HPA Axis Dysregulation or “Burn Out”: Is it your reason for extreme fatigue and weight gain?

We’ve all heard of chronic stress being detrimental to our bodies. But do you know How, Why it happens, and What to do about it?. Grab a hot tea, sit back and enjoy.

Let me introduce you to your Hypothalamic-Pituitary- Adrenal Axis (HPA Axis).

~Bear with me while I go through some human physiology~

Stress triggers release of corticotropin-releasing factor (CRF) in the Hypothalamus (located at the base of the brain), and binds to CRF receptors on the anterior Pituitary gland (size of a pea- located near hypothalamus). This releases adrenocorticotropic hormone (ACTH) that binds to receptors on the Adrenal Cortex (located above kidneys), and releases CORTISOL1.

Cortisol is the main steroid hormone involved in stress and the “Fight-or-Flight”response. During this response, our body’s main priority is survival, whilst non-essential systems are suppressed2.

These include:


Mobilise stored blood glucose for energy and muscle contractions

Enhance cardiovascular system function, and to allow increased blood flow to muscles

Regulate blood pressure

Reduce inflammation


Suppress less essential functions: immune system, digestive system and reproduction system

| Did you know? |

Adrenal glands also release Adrenaline and Noradrenaline3:

-Increases heart rate

-Increase blood pressure

-Increase blood sugar levels

-Constrict (narrow) blood vessels

-Relax airway smooth muscles to improve breathing

In normal physiological conditions, blood cortisol is elevated in the blood for several hours post stressful event. This sends a negative feedback signal back to Hypothalamus and Pituitary glands to stop CRF and ACTH1. This adaptive response to threatening events is advantageous to protect us from harm. For instance, back in the stone-ages, to outrun a saber-toothed cat. However due to modern times, with sustained stress exposure from work demands, family life, sleep deprivation, poor mental/emotional health, poor self-care and food choices, illness and trauma, and a toxic environment, we can find ourselves chronically stressed.

Chronic stress or repeated exposure to triggers, results in elevated HPA axis activation. Excessive cortisol prevents proper negative feedback loop, receptors in hypothalamus becomes less sensitive to “off-switch” leading to elevated cortisol = cortisol resistance thus reduce hypothalamus and pituitary sensitivity4 5. This means= always on “Fight or Flight” mode. We eventually overuse our adrenals and ability to regulate cortisol metabolism during necessary periods (such as getting up for work).


-Extreme fatigue (may need more caffeine / sugar for energy, or to stay awake)

-Body aches (muscle or headaches)

-Sleep disturbance (Difficulty falling asleep and / or staying asleep)

-Digestive issues (Bloating, Indigestion, Reflux, Abdominal pain, Change in bowel habits)

-Hormonal changes (Women: irregular periods, Men & Women: low libido)

Long term effects

-Poor immune function, frequently catching colds or feeling “run down”

-Constant raised blood sugars trigger a hormonal response, that stores into FAT cells around the tummy

-Hyperinsulinemia decreases sensitivity in the cell, risk of impaired blood sugars (Pre-diabetes,Type 2 Diabetes)

-Elevated blood cholesterol ie. Triglycerides, and risk of Cardiovascular disease, Fatty Liver disease

-Low grade inflammation, feeling sore, painful body parts Brain fog

-Inability to lose weight / weight gain

Cortisol signals resistance of glucose into cells to allow more glucose for energy as possible. Signalling hormone is released from the pancreas in response to elevated blood glucose, promotes glucose and fatty acids stored as visceral fat (belly fat)6. When cortisol levels are constantly elevated, our Central Nervous System becomes overactive. We may deal with stress in different ways such as comfort eating, smoking, drinking and other. Cortisol also breaks down lean muscle tissue to supply glucose as fuel (Gluconeogenesis), so we lose lean muscle and can gain body fat. Impacting on metabolic rate 7.


Avoid caffeine When we limit caffeine and overall stimulant intake, we give our adrenals a break. Try herbal teas, green tea and sleeping more.

Adequate sleep Sleep is a time for your body to recuperate and restore it’s bodily functions. Sleeping 7-8 hours per night is ideal. What can you do to improve the quality of your sleep?

Stress Management So important! Identify what is causing you stress, overwhelm or anxiety. Can we treat the cause? Can we look into counselling or perhaps mindfulness practice?

Limit refined sugar intake Reducing these will help stabilise your blood glucose levels, so you don’t experience an exaggerated energy slump. These can be hard to overcome without more sugar for a boost.

Nutrition status A diet rich in nutrients will supply the tools for your body to handle stress more efficiently. These include B Vitamins, zinc, magnesium and clinically trialled adaptogens. Nutrient deficiencies are commonly found in patients struggling to cope with everyday stressors.

If you need help on the above, or for more information on how diet and lifestyle can naturally support you in dealing with stress, get in touch!

Until next time,

Bonny. C ~



Warrior A. Image: https://www.integrativepro.com/Resources/Integrative-Blog/2016/The-HPA-Axis

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508039/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395581/#B191

3. https://www.hormone.org/hormones-and-health/hormones/adrenaline

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4353372/



7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958156/

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