor concentration, insomnia, fluctuating 'highs' and 'lows', energy drops, food cravings, stimulant cravings, uneven weight, stress and, inevitably, life-threatening illness. The effect on the body of excessive stimulation is adrenal overload and eventually burn-out. Sure, you wake up, but the body's chemistry scrambles to restore balance. This pattern of ups and downs may go on all day as you try to meet the many demands thrust upon you. Why do we do this?

Stimulating Society

To a large extent we find the roots of our own need for stimulants in the Industrial Revolution. It demanded brutally long hours from workers, whom it fuelled with tea, coffee and tobacco as a means of pushing them to work faster and more efficiently. Soon sugar entered the mix to sweeten the tea and coffee, and then, chocolate. Ever-increasing consumption continued right into the 20th century and rapidly became part of the daily rituals of people throughout Europe who were desperately malnourished as diets changed dramatically in the growing cities and workhouses. It continues to grow into the new century.

These stimulants keep adrenal hormones pumping and keep us in the 'fight flight syndrome' in which our bodies become programmed for fear and aggression. In the 21st century we fight and take flight metaphorically. Ours is an urban jungle where we battle with traffic, reacting to an alarming memo that threatens to kill a deal, living with the fear of redundancy, working to deadlines, surviving, not thriving, and expressing our anger and frustration by tooting the horn or smashing our fist.

Are You Addicted to Stress, Sugar or Stimulants?

If this sounds familiar, the chances are you too are caught in the vicious cycle of sugar, stress and stimulants (see Figure 1). To fuel our need for energy we eat carbohydrate. This breaks down into glucose, which the bloodstream then circulates to all our energy-giving cells. As blood sugar levels rise, the hormone insulin is released to carry the glucose into the cells, and then the blood sugar levels fall. This drop triggers the brain to tell you to eat something sweet - or have a stimulant or stay stressed.

By staying stressed, with dopamine, adrenalin, noradrenalin and cortisol pumping, the body can more easily liberate stores of glucose, held as glycogen in muscles and the liver. That's why, when you wake up tired, ten minutes of recalling everything you have to worry about soon gives you the edgy energy necessary to get you going.

The alternative is to consume some sugar, perhaps in the form of toast and jam, an almond croissant, or a sugared cereal, or to consume a stimulant. Nicotine will do it, but the number one stimulant is caffeine, found in tea or coffee.

All of these scenarios raise adrenal hormone levels in the short term and lead to adrenal exhaustion in the long term. Most worrying is the increase in the adrenal hormone cortisol. Raised levels of cortisol have been linked to poorer memory and a shrinking of the hippocampus the brain's memory sorting centre.[2]

After only two weeks of the raised cortisol levels of stress, the dendrite 'arms' of brain cells that reach out to connect with other brain cells start to shrivel up, according to research carried out at Stanford University in California by Robert Sapolsky,
Professor of Neuroscience.[3]

Why Caffeine Isn't Good for You

Stimulants are substances that make us more alert, energized, cheerful, or even high. They include sugar, coffee, tea and cigarettes, and the more extreme amphetamines and cocaine. They all affect the limbic system, which is the emotional centre of the brain, and, more specifically, the receptors for the stimulating neurotransmitter, dopamine. All stimulants we use cause the release of the neurotransmitter, dopamine. Under conditions of stress, it is released to a level that can be one hundred times the normal! This is because dopamine is a motivator, as well as a precursor to adrenalin and noradrenalin - both of which are crucial to survival.

The brain not only seeks pleasure and stimulation, it craves balance. When feel-good neurotransmitters, noradrenalin and dopamine, are released in the synapses, they produce a feeling of well-being. However, in response to this short-term increase of feel-good neurotransmitters in the synapses, the neuron receptors adjust in such a way as to neutralize the effects. This process, called 'down regulation' makes the receptor sites less responsive, requiring more of the stimulant substance (e.g. caffeine, nicotine, cocaine) to release more neurotransmitters into the synapses, but this results in even more down regulation. Thus, the initial short-lived euphoria of a powerful reinforcer such as coffee is followed by ever-increasing anxiety, depression, irritability and extreme fatigue. Your natural response to this? - an intense craving for more of the stimulant.

Coffee: Brewing Up Trouble

Found in over a hundred plants throughout the world, caffeine is our number one stimulant, mainly consumed in drinks, hot and cold. Over a thousand years ago, Muslims used coffee for religious rituals. When the stuff finally reached Europe in the seventeenth century, it was seen by the authorities as a dangerous drug. Nonetheless, coffeehouses spread, as did dependence on this new drug. The rest is history. Together with tea, it comprises 97 per cent of worldwide caffeine consumption.

Caffeine boosts mood and energy by blocking the receptors for a brain chemical called adenosine, whose function is to stop dopamine release. With less adenosine activity, then, you increase dopamine and adrenalin. Caffeine is also highly addictive. Research shows that consuming as little as 100mg a day can lead to withdrawal symptoms when you stop, including headache, fatigue, difficulty concentrating and drowsiness. Is it all bad news for caffeine?

At best, we can say that coffee has minor short-term mental and emotional benefits, but these are not sustained. A study published in the American Journal of Psychiatry observed 1,500 psychology students divided into four categories depending on their coffee intake: abstainers, low consumers (1 cup or equivalent a day), moderate (1 to 5 cups a day) and high (5 or more cups a day). On psychological testing, the moderate and high consumers had higher levels of anxiety and depression than the abstainers, and the high consumers had a higher incidence of stress-related medical problems coupled with lower academic performance.[4] The bottom line? Use in moderation, if not complete abstinence.

Tea: Not So Refreshing

A strong cup of tea contains as much caffeine as a weak cup of coffee - with all the attendant risks. In Britain we drink a staggering one billion cups of tea a week. The tannin content also interferes with absorption of minerals. Green tea, however, does have some redeeming features. As well as the caffeine, it contains certain important health-giving compounds. These polyphenols or catechins are potent antioxidants, with cancer-protective and anti-ageing effects.

Colas: Message in a Bottle

Cola drinks contain about a half to a quarter of the caffeine found in a weak cup of coffee. The original Coca Cola even contained small amounts of coca (cocaine), hence the name. Today's drinks usually contain sugar and colourings, which also act as stimulants. Maybe worse, diet drinks contain the artificial sweetener aspartame (Nutrasweet), which can be toxically overstimulating to the brain. We have seen people who thought they were 'going crazy' with anxiety, insomnia and disordered thinking magically recover when they stopped their diet drinks. Even more worrying are Red Bull and the plethora of look-alike drinks, containing 90mg of caffeine, plus mega amounts of sugar.

Natural Stimulants

Of course, the way out of the exhaustion epidemic is to eat super-healthy food, take the right supplements, avoid these harmful stimulants and control your stress level. In addition, there are safe and natural supplements you can take instead. Rather than draining your reserves, these ones help to sustain energy. They can rebuild and maintain your adrenal function, boost your mood and optimize your performance. They are not only non-addictive, but also help to overcome cravings to stimulants that are. Nor do they encourage increasing tolerance followed by addiction: the same dose will consistently give you the same response.

There are two broad categories that restore and enhance energy. First there are the adaptogenic herbs:

* Liquorice;
* Ginseng (Asian/American/Siberian);
* Ashwaganda;
* Reishi mushroom;
* Rhodiola.

Then there are the amino acids and vitamins:

* Tyrosine;
* Phenylalanine;
* Pantothenic acid;
* Vitamin C.

Adaptogens help the body adapt to stresses of various kinds, such as heat, cold, exertion, trauma, sleep deprivation, toxic exposure, radiation, infection and psychological stress. They cause no side effects, are effective in treating a wide variety of illnesses, and help return the body to homeostasis. For example, if your blood pressure is too high, an adaptogen will lower it, and if your blood pressure is too low, it should raise it, thus moving it towards a normal, balanced state. While these are not actually stimulants, by supporting and rebuilding your adrenals, they promote a feeling of increased energy and well- being, with no tolerance build-up, down regulation or addiction.

The Ginsengs

There are actually three different herbs commonly called ginseng: Asian ginseng (Panax ginseng), American ginseng (Panax quinquefolius) and Siberian ginseng (Eleutherococcus senticosus). The latter herb is actually not ginseng at all, but Russian scientists who researched it found that it functions nearly identically.

Asian Ginseng

Asian ginseng is a perennial that grows in northern China, Korea and Russia. More yang or stimulating, it also raises body temperature, strengthens digestion and the lungs, and calms the spirit. Its close relative, American ginseng, is cultivated in the United States, though largely exported to Asia. It is prized there as a yin herb - less heating, less stimulating, and more balanced than Asian ginseng.

The active ingredients are called ginsenosides. There are many different ones, each having their specific effects. For example, some may enhance stimulant neurotransmitters, others will dampen them - all in the same plant! Thousands of years of traditional usage is still the main guide to which ones to take and how to take them. Ginseng appears to enhance ACTH, the messenger hormone that tells the adrenals to produce cortisol, thereby helping the body deal with stress.

In 1968, and then in 1990, two different surveys from German universities were published on Asian ginseng.[5] They looked at 37 studies done between 1968 and 1985, with a total of 2,562 cases, and treatment over a 2-3 month period. In 13 studies, subjects showed an improvement in mood, and in 11, improvement in intellectual performance. All showed a near absence of side effects.

Siberian ginseng

Eleutherococcus senticosus or 'Eleuthero' - grows mostly in China and Siberia. In the 1940s, the Russian scientist who began researching this much less expensive herb concluded that it was as good as the other ginsengs. It can be taken for a longer time than Asian ginseng, since it is less stimulating.

Besides protecting us from stress, it also increases oxygenation of the cells, thereby increasing endurance, alertness and visual-motor co-ordination. This also makes it an excellent supplement for athletes. Its effects on brain function make it useful in the elderly, particularly when combined with the cognitive enhancing herb, ginkgo.

Besides being characterized as a tonic herb, Siberian ginseng is also regarded as a mild but significant stimulant, referring its ability to increase your work capacity after a single dose. This is in contrast to its tonic action, increasing your work capacity not just during the time period you're using it, but for some time afterwards as well. Siberian ginseng, a stimulating tonic, has the rare ability to increase both immediate and long-term energy.

Ginseng is available as powdered root in capsules or made into tablets, or as an alcohol-based tincture. The recommended dose of Asian ginseng is 100-200mg daily of a standardized extract containing 4-7% ginsenosides. Siberian ginseng is taken at a dose of 200-400mg daily of standardized extract, containing greater than 1% eleutherosides. The dose of tincture is 5ml twice daily of a 1:5 concentration (i.e. 5 parts alcohol to 1 part ginseng). According to Chinese tradition, the best way to use ginseng is as part of a two- or three-month restoration programme, followed by a short break.

Ginseng - Siberian and Asian

How they work: Adaptogenic; support the adrenal glands.

Positive effects:

* enhance the body's response to stress;
* decrease feelings of anxiety and stress;
* increase immediate energy (stimulant);
* restore vitality, energy, and endurance over time (tonic);
* increase mental and physical performance.

Cautions: None for Siberian ginseng. For Asian ginseng possible menstrual abnormalities and breast tenderness. Overuse can cause overstimulation, including insomnia in sensitive individuals. Take a one-month break after taking ginseng for three months.
How much? For Siberian ginseng 200-400mg daily; for Asian ginseng, 100-200mg daily of a standardized extract containing 4-7% ginsenosides.

Ashwaganda

An Ayurvedic herb from India, ashwaganda (Withania somnifera), also known as Indian ginseng, is increasingly being integrated into Western herbal practice. It is an excellent immune enhancer and adaptogen; it improves energy and calms the response to stress. Similar to St John's wort, it reduces levels of the stress hormone cortisol. It is also used to enhance memory and cognition in the elderly in India. This is likely to be due in part to its actions as an antioxidant, and partly to its ability to increase acetylcholine receptor activity. Ashwaganda also enhances libido, and can be used as an aphrodisiac. Research has shown that it can increase thyroid hormone levels and basal body temperature in some patients. In a study on animals with arthritis, ashwaganda proved better at reducing symptoms than hydrocortisone, suggesting that it has potent effects on adrenal hormone balance.

The recommended dose is 300mg of a standardized extract, providing 1.5% of withanolides, two to three times daily.

Ashwaganda (Withania somnifera)

How it works: Adaptogen, stabilizes cortisol levels.
Positive effects: Energizing, calming, reduces high cortisol levels, enhances libido, memory and cognition.
Cautions: None
How much? 300mg 2-3 times daily.

Liquorice

Liquorice root (Glycyrrhiza glabra) provides support for the adrenal glands, helping with mild adrenal insufficiency and hypoglycaemia. It is also used in women for its oestrogen-balancing properties. It stimulates the adrenal cortex to elevate cortisol by preventing its breakdown. The way this works is by inhibiting the action of an enzyme called HSD, which breaks down cortisol. So, if you take liquorice the cortisol you make lasts longer. The effect of liquorice lasts for about two hours.

Since it can extend the life of cortisol, liquorice is more appropriate if you are either mildly stressed or exhausted. Also don't take it at night since, in the evening, you want your cortisol level to be falling before sleep. Liquorice helps to raise low blood pressure, which often accompanies chronic fatigue, but this can also lead to hypertension (high blood pressure) in susceptible individuals. Dose is 500mg twice a day, morning and midday.

Liquorice (Glycyrrhiza glabra)

How it works: Prevents the breakdown of cortisol, thereby raising cortisol levels.
Positive effects: Improves adrenal function if exhausted, and raises low blood pressure if adrenally exhausted.
Caution: Can raise blood pressure in susceptible individuals. Not recommended for those with raised cortisol levels.
How much? 500mg twice a day, morning and midday, not in the evening.

Reishi Mushroom

The glossy red or black cap of this Chinese mushroom looks unusual, especially to Western eyes. Inside are phytochemicals that make it one of the most respected tonics in herbal medicine. In Asia, especially China and Japan, it has been revered for as long as 5,000 years. Chinese reishi mushroom (Ganodermum lucidum) is often used to modify or enhance the effects of other stress-fighting herbs. It has multiple benefits and no significant side effects. It is used to calm the mind, sharpen thinking, energize you when you are fatigued, and even lower high blood pressure.

Reishi Mushroom (Ganodermum lucidum)

How it works: Acts as an adaptogen, stabilizing adrenal hormones.
Positive effects: Both calming and energizing.
Cautions: None.
How much? In tincture form (20%) 10ml 3 times a day; tablets 1000mg, 1-3 tablets, 3 times a day.

Rhodiola

Another amazing adaptogen from the East with a long history of use is rhodiola. Growing in the Arctic regions of eastern Siberia, it is often called Arctic root. Folklore says that "those who drank rhodiola tea regularly will live more than 100 years". Chinese emperors, in search of the elixir of life, would send expeditions to Siberia to bring back this potent herb.

But it isn't all folklore. Modern science has confirmed that rhodiola has many proven benefits. Among these are its ability to improve energy, balance stress hormones, improve mood and boost your immunity. As an adaptogen it appears to be at least as powerful as ginseng, and protects against high levels of the stress hormone cortisol. However, it also stimulates both mental and physical performance. For this reason it was used in the Soviet Union to improve athletic powers.

Rhodiola's effects on the brain are perhaps the most interesting. Numerous studies have shown it to improve concentration, especially when tired. In one proofreading test, those taking rhodiola decreased their number of errors by 88 per cent! It also helps the brain make serotonin, which we shall learn is a key 'happy' neurotransmitter. In one study, 128 people suffering from depression were given 200mg of rhodiola. Two-thirds of the patients (65%) had a major reduction in or disappearance of their symptoms. On top of this, rhodiola boosts immunity and has proven anti-cancer properties.

As with other herbs, make sure you are getting the real thing. There are many plant varieties of rhodiola, but the one that works is called Rhodiola rosea. While it has many active ingredients, the key components are called rosavin and salidroside. So it is best to take rhodiola supplements that are standardized, and therefore guarantee, at least 2 per cent rosavin and 1 per cent salidroside.

Rhodiola (Rhodiola rosea)

How it works: Acts as an adaptogen, stabilizing adrenal hormones and promoting serotonin production.
Positive effects: Improves concentration, stress resistance, physical performance and mood. Boosts immunity.
Cautions: None.
How much? 200-300mg daily with meals of a standardized extract.

Stimulating Amino Acids

The stimulating amino acids, phenylalanine and tyrosine, affect mood, energy, sexual interest, mental performance and memory.

Since amino acids are found in such high-protein foods as meat, fish and eggs, you might think that the way to increase your amino-acid levels would simply be to eat more of these foods. However, each protein supplies different combinations of amino acids. An individual may have specific amino acid deficiencies, or increased needs, due to reasons such as prolonged stress, that can't be supplied adequately in the diet, so need to be taken as supplements.

To achieve the best results, very specific instructions are necessary to follow in taking specific amino acids. The stimulant amino acids are best taken separately from other proteins and amino acids to enhance their absorption, since they compete with the others for transport into the brain.

Phenylalanine

Found in meats, wheat germ, dairy products, muesli, chocolate and oat flakes, phenylalanine is an essential amino acid that is converted by the body into tyrosine. This is then turned into the neurotransmitters dopamine, noradrenalin and adrenalin. It acts like natural caffeine, but without the downside.

Phenylalanine becomes depleted in cases of chronic stress and burn-out, as well as by overuse of stimulant drugs, including cocaine, speed and nicotine. Phenylalanine helps alleviate symptoms of withdrawal, since it restores normal brain chemistry. While supplementing DL-phenylalanine (DLPA) is an effective natural stimulant, it tends to be less effective than tyrosine, which is one step closer to dopamine, noradrenalin and adrenalin.

DL-phenylalanine (DLPA)

How it works: Precursor for tyrosine which converts to dopamine, adrenalin and noradrenalin.
Positive effects: Enhances mood, promotes energy, relieves pain and controls appetite.
Cautions: Can be too stimulating, generating anxiety, high blood pressure or insomnia; should not be taken by phenylketonurics. Not recommended for those with a history of mania or mental illness.
How much? 500-1000mg of DLPA on an empty stomach first thing in the morning.

Tyrosine

Tyrosine is found in protein foods, and made in the body from phenylalanine. It readily crosses the blood brain barrier to produce the neurotransmitters, dopamine, noradrenalin and adrenalin. It is also used to make thyroid hormone, your body's energy controller, which manages both your metabolic rate and energy production.

Tyrosine has the same effects in the brain as phenylalanine, usually acting more rapidly, as it is one step further down the line. Neither amino acid should be taken with MAO inhibitors (certain antidepressants that have food restrictions), or by phenylketonurics, those with malignant melanomas, or during pregnancy and nursing.

As with DLPA, take 500-1000mg of tyrosine on an empty stomach first thing in the morning to prevent competition from other amino acids. It works best if taken with its co-workers - B vitamins, magnesium, zinc, manganese, iron and copper, such as Tyroplex. If you are feeling like you need a caffeine boost, take a 500mg tyrosine supplement instead.

Tyrosine

How it works: Precursor to stimulating neurotransmitters dopamine, adrenalin, noradrenalin and thyroid hormone, thyroxine.
Positive effects: Enhances mood, promotes energy and motivation, supports healthy thyroid function.
Cautions: Hypertension in those susceptible. Should not be taken by phenylketonurics. Not recommended for those with a history of mania or mental illness.
How much? 500-1000mg on an empty stomach first thing in the morning.

Action Steps for Natural Stimulation

The first steps to maximizing your natural energy and motivation are to reduce your stress level, balance your blood sugar and avoid or reduce your intake of stimulants to an absolute minimum.

The key to naturally stimulating supplements are the adaptogens. Liquorice can also be overstimulating so don't supplement it if you are very stressed or exhausted.

The following nutrients are worthy additions to a supplement programme designed to enhance your energy and motivation.

Nutrient Daily Amount
Siberian ginseng* 100-200mg
Asian/American ginseng* 100-200mg
Ashwaganda 500-1000mg
Reishi mushrooms* 150-300mg
Rhodiola 100-300mg
DLPA 500-1000mg
Tyrosine 500-1000mg
Pantothenic acid 100-500mg
Vitamin C 1000-3000mg

*Please note: all amounts given for herbs are for specified standardized extracts.

Adapted from the book, Natural Highs (Piatkus £14.99 out on 25 September), by Patrick Holford and Dr Hyla Cass.

References

1. Metro Survey conducted by www.mynutrition.co.uk; results available on the website.
2. Lupien S. Longitudinal increase in cortisol during human aging, hippocampal atrophy and memory deficits. Nature Neuroscience. 1(1): 69-73. 1998.
3. Sapolsky RM. Why Stress is bad for your Brain. Science. 273(5276): 749-50. 1996.
4. Gilliland K and Andress D. Ad lib caffeine consumption, symptoms of caffeinism, and academic performance. American Journal of Psychiatry. 138(4): 512-14. 1981.
5. Brekman I and Dardymov IV. New substances of plant origin which increase nonspecific resistance. Annual Review of Pharmacology. 9: 419-430. 1969.