What supplements increase noradrenaline (norepinephrine) levels?

Supplements That Increase Noradrenaline (Norepinephrine) Levels

Yohimbine is the most effective supplement for increasing noradrenaline levels, acting as an alpha-2 adrenergic antagonist that promotes norepinephrine release. While several other supplements and medications can affect norepinephrine levels, yohimbine has the most direct and documented effect as a supplement specifically for this purpose.

Primary Supplements That Increase Noradrenaline

1. Yohimbine

• Mechanism: Alpha-2 adrenergic receptor antagonist that increases norepinephrine release 1
• Evidence: Listed in guidelines as a substance that can increase blood pressure through sympathetic activation 2
• Cautions:
  • Can cause significant side effects including anxiety, hypertension, and tachycardia
  • Contraindicated in patients with cardiovascular disease, hypertension, or psychiatric conditions

2. L-Tyrosine

• Mechanism: Amino acid precursor for catecholamine synthesis (including norepinephrine)
• Evidence: Supplementation (150 mg/kg) has been shown to augment sympathetically mediated vasoconstriction responses in older adults 3
• Effectiveness:
  • Most effective during acute stress or when catecholamine systems are depleted 4
  • Not effective for increasing norepinephrine in non-stressed conditions 5
• Typical dosage: 500-2000 mg, more effective during acute stress situations

Other Substances That Affect Norepinephrine

Prescription Medications

• Norepinephrine (direct administration): Used in critical care settings for shock 2
• Selective Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs): Mentioned in guidelines for neuropathic pain treatment, these increase norepinephrine by blocking reuptake 2
  • Example: Duloxetine (20-30 mg daily, up to 120 mg/day)

Sympathomimetic Agents

• Midodrine: Alpha-1 adrenergic agonist (2.5-10 mg three times daily) 2
• Droxidopa: Synthetic amino acid precursor that converts to norepinephrine (100-600 mg three times daily) 2
• Ephedrine/Pseudoephedrine: Found in some decongestants, increases norepinephrine release 2
• Amphetamines: Increase norepinephrine release and block reuptake 2

Clinical Considerations

Effectiveness Factors

• Supplements like L-tyrosine are most effective when:
  1. Neurotransmitter function is intact
  2. Norepinephrine is temporarily depleted (e.g., during stress)
  3. Used in short-term stressful situations 4

Safety Concerns

• Increasing norepinephrine can raise blood pressure and heart rate
• Particular caution needed in patients with:
  • Cardiovascular disease
  • Hypertension
  • Anxiety disorders
  • History of stroke
  • Taking MAO inhibitors (can cause hypertensive crisis)

Common Pitfalls

1. Expecting effects in non-stressed conditions: L-tyrosine supplementation shows minimal effects on norepinephrine levels in normal, non-stressed conditions 5
2. Overlooking contraindications: Yohimbine is contraindicated with cardiovascular disease and can cause significant side effects
3. Drug interactions: Many norepinephrine-boosting supplements can interact with antidepressants, stimulants, and blood pressure medications

Monitoring Recommendations

• Blood pressure and heart rate should be monitored when starting any supplement that increases norepinephrine
• Start with lower doses and gradually increase as tolerated
• Discontinue if experiencing significant increases in blood pressure, anxiety, or palpitations

Remember that while these supplements can increase norepinephrine levels, they should be used with caution, particularly in individuals with cardiovascular conditions or those taking medications that affect catecholamine systems.