The hypothalamic pituitary adrenal (HPA) axis is the subsystem in the body where the hypothalamus and pituitary glands in the brain interact with the adrenal glands, located on top of each kidney. Why is the HPA axis something you should familiarize yourself with? Studies have discovered a link between the HPA axis and the role it plays in certain syndromes and disorders relating to the central nervous system, including adrenal fatigue.

What Does the HPA Axis Do?

Most notably, the HPA axis functions as the stress response system within the body, but it also helps control the following:

  • Mood
  • Immunity
  • Temperature
  • Digestion
  • Libido
  • Metabolism
  • Heartburn

When stress of any kind is placed on the body, the hypothalamus releases corticotropin-releasing hormone (CRH), which, in turn, forces the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH then moves down into the kidneys to stimulate the adrenals so they will then produce glucocorticoids. Glucocorticoids are the steroids responsible for maintaining a proper metabolism, keeping inflammation at bay, and for initiating the immune response. The most famous glucocorticoid is cortisol, appropriately known as “the stress hormone.”

Cortisol is responsible for helping the body withstand the stresses put upon it, like when you don’t get enough sleep, you exert yourself too much in spin class, you feel anxious and stressed out about a work project, or any time you injure yourself. This release of cortisol into the system is referred to as the fight-or-flight response.

When your body is forced into a constant state of fight-or-flight due to excessive and repeated stress, your body suffers from adrenal fatigue. The reason for this is a communication breakdown between the adrenals and the hypothalamus and pituitary glands. In a healthy individual, when cortisol initiates the fight-or-flight response, it also sends a signal back to the brain telling the hypothalamus and pituitary glands to stop producing CRH and ACTH. When all three are working in accordance, the body will calm down once the stressor placed upon it subsides.

But what happens when all parties involved in the HPA axis stop communicating with one another?

For lack of a better term, your HPA axis can breakdown, meaning it can send your body completely out of whack. In its worst state of disrepair, HPA axis dysfunction can lead to one of the following in a family of illnesses known as central sensitivity syndromes:

  • ​Migraines
  • Chronic fatigue syndrome
  • Myofascial pain syndrome
  • Fibromyalgia
  • Irritable bowel syndrome (IBS)
  • Temporomandibular joint disorder (TMJ)
  • Restless legs syndrome
  • Vulvodynia

While not classified as central sensitivity syndromes, the HPA axis also plays a role in post-traumatic stress disorder (PTSD), bipolar disorder, depression, and anxiety.

Even minor disruptions in the HPA axis can lead to symptoms commonly associated with adrenal fatigue, including:

  • ​​Achiness
  • Poor circulation
  • Hair loss
  • Sudden weight loss
  • Fatigue
  • Insomnia
  • Brain fog
  • ​Irritability
  • ​​Digestive issues

Fortunately, there are a number of ways to ensure your HPA axis is functioning at optimal capacity.

Maintaining Optimal HPA Axis Function

Eliminating stress from your life is impossible, but by staying healthy and acquiring the tools to properly manage stress, you can prevent HPA axis dysfunction from occurring.

Not getting enough sleep can have an extremely negative effect on the body, namely, lack of sleep can inhibit cortisol production. Abnormal sleep patterns and insomnia contribute to other significant health issues, including increased anxiety and weight gain. Ensuring that you are getting a decent night’s sleep is vital to maintaining optimal health and the health of your HPA axis.

Another way to manage stress is to ensure you’re getting enough exercise. It’s important to be mindful as to the type of exercising you’re getting and how much. Those with chronic fatigue and fibromyalgia will benefit most from low-impact activities such as yoga, Pilates, and warm water aerobics. Performing exercises that are too strenuous can result in post-exertional malaise, which can leave you feeling flu-like and exacerbate symptoms. If your body can handle it, going out for a walk or a bike ride can do wonders for your stress levels, not to mention for your health.

Be careful, though, as too much exercise can trigger the fight-or-flight response and lead to further dysfunction of the HPA axis.

Many issues associated with an HPA axis dysfunction involves chronic inflammation. One of the most effective ways to reduce inflammation levels is by eating low and non-inflammatory foods. Always consult a physician before beginning any type of diet plan, but an anti-inflammatory diet loaded with leafy greens, omega-3 rich fish, beans, nuts, and high-fiber fruits like raspberries and blackberries can work wonders for reducing inflammation, as can avoiding overly processed foods, refined sugars, excess caffeine, dairy, and alcohol.

In addition to sleep, exercise, and eating a healthy diet, finding ways to keep calm throughout your day is vital to keeping your HPA axis hormone levels in check. The best way to do this is by cultivating a meditation practice, whether it be guided or on your own; other effective forms of self-care include massage and acupuncture.

When you approach your stress levels in a conscientious way, you can restore balance to your HPA Axis and eliminate adrenal fatigue. It can be a challenge to maintain when you lead a busy life, but the good news is you don't have to do it alone: our team helps patients overcome adrenal burnout every single day. If you're ready to regain the vibrance in your energy, request your new patient consultation & treatment today.



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