For SURGERY RECOVERY, adrenal support with the herbs ashwagandha, eleutherococcus, and rhodiola can increase the capacity to manage physiological stress, directly improving the wound healing process. These botanical adaptogens stabilize cortisol and corticosteroids, hormones produced by the adrenal glands, which influence optimal tissue repair, protection, and growth. Adequate cortisol levels enhance energy and stamina needed for surgery healing, and stimulate nutrient metabolism and steady blood sugar. Stable adrenal activity also helps robust immune function, reducing post-op infection risk, and boosting the body’s healing powers.
Adaptogens are plant-derived compounds that encourage and restore normal function. Depending upon what the target organ needs, they can either calm over-activity, or reverse and improve a deficiency; an example of the intelligence of nature. Adrenal adaptogens are botanicals that support stable cortisol and adrenal hormone output, normalize endocrine function and support adaptation to environmental stress. They also stabilize brain chemistry and emotional health.
Optimal adrenal gland function and surgery recovery
The adrenal glands naturally secrete balanced amounts of cortisol, which is essential for life and maintains healthy immune function, energy reserves, blood pressure, blood sugar, muscle tone, and prepares the body for action. However, if the sympathetic nervous system is pushed into overdrive and stress hormone levels climb too high, excess cortisol can impede wound closure, disrupt scar formation, and increase infection risk. Chronic stress and adrenal overdrive cause cumulative damage over time, as severely high levels of stress hormones accelerate free radical damage to tissues, slow the healing process, and elevate blood sugar. Remedies that stabilize adrenal corticosteroid output will encourage speedy surgical healing, good energy and stamina, correct levels of inflammation to clear damaged cells, and healthy immunity.
The importance of stress management in surgery recovery
“The stress of surgery, with its physical injury and emotional challenges, has a substantial clinical impact on wound repair biology. Improved stress management significantly helps tissue recovery after surgery.”
Dr. Rachelle Herdman, Custom Health Guide
The healing process goes through several interconnected stages:
- Inflammation signals the body to activate healing cells. Pro-inflammatory cytokines are messenger molecules essential to this effort. They protect against infection and prepare injured tissue for repair.
- Cytokines signal the recruitment and activation of phagocytes: specialized cells whose job is to ingest harmful foreign particles, bacteria, and dying cells. Phagocytes prepare the way for new healing scar tissue to form. Additionally, cytokines help fibroblasts and epithelial cells remodel damaged tissue.
- The next stage of wound healing is the proliferative phase, when new tissue is made. It involves the recruitment and replication of cells necessary for tissue regeneration and capillary regrowth.
- Finally, wound remodeling and repair begins, a process that may take weeks or months as the initial rudimentary scar tissue is gradually reshaped, strengthened, and refined to match the original tissue.
The role of adaptogens in surgery recovery
Supporting adrenal function with ashwagandha, eleutherococcus, and rhodiola enhances the ability to grow healthy new tissue. As an example, skin normally has a fatty layer which protects and insulates it, retains moisture, and gives it resiliency. Excessive cortisol damages this layer, resulting in thin, fragile skin prone to easy bruising and infection. When free radicals are generated faster than the cells’ antioxidant mechanisms can neutralize them, the cells and its DNA are damaged. Adaptogens help to protect healing tissues from these setbacks.
Ashwagandha is a mighty medicinal herb and one of the most important botanicals in Ayurveda, the traditional Indian holistic medical system based on body type. Ashwagandha is considered a “Rasayana” or rejuvenator, and has been used for over 3,000 years for its wound-healing and immune-boosting abilities, and to help the body manage stress.
Its botanical name is Withania somnifera, and it is also known as Indian ginseng and winter cherry. The root smells like horse or “ashwa,” which gives this herb its name. Consuming it is said to imbue one with the power of a horse. Extracts from ashwagandha’s root or leaves are used to treat a variety of conditions including delayed healing, poor immune responses, low thyroid, inflammation, and stress.
In one important 2010 study on wound healing and diabetes, ashwagandha was administered both orally and topically to wounds to measure its effect on tissue healing. Both forms of treatment with ashwagandha led to significantly better healing times than those treated with placebo, with the oral form performing better than the topical treatment. The subjects who received ashwagandha also showed significantly increased collagen production and higher levels of other markers for healing.1
Eleutherococcus, a member of the ginseng family, is a time-honored adaptogenic herb that was first used as an herbal remedy in China some 2,000 years ago. In Traditional Chinese Medicine (TCM), eleutherococcus is said to increase Qi, or vital energy, and to improve sleep. Over time, eleuthero strengthens the body and increases endurance. In modern times it has been shown to help the body manage stress, and to boost immune function and especially antibody production, both before and during illness.2
One of the most extensively researched botanicals in the world, eleuthero root is rich in antioxidants that help to balance hormones, support the adrenals, and benefit energy levels.
By stabilizing cortisol output and enhancing the immune system, eleuthero can improve and speed the healing process. Many beneficial phytochemical compounds, the medicinal components of plants, have been separated from eleuthero root, including saponins, lignans, coumarins, and flavones. Several studies have shown that these eleutherosides may help prevent and repair nerve damage. One study isolated twelve compounds, and at least three showed obvious protective effects against nerve atrophy, an ever-present risk during surgery recovery.3
Eleutherococcus enhances immunity, reduces the risks of post-operative infections, and maintains healthy T4 immune lymphocytes.4,5 In addition, it can weaken pathogens that enter the body. Researchers found that eleutherococcus has significant antiviral activity, and it inhibits virus replication in cell cultures, preventing viral spread.6 In the body, eleutherococcus shows strong antioxidant activity, helping to speed recovery after infection.7
Rhodiola, also known as golden root, has been used for centuries in the traditional systems of medicine in Europe and Asia, most importantly as an anti-stress and adaptogenic agent. Its root contains more than 140 active ingredients, the most potent of which are rosavins and salidroside. These healing compounds work on human biochemistry to increase “nuclear translocation of DAF-16,” which is a common and needed response to stress.8 Rhodiola nourishes the adrenals to help the body react to stress in the best way possible, by maintaining ample cortisol and hormone levels, and enhancing stress tolerance while easing anxiety. Rhodiola increases energy and resilience, and it improves sleep quality for regenerative healing.
In addition, rhodiola is effective for improving skin wound repair and reducing delayed healing. It has immune-enhancing actions to lower the risk of post-operative infection. An important 2007 study investigated the healing efficacy of rhodiola extract and its rich content of polyphenols and confirmed that rhodiola improves dermal wound repair. The results verified that rhodiola extract increased DNA, protein, and antioxidants, for significant epithelial wound healing in contrast to a control group who did not receive rhodiola.9
Vitamins B5 and C enhance the adrenal supportive and surgery recovery actions of ashwagandha, eleutherococcus, and rhodiola. These vitamins are essential cofactors for the adrenals to make correct amounts of their hormones, and thus are needed for adaptogens to be fully effective. Stress and poor diet can deplete vitamins B5 and C.
Research demonstrates that surgery recovery is faster, with better tissue healing, when patients feel they cope better with stress. A meta-analysis of studies using a variety of wound healing models and outcomes, found a direct correlation across studies between psychological stress and wound healing.10 This tells us that the relationship between stress and wound repair is both statistically significant and clinically relevant. If we can help patients to manage stress, their physical healing proceeds better. An early 1991 study found that patients who reported more stress on the third postoperative day had longer hospital stays, compared to less anxious individuals.11
Clinical research also shows that a more hopeful and optimistic mood improves post-operative healing. An internal medicine study found that the more optimistic individuals out of 309 patients who underwent elective coronary artery bypass graft surgery had better recovery after their first procedure, and they were less likely to be re-hospitalized than less optimistic individuals. Conversely, patients who experienced more depressive symptoms were more likely to suffer infection or other complications, and require rehospitalization than individuals reporting less distress.12 In 2005, this result was replicated in a study of 72 patients undergoing coronary artery bypass surgery. Patients who had more depressive symptoms at discharge had more infections and poorer wound healing in the 6 weeks following surgery, compared to participants who reported less distress.13
Our patients’ experience with ashwagandha, eleutherococcus, and rhodiola
In our clinic, we regularly recommend adaptogenic herbs including ashwagandha, eleutherococcus, and rhodiola for our patients undergoing surgery. We see them recovering as or more quickly than expected, with lower rates of post-surgical infections. They report better stamina, feeling less debilitated than they anticipated after surgery, and returning faster to their usual levels of activity. These patients also notice good sleep and more emotional resiliency, and better ability to cope with stress without feeling helpless. They often recover feeling that surgery was less traumatic than they had expected.
Recommendation: A formula including a daily dose of: Ashwagandha root extract (3.5% with anolides) 100mg; Eleutherococcus Senticosus (20:1) 50mg; Rhodiola rosea extract (3% rosavins, 1% salidroside) 200mg; with Vitamin C, buffered (ascorbate) 500mg; Vitamin B5 (calcium pantothenate) 100mg; Vitamin B6 (pyridoxal-5-phosphate) 50mg. Optional supportive ingredients could include: Astragalus root 150mg, Panax Ginseng extract (10% ginsenosides) 100mg, and Schizandra berry 75mg. This formula should be taken with breakfast or lunch, or divided between each of these meals, or as directed by your healthcare provider.
- Prasad, S.K., et al., [ed.] John M. Pezzuto. “Wound healing activity of Withania coagulans in streptozotocin-induced diabetic rats.” Informa Healthcare USA, Inc., December 2010, Pharmaceutical Biology, Vol. 48, pp. 1397-1404.
- Drozd JA, Sawicka TE, Prosinska JO. Estimation of humoral activity of Eleutherococcus senticosus. Acta poloniae pharmaceutica. 2002;59(5):395-402.
- Bai, Yanjing, et al. “Active components from Siberian ginseng (Eleutherococcus senticosus) for protection of amyloid β (25–35)-induced neuritic atrophy in cultured rat cortical neurons.” Journal of natural medicines 65.3-4 (2011): 417-423.
- Kupin, V. I., and E. B. Polevaia. “Stimulation of the immunological reactivity of cancer patients by Eleutherococcus extract.” Voprosy onkologii 32.7 (1986): 21-26.
- Bohn, B., C. T. Nebe, and C. Birr. “Flow-cytometric studies with eleutherococcus senticosus extract as an immunomodulatory agent.” Arzneimittel-Forschung 37.10 (1987): 1193-1196.
- Glatthaar-Saalmüller, Bernadette, Fritz Sacher, and Anke Esperester. “Antiviral activity of an extract derived from roots of Eleutherococcus senticosus.” Antiviral research 50.3 (2001): 223-228.
- Poolsup, N., et al. “Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials.” Journal of clinical pharmacy and therapeutics 29.1 (2004): 37-45.
- Panossian, Alexander, and Georg Wikman. “Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity.” Current clinical pharmacology 4.3 (2009): 198-219.
- Gupta, Asheesh, et al. “Effects of Rhodiola imbricata on dermal wound healing.” Planta medica 73.08 (2007): 774-777.
- Gouin, Jean-Philippe, and Janice K. Kiecolt-Glaser. “The impact of psychological stress on wound healing: methods and mechanisms.” Immunology and Allergy Clinics 31.1 (2011): 81-93.
- Boeke S, Duivenvoorden HJ, Verhage F, et al. Prediction of postoperative pain and duration of hospitalization using two anxiety measures. Pain. 1991;45(3):293–7.
- Scheier MF, Matthews KA, Owens JF, et al. Optimism and rehospitalization after coronary artery bypass graft surgery. Arch Intern Med. 1999;159:829–35.
- Doering LV, Moser DK, Lemankiewicz W, et al. Depression, healing, and recovery from coronary artery bypass surgery. Am J Crit Care. 2005;14(4):316–24.
- MacKay, D, and AL Miller . “Nutritional Support for Wound Healing.” Chiropractic Resource Organization, 8 Nov. 2003.
- Christian, Lisa M., et al. “Stress and Wound Healing.” Neuroimmunomodulation, U.S. National Library of Medicine, 6 Aug. 2007.