What is HPA Axis Dysregulation?

HPA axis dysregulation (HPA-D) is the scientific term for the popular syndrome known as “adrenal fatigue.” It refers to a constellation of signs and symptoms including fatigue, sleep disruption, poor exercise tolerance and recovery, low libido, brain fog, weakened immune function, and reduced stress tolerance. HPA axis dysregulation is caused by many different aspects of the modern lifestyle, including poor diet, sleep deprivation, chronic stress, lack of (or too much) exercise, and inflammation. HPA axis dysregulation affects nearly every cell and tissue in the body. For this reason, it must be addressed in virtually all cases of chronic illness in order for healing to occur.

There are four primary triggers of HPA axis dysregulation, listed below.

Four Triggers of HPA Axis Dysregulation

  1. Perceived Stress. There are four key determinants that determine the magnitude of HPA response. NUTS is an often-used mnemonic for this.
  2. Novelty of the event
  3. Unpredictable nature of the event.
  4. Perceived threat to body or ego
  5. Sense of loss of control
  6. Things like finances, relationships, work, public speaking, and internal stress perception caused by neuronal imbalances.
  7. Generally, psychological stress is more harmful because there is less sense of control and it lasts much longer.
  8. Circadian Disruption. The HPA axis and circadian rhythm are intertwined and have the ability to profoundly impact one another.
  9. Sleep deprivation, artificial light exposure, nighttime light exposure, getting too little exposure to natural light during the day, jet lag, shift work, and caffeine.
  10. Glycemic Dysregulation. There’s a bidirectional relationship between the HPA axis and metabolic functions, so a disruption of one will harm the other.
  11. Poor diet, lack of sleep, and lack of exercise.
  12. Visceral fat is caused by elevated cortisol,which in turn triggers inflammatory mediators.
  13. Hypoglycemia leads to HPA axis activation, so impaired glucose sensing can also cause increased cortisol.
  14. Inflammation. Cortisol is a powerful anti-inflammatory agent, so acute or chronic inflammation triggers the HPA axis and increases cortisol.
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