Adrenal Fatigue vs HPA Axis Dysfunction

The pseudoscientific diagnosis of adrenal fatigue (hypoadrenia) is given to many patients desperately seeking a cure for their constant tiredness, brain fog, and lack of motivation. Hypoadrenia falsely claims the adrenal gland is not producing an adequate amount of hormones. Expensive supplements and other unnecessary treatments can be prescribed. Without getting to the heart of the actual problem, however, constant fatigue cannot be adequately treated.

What Is the HPA Axis and How Does It Work

The HPA axis stands for the hypothalamus, pituitary gland, and adrenal cortex intersection. This organism functions as the body’s stress-response system. When our bodies experience psychological and physical stress, a chain reaction begins. The stress signal is generated in the hypothalamus and then makes its way through the pituitary gland and adrenal cortex. The adrenal cortex produces 4 hormones:

• Cortisol – Cortisol is the steroid hormone in the HPA axis that gets most of the attention but it’s actually only part of the problem. Cortisol sounds the alarm in times of stress, preparing the body for a physical response. Cortisol can be triggered by external and internal factors, meaning it can be kicked on by a fear-inducing boss as well as an unhealthy diet.
• Corticotropin-Releasing Hormone (CRH) – Also called corticotropin-releasing factor (CRF). This is the stress hormone released by your hypothalamus that stimulates the pituitary gland causing it to release adrenocorticotropic hormone. This too can be caused by external or internal factors.
• Adrenocorticotropic Hormone (ACTH) – As mentioned above, this hormone is released by your pituitary gland where it then causes the production of glucocorticoids in the adrenals.
• Glucocorticoids – Cortisol is a glucocorticoid, but there are others within this family produced by the adrenal glands. Glucocorticoids are steroids, which help regulate immune system response primarily through reducing inflammation.

Why Chronic Fatigue Is Prevalent in Today’s World

Today’s modern world is mismatched with our makeup. Early humans’ stress-response system—the fight or flight system—was for life or death situations. Presumably, these life or death situations occurred once every two weeks—(at least not every day)—with an adequate amount of time to recover. Today, though, humans experience stressful situations on a daily basis. These milder versions are certainly not considered “life or death” situations all the time. However, bills, unruly children, patronizing bosses, hard-to-achieve beauty standards and the like all make for pretty unpleasant situations, which usually are stressful.

This sustained exposure to stress makes the hypothalamus and pituitary gland desensitized to the negative feedback of chemicals such as cortisol. Having that desensitization is like developing a tolerance for a substance, which disrupts the normal functioning of the body. Another good example is insulin resistance in type 2 diabetes patients. Plain and simple—the body does not properly work nor goes back to normalcy or homeostasis. Most arguably the worst side effect of the hypothalamus and pituitary gland’s desensitization and imbalance from constant stress is exhaustion—or fatigue.

Aging & Cortisol Levels

Age also plays a role in this health issue as well. Older women secrete more cortisol in response to stress than do older men. Younger women secrete less cortisol overall as well. For women, when the perimenopausal, menopausal, and postmenopausal stages occur, there is a deficit in estrogen and progesterone. These two hormones play a significant role in the regulation of the HPA axis. The reduced sensitivity of this organ produces an influx of cortisol causing unpleasant side effects such as difficulty sleeping, irritability, anxiety, negative mood, and other concerns.

It does not have to be this way. It’s possible to take control of the HPA axis and reduce stress. Seeing a Functional Medicine practitioner can have a profound effect on the mood and fatigue levels. It’s easy to “overdo it” with unnecessary pharmacologic interventions. It’s also possible to overcompensate with Integrative Medicine interventions. The importance of seeing a provider who understands how to unfold the layers in your unique architectural complexity is pivotal to fighting the desensitization of the HPA axis, which usually manifests into chronic fatigue. Extensive blood work and diagnostic labs are the necessary means to understand the customized treatment plan you might need.

If you’re worried about your chronic fatigue and want your life back, make the investment in your health. Reach out to a Functional Medicine provider to see what your options are.

Evidence-Based Supplementation to Reduce Stress

• Ashwagandha (Withania somnifera) has been shown in clinical studies to reduce stress and occasional anxiety in adults. A literature review demonstrated that ashwagandha exerts “positive influence on the endocrine, cardiopulmonary, and central nervous systems.” Ashwagandha may be helpful in modulating the mood and hormonal responses in women in times of stress.
• Vitamin B6 (pyridoxine) is a cofactor for approximately fifty different enzYuniquees and plays a role in the production of neurotransmitters, such as serotonin, dopamine, epinephrine, norepinephrine, and gamma-aminobutyric acid (GABA). Vitamin B6 may also be helpful for premenstrual mood support.
• Melatonin is synthesized from tryptophan and secreted by the pineal gland during periods of darkness. Human research has found that supplemental melatonin promotes sleep, improves sleep quality, and shortens sleep onset latency, particularly in people age 55 and older. Women experiencing occasional sleeplessness due to an overactive HPA response may benefit from melatonin.
• L-Theanine has been shown to increase serotonin and dopamine levels in humans, which may promote muscle relaxation and improved sleep. L-Theanine is a non-drowsy, non-habit forming option for women who need restful sleep to support healthy daily cortisol rhythms.