What You Need to Know About the HPA Axis—The First Step to Your Best Health
Let’s talk about stress. It’s everywhere—tight deadlines, traffic jams, never-ending to-do lists, and even the constant buzz of notifications. Life is full of stressors, and while some of us can push through them and bounce back, others get stuck in a cycle where stress becomes the norm. And here’s the problem: when stress takes the driver’s seat for too long, our bodies struggle to keep up, leading to burnout, hormone imbalances, and a cascade of health issues.
So, how do we break the cycle? It all starts with understanding the HPA axis—the critical communication network between your brain and adrenal glands that regulates stress, hormones, and overall well-being. If your HPA axis is out of whack, your entire body feels the effects. Let’s dive in.
What is the HPA Axis? And Why Should You Care?
Think of the HPA axis (hypothalamic-pituitary-adrenal axis) as your body’s command center for handling stress. It’s like your built-in thermostat that constantly adjusts hormone levels in response to life’s demands. When things are running smoothly, your body can handle stress and recover efficiently. But when stress becomes chronic or severe, the system can go haywire—keeping your body in constant fight-or-flight mode.
This system affects more than just stress; it regulates hormones like cortisol, DHEA, estrogen, progesterone, testosterone, and adrenaline. Cortisol, often called the “stress hormone,” plays a key role, but it’s meant to rise and fall naturally throughout the day. When it stays too high or drops too low at the wrong times, you start to feel it—physically and mentally.
What triggers HPA axis dysfunction? More than you might think. Chronic stress, infections, trauma, surgery, food sensitivities, poor sleep, toxic relationships, and even extreme weather can throw off this delicate balance.
Signs Your HPA Axis is Out of Balance
If your HPA axis isn’t functioning properly, your body will send you signals—sometimes subtle, sometimes loud. These can include:
🔹 Fatigue that doesn’t go away with rest
🔹 Brain fog, poor memory, or trouble concentrating
🔹 Mood swings, anxiety, or depression
🔹 Blood sugar fluctuations and sugar cravings
🔹 Dizziness when standing up quickly
🔹 Sleep struggles—either trouble falling asleep or waking up at odd hours
🔹 Digestive issues (bloating, indigestion, IBS-like symptoms)
🔹 Hair thinning or loss
🔹 Increased food sensitivities
🔹 Weight gain, especially around the midsection
🔹 Weakened immune function—getting sick often
🔹 Hormonal imbalances—PMS, irregular cycles, perimenopausal symptoms
🔹 Feeling “wired but tired” or completely burnt out
Sound familiar? If you’re experiencing multiple symptoms, your HPA axis might be struggling to keep up. And the longer it stays out of sync, the more it impacts everything—from your metabolism and immune system to your heart, brain, and bones.
The Far-Reaching Effects of HPA Axis Dysfunction
Long-term imbalances in the HPA axis don’t just leave you feeling run-down—they can trigger or worsen chronic conditions.
✔️ Brain & Mood – Both high and low cortisol levels have been linked to depression, anxiety, and brain fog. Studies even suggest chronic stress may contribute to Alzheimer’s disease by increasing amyloid-beta plaque formation.
✔️ Thyroid Function – Too much cortisol can block thyroid hormone activation, leading to symptoms of hypothyroidism—even if your lab results look normal.
✔️ Blood Sugar & Weight Gain – Chronically elevated cortisol levels are tied to insulin resistance, prediabetes, and stubborn belly fat.
✔️ Heart Health – Chronic stress increases the risk of high blood pressure, heart disease, and stroke.
✔️ Bone Loss – High cortisol levels accelerate osteoporosis, increasing fracture risk.
✔️ Gut Health – Too much stress can lead to leaky gut, IBS, food sensitivities, and acid reflux.
How to Restore Balance to Your HPA Axis
The good news? You CAN reset your HPA axis and support your adrenal health. It’s all about giving your body the right tools to recover.
Here’s where to start:
✔️ Prioritize Sleep – Aim for 7-9 hours and stick to a regular bedtime (ideally before 10 p.m.). Avoid blue light (phones, TVs, tablets) at least an hour before bed.
✔️ Balance Blood Sugar – Skipping meals or eating too many carbs without protein and healthy fats can cause blood sugar crashes, which stress your adrenals.
✔️ Manage Stress – Incorporate meditation, deep breathing, yoga, or journaling into your routine. Even a few minutes a day helps regulate the HPA axis.
✔️ Reduce Caffeine & Alcohol – Both can overstimulate cortisol production and interfere with sleep.
✔️ Optimize Nutrition – Load up on whole foods, quality protein, healthy fats, and anti-inflammatory nutrients like magnesium, vitamin C, and B vitamins.
✔️ Move Your Body – Exercise is great, but overdoing it can stress your adrenals. Stick with moderate movement like strength training, walking, pilates, or yoga.
✔️ Consider Targeted Supplements – Adaptogens like ashwagandha, rhodiola, holy basil, and licorice root help regulate cortisol. DHEA might also be helpful for some people.
✔️ Test, Don’t Guess – If you’re experiencing multiple symptoms, a functional medicine approach can help assess your HPA axis function through saliva, urine, or blood tests.
Get Support From a Functional Medicine Doctor
If you’ve been struggling with fatigue, brain fog, anxiety, stubborn weight gain, or hormone imbalances—and conventional medicine hasn’t provided answers—it might be time to look deeper at your HPA axis.
I’m Dr. Lisa Ballehr, and I specialize in helping patients identify and address HPA axis dysfunction through a root-cause approach. Instead of masking symptoms, I focus on uncovering what’s truly driving your health concerns and creating a plan that works for YOUR body.
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