Stress & the HPA Axis (and signs of adrenal fatigue)
WHAT IS THE HPA AXIS?
The HPA axis is the communication network between the Hypothalamus, Pituitary gland, and Adrenal glands.
It is the body's primary system for recognizing and responding to stress.
Whenever the brain recognizes stress, it triggers a hormone cascade to alert the rest of the body.
This results in a release of cortisol (aka "stress hormone"), which tells the body to react AND turns off the signals from the brain.
GOOD STRESS
This system is designed to respond to stress in a balanced way.
In fact, some stress is actually beneficial for keeping the brain and body in tip-top shape.
Examples of eustress (good stress) include regular exercise, cold exposure, fasting, excitement, or new challenges.
CHRONIC STRESS
However, when stress levels become negative or overwhelming, it is considered distress.
If someone is overloaded with chronic distress, the system can get worn out (often described as "HPA dysfunction" or "adrenal fatigue").
Over time, the body stops responding to cortisol, leading to cortisol resistance.
HPA AXIS DYSFUNCTION
Chronically elevated levels of cortisol are like the "boy who cried wolf".
To compound the problem, communication between these glands is disrupted, the HPA axis becomes imbalanced, and the body loses the ability to respond appropriately to everyday stressors.
What to do? Try to eliminate and manage stress, prioritize sleep, and eat to nourish.
SIGNS OF HPA DYSFUNCTION
constant fatigue (regardless of sleep)
get irritated or snap easily
cravings (especially sugar & salt)
need caffeine to get through day
susceptibile to infections
digestive issues
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References
Jones, D. S., Bland, J. S., & Quinn, S. (2010). Textbook of Functional Medicine. Institute for Functional Medicine.Stephens, M. A., & Wand, G. (2012). Stress and the HPA axis: role of glucocorticoids in alcohol dependence. Alcohol research : current reviews, 34(4), 468–483.
Incollingo Rodriguez, A. C., Epel, E. S., White, M. L., Standen, E. C., Seckl, J. R., & Tomiyama, A. J. (2015). Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: A systematic review. Psychoneuroendocrinology, 62, 301–318. https://doi.org/10.1016/j.psyneuen.2015.08.014
Ferrer, A., Labad, J., Salvat-Pujol, N., Monreal, J. A., Urretavizcaya, M., Crespo, J. M., Menchón, J. M., Palao, D., & Soria, V. (2020). Hypothalamic-pituitary-adrenal axis-related genes and cognition in major mood disorders and schizophrenia: a systematic review. Progress in neuro-psychopharmacology & biological psychiatry, 101, 109929. https://doi.org/10.1016/j.pnpbp.2020.109929
Von Werne Baes, C., de Carvalho Tofoli, S. M., Martins, C. M., & Juruena, M. F. (2012). Assessment of the hypothalamic-pituitary-adrenal axis activity: glucocorticoid receptor and mineralocorticoid receptor function in depression with early life stress - a systematic review. Acta neuropsychiatrica, 24(1), 4–15. https://doi.org/10.1111/j.1601-5215.2011.00610.x
Dunlavey C. J. (2018). Introduction to the Hypothalamic-Pituitary-Adrenal Axis: Healthy and Dysregulated Stress Responses, Developmental Stress and Neurodegeneration. Journal of undergraduate neuroscience education : JUNE : a publication of FUN, Faculty for Undergraduate Neuroscience, 16(2), R59–R60.