The #1 Cause of HPA Axis Dysfunction (Adrenal Fatigue)

Written By


Expert Reviewed By

Dr. Lauryn Lax, OTD, MS

Dr. Lauryn, OTD, MS is a doctor of occupational therapy, clinical nutritionists and functional medicine expert with 25 years of clinical and personal experience in healing from complex chronic health issues and helping others do the same.

Hpa Axis Dysfunction

The HPA Axis Dysfunction or Adrenal Fatigue

HPA Axis Dysfunction or adrenal fatigue is real…don’t believe me? Read on for yourself to find out how it can happen to anyone, and the #1 cause behind it all.  Hpa Axis Dysfunction I’ve been quiet in social media world the past several months and, to be honest, it’s been a rough stretch to say the least. In short: “Adrenal fatigue” or HPA Axis Dysfunction is real, and if you’ve ever experienced an extreme bout of stress, you’ll know what I mean. Here’s a little personal story, and the science and research to prove it. 

Stress = The #1 Cause of HPA Axis Dysfunction

In fact, stress alone is the #1 driver of HPA Axis Dysfunction—the primary attributed cause of practically every known ailment plaguing our society today—from diabetes, to cancer, autoimmune disease, anxiety and beyond. Contrary to popular belief, stress goes far beyond just mental stress alone. Physical stress is often times even more detrimental, as it more easily goes unseen, including: imbalances in the basic human needs (such as lack of sleep, dehydration, poor nutrient density, sedentary or overtraining lifestyles), to gut dysfunction (SIBO, leaky gut, IBS), circadian rhythm dysfunction, inflammation, and light exposure (blue screens, light at night, etc.). In fact, you can be sitting on a beach in Tahiti with a margarita in hand, seemingly no care in the world, but your body STILL be under a significant amount of stress, such as: fighting leaky gut and acne, experiencing shortness of breath from overwork in your daily lifestyle and lack of sleep, and hormone imbalances from overtraining in the gym and under-eating fat and protein. Regardless of what type of stress you face (physical or mental), our bodies can only take so much stress. While stress is inevitable (impossible to avoid in modern day), if you go over your individualized threshold of stress or experience a significant amount of stress in a short amount of time, your body may back fire. Enter: “Adrenal Fatigue” or “HPA Axis Dysfunction.”

My HPA Axis Dysfunction Story

It all began in March of 2018. Actually, rephrase that: It all began about 3 years ago, in 2015—the beginnings of my business and life as an entrepreneur. Eager to “save the world” with my business aspirations in the health and wellness field, I went to work on the front lines, doing things like:

My Job (“Saving the World”)

  • Therapy:

Providing counseling and therapy services to individuals with emotional baggage to get rid of;
  • Nutrition:
Offering support plans and nutritional guidance for individuals seeking health improvements;
  • Functional Medicine:
Knocking conventional medicine on its head with functional medicine—providing tools, resources, protocols and procedures for helping people truly heal, not just manage their disease: —You know, just “saving the world” (or trying to). Along with these pursuits, a sneak peek into my life as an entrepreneur looked something like this for a couple years:

HPA Axis Dysfunction Begins: (Stressful) Life of an Entrepreneur (Beginning Fall of 2015)

6 a.m. Rise & Shine. Wakeup to my alarm across the room (despite wanting to go back to sleep after 5 hours of sleep) Brushing my teeth, swigging a protein shake, and rushing to get ready for the day to make it to the gym by 6:30 a.m. or 7 7-8:30 a.m. Workout. Hitting a workout in the gym first thing to get energized for the day 8:30 a.m. Breakfast: Another protein shake, greens, coconut butter and 1/2 a banana on my way to my office 9 a.m.-2 p.m. Work It Start the work day, seeing new clients and writing or creating my next online project or book. 2 p.m.-3:30 p.m. Workout #2. Hit the gym again for a break in the middle of the work day to burn off energy and clear my head. 3:30 p.m. Lunch. Chicken, avocado, greens, beets. 4 pm-7:30 p.m. Work It. Back to the grind. 7:30 or 8 p.m. Group Meeting. Mixing, mingling and talking more about business. 9:30 p.m. Workout. Force myself to hit the gym again after a long afternoon of sitting to work out pent up energy for 40-60 minutes. 10:30 p.m. Dinner. Dinner at home: Turkey burger patty, sweet potato, coconut butter, greens sautéed in ghee. 11 p.m.-1 a.m. Work. Finish my work for the day (e-mails, admin, etc.). 1 or 1:30 a.m. Bed. Hit the sack and sleep like a rock for about 5 hours. Wakeup and do it all over again! 

But Stress is “Normal” Right?…

Hpa Axis Dysfunction Can you relate? Or do you know anyone who is an entrepreneur, or in school, or loves what they do, or who is super stressed over their work or life—and keeps a similar schedule? (Burning a candle at ALL ends). Face it: Stress and “running on a hamster wheel” is normal, and if you are NOT doing it, then you better watch out because (gasp) you may fall behind. Although I thought I was made of “steel”—immune of stress wreaking havoc on my health—my body had other plans in mind. Before I realized it, various (silent) health issues began to arise including:

Health Issues Arise (2016-2017)

  • IBS
  • SIBO (small intestinal bacterial overgrowth)
  • Unwanted weight loss (losing about 10 pounds over the course of about 3 years due to malabsorption and gut issues)
  • Bloating after eating
  • Chronic constipation
  • Shortness of breath if I slept less than 5 hours multiple days in a row
  • Gym performance decline (loss of strength, endurance, gains in the gym)
  • Hormone imbalances (losing my period)
However, despite all these “new” symptoms, I was completely checked out from my body—laser focused on checking off to-do lists, getting further ahead in business and growing a company. In addition to not feeling on “top of my A-game,” other things in my life began to shift too, such as:

Lifestyle Imbalance (2016-2017)

  • Isolation from friendships (in place of work)
  • Working on weekends and evenings instead of spending time with people or taking breaks
  • Lack of interests and activities outside of work
  • Disconnection from my “source”—time spent in Word, prayer
  • Disconnection from the great outdoors (staying inside most of the days)
  • Over-screen exposure (upwards of 10-12 hours per day in front of a computer)
  • Loss of “who I am” or what I like to do (outside work)
  • Running towards a goal with no end in sight
To say the least, I became more like a robot, and less like “Lauryn”—the well rounded individual I am in my core. I could talk and write all day about living a health lifestyle, and I knew WHAT to do, but when it came to my own health and life, there wasn’t time to do all the things I preached about! Hpa Axis Dysfunction As a busy entrepreneur, trying to save the world, who had time to do things like sleep 7-8 hours, or mix up my workouts, or eat a variety of nutrient dense foods, or make time for hobbies and passions and relationships?! This schedule and pace continued for a good 3 years before my body really began to speak—letting me know that something was up.

Getting Out of Balance: SIBO, Leaky Gut, IBS & Beyond (September 2017)

Come September 2017, I was hit with a severe case of SIBO—Small Intestinal Bacterial Overgrowth—in which my body, under high amounts of physical and mental stress, developed a gut condition where unhealthy bacteria overpopulated my small intestine. The result? Rapid weight loss and IBS. Although I have struggled with “gut stuff” (constipation and IBS) most of my life, things really kicked up. Seemingly overnight, I went from just feeling bloated after most meals to having to run to the bathroom after most meals with loose watery stools, or the opposite, waking up super constipated—unable to go at all. This conundrum continued for a good 4 months before I decided to dig deeper and consider what else may be going on under the hood. Thanks to my functional medicine background and training program at the time, we were actually learning about SIBO at the same time, and come to find out, SIBO is exactly what I had—triggering unwanted weight loss, malabsorption, bloating, constipation, tummy cramps, and the inability to tolerate most FODMAP foods. At the turn of the New Year (January 2018), I was treating SIBO at home with a strict supplement protocol, courtesy of my functional medicine training, and by the end of February, I was feeling much better on the gut front—except about 10 pounds lighter than I’d want to be. “What’s wrong with Lauryn?” I could sense others saying with their eyes, and it appeared I was “back” into my eating disorder that I had struggled with from ages 10-24. I could hardly look in the mirror myself, and sitting at barely 100 pounds (on a “good day”), for my 5’4’’ frame, I felt it—felt weaker, and more discouraged, despite being more at peace with eating, feeding my body well and even giving up cardio in place of more muscle building workouts. However, despite my efforts to gain weight—it wasn’t happening. Eating approximately 2400 calories each day wasn’t doing it. “Carbing up” wasn’t doing it. Working out a little bit less wasn’t doing it. By March 2018, I found myself in a Gastrointestinal Doctor’s office to try to “get to the bottom” of things to see what—if anything—in my gut was still keeping me from putting on some weight that I wanted, and the conventional medicine “rabbit hole” began.”

The Plot Thickens: The Triggering Event (My Colonoscopy) (March 2018)

Hpa Axis Dysfunction To start, the doctor ordered a CT scan of my intestines to start, finding a presentation of a “Megacolon” and “Autoimmune bowel,” and advising we do a colonoscopy to do some deeper digging to see what, if any, autoimmune diseases were present as well as any blockage or structural issues preventing me from absorbing nutrients and restoring bowel function. In addition, I had a full blood panel done and hormone panel, and the results revealed:
  • Iron Overload
  • Low Thyroid Function
  • Low Vitamin D
  • SUPER High Cortisol
  • Low Sex Hormones (practically NO testosterone, estrogen, progesterone)
By the end of March, “C-Day” (“colonoscopy day”) arrived (and so did countless health side effects from this invasive procedure).

Colonscopies: More Harm Than Good

Colonoscopies have become one of the most prescribed outpatient procedures in America with more than 15-million performed each year (1) (CDC, 2016), and are only growing in prevalence. While only about 50% of adults, ages 50-75, who “should have” colonoscopies comply with recommended guidelines, in 2018, the National Colorectal Cancer Roundtable (a group of public and private organizations) aims to raise the percentage of people screened for colorectal cancer to 80%. And although colonoscopies are thought to be “necessary” for detecting “gut issues”—particularly colon cancer—they actually may be more detrimental than good. In fact, according to Dr. Mercola and Dr. Michael Greger, about 1 in every 350 colonoscopies end up doing serious harm.  I am a case study example.

Colonoscopy: Little Known Side Effects

Common (little known) side effects from this invasive bacteria with a scope include:
  • Perforation (puncturing) of the intestines (Gatto et al, 2003) (2)
  • Dysbiosis (imbalanced gut bacteria) (Lorenzo et al, 2016) (3)
  • Infection with another person’s gut bacteria
  • Eradication of healthy gut bacteria from prep (Lorenzo et al, 2016) (3)
  • Electrolyte, bacteria and blood sugar imbalances (from the “prep diet” and extreme cleansing that is mandated) (Shobar et al, 2016) (4) (Mai et al, 2006) (5)
The result? A gut microbiome that is “worse” off then prior to the colonoscopy. Given that our gut bacteria and our gut itself is the “gateway” to health, if our gut bacteria gets off (or even MORE off), then you can bet your bottom dollar, other body systems get “off” by “imbalanced.” Healthy gut bacteria or unhealthy gut bacteria determine whether the following body mechanisms are healthy or unhealthy, including:

Gut Bacteria Govern Our Health

  • Immune function (disease, skin) (Oregon State University, 2013) (6) (Nanjundappa et al, 2017) (7)
  • Digestion (Lawrence, 2017) (8) (Kim et al, 2012) (9)
  • Heart/cardiac function (Tang et al, 2017) (10)
  • Weight and metabolism (Filip et al, 2018) (11)
  • Blood sugar regulation (Kumamoto University, 2018) (12)
  • Brain health (anxiety (Hoban et al, 2017) (13), depression (Clapp, 2017) (14) and memory (Lund University, 2017) (15)
  • Adrenal health (i.e. “HPA-Axis” affecting hormones, cortisol and thyroid) (Konturek et al, 2011) (16) (Cryan et al, 2011) (17)
  • Exercise progress (or plateaus) (Clarke et al, 2014) (18)
  • Headaches (Gonzalez et al, 2016) (19)
  • Attention/ADHD/ADD (Carmen et al, 2017) (20)
  • Cancer (Fellows et al, 2018) (21)

A better option than colonoscopies?

Stool testing—Addressing gut bacteria and gut health itself—prior to looking for structural issues with a scope. (Bullman et al, 2017) (21) Since gut bacteria, gut infections, parasites and bacterial imbalances determine whether you get cancer, IBS or autoimmune disease in the first place, comprehensive stool analysis, like this one by Doctors Data or this one by GI Map, can be tremendously helpful in assessing “underlying issues.” Additionally, organic acids testing, SIBO breath testing and even a new blood test (Tsai et al, 2018) can give you more information as well. (This is something a GI doc won’t typically tell you).

Me: Post Colonoscopy (April-May 2018)

My colonoscopy was the “straw” that broke the camel’s back —accumulating the past 3 years of stress in one fatal swoop on “C-Day” (colonoscopy day). The “prep diet” was too much for my already-weakened body to handle (i.e. clear liquid fasting). Couple NOT eating all day with a full bottle of Miralax laxative powder, laxative tablets and all afternoon on the toilet, and by midnight that night, I was “far gone.” Walking up the stairs to go to bed, I blacked out—passing out on the floor, and eliminating more bowels. It took me about a minute to come to, as I don’t remember what happened, and strewn on the floor, my body started convulsing and trembling, my teeth chattering, and all I remember is asking my mom for a banana—some potassium. Ten minutes later, the ambulance was there, and I was hooked up to IV fluids, EKG monitor and  a blood pressure cuff on my way to Dell Seton Medical. “Electrolyte imbalance,” the ER doc diagnosed, and by 4 a.m., my mom and I were back out the door to prepare for my 5 a.m. colonoscopy arrival time. I went through with the procedure, but little did I realize the “health issues” were not over, as my body spent the next 5-6 weeks trying to recover from the stressful event, inclusive to:
  • 2 more ER visits (for “electrolyte imbalances” and hypoglycemia)
  • 3 urgent care visits for more fluids and blood work
  • A GI Doctor office that would not return my phone calls post-procedure
  • A severe acute allergic reaction to a cat that moved in with a new roommate
  • Blood sugar highs and crashes
  • And more than a handful of diagnoses, speculations and prescriptions from docs trying to figure out what was going on, including: Asthma, Type I Diabetes, obstructed respiratory system, low sodium, iron overload, and…adrenal insufficiency (aka: “adrenal fatigue” or “HPA Axis Dysfunction”). 

Adrenal Insufficiency (aka: HPA Axis Dysfunction)

Hpa Axis Dysfunction Adrenal insufficiency (aka adrenal fatigue—or “HPA Axis Dysfunction”)  IS real, and although our bodies are resilient to handle stress, if TOO MUCH stress happens at once, or a SUPER STRESSFUL event sets you over the edge, then HPA Axis Dysfunction is a byproduct. The result? Complete body imbalance The news was really no new news to me. It was more like an “A ha!” moment. A ha! This is EXACTLY what I had been experiencing all along, I thought. I could talk about adrenal insufficiency or HPA Axis Dysfunction ALL DAY LONG. I could write about it and educate others about it. However, when it came to looking at myself in the mirror and facing the facts that I had NOT been taking myself…easier said than done. (It is like the nail salon technician that paints everyone else’s nails—but their own). Flat on my back, in a hospital bed in the ER after an emergency trip due to a 3 a.m. hypoglycemic blood crash after a friend’s wedding in Dallas was the wakeup call I needed. For the past two years, (ever since my symptoms of SIBO, gut dysfunction and other health maladies had begun), my prayers had been:
  • “Lord, be Lord over my body,” 
  • “Lord, bring the manna and balance to my life,” and,
  • “God, help restore my body to health and help me put on healthy weight.”
Be careful what you pray for. Never in a million years did I think that my “answer” to my prayer would be in the form of a blood sugar crash, but it was the wake up call I needed. It was as if God was saying: “Lauryn, you DON’T have to save the world…I have already done enough.” And, “Instead of trying to bring glory to yourself, bring glory to me. Live out the gifts I’ve created and let me provide the rest.” Mic drop. I spent the rest of the weekend, praying, thinking and broken. I didn’t want to go back to my hamster wheel ways. And you know what…I didn’t have to. I don’t have to. And whatever plates you are spinning or race you are running too…You don’t have to either.

How HPA Axis Dysfunction Happens

So…how did my body get SO out of whack in the first place?! How does HPA Axis Dysfunction REALLY happen? In functional medicine, there is typically a “triggering event” that sets the body “over the edge” for HPA Axis Dysfunction and distress. In my case: the colonoscopy (on top of the past 3 years of stress) resulted in disrupted gut bacteria, along with my side effects:

My Side Effects of HPA Axis Dysfunction

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  • “Diabetes,” hypothyroidism
  • Unwanted weight loss and inability to gain weight
  • Suppressed immune function
  • Autoimmune disease
  • Feeling “wired and tired”
  • Shortness of breath
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  • Hormone imbalances
  • Apathy about my work
  • IBS
  • Poor workout performance
  • Electrolyte imbalances
  • Melancholy mood
  …And, to say the least, an entrepreneur who was anything BUT her healthiest, most vibrant, kick-ass self.   

Other Side Effects of HPA Axis Dysfunction

For others, “adrenal fatigue” or HPA-Axis Dysfunction may present as one or several of the following: [fusion_builder_column spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” background_color=”” background_image=”” background_position=”left top” background_repeat=”no-repeat” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” type=”1_2″]
  • Inability to lose weight
  • Mood swings
  • Fatigue
  • Anxiety or Depression
  • Autoimmune conditions
  • Food intolerances
  • Insomnia
  • Needing coffee or sugar to function
  • Headaches
  • High blood pressure
  • Low or high heart rate
  • Feeling dizzy when standing up
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  • Inability to concentrate/focus or memory loss
  • Lyme disease
  • Catching colds, flus or illnesses easily
  • Not “feeling like yourself”
  • Skin breakouts or acne
  • Feeling burned out or unable to do your usual basic “to dos”
  • Inability to tolerate exercise like you once did
  • Random allergies you’ve never had before
  How does adrenal fatigue happen to one person but not another? What separates “adrenal fatigue,” or HPA Axis Dysfunction from regular stress? Check out this blog to find out ALL about adrenal fatigue and HPA Axis Dysfunction, how to find out if you have it and how you (and I) can heal. Resources 1. CDC. 2016. Colorectal Cancer Screening Capacity in the United States 2. Nicolle M. Gatto, Harold Frucht, Vijaya Sundararajan, Judith S. Jacobson, Victor R. Grann, Alfred I. Neugut; Risk of Perforation After Colonoscopy and Sigmoidoscopy: A Population-Based Study, JNCI: Journal of the National Cancer Institute, Volume 95, Issue 3, 5 February 2003, Pages 230–236, 3. Lorenzo et al. 2016. Persisting changes of intestinal microbiota after bowel lavage and colonoscopy 4. Shobar et al. 2016. The Effects of Bowel Preparation on Microbiota-Related Metrics Differ in Health and in Inflammatory Bowel Disease and for the Mucosal and Luminal Microbiota Compartments. 5. Mai, V., Greenwald, B., Glenn Morris, J., Raufman, J., & Stine, O. C. (2006). Effect of bowel preparation and colonoscopy on post‐procedure intestinal microbiota composition. Gut, 55(12), 1822–1823. 6. Immune: Oregon State University. (2013, September 16). Gut microbes closely linked to proper immune function, other health issues. ScienceDaily. Retrieved May 28, 2018 7. Immune: Nanjundappa et al, 2017. A Gut Microbial Mimic that Hijacks Diabetogenic Autoreactivity to Suppress Colitis. 8. Digestion: Lawrence, K., & Hyde, J. (2017). Microbiome restoration diet improves digestion, cognition and physical and emotional wellbeing. PLoS ONE, 12(6), e0179017. 9. Digestion: Gene Kim, Fnu Deepinder, Walter Morales, Laura Hwang, Stacy Weitsman, Christopher Chang, Robert Gunsalus, Mark Pimentel. Methanobrevibacter smithii Is the Predominant Methanogen in Patients with Constipation-Predominant IBS and Methane on Breath. Digestive Diseases and Sciences, 2012; DOI: 10.1007/s10620-012-2197-1 10. Heart: Tang et al, 2017. Gut Microbiota in Cardiovascular Health and Disease 11. Weight: Filip Ottosson, Louise Brunkwall, Ulrika Ericson, Peter M Nilsson, Peter Almgren, Céline Fernandez, Olle Melander, Marju Orho-Melander. Connection between BMI related plasma metabolite profile and gut microbiota. The Journal of Clinical Endocrinology & Metabolism, 01 February 2018 DOI: 10.1210/jc.2017-02114/4834036 12. Blood Sugar: Kumamoto University. (2018, April 10). How intestinal bacteria can affect your blood sugar and lipid levels. ScienceDaily. Retrieved May 28, 2018 from 13. Anxiety: Alan E. Hoban, Roman M. Stilling, Gerard M. Moloney, Rachel D. Moloney, Fergus Shanahan, Timothy G. Dinan, John F. Cryan, Gerard Clarke. Microbial regulation of microRNA expression in the amygdala and prefrontal cortex. Microbiome, 2017; 5 (1) DOI: 10.1186/s40168-017-0321-3 14. Depression: Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice, 7(4), 987. 15. Memory: Lund University. (2017, February 10). Gut bacteria may play a role in Alzheimer’s disease. ScienceDaily. Retrieved May 28, 2018 from 16. Adrenal Health: Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of physiology and pharmacology : an official journal of the Polish Physiological Society, 6, 591–599 17. Adrenal Health: Cryan, J. F., & O’Mahony, S. M. (2011). The microbiome-gut-brain axis: From bowel to behavior. Neurogastroenterology & Motility, 23(3), 187–192. doi:10.1111/j.1365–2982.2010.01664.x 18. Exercise: Clarke, S. F., Murphy, E. F., O’sullivan, O., Lucey, A. J., Humphreys, M., Hogan, A., . . . Cotter, P. D. (2014). Exercise and associated dietary extremes impact on gut microbial diversity. Gut, 63(12), 1913–1920. 19, Headaches: Antonio Gonzalez, Embriette Hyde, Naseer Sangwan, Jack A. Gilbert, Erik Viirre, Rob Knight. Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the American Gut Project Cohort. mSystems Oct 2016, 1 (5) e00105-16; DOI: 10.1128/mSystems.00105-16 20, Attention: Carmen Cenit, María & Campillo Nuevo, Isabel & codoñer-franch, Pilar & G. Dinan, Timothy & Sanz, Yolanda. (2017). Gut microbiota and attention deficit hyperactivity disorder: new perspectives for a challenging condition. European Child & Adolescent Psychiatry. 26. 10.1007/s00787-017-0969-z. 21. Cancer: Fellows et al. 2018. Microbiota derived short chain fatty acids promote histone crotonylation in the colon through histone deacetylases. Nature.  9(105). doi:10.1038/s41467-017-02651-5. Tsai et al. 2018. Prospective clinical study of circulating tumor cells for colorectal cancer screening. Journal of Clinical Oncology. 36, no. 4_suppl. 556-556… DOI: 10.1200/JCO.2018.36.4_suppl.556. 22. 6. Bullman et al. 2017. Analysis of Fusobacterium persistence and antibiotic response in colorectal cancer. DOI: 10.1126/science.aal5240
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