Hormone & Stress Rhythm

Written by Dr. Ryan Kneessi, ND

The mechanisms this protocol supports

The HPA axis is the communication loop between the brain and the adrenal glands that manages cortisol. In a healthy rhythm, cortisol rises in the morning to help you wake and gradually falls in the evening so you can rest.

Methylation is a chemical process that depends on B vitamins, and the body uses it to process hormones such as estrogen and to make and break down neurotransmitters. Magnesium supports both the nervous system and hundreds of enzymes throughout the body.

Research has linked a flattened daily cortisol rhythm with poorer emotional and physical health, and chronic stress has also been linked with faster cellular aging. This protocol supports the rhythm itself instead of simply pushing energy up or down.

What is in the protocol

The exact products and directions are listed in the Fullscript plan, and here is what each one is commonly used to support.

• Qualia Magnesium+ combines several forms of magnesium that support the nervous system and a healthy stress response.
• Cortisol Manager from Integrative Therapeutics is a blend that includes ashwagandha and is commonly used to support a healthy evening cortisol pattern and restful sleep.
• HPA Adapt from Integrative Therapeutics is an adaptogen blend that is commonly used to support the HPA axis during periods of stress.
• Methyl-Guard Plus from Thorne provides methylated B vitamins and related nutrients that support methylation and hormone metabolism.

Related protocols you may find helpful include Sleep & Overnight Repair.

How to use it thoughtfully

Please talk with your provider before starting, especially if you take medications, are pregnant or nursing, or have a health condition. This page does not list amounts, so follow the label or the specific guidance your provider gives you. When you can, add one product at a time so it is easier to notice how you feel.

Sleep, nourishing food, daily movement and stress care are the foundation, and supplements are meant to build on them. Ashwagandha and some other adaptogens are not appropriate during pregnancy and can interact with thyroid, sedative and immune-related medications, so please check with your provider first.

What the research shows

This protocol has not been tested as a whole in a clinical trial, so the studies below cover its main ingredients.

Ashwagandha has the most human research among adaptogens. In a 2012 trial by Chandrasekhar and colleagues, 64 adults with chronic stress took 300 mg of root extract twice daily or a placebo for 60 days. Stress scores and blood cortisol fell significantly more than with placebo, with mild side effects in both groups. It was a single-center trial of one extract.

L-theanine was tested in a 2019 crossover trial by Hidese and colleagues in which 30 healthy adults took 200 mg a day or a placebo for four weeks each. Stress-related symptoms, anxiety and sleep quality scores improved during the L-theanine period. The study was small and short.

In a 2012 double-blind trial by Abbasi and colleagues, 46 older adults with insomnia took 500 mg of magnesium or a placebo daily for eight weeks. Compared with placebo, the magnesium group improved insomnia severity scores, sleep efficiency and time to fall asleep, with higher melatonin and lower cortisol, although total sleep time did not differ significantly. The trial was small and in older adults who may have had low magnesium intake.

Frequently asked questions

Sources

• Fries E, Dettenborn L, Kirschbaum C. The cortisol awakening response (CAR): facts and future directions. Int J Psychophysiol 2009. PMID: 18854200. https://pubmed.ncbi.nlm.nih.gov/18854200/
• de Baaij JH, Hoenderop JG, Bindels RJ. Magnesium in man: implications for health and disease. Physiol Rev 2015. PMID: 25540137. https://pubmed.ncbi.nlm.nih.gov/25540137/
• Adam EK, et al. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology 2017. PMID: 28578301. https://pmc.ncbi.nlm.nih.gov/articles/PMC5568897/
• Epel ES, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci U S A 2004. PMID: 15574496. https://pmc.ncbi.nlm.nih.gov/articles/PMC534658/

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