"Why Am I SO Tired?" Adrenal Fatigue, the HPA Axis and Cortisol
In today's world, adrenal fatigue, the HPA axis and cortisol are major players in our health. With 24/7/365 news and social media, downtime is a thing of the past. We seem to have accepted being "stressed out" as normal.
It's not normal! It's common -- oh, so common. And dangerous: it wears us down to the very core.
It doesn't have to be that way. You can heal that HPA axis and live again! Let's start with a quick primer on the system.
The Hypothalamic-Pituitary-Adrenal (HPA) axis is our main stress-response system. When under stress, our HPA axis helps prepare us for fight or flight.
Fight or Flight?
Fight or flight mode is for when your brain and body perceive DANGER.
When we are calm and happy and see the world and our place in it as safe, we don't hop deep into fight or flight mode often. Just hearing a siren, heavy traffic, being late to work... these everyday stressors don't send the HPA axis into action (explained below).
Conversely, when we don't feel safe, anything at all can trigger us! Subconsciously, EVERYTHING starts to be perceived as a danger and fight/flight can become a way of life. You become a warrier/worrior -- ready to fight or flee at the drop of a hat.
This is what happened for me. My HPA axis switch got turned on and I could not turn it off -- I didn't know how. I didn't know I had an HPA axis... This state of being took a major toll on my life. Eventually, I ended up in the hospital on my deathbed. Emotionally, I was drained; life was not fun.
But I'd been in this state of high alert for so long, I THOUGHT IT WAS NORMAL!!! <<< That's the scary thing. We forget what is normal. We forget what healthy feels like.
Here's How the HPA Axis Works in a Healthy Body
You experience a major stressor. This can be either acute, like a car accident or hearing of an unexpected death. Or it can be chronic, like being the primary caregiver to a sick or elderly loved one. Here's what happens:
1. Your hypothalamus releases corticotropin-releasing factor (CRF).
2. That CRF binds to CRF-receptors on your anterior Pituitary gland.
3. Your Pituitary gland releases adrenocorticotropic hormone (ACTH).
4. The ACTH binds to receptors on the adrenal cortex and stimulates release of cortisol. Cortisol will be released for several hours after encountering the stressor.
5. Cortisol's job is to pump you up to fight or flee. One way it does this is to alert the liver to release glycogen (stored sugar) to the blood stream. Sugar is instant energy and mood elevation. (This is one reason why, when we are tired or depressed, we crave sugar when what we really need is sleep or vacay!)
6. At a certain blood concentration of cortisol, protection is ostensibly achieved -- you've fought or fled, danger is no longer perceived.
7. Cortisol then exerts negative feedback to the HPA axis, stopping the alarms and release of CRF and ACTH.
8. Systemic homeostasis returns.
Here's How the HPA Axis Gets Jammed Up in an Unhealthy State
With repeated exposure to stressers -- real or imagined -- there is repeated and sustained HPA axis activation.
The HPA axis remains on high alert (and can remain so perpetually). This means secretion of alarm chemicals -- such as epinephrine and norepinephrine from the adrenal medulla -- and secretion of CRF, ACTH and cortisol can be fairly constant.
In turn, the hypothalamus and pituitary glands can no longer maintain an appropriate level of SENSITIVITY to cortisol's negative feedback. Remember that cortisol's negative feedback is meant to stop the alarms. If the H&P become insensitive to the feedback, the alarms continue.
Systemic homeostasis does NOT return -- it cannot return in a state of constant or near-constant stress!
Under NORMAL conditions, our tissues experience only fleeting glimpses of the alarm catecholamines and cortisol. In ABNORMAL conditions, our tissues experience an abundance. These hormones and chemicals are catabolic, meaning "tear down". If the shut-off mechanism has been de-sensitized, the flow continues and we are in a nearly continuous catabolic state, rather than in homeostasis (balance).
Because the HPA axis is so far out of sync, this system will not repair automatically. In fact, it will begin to drag other systems down with it! Our biological systems don't work in a vacuum, they work synergistically. When a system fails and begins to affect other systems, my mentor calls this Metabolic Chaos.
Our biological systems don't repair on their own without intervention. In functional medicine world, intervention is simple and requires no drugs or surgery. More on this below.
A brief mention of the weight-loss/cortisol/insulin-resistance connection. When people say "stress is related to not being able to lose weight", this is what they are referring to. Remember #5 above? Cortisol's job is to release sugar to your blood stream during fight or flight. When that sugar hits your blood, your pancreas is alerted to release insulin. A steady flow of cortisol = high blood sugar = hyperinsulinemia. Researchers believe this is what leads to insulin resistance which leads to an inability to lose weight, eventually metabolic syndrome (obesity), then diabetes, then dementia (aka "Diabetes 3")! High stress does more than just wear you out.
We used to call this failing system "adrenal fatigue". However, the adrenal glands themselves don't really get fatigued or worn out. What has actually happened is that the communication lines in the HPA axis are in a jumble. In functional medicine, we call this HPA axis dysregulation.
Call it whatever you like -- we all know what's going on here: you are whipped. There is a solution...
Your Over-Stimulated HPA Axis is Fixable ❤
In fact, restoring homeostasis to the HPA axis is the primary goal and first step to restoring whole body health! Three years ago, I fixed mine with a
little boatload of help from my functional practitioner friends! Today, it's actually a pretty simple process.
As always, your questions are welcome. My email and phone (text or call) are at the top of every page. You can also set up a free 30 minute consultation if you like -- click here to do that. I'd love to chat with you and help you get started on the road back to healthy living!!! /=;-)