To understand this we must first understand what the HPA-axis is and what happens when it is not functioning properly (HPA axis dysfunction). The hypothalamic-pituitary-adrenal axis is responsible for helping us adapt to stress. In response to stress, cortisol is released for several hours after encountering the stressor. Cortisol is a hormone that is made by the adrenal glands and is best known for its involvement in the fight or flight response. We need cortisol for the body to function properly, but when we are constantly stressed the HPA axis gets desensitized to the negative feedback loop that is necessary telling it to “calm down”, leading to chronic stress on the hypothalamus, pituitary gland and adrenal glands (4).
Adapted from: Wikipedia Hypothalamic-pituitary-adrenal axis. (2016, August 13)
Retrieved from: https://en.wikipedia.org/wiki/Hypothalamic–pituitary–adrenal_axis
What Causes HPA Axis Dysfunction?
It is important to understand that many different aspects of our lifestyle can cause HPA axis dysfunction. Any event that causes wear and tear on the body is a stressor. This can be physiological, emotional, physical, environmental etc. If someone does not feel emotionally stressed and they don’t have any physical stress that they know about, they can still have something like a gut infection or food intolerance that will cause their body stress, therefore causing HPA axis dysfunction.
In the book “The Role of Stress and the HPA Axis in Chronic Disease Management”, Dr. Guilliams talks about the four categories of stressors that lead to chronic HPA Axis dysregulation. There is perceived stress, circadian disruption, glycemic dysregulation, and inflammatory signaling.
The HPA axis can easily be triggered by signals outside the body that are non-physical, which the brain perceives as threatening. Things like public speaking, financial and relationship trouble, work stress etc. are called “perceived” stressors because how people perceive the event has the ability to affect HPA axis function.
Circadian rhythms are physical, mental and behavioral changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in an organism’s environment (2). The HPA axis is intimately tied to the mechanisms controlling circadian rhythm. Unfortunately, most people have the ability to ignore these important cues when choosing their work, social, sleeping and entertainment schedules (1). What this means is that working the night shift and sleeping during the day, not getting enough sunlight during the day, and the use of electronics at night, can lead to HPA axis dysfunction as well as many different metabolic dysfunctions like obesity and insulin resistance.
Glycemic dysregulation is the inability of your body to regulate your blood sugar levels, which can lead to hyper or hypoglycemia. Poor diet, lack of exercise and lack of sleep can not only dysregulate the HPA axis but it can cause glycemic dysregulation. Cortisol is very important for regulating glucose. When stress happens, the body raises cortisol levels and therefor can raise blood sugar levels. The rising epidemic of insulin resistance, obesity, and their related metabolic disorders has a complex cause-and-effect relationship with the increase of stress-related disorders.
Cortisol is a powerful anti-inflammatory steroid. When someone has chronic inflammation, his or her body will signal the HPA axis to secrete more cortisol in order to decrease the inflammation. The increase in cortisol downregulates inflammatory pathways within tissues and immune cells through genomic and non-genomic signaling. This suppresses most other immune functions, which explains so many of the side effects of prednisone and other steroid drugs (3). Inflammation from food allergies, obesity, rheumatic diseases, or anywhere can be a HPA axis stressor.
How Do We Support the HPA Axis?
Supporting the HPA axis is extremely important in chronic disease management. It is important to understand that you must support the central nervous system, the adrenal glands and the way in which cortisol signaling functions within the tissue. This is achieved by removing as many known stressors as possible. In addition:
- Stay away from inflammatory foods like gluten, sugar, grains and dairy
- Avoid food sensitivities and allergies
- Get tested and treated for any infections like SIBO, yeast overgrowth etc. that may be causing stress on the body.
- Use tools like mindfulness training and yoga to help with the way you perceive stress.
- Get plenty of sunlight and fresh air during the day and stay away from electronics like TV, cell phones, computers and artificial house lights at night.
- Consider supplementing with adaptogenic herbs, Vitamin C, B vitamins and phosphatidyl serine (I recommend you work with a skilled practitioner to find out which supplements are right for you).
- Have adrenal gland hormones like cortisol, DHEA and sex hormones tested by a skilled practitioner so they can create a specific treatment protocol for you.
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Guilliams, T. The Role of Stress and the HPA Axis in Chronic Disease Management. Point Institute, 2015. Print
Circadian Rhythms Fact Sheet. (2016, April 6).
Kresser, Chris. “HPA-D:Etiology.” Adapt Framework Level 1, kresserinstitute.com
Greenfield, B. (2016) Two Ways Your Brain Breaks and Exactly What You Can Do About It Part 2.