Chronic Fatigue? Maybe it’s HPA Axis Dysregulation
So you have been suffering from Chronic Fatigue Syndrome and you want to get to the bottom of it. You may have heard of “Adrenal Fatigue” in the past. This is a term used by some integrative healthcare practitioners that historically has not been widely accepted within the scientific community. More recently, a mountain of evidence has accumulated within scientific literature accounting for the syndrome of “Adrenal Fatigue.” This term has been replaced by the more appropriate “HPA Axis Dysregulation.” “HPA Axis” stands for Hypothalamic-Pituitary-Adrenal Axis, and encompasses the way these two parts of the brain and adrenal glands interact with one another. This term is more appropriate as it turns out the root of the problem isn’t in the Adrenal glands, themselves, but rather in the relationship between the Adrenals and the brain. HPA Axis Dysregulation has been found in a high proportion of patients with Chronic Fatigue Syndrome. This is something that I think should be considered in anyone dealing with abnormal fatigue.
What does the HPA Axis do?
Responds to external stressors so you can adapt situationally
Regulates blood pressure
Regulates immune function
Contributes to your metabolism
How the HPA Axis Works
Your brain has an area called the Hypothalamus which is part of the Limbic system, and it is responsible for regulating part of the Autonomic Nervous System. Regarding the HPA Axis, the hypothalamus plays the role of the watchtower. It monitors the levels of your adrenal hormones in the body and makes sure they are within an optimal range for metabolic function. The Hypothalamus communicates with the nearby Pituitary Gland, which is like the gas pedal for your metabolism. When your adrenal hormones are too low, the hypothalamus tells the Pituitary to step on the gas. When the hormones are too high, it tells it to ease up on the gas. The Pituitary gas pedal works by way of hormones it secretes that travel through your circulatory system directly to the Adrenal glands. The Adrenals are kind of like an engine for your metabolism. When they receive the gas signal from the Pituitary, the Adrenals increase the production of the hormones they oversee which includes Cortisol, DHEA, Aldosterone, Epinephrine, and Norepinephrine, among others. These hormones then travel through your blood to the rest of your body and affect the metabolic behavior of every cell in your body
Causes of HPA Axis Dysregulation
Exposure to continuous stress over a long period of time or exposure to a major single stressful event are common causes of this disorder. Chronic illness may also be a cause, as well as physical stressors such as recreational substance use, bodily injury, and dietary factors. When your body is overexposed to stressors, this can cause the watchtower of the Hypothalamus to become desensitized to your adrenal hormone levels. This leads to dysregulation of the adrenal hormones.
Signs of HPA Axis Dysregulation with Deficient Adrenal Hormones
Severe fatigue, depression, brain fog, bloating, loose bowel movements, heartburn, shallow breathing, low blood pressure, feeling cold compared to other people, heart palpitations, low blood sugar, weak muscle strength, lowered immune function, frequent clear urine, urinary incontinence, salt/sugar cravings.
Signs of HPA Axis Dysregulation with Excess Adrenal Hormones
High blood pressure, increased cholesterol, irritability/anger, excessive energy or fatigue, insomnia, increase in visceral fat, poor immune function, heartburn, bad breath, constipation or loose stool, sugar cravings.
How to know you have HPA Axis Dysregulation
There is specialty lab testing available for this disorder, such as a saliva based test that looks at changes in your adrenal hormone levels throughout the day. There is also urinary testing available which looks at metabolites of hormones. These tests are typically difficult to have covered by insurance and may need to be paid for out of pocket. A good herbalist, however, can generally guide treatment without the need for testing.
Herbal Treatment
In Western herbalism, there is a class of herbs known as “Adaptogens” which work in part by increasing your brain’s sensitivity to your Adrenal hormone levels, as well as providing many other benefits throughout the body, such as modulating your immune function, regulating blood sugar levels, lowering inflammation, and helping you adapt to stressful situations more gracefully. There is a lot of nuance to herbalism, and this is where I come in. Some adaptogenic herbs are more tonifying and stimulating, while others are more sedating. I can create a custom blended herbal formula for you that can help you to feel better even after the first dose.
How to support your HPA Axis at home
Be sure to get enough sleep. Poor sleep affects the HPA Axis, and vice versa. Support habits that help you fall asleep and stay asleep throughout the night. Have a consistent sleep schedule. Go to bed and wake up at the same time each day.
Nutritionally, focusing on eating a traditional whole food diet that is minimally processed and without refined sugar can reduce some of the stress placed on your body. Make sure every meal you have includes protein, complex carbohydrates, and a healthy source of fat. Research has shown that a Mediterranean style diet is protective against HPA Axis dysregulation.
Incorporating a mindfulness practice into your daily life - even just 5 minutes per day can have a big impact when performed consistently. Research has shown that Mindfulness Based Stress Reduction practices promote improved HPA Axis function.
Minimizing or removing caffeine takes a major stress off your HPA Axis while you are trying to heal. Caffeine desensitizes your brain to your cortisol levels and makes it harder to get back on track. Keep in mind this is only temporary!
Eating foods rich in Vitamin C, or taking a Vitamin C supplement, provides nutrients your Adrenal glands need to synthesize the hormones they produce. Vitamin C is more prevalent in your Adrenal glands than anywhere else in your body. Vitamins B5 and B6 are also important for Adrenal hormone synthesis.
If you are interested in exploring the underlying cause of your fatigue, please reach out and let’s work together.