Are you tired all the time? Is your mind racing when you get into bed and when you get up in the morning? Are you always sore from training and have trouble recovering from workouts?
All of these are symptoms of too much cortisol and a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis. The trouble with stress and fatigue of this kind is that it can’t be cured with a single good night’s sleep or a week’s vacation. Those can help temporarily, but as soon as you get back to the rigors of daily life, fatigue and all the problems that come with it will return.
You’ve got to go to the root of the problem and repair your HPA axis, which regulates the most important hormones in the body. Because hormones affect every aspect of human function, fixing your HPA axis allows for peak energy and physical performance, enhanced motivation, and an upbeat mood.
This article will help you understand how the HPA axis “breaks” and give you simple strategies for fixing it.
What is HPA Axis Dysfunction?
The first step is to understand what the HPA axis is. The HPA axis includes three specific parts of your body:
1) The hypothalamus (in the brain) links the nervous system to the endocrine system via the pituitary gland. It’s responsible for many processes but especially metabolism.
2) The pituitary gland is in the brain just below the hypothalamus and it releases a number of hormones in an effort to keep the body in homeostasis.
3) The adrenal glands are located above the kidneys and release three types of hormones: 1) those involved in blood pressure regulation and electrolyte balance such as aldosterone, 2) stress hormones like adrenaline and cortisol, and 3) androgens, which serve as precursors for testosterone and estrogen.
These three parts of the body regulate functions including your stress response, sleep, mood, and energy levels, among others. Ideally, they work closely together in a cascade-like fashion such that when one is released it will have either a positive or negative effect on other hormones, which enables the body to return to homeostasis. To understand this, let’s look at some of the most important hormones that the HPA axis depends on:
1) Corticotropin Releasing Hormone (CRH) is released from the hypothalamus in response to stress. It then stimulates the pituitary gland to secrete ACTH. The more stress your body experiences the more CRH released.
2) ACTH is released from the pituitary and travels to the adrenal glands to increase production of glucocorticoids.
3) Glucocorticoids are released from the adrenals and they regulate metabolic rate, your immune response, and inflammation. One of the best known glucocorticoids is cortisol. It prepares your body to withstand all kinds of stress by releasing energy stores. The catch is that the adrenals don’t differentiate the type of stress your under and whether you need extra energy. This means cortisol is elevated equally in response to depression, injury, lack of food, intense exercise, a long commute in the car, a fight with a loved one, etc.
It’s important to understand that the HPA axis operates on feedback loops. A negative feedback loop occurs when the secreted hormone loops back to decrease further secretion from the gland.
Cortisol provides a perfect example of how a negative feedback loop is supposed to work: You experience stress and CRH is released from the hypothalamus triggering ACTH from the pituitary, leading to cortisol release from the adrenals.
As cortisol enters the blood stream it stimulates epinephrine, which activates the sympathetic nervous system and turns on your flight or fight response. At this point, you should feel ready to take action—whether to crush a heavy set of deadlifts, outsprint an opponent, win a verbal fight, or solve a difficult mental problem at work. Hunger will be absent and you’ll feel no pain.
At the same time that all this is happening, your body will sense the high cortisol levels, and shut off release of CRH and ACTH release. This will allow cortisol to go down, leading to a drop in norepinephrine activity, gradually calming you down.
In healthy people who don’t have much stress, the HPA axis is activated infrequently enough that it is able to stay healthy and responsive. However, in people who suffer chronic stress and anxiety, cortisol and norepinephrine are continuously overproduced. The body’s cortisol receptors become resistant to cortisol signals and the HPA axis becomes desensitized to the negative feedback telling it to “chill out.”
The hypothalamus and pituitary won’t respond to the negative feedback and will continue to release CRH and ACTH and the adrenals keep getting the message to pump out cortisol. The result is chronically high cortisol levels, which have a number of negative effects on the body.
The classic example is how cortisol affects body composition: When balanced, cortisol can be beneficial for body composition by triggering fat burning. During exercise, cortisol is released to increase the amount of fat your body uses, while sparing glycogen, which is the fuel source for muscle.
However, when cortisol levels are chronically high, muscle loss and fat gain often occur. If you are in an energy surplus, high cortisol in the presence of insulin makes the body store fat. When you get into the habit of suffering through a stress-packed work day and then come home and chow down on pasta and cocktails, the combination of high cortisol, high insulin, and excess calories will lead to obesity over time.
Of course, chronic stress can be very debilitating, especially when it’s combined with illness, depression, excessive exercise, sleep deprivation, or a poor diet. Not only does the HPA axis get disturbed, but other systems in the body are negatively affected. Here are just a few examples of the byproducts of HPA dysfunction:
The androgen hormones, such as testosterone and estrogen, can become depleted, affecting everything from reproduction and libido to body composition and recovery from exercise. The body uses the same precursor (pregnenolone) to manufacture the androgens as it does cortisol, so not only will you have more cortisol, but less of these hormones that are crucial for health, body composition, and well being.
Imbalanced neurotransmitters (particularly serotonin, dopamine, and GABA) lead to fatigue, mood disorders, and addictive feelings for food and other comforts.
Depletion of nutrient levels leads to a buildup of inflammation and fatigue. B vitamins are key stress fighting nutrients, whereas vitamin D is necessary for eradicating inflammation and managing mood. Vitamin C is necessary for synthesis of both hormones (cortisol, testosterone) and neurotransmitters, while helping to clear cortisol after a stressful event.
The good news is that HPA dysfunction is fixable, but because it’s a complex problem that involves multiple parts of the body, you need to attack it from all angles. What follows is a comprehensive list of actions you can take to repair this bad boy in the healthiest and most lasting way possible. By addressing these components, you’ll be well on your way to full repair!
#1: Cope With Your Stress
It's kind of a no-brainer that your first step to repairing the HPA axis is to develop a stress management plan. But it's worth repeating because stress has become such a pervasive, constant part of our lives to the point where an insanely stressful lifestyle is actually admired. No more! By removing the stimulus, you give yourself the chance to reset the HPA axis with the various techniques that follow.
#2: Do Meditation
Studies show that meditation and other activities we find pleasurable can literally soothe the HPA axis, relaxing the parasympathetic nervous system and calming the body. For example, one study found that after volunteers did meditation for four months, they had lower levels of cortisol but higher levels of testosterone, DHEA, and growth hormone, indicating a better functioning HPA axis. Melatonin, the sleep hormone, was also enhanced.
#3: Exercise—But Not Too Much
Studies done on sedentary people show that intermittent forms of exercise such as weight training and sprint intervals can reset the HPA axis so that it becomes more responsive and cortisol balance improves. The key is to not overdo it with two-a-day workouts or long, intense cardio sessions. Two to four weight workouts and two short interval workouts of less than 25 minutes a week will do the trick for most people.
#4: Avoid Skipping Meals
Eating resets your entire hormonal cascade and improves the body’s biological circadian rhythm. This is the reason why we recommend frequent, small meals eaten at the same time each day. Eating a meal containing high-quality protein, healthy fat, and a green vegetable every 2 to 4 hours will minimize blood sugar spikes and help balance cortisol.
#5: Avoid Junk Food & Alcohol
High cortisol is well known for causing cravings for high-fat, high- sugar junk foods. At the same time, cortisol shuts off the goal-oriented, rationale parts of the brain. This means you eat more, and you’re more likely to choose low-quality foods, which the body will readily store as fat. Alcohol is just as bad, especially since people often use it as a go-to stress management tool.
#6: Eat A Nutrient-Rich, Higher Protein Diet
A key symptom of an altered HPA axis is hunger and cravings. Planning meals around whole protein (meat, fish, eggs, dairy) and vegetables will avoid this by increasing the release of gut hormones that keep you satisfied.
#7: Avoid Caffeine Throughout The Day.
Research suggests that if you are anxious or mentally stressed, caffeine can increase cortisol levels higher than they would be in the absence of caffeine. And although habitual coffee drinkers don’t experience a cortisol spike in the morning, if you dose yourself with coffee throughout the day, cortisol will be elevated when you least need it.
#8: Get Enough Sleep
Solving lack of sleep will require different actions depending on your situation. The first step is to establish good sleep habits: Have a set bedtime, sleep in darkness, and avoid electronics before bed. There’s some evidence that people recovering from HPA axis dysfunction do best getting up later in the morning—around 8 or 9 rather than 6 or 7—so you might want to try it if it’s an option. The second step is to overcome insomnia or a racing mind. Melatonin, valerian, or sleep medication are all options that have helped people get the rest they need to start the repair process.
#9: Eat Plenty of Healthy Fat
The body uses cholesterol in dietary fat to synthesize certain hormones, whereas the omega-3 fats in fish oil are necessary for brain and nerve function. Lack of them is consistently linked with fatigue, hormone imbalances, and neural problems. The key is to get a variety of fats from whole sources: saturated fats from meat and dairy, fish oil, and monounsaturated fat from nuts, seeds, and avocados.
#10: Shut Down Inflammation
There are certain nutrients that are effective at fighting the inflammation that is associated with a malfunctioning HPA axis: Curcumin, omega-3 fats, vitamin C, and probiotics are all available in food and supplement form.
#11: Try Extra Taurine, Magnesium & B Vitamins
Taurine has a calming effect on the brain and can reduce anxiety and racing thoughts that activate the HPA axis. Vegan diets are notoriously deficient in taurine, but anyone who suffers from stress can probably use a little extra—try up to 5000 mg a day.
Magnesium is known as the anti-stress mineral, calming the cardiovascular system and lowering cortisol. It's also been found to improve sleep in people suffering insomnia. Up to 500 mg a day is indicated by the literature.
B vitamins, particularly B5 (pantothenic acid), 6 (pyroxidine), and 12 (cobalamin) are necessary for metabolic health and play a key role in stress management. They can easily become depleted on a poor diet or if you are a poor methylator, which is a genetic trait involved in detoxification.
#12: Have Fun
Having fun is one of the most powerful stress reducers available. Research shows laughing with friends, playing with pets, and listening to music will all lower cortisol and balance hormones.