The HPA Axis- why treating just the adrenals doesn’t always work
Adrenal fatigue is everywhere, but what people don’t realize is that it is just a symptom, not a disease or disorder. It is the outcome of having many different nutritional imbalances, toxicities, and the effect of chronic stress. Some of the biggest complaints for those with adrenal fatigue are depression, anxiety, apathy, detachment from reality, or depersonalization/derealization.
I’ve been saving this post until I was absolutely sure I understood this topic. Since I learned about adrenal fatigue and started treating myself for it, this sense of apathy and detachment were the only issues that kept getting worse as time went on. I was rid of nearly every other symptom, but I could not figure out what was causing the feeling that I was out-of-body.
I finally saw this sentence a few months ago that gave me an “ah-ha” moment:
“Depersonalization disorder may be associated with dysregulation of the hypothalamic-pituitary-adrenal axis, the area of the brain involved in the “fight-or-flight” response. Patients demonstrate abnormal cortisol levels and basal activity.” (Source)
The HPA Axis! That was the link between this common occurrence of detachment and adrenal fatigue. Like I mentioned before, adrenal fatigue is just one of many symptoms that people get- most people never even think about the pituitary gland or the hypothalamus gland. But in truth, when we are not feeling our best, our WHOLE bodies can be out of whack. Hyper-focusing on one organ or one nutrient deficiency is not the solution.
What is HPA Axis Dysfunction?
What exactly is the function of the HPA axis?
“The HPA axis includes three specific parts of your body:
1) the hypothalamus (part of your forebrain);
2) the pituitary gland (just below the hypothalamus);
3) the adrenal glands (at the top of the kidneys).
These three parts work together to regulate functions such as stress response, mood, digestion, immune system, libido, metabolism and energy levels.” (Source)
So basically, the HPA is extremely important for our overall health! It is involved with these chemicals in the body: corticotropin-releasing factor, cortisol, glucocorticoids, and ACTH (adrenocordicotropic hormone). Read a little about these hormones here.
What do the hypothalamus, adrenals, and pituitary do?
The Hypothalamus is the link between the nervous and endocrine systems and it regulates most of our endocrine activity. The hypothalamus is the most important link between mind and body- which is why HPA dysfunction can make us feel out of touch with reality. It helps regulate the secretion of hormones from the pituitary gland, helps maintain fluid balance, regulates body temperature (a biggie for a lot of people!), plays a part in hunger and thirst, influences sexual behavior as well as other emotional aspects (again- that feeling of disassociation), and the sleep-wake cycles.
The pituitary gland is the “master gland of the body” because it secretes at least 7 different hormones that effect the whole body. It secretes ACTH to the adrenals, TSH to the thyroid, FSH and LH to the gonads, prolactin to the mammary glands, growth hormone to the bones, oxytocin to the uterus and mammary glands, and antidiuretic hormone to the kidneys. Can we see how important it is now??
The adrenals are the emergency glands of the body. When we are constantly stressed, our bodies cannot keep up with the demands of homeostasis (keeping the body in balance). The brain sends messages that activate the sympathetic nervous system (fight or flight) and the adrenal glands, which releases adrenaline- and this is whether we truly need it or not. The body doesn’t know if you were truly in peril or if it was just a small scare. The hypothalamus signals the pituitary to release ACTH which increases cortisol and helps us deal with the threat at hand.
Someone that suffers from chronic anxiety (mostly due to a nutritional imbalance, a parasitic infection, or other toxic build-up) will be in a constant circle of “fight-or-flight” which continually weakens the adrenal glands. The constant rush of cortisol creates many issues itself and eventually the adrenals get burned out because they cannot handle the stimulation anymore.
The adrenals are responsible for 3 sets of steroid hormones, which depend on the anterior pituitary to stimulate them. (Steroid hormones actually help activate genes- perhaps all of this MTHFR madness is because of dysregulation hormones and minerals!)
- Glucocorticoids: The most important hormone in this category is cortisol. Glucocorticoids promote the production of glucose from other nutrients like amino acids, reduce inflammation, and help supply the body with glucose when it is under stress. Too much of these hormones can lead to depressed immune function, and high blood sugar levels.
- Mineralocorticoids: the most important hormone in this group is aldosterone. Aldosterone helps to maintain homeostasis of sodium and potassium ions by stimulating the kidneys to conserve sodium and to excrete potassium.With low aldosterone, we tend to lose salt quickly and become dehydrated very easily.
- Sex Hormones: Think estrogen, progesterone, DHEA, and testosterone.
This is why the HPA axis is such a huge part of health! The whole stress response involves the hypothalamus, the pituitary and the adrenal glands.
How do we fix this stress response?
- Destress: Easier said than done, I know. But it is crucial to healing. If you can completely eliminate stressors in your life (like a person that is toxic to you or a job that you absolutely hate), then that is the BEST thing to address first. If your stress isn’t going anywhere (like you are a caretaker of children or an incapacitated family member), then there are many ways to try to handle stress. Yoga, EFT, Buteyko Breathing, walking in nature, finding a hobby like reading, writing, or crafting are all great ways to learn to manage your stress and unplug your mind!
- Cool it on the exercise- excessive exercise is a HUGE trend these days. People tend to focus on exercise more than diet, when diet is actually more important for your health! There’s no problem with normal amounts of exercise, but pushing yourself to the limit everyday does not help you, especially if you aren’t replacing nutrients afterwards. Heavy exercise can actually raise cortisol levels way too high, which is what brings you into the state of HPA dysfunction.
- Heal Inflammation- those with high cortisol tend to have high inflammation as well. Reduce/manage your stress levels and use anti-inflammatory foods and herbs like cod liver oil, turmeric, aloe vera, magnesium, kelp, and papaya.
- SLEEP!!!! Sleep is perhaps the number 1 most critical thing needed to heal from every illness. And yet it is one of the first things that suffers when health starts to suffer.This is the most underestimated healer out there. We just need sleep! It’s not just because it keeps us happy- it helps us regenerate and heal, as well as helping us to eliminate toxins. If we are always on the go during the day and we aren’t sleeping enough at night, we simply cannot function well. The first part of ANY healing plan should be to evaluate your sleep. If you aren’t getting enough because of your schedule, then it is time to cut down on things to take care of yourself no matter how hard this might be. “You cannot pour from an empty cup.” If you are healing from any illness, you have to focus on yourself as much as you can in order to truly heal. This may be hard for a lot of people but it is crucial!If you having any trouble sleeping, there are a variety of reasons why this could be happening. Read my post on how to bust insomnia here. You can also check out this article from ARL about the importance of sleep.
- My added tip for healing from HPA dysfunction is to get an HTMA. This will show us how your body is responding to stress, what nutrients you are deficient in or even burning through because of stress, as well as the state of your adrenals. Healing can take time, but it is so important to learn what YOUR personal biochemistry is so you can treat yourself correctly. Fixing your deficiencies and imbalances as well as rebuilding the body is all essential so we can get you to sleep better, heal from inflammation, and reduce stress in the body.
- CHOLESTEROL! ALL of the hormones that run the adrenals need cholesterol to be made. The lie that cholesterol is bad for us is a primary reason why we are all so deficient in hormones. We need cholesterol to create pregnelone, which in turn can be used to make the rest of the hormones like estrogen, cortisol, progesterone, and aldosterone. If you want to see a chart that explains this, check it out here.
- Get sunlight when you can. The hypothalamus helps to regulate circadian rhythms. Exposure to sunlight not only helps us raise vitamin D levels, but it helps the body to regulate sleep.
- Love your lymph and liver. When our bodies start to go into burn-out, they cannot function well in all aspects. With low adrenal function, we have low energy production, and with low energy we cannot properly detox. Since toxins, parasites, and viruses can build up over time and get stored in our bodies, aiding the detoxification process is absolutely essential. Start slow with things like rebounding and castor oil packs. The lymph system is designed to destroy and remove toxins, bacteria, viruses, etc but it cannot do its job properly if it is overloaded or undernourished.