Adrenal Fatigue-HPA Axis Dysregulation

Adrenal Fatigue–HPA Axis Dysregulation: Do You Have It? What Are the Signs? How to Treat It? And How to Prevent It in The Future!

Fatigue is perhaps one of the most common health complaints that people have today. We hear a lot of talk today about stress and “adrenal fatigue”. While this is a popular term; it is not supported by scientific literature. The terminology is based on Hans Selye’s “general adapation syndrome” which predicts changes in levels of stress hormones over time in response to chronic stress. The hormones: cortisol, DHEA and pregnenolone are correlated in 3 stages, level of cortisol begins to elevate in Stage 1 (Alarm), but in Stages 2 and 3 (Resistance + Exhaustion) the hormones begin to diminish until they become depleted (really low) by Stage 3 “exhaustion”. But there are several problems with this basis: the levels of cortisol may be misinterpreted, cortisol is controlled by the brain (not the adrenal glands) and adrenal fatigue does not align with our current understanding of HPA axis physiology. Correctly, adrenal fatigue is HPA axis dysregulation.

What Does HPA Stand For?

Hypothalamus – part of the brain located at the base near the pituitary gland. Its main job is to regulate hormone production, which affects a number of physiological processes such as body temperature, emotions, appetite, sleep and others. The hypothalamus connects the endocrine system to the nervous system.
Pituitary Gland – the “master gland,” and is the center of the endocrine system. It takes information from the hypothalamus, makes hormones the body needs, and sends this information to other glands in the body to perform their own essential functions.
Adrenal Glands – 2 small glands (each the size of a walnut) located just above the kidneys. They receive information from the pituitary gland to make necessary hormones. The adrenal glands make cortisol (which is made in the mitochondria of the adrenals), DHEA, aldosterone and norepinephrine/epinephrine.

The HPA axis is a complex set of feedback interactions which include the hypothalamus, pituitary gland, and the adrenals. These interactions form a major part of the neuroendocrine system, which controls reactions to stress and regulates many of our body processes, including: digestion, immune function, mood and emotions, hormonal fluctuations, sexuality, and energy levels. It has direct impact on the thyroid, ovaries, testes, brain, and adrenal glands and how well they function. The overall job of the HPA axis is “mediator of the response to stress as well as the regulation of stress”, it is the uniting system for interactions of the glands, hormones, and parts of the brain that mediate the general adaptation syndrome.

Our Human Stress Response

The human stress response involves many components. First, the brain will initiate an immediate response signaling the adrenal glands to release epinephrine and norepinephrine. Next the hypothalamus and pituitary release cortisol from the adrenals. The nervous system will initiate responses: alertness, focus, reduction of pain receptors and the inhibition of reproductive behaviors. The sympathetic nervous system begins to increase the heart rate, blood pressure and release fuel to help fight or get out of danger as it redirects blood flow to the heart, muscles and brain, away from the gastrointestinal tract and digestive processes. Because of these demands there is a huge increase in energy production and utilization of nutrients and fluids in the body. Once the stressful situation has passed, the brain signals the responses to be “turned off” and recovery and relaxation allow the body to re-establish balance by replacing nutrients and getting rid of waste products accumulated during the stress response.

The goal of the stress response in the HPA axis is extremely important on body function: maintain effective blood supply to the brain, heart and skeletal muscles; increase energy production through gluconeogenesis (conversion to glucose from fatty acids and amino acids); optimize ATP production, and maintain our physiological reliance for short-term needs. It truly is our survival regulator!

Let’s take a look at what exactly at what causes dysregulation in the HPA axis is and why is it so important for everyone to know the signs today!

What Causes HPA Axis Dysregulation?

There are a variety of stressors that can bring on HPA axis dysregulation. But it comes down to two types of stress: acute and chronic. But it is the chronic stress that over time will cause the body to function at a less-than-optimal level and cause symptoms of fatigue, poor quality sleep, immune, and hormonal issues. It becomes a cascade in the body; when not addressed, can cause serious issues.

Inflammatory factors can stimulate the HPA axis to increase cortisol production, and prolonged inflammation can promote chronic HPA axis activation. Chronically elevated cortisol creates inflammation in the body, which can disrupt the function of the biochemistry in our brain, which controls other hormones throughout the body. Inflammation is a huge topic in itself, and seems to be the common-denominator of various health conditions.

Symptoms + Conditions of HPA Axis Dysregulation

Common Symptoms

Waking up and feeling no incentive and no inspiration to get out of bed and start the day may sound like a normal everyday occurrence. What you may not know though, is that it could be a sign of issues in the inter-workings of your body. You may think you just have sleep issues or that you are worn out and tired. You suddenly feel tired in the middle of the day and just pass it off as too much-accumulated stress. Again, this is what most would refer as “adrenal fatigue” but now we know the “why”. We know that HPA axis dysregulation is more than adrenal fatigue because it involves more than just the adrenals…..it’s the whole axis!

People everywhere tend to overlook these signs. When in reality, they may be symptoms of a budding health issue. HPA axis dysregulation feeds on lack of motivation, overwhelming stress, and chronic fatigue. HPA axis dysregulation is more common than you might think. Low levels of cortisol hormone production in the bloodstream can cause extreme fatigue. One study found that HPA axis dysfunction “has been found in a high proportion” of Chronic Fatigue Syndrome patients.

This way of life shouldn’t be the case and shouldn’t be taken lightly.

As this fatigue begins to spiral downward, it becomes harder to properly finish tasks and goals. With a lack of motivation and lack of proper rest, the body begins to slowly give out and become heavy and tired all the time. And sadly, all of these symptoms and physical reactions connect back to the leading symptom of HPA axis dysregulation – stress.

Spotting the Symptoms

The symptoms of HPA axis dysregulation range between a variety of physical and mental aspects; however, there are a few more common signs. These are the symptoms that have been seen constant throughout the recorded cases of patients with HPA axis dysregulation:

Chronic fatigue syndrome
Inability to sleep/insomnia
Trouble finishing tasks
Lingering stress (physical, emotional, and/or mental)
Feeling tired but wired
Unexplained weight gain or weight loss
Brain fog, difficulty concentrating, and poor mood
Hormone imbalances

Each of these symptoms can have a heavy effect on the production of cortisol, as it slows the progression of a chemical trade-off. The proper chemical hormones in the body do not recognize or differentiate the need for cortisol in the adrenal glands; thus, it stops sending and producing it efficiently. This leads to constant bouts of fatigue, which then leads to the inability to fall asleep and a lack of motivation to get up and be active in the morning.

Lesser Known Symptoms

Although, it is rather unanimous that the leading cause of HPA axis dysregulation is stress, there are a few lesser known symptoms to also look out for.

Body aches (particularly in the back and chest)
Lightheadedness
Low blood pressure
Low blood sugar
Craving salty snacks constantly
Sudden lowered immune system health
Joint and muscle pains
Newly formed allergies
Anxiety
Depression

When our body is under stress we need key nutrients including B vitamins, Magnesium, Vitamin C, and Zinc, as well as digestive enzymes and HCl (hydrochloric acid). These nutrients can quickly become depleted during HPA axis dysregulation. As always, the best support for your HPA axis is wholesome, nutrient-dense foods that will support your body’s endocrine system and give it the fuel it needs to function even in times of stress + lifestyle factors that support optimizing health.

Dealing with Stress

As the body encounters everyday bouts of stress and anxiety, the adrenal glands let out a healthy dose of cortisol. However, over time, the stress response can become hypersensitive and eventually result in low cortisol output causing stress to build to intolerable levels.

In this situation, it is important to understand that our bodies will produce lower levels of cortisol on a daily basis. Sufferers can usually aide in relieving a part of this stress by adding mediation, deep breathing, and/or mild exercise to their daily routines. Having a time set aside of clearing the mind and de-stressing the body, gives-off a happy feeling in the brain that releases serotonin. This hormone counteracts the cortisol not being distributed in the body by leaving them happy and content, so there is no focus on unwarranted stress.

Some other methods include surrounding oneself with essential oils and a peaceful environment. Both seem to also do the trick of shutting of stressful thinking in the brain while also relaxing the tense buildups in the body from lack of good sleep. Lavender is one of my favorites!

Functional Medicine Care for HPA Axis Dysregulation

There are many ways to support the HPA axis with lifestyle changes, including functional medicine. One of the most impactful ways to support the HPA axis is by modulating your overall stress.

Here are some successful methods of addressing HPA axis dysregulation:

Functional Medicine Labs (saliva, urine and/or serum) to test levels of cortisol, DHEA and other hormones; along with basic blood chem panels to check on metabolic and nutrient imbalances
Nutrients (B vitamins, Magnesium, Zinc, Vit C, and glandulars) + Adaptogens (Adaptogenic herbs such as Eleuthero, Rhodiola, Cordyceps, Ashwagandha, Schisandra, and Holy Basil)
Balance blood glucose levels with eating a healthy diet (anti-inflammatory/Mediterranean): good fats (avocado, clean nuts + seeds), quality protein (grass-fed, pastured-raised meats + clean-sourced fish), sulfur-rich veggies (broccoli, Brussel sprouts, spinach, cauliflower + kale)
Know your Vit D level-have it tested and work on reaching + maintaining optimal levels
Practicing meditation + yoga + deep breathing daily
Lifestyle: planning your days and tasking by top productivity/priority
Prioritize sleep and create obstacle situations which force you to get out of bed (setting an alarm without snooze and placing it far out of reach)
Walking outside during the day for a minimum of 30 minutes a day + low-intensity exercise
Acupuncture + Naprapathic treatments

These methods have been shown to be effective with living with HPA axis dysregulation; however, it is important to choose a wellness plan that not only makes you happy and healthy but one that is also safe for your overall body and mental health.

Staying Mindful

Knowing the signs of HPA axis dysregulation and how to decrease your level of stress is only the beginning of the process. It takes being mindful to know how we react to any kind of stress. The body will react depending on your perception of stress and not necessarily what the stressor may be. Mindfulness is worth practicing daily to keep our stress in check. And keep in mind that HPA axis dysregulation is not only an adrenal fatigue issue, it involves way more than just those little adrenals!

As you see there is so much you can do to improve the quality of your HPA axis health, and in turn, your overall wellbeing. Work together with a licensed practitioner for professional recommendations regarding a wellness plan for the health of your endocrine system! Once you begin to make small lifestyle changes the benefits will leave you feeling physically and mentally strong and balanced!

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Adrenal Fatigue-HPA Axis Dysregulation