The Science of Adrenal Fatigue (Progression of HPA Axis Dysfunction)
HPA Axis Dysfunction and cortisol dysregulation is something I had to work on when I was healing my body back to fertility. You can read more on ‘My Story’.
What is HPA Axis Dysfunction?
Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction is when the pathway from the Hypothalamus to Pituitary to Adrenal Cortex is disrupted. More commonly known as adrenal fatigue, however in Functional Diagnostic Nutrition® (FDN) this terminology is not used as it is misleading and not as straightforward as the adrenals fatiguing. It is also not recognised by medical practitioners.
Some Basic Physiology.
- The Hypothalamus is the thermostat that regulates all hormones in the body, it is also the control centre for the body’s stress response.
- When you get stressed the hypothalamus releases corticotropin-releasing hormone (CRH).
- This stimulates the pituitary to produce adrenocorticotropic hormone (ACTH), which in turn stimulates the adrenal cortex to produce cortisol, the major stress hormone; cortisol.
- Cortisol will endeavour to deal with the stress in the body. It’s a natural anti-inflammatory and painkiller. It also raises blood sugar levels for immediate energy. This is a normal, adaptive response to stress to maintain homeostasis (balance in the body).
Where it can go wrong?
In the modern world, we are under different stresses to those our forbearers encountered. As opposed to a ‘crisis’ situation where people had to fight or flee a life-or-death situation, we now have a constant stream of daily stress. This can be disruptive to health as it results in our bodies being stuck in ‘flight or fight’ mode. If this stress continues it can affect whole systems of the body such as: carbohydrate metabolism, detoxification capacity, fat and protein metabolism, endocrine function, neural tissue health and musculoskeletal health
External stresses come in a myriad of forms such as financial pressure, sitting in traffic or running a household. It can be constant, and it is imperative that one has the tools and mechanisms to cope with these daily stressors of life.
There are also the internal stresses that have a powerful effect on the body. These are harder to identify and can include: blood sugar issues, parasites, pathogens, metabolic conditions or food sensitivities.
If stress continues, external or internal, the body outputs more and more cortisol to cope, moving it to a state of HPA Axis Dysfunction. This can result in a situation where the body can’t continue to output enough cortisol, progressing to a path of metabolic chaos, subsequently leading to dysregulated cortisol.
In FDN we determine the dysfunction by testing salivary cortisol over a 24-hour period, assessing the sum and cortisol pattern. FDN categorizes the dysfunction by phases: Acute, Compensatory and Exhaustion Phase. Further details are outlined below:
- The body is still adapting to stress;
- The total cortisol sum maybe high; and
- People may feel good in this state as a result of the high cortisol, high blood sugar and high adrenalin.
- The body isn’t compensating as well to the constant stress. The cortisol sum may show a lower reading;
- Symptoms such as tiredness, hormonal imbalance and a decrease in immunity begin to appear: and
- Low sex hormones.
- The body has lost its adaptive reserve, and is not outputting the amount of cortisol needed to deal with the stress load, the cortisol sum is very low;
- A myriad of symptoms can be identified during this phase. These include: major fatigue, sugar cravings, low blood pressure, anxiety, depression, cold body temperatures, an increase in infections, sleep disturbances and more injuries, among others; and
- Failure will eventually occur if your body fails to produce cortisol, you could end up on medication for the rest of your life.
How do I know if I have HPA Axis Dysfunction?
Test don’t guess. The best way to know for certain is to do a functional saliva test, which will give an insight into what is occurring in the body at a physiological level. Some indicators are any or some of the following:
- Tired after a nights sleep;
- Wired but tired at night;
- Overly anxious;
- Buzzing extra hard after coffee;
- Feeling worse after exercise;
- Sick often;
- Injured frequently;
- Can’t shift weight and/or
- Low libido.
What to do if I think this is me?
Seek medical advice and/or consult a health practitioner. If it is not an actual malfunction with the hypothalamus, pituitary or adrenal cortex , treatment can be managed through lifestyle and natural supplements. FDN has achieved great success at managing HPA Axis Dysfunction, and other ailments, by following the D.R.E.S.S principle of; diet, exercise, stress reduction (internal and external) and smart supplementation.