HPA Axis Dysfunction
Stop calling it Adrenal Fatigue, it’s HPA Axis Dysfunction.
We’re relatively casual with our use of the word stress but few of us truly understand its full impact on our lives. Even when we’re not aware we’re experiencing it, our bodies are carrying out the mechanics of a stress response as we proceed with the business of daily living. Previously described as adrenal fatigue, we now know that the full effect of chronic stress goes beyond just the adrenal glands. It affects the entire HPA axis, which is why when it comes to the insidious and far-reaching effects of stress, it’s HPA Axis Dysfunction that we need to understand.
What is the HPA axis?
The HPA Axis describes the interaction between the hypothalamus, pituitary gland, and adrenal glands. The main function generally attributed to the HPA axis involves the body's chain reaction to stress as follows:
The hypothalamus triggers our fight-flight-freeze response which stimulates the pituitary gland to release adrenocorticotropic hormone (ACTH) into the bloodstream. ACTH then causes the adrenal glands to release cortisol. When cortisol reaches peak levels in the blood, the hypothalamus responds by turning off the stress response.
What does that mean for you exactly? It means there is a myriad of ways this chain reaction presents in the body, all of them worth noting and worth learning so that you can understand how your body works and better discern signals of distress.
A stress response means an increased heart rate, increased blood pressure, and the body’s immune response shutting off. It means blood flow to the prefrontal cortex is deprioritized, weakening your ability to use adequate judgement. Blood flow to the gut is also deprioritized, decreasing your ability to digest and absorb nutrition. Your blood sugar goes up to fuel the muscles responsible for the fight-flight response, increasing your risk of insulin resistance. There is pupil dilation, muscle stiffness, a 30 point drop in IQ and finally, bronchial dilation, which can make it hard to breathe and is sometimes described as “air drowning.” These are just some of the known effects on the body during a stress response. They may not be fun to read but are empowering to know.
What causes HPA axis dysfunction?
When stressors continue to present themselves, the fight-or-flight reaction stays on, keeping cortisol elevated. This chronic or prolonged stress reaction, when cortisol remains high, is when dysfunction of the HPA axis occurs. Because occupying the human body is a complex and diverse experience, we all react to stress differently. Here are some of the notable ways an HPA axis dysfunction can affect us:
Addiction: HPA axis dysfunction causes a decrease in dopamine which is responsible for our pleasure response. As we feel less pleasure, we need more of (insert applicable substance here) to achieve the same pleasure response, which can lead to overuse, addiction, and substance abuse.
Never Get Sick: You read that right, but in this case, it’s not a good thing. Your immune system does what it does, it pushes back to protect you, but this comes at the cost of it becoming increasingly dysregulated. This can lead to being sick all the time or weirdly, never getting sick. And while never getting sick sounds great, when its’ because of an imbalanced immune system, it’s a sign that your immune system is potentially on overdrive. Under prolonged stress, the immune system becomes either over or under-reactive and will eventually prove inefficient (burnout), increasing your risk for auto-immune diseases and an increase in cancer cells.
Gut Health, Food Intolerances, + Allergies: Chronic stress can lead to a decrease in gastric integrity which can cause holes in the gut lining. This leads to food particles being where they shouldn’t and an increased immune response to foods that never caused an issue for you before. This type of immune response, when repeated, can even train your body to become allergic to these previously unproblematic foods.
Slow Healing: The body is slow to heal or does not heal at all from injury.
Memory Matters: The Hippocampus, which is responsible for turning short-term memory into long-term memory and turning experiences and felt memories into narratives, shrinks from chronically elevated cortisol. This can even contribute to creating damaging or distorted narratives about who we are and what our life is.
Impaired Judgment: The prefrontal cortex becomes atrophied, lessening our capacity to use judgment.
Increased Estrogen-Progesterone Imbalance: Over a prolonged period, the body can’t sustain the necessary cortisol levels. It starts to use the building blocks from other hormones to keep producing cortisol which can lead to a decrease in hormones like progesterone, causing a corresponding spike in estrogen. Elevated estrogen, as we know, can cause many health imbalances including an increased risk for breast cancer.
So, what can we do?
It can feel overwhelming to learn about all the ways stress might be affecting us, but the good thing is, there are always ways to counteract it. A great strategy for overcoming chronic stress, or trauma-related stress, includes feeding our nervous system and regulating our HPA Axis. One of the ways to do that is to work on increasing the tone of our vagus nerve by stimulating it. One effective way to stimulate your vagus nerve is to practice meditative, deep breathing exercises, and to access co-regulation with your massage therapist or acupuncturist. We’ll be sharing more in our next few blog posts as well. Stay tuned by signing up for our newslettter