HPA Axis Dysfunction affects many people and having the right treatment could help them live fuller lives.

Stress is “normal.”

…So is feeling imbalanced. At least for approximately 3 in 4 Americans who will experience “adrenal fatigue” in their lifetime, according to Dr. James Wilson, author of Adrenal Fatigue: the 21st Century Stress Syndrome (2001). 

Stress: Mental & Physical

Most people think of stress as psychological and emotional stress.

man with HPA Axis Dysfunction

Technically, however, stress is defined as:

 Any event in which environmental demands, internal demands, or both, strain or exceed the adaptive resources of an individual.”

(In other words: Stress is a demand on our mental or physical body that we can’t handle well). 

Stress (both mental and physical) is the “elephant in the room,” that sets the stage for all sorts of disease and health problems we experience in our lifetime. 

Common Stress

You and I encounter hundreds—if not thousands—of stressors in our daily lives, some that happen in the blink of an eye, and others that linger for years.

Common daily stressors include:

  • Gut-irritating foods, like chocolate-glazed donuts, beans or even difficult-to-digest raw broccoli in your gut
  • Getting stuck in rush-hour traffic
  • An e-mail exchange where the person’s tone on the other end seems tense
  • A spat with your significant other
  • Negative news headlines on our notifications throughout the day
  • Running late
  • Drinking 2-3 cups of coffee to tide you over after 4 hours of sleep
  • A 3 pm sugar binge when a sugar crash strikes
  • Accidentally overeating or feeling really hungry before a meal
  • Pushing ourselves hard in an intense workout
  • Feeling the crunch of a tight deadline at work
  • Lack of sleep one night
  • Saying “yes” when you really wanted to say “no”
  • Getting over-heated in the sun

Generally, daily, or “acute” (short-term) stressors are things we quickly adapt to—

If you get hot for instance, you naturally seek to cool your body off with some AC. If you ate too much, you may not feel like eating as much the next meal; or if your body is ‘stressed’ with hunger, you typically eat something to ‘adapt’ and calm the stress.If you didn’t get much sleep last night, you may try to find time to take a nap, or to get to bed extra early tonight.

With short term stress, your body and mind is innately wired to learn how to deal with the stress.

However, when stress lingers and remains (with little to no relief in sight)…

Houston, we have a problem!

Some examples of chronic—lingering—stress may include:

  • A rocky or strained relationship with a significant other, business partner or best friend
  • Financial pressures
  • An autoimmune condition—that won’t go away
  • Years of eating a processed food diet or disordered eating habits
  • Daily (constant) demands of a boss we can never please or a job we hate
  • Trying to do everything—and not being able to do any one thing really well

  • Not eating enough (every day), dieting or restriction
  • Drinking 2 to 3 cups of coffee (every day)
  • Burning a candle at both ends—every day
  • Sleeping 5-6 hours most nights
  • Staring at screens fo 8-10 hours per day
  • Overtraining (Chronic cardio with little to no rest for recovery)
  • Overwork and little to no play
  • Staring at computer screens while hunched over—every day


Try as we may to adapt, relief doesn’t come, and if chronic stress persists, things go awry BOTH physically and mentally.


Technically we call this “HPA Axis Dysfunction.”

HPA Axis Dysfunction 101

HPA Axis Dysfunction is another word for what’s come known as “adrenal fatigue” or “poor stress management” in laymen’s terms. Mental and physical stress triggers the hypothalamus in your brain to activate two distinct pathways of the stress response:

1.) The “Fight or Flight” System (“Sympathetic Medullary System”): the system the responds IMMEDIATELY to stress, like increasing your heart rate, blood pressure, alertness, and metabolic rate; and,

2.) Your HPA-Axis (Hypothalamic Pituitary Adrenal Axis): the “mothership” of all things stress related in your body.

HPA Axis Anatomy

The HPA-Axis involves three key parts of your brain and body: 

Hypothalmus. The region in your brain that controls the “automatic” (autonomic) functions like: metabolism, body temperature, thirst, hunger, sleep and emotional activity.

Pituitary. A “hormone regulating” gland, in your forehead, that helps your body feel, helps you manage stress, and stimulates growth, hormone balance, reproduction, and lactation.

Adrenal Glands. Two pea-sized endocrine (hormone) glands that produce a variety of hormones including adrenaline, aldosterone and cortisol (your stress hormone)

If your HPA-Axis takes a hit from LOTS of stress or chronic (ongoing) stress, then it leads to “HPA Axis Dysfunction,” resulting in an assortment of side effects, including:

  • Inflammation
  • Blood sugar imbalances
  • Most all disease: Cancer, diabetes, heart disease, etc.
  • Mood imbalances, like depression
  • psoriasis or eczema;
  • IBS, bloating, or other digestive symptoms

  • Brain fog 
  • Hormone imbalances
  • Infertility
  • And (you guessed it) chronic—ongoing anxiety—that anxiety you seemingly can’t control, no matter how hard you try to think about controlling it. 


“HPA Axis Dysfunction” is simply another way of saying, “chronic” stress.” Chronic stress is the root of all imbalance in the body. 

And tying back to our gut-brain-body connection, chronic stress often stems back to the gut. It’s all intertwined!

HPA-Dysfunction vs. Stress

But don’t we all experience stress in our lives? Shouldn’t we just be able to deal with it?

What’s the difference in every day stress vs. “HPA Axis Dysfunction?”

Good questions!

True, our bodies DO deal with A LOT when it comes to stress; and your body (and brain) can take A LOT (“bring it on!”). But when stress goes overboard, or lasts for a long time (without proper recovery) our body can only handle so much.

Example: the Poptarts and Cheetohs I ate daily as a kid, and artificial sweeteners and additive-filled protein powders I ate for years in college and young adulthood. 

The result from these chronic stressors in my life? Frequent bloating, constipation, bacterial overgrowth, and the anxiety I battled in my teens and young 20’s. My body was not designed and wired to eat Silicon Dioxide, aspartame, corn solids or high-fructose corn syrup.

Gone are the days of our ancestors who lived in the natural (toxin-free) environment, ate nutrient-rich foods, and spent their days in accordance to the rhythms of the sun. Eventually my repetitive poor quality foods led to poor gut health, which then led to stress and a variety of symptoms. 

Consider the variety of stress your own body encounters on a daily basis:

  1. Working a job you don’t love, staring at a screen for 8-hours and staying stuck in your cubicle;
  2. Barely getting 6-hours of sleep
  3. Running off 2 to 3 cups of coffee every day
  4. Eating ketchup, pasta sauce, yogurt and deli meat—laden with hidden sugar
  5. Forgetting to eat, or subsisting off of chicken and broccoli—not eating enough
  6. CrossFitting, spinning or running miles upon miles 5 to 6 days per week with little attentio to your recovery 

If this becomes your “norm,” that HPA-Axis of yours also takes a hit. And when your HPA-Axis takes a hit, a “normal stress” response no longer remains.

Cortisol Conundrum

Speaking of “normal stress, “ever heard of the hormone cortisol?

Cortisol is your “stress hormone” that helps you deal with “normal stress.” In the good ol days, it helped humans run really fast from bears chasing them in the woods; and it helped you “suck it up” when the mean girls left you out at the lunch table in middle school. 

Cortisol is directly produced and regulated by the HPA-Axis. 

Higher amounts of stress produce more cortisol.

If cortisol levels are constantly produced and pumped out (with little to no recovery or rest from the stress), then the HPA-Axis gets pooped out!  

sugar cravings HPA Axis Dysfunction

And we are right back to square one: Imbalance and inflammation (think: mood swings, sugar cravings, racing thoughts, disrupted gut flora leading to disrupted serotonin in the brain, increased or decreased respiration rate, elevated blood pressure, etc.).

Without the ability to regulate stress (normally), your body and mind naturally become more sensitive and fragile to respond to even little stressors (like a loud noise, the lack of control, a comment someone said, the effects caffeine, etc.). 

Again: stress is more than just a mental battle, it is also a physical battle.

How do I know if I have HPA Axis Dysfunction?

It’s not always easy to “see” or diagnose—especially if your “subpar (stressed out) norm” has become your norm.

Common signs of an out-of-whack HPA-Axis include:

  • Anxiety—that doesn’t go away
  • Panic attacks
  • Feeling wired and tired at night
  • “Waking up” when you workout—and needing the highs of workouts to keep going
  • Plateaus in training, “gains” and physical goals
  • Muscle weakness or wasting
  • High or low blood pressure
  • Suppressed respiration (needing “more air” during training)
  • Subpar performance
    “Crazy fast” metabolism or super slow metabolism
  • Telling your body to “work harder” or “push more”—with difficulty implementing it
  • Digestion difficulties (bloating, gas, IBS, constipation)
  • Suppressed appetite
  • Hormone imbalances (low testosterone, loss of period, infertility)
  • Hypoglycemia (low blood sugar)
  • Unable to go long between meals without getting a headache/shakey
  • Dependence on coffee, sugar or artificial sweeteners
  • Never feeling 100% rested
  • Apathy and/or burnout
  • Feeling emotionally “flat”
  • Falling asleep if you sit anywhere for too long

  • Insomnia
  • Weepy for now reason
  • Inability to lose weight
  • Mood swings
  • Fatigue
  • Anxiety or Depression
  • Autoimmune conditions
  • Food intolerances
  • Headaches
  • High blood pressure
  • Low or high heart rate
  • Feeling dizzy when standing up
  • 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
  • “Diabetes” 
  • Thyroid issues/hypothyroidism
  • Unwanted weight loss and inability to gain weight
  • Feeling “wired and tired”
  • Shortness of breath
  • Hormone imbalances 
  • Apathy about my work
  • IBS
  • Poor workout performance
  • Electrolyte imbalances


If any of these factors are ongoing (lasting more than 7 days), then it may be worth at least exploring if you could benefit from “resetting” your HPA-Axis (i.e. targeting stress).

What to Do About It

Address stress—the elephant in the room.

Not just mentally, but physically. 

Remember: While talking about your anxiety and counseling with someone around your anxiety can be two HUGE PIECES of the anxiety puzzle, if your physical well-being goes unaddressed (targeting stress reduction and improving gut health), then you are only treating half the “problem.”

How to do it? 

Here are some basics to start:

1. Assess Your Own Stress.

What are the top stressors in your life right now, and what stressors have you dealt with in your past? Surgeries? Medications? Light exposure? A job you hate? Food intolerances? Gut issues? Make a list of both psychological and physiological factors that may be contributing to your current state of stress.

2. Test Don’t Guess.

Many people read about “adrenal fatigue” or HPA Axis Dysfunction on Google and immediately turn to self-treating—buying supplements and tea labeled “adrenal support” at Whole Foods, downloading the Headspace meditation app, and diffusing lavender in the air. However, without understanding a full picture of the cortisol imbalance in your body (if at all), you may be under treating or over treating. For instance, your cortisol may be high or low, melatonin may be suppressed or perfectly normal, estrogen may be nonexistent or extremely elevated.

In addition, cortisol imbalance may be triggered by the gut, the hypothalamus or your thyroid, or a mix of all three. The problem is, if you treat your “issue” inappropriately you risk not getting to the “root” or potentially making the problem worse. A comprehensive saliva/urine test like the DUTCH test can help you get a clearer picture of your unique cortisol story. Consider working with a functional medicine practitioner to navigate test results, as well as address any other underlying health imbalances contributing to your condition.

3. Eat a Nutrient Dense Diet

  • Balance your meals with protein, healthy fats and moderate carbs. No extremes. 
  • Protein, particularly in the morning, has a balancing effect on blood sugar. 
  • Avoid foods with fillers, sweeteners and unknown ingredients.
  • For a time, avoid caffeine and alcohol. 
  • Prioritize clean filtered water (Tip: Add a pinch of sea salt to 12 to 16 ounces of water in the morning. Sea salt is a natural electrolyte to balance sodium levels). 
  • Also don’t neglect mindful eating (chewing your food well, slowing down at meal times, not eating on the go or while watching TV, etc.). Mindfulness is a game changing practice your body appreciates.Reset Your Circadian Rhythms
  • Eliminate blue light exposure at night (blue-blocking glasses, nightshift apps on your phone),
  • Get back to nature (aim for 30-60 minutes at least of fresh air)
  • Eat at regular intervals

4. Catch Enough Zzzz’s

Sleep at regular times (keep a schedule). Speaking of sleep is essential to just about every type of “wellness” protocol, but it is particularly essential for HPA Axis Dysfunction recovery. Prioritize 7 to 9 hours each night.

5. Move Your Body

Overtraining is a common cause of HPA Axis Dysfunction. Common signs of overtraining include difficulty recovering from workouts, increased gut issues or loss of appetite, a plateau or decrease in performance, increased body fat despite regular exercise and “eating clean,” poor sleep, restlessness, anxiety, fatigue, muscle or joint pain, suppressed immune system, and low mood.

people swimming treat HPA Axis Dysfunction

The best exercise? In the immediate recovery period, opt for lower intensity exercise such as walking, cycling (not cranking up the notch on your spin bike), strength training, swimming, or yoga over high-intensity activities like CrossFit WODs, Orange Theory workouts or straight-up cardio training. Just Say No.

What’s filling your life and what’s draining you? Take a thoughtful inventory of what’s crowding your space. Cut out the things on your plate that are weighing you down.

6. Relax

As cheesy or overrated as it sounds, take time out to settle your mind and integrate mindful activities through mental and physical (intentional) relaxation.

Consider these:

  • Biofeedback/Heart Math
  • Yogi Breathing 
  • Yoga 
  • Tai Chi


These are just a few ways people actively seek to “relax” more. Although it will probably be “awkward” at first, by starting small and prioritizing relaxation (even 5 minutes in the morning) make a difference.

7. Supplement Smart

A big mistake people make is taking random supplements that can actually make your adrenal fatigue worse, not better, if not careful. As mentioned, testing and not guessing helps prevent over-treating or under-treating with supplements. However, there are some natural and gentle supports for HPA Axis Dysfunction that can work for many people as your figuring out your unique picture including: