These are some of the most common symptoms of what is commonly known as “adrenal fatigue.” But the biggest problem is that many patients go to their doctor, explain these symptoms, and share their concern that they are struggling with adrenal fatigue, only to be told by their doctor that adrenal fatigue isn’t real. The only problem is that your symptoms are real, and you deserve health. In other words, you deserve to know how to recover from adrenal fatigue, or whatever it is you’re dealing with.

But let’s start by addressing the elephant in the room:

Is “adrenal fatigue” real?

Yes. The symptoms are absolutely real, and they are absolutely related to the adrenal system. However, no, the idea that the adrenal glands become “fatigued,” so causing the above symptoms, isn’t quite how things work. Instead, we use the phrase hypothalamic-pituitary-adrenal axis dysfunction. Let’s dig in…

Stress, adrenal glands, cortisol, oh my!

Let’s first talk about what the word “stress” means. The way I typically think about stress is any condition under which the brain or body needs to be operating at a higher-than-normal level. This could be psychological (i.e. demands at work or school), emotional (i.e. relationship problems), physical (i.e. induced by exercise or sickness), or nutritional (poor diet in terms of quantity and/or quality). Whenever we are in a stressful situation, our bodies release stress hormones into our blood stream, which help our minds and bodies to respond to the stressful situation. The most notable of these stress hormones is cortisol.

Cortisol is produced in the body through a feedback loop called the hypothalamic-pituitary-adrenal axis. Basically, this means that the hypothalamus and pituitary gland (two parts of the brain) work together with the nervous system to communicate with the adrenal glands (located in the abdomen) to produce cortisol. This cortisol is released into the blood stream and acts on every organ of the body to get it ready to encounter the stressful situation. Some of these stress responses include:

• increased blood sugar (for quick energy)
• increased heart rate and blood pressure (to get the body moving)
• decreased digestion (who has time to run to the bathroom when they’re being chased by a bear?)

This loop is important for two reasons. First and foremost, the hypothalamus and pituitary axis are responsible for managing more than just the stress response in the body. These two parts of the brain utilize hormonal signals to regulate almost every other system in the body—everything from digestion, to fertility, to the thyroid…you name it!

When stress levels are high (or stressful situations are frequent), the hypothalamus and pituitary gland are forced to focus their efforts on managing the stressful situation. That means the other bodily systems fall to the wayside, which is why many people struggle with fertility and digestive issues, for example, due to stress. Although this is frustrating, it makes a lot of sense, because fertility and digestion don’t matter so much if you get eaten by a bear. The most important thing is to get away from the bear so that you can survive long enough to worry about fertility and digestion! The issue, of course, is that we are rarely chased by bears in the modern age. Instead, we’re chased by thoughts of monstrous work assignments, relationship issues, and other worries. Or, we’re doing a whole lot of running even though there are no bears around (too much exercise). For us in our modern age, the chronic stress response isn’t about survival…it’s a health problem.

The second important consideration of this HPA-axis feedback look is the concept of cortisol resistance. This is the term we use to describe the syndrome of “adrenal fatigue.” In this situation, the cortisol rise and rise and rise, until they can’t rise any more without causing huge problems. The result is elevated cortisol that isn’t having the intended effect. (There’s a need for more of a stress response in the body, but the adrenals are working at capacity.) We call this cortisol resistance. It’s almost as if the brain is saying “we need more cortisol” and the adrenals respond by saying “I don’t think that’s a good idea!”

Out of a protective effort, the high levels of cortisol signal to the hypothalamus to stop signaling so much. In some regards, operating the adrenals at max capacity still isn’t enough, and so the body recognizes that it had might as well pull back on the amount of cortisol it produces. Just like an overworked pancreas eventually stops producing insulin in late stages of type 2 diabetes, the adrenal glands can stop producing enough cortisol to maintain healthy responses. Some circles refer to this as “fatigue,” but the adrenals don’t really get fatigued. It’s more that the body has reached its maximum stress threshold and protectively responds by shutting itself down. But it feels a lot like fatigue.

Supporting the HPA axis

The best way to avoid “adrenal fatigue” or cortisol resistance is to avoid reaching “max capacity” of the body’s stress response. While some stressors are unavoidable, others are much more manageable. Emotional and psychological stressors are much more difficult to control than physical and nutritional ones, however, so it’s always a good idea to start with a balanced diet, keeping up with regular, moderate exercise, and sleeping enough.

For everything in between, which we have less control over, we can support our adrenal responses with herbs and supplements that help us respond to stress on a biochemical level. The mechanism of action of some of these nutraceuticals vary, but the main idea is that they help reduce inflammation, moderates the severity of the stress response to any given trigger, and helps the body recover from stress faster. Some of these evidence-based supplements include:

• Panax ginseng (Korean ginseng): improves sensitivity to cortisol, so the body doesn’t have to produce as much
• Ashwagandha (Indian ginseng): counteracts biological effects of extreme stress like changes in blood sugar, helps reduce cortisol levels, reduces anxiety behaviors
• Rhodiola rosea: protects the cardiovascular system against long-term effects of stress
• Phosphatidylserine: counteracts stress-induced activation of the HPA axis
• Cod Liver Oil: reduces cortisol spike following a stress trigger

To sum things up…

Stress in life is unavoidable, but there’s a lot we can do to improve our health by managing our exposure to stress…especially long-term. From eating well, to managing exercise and sleep, to keeping work-life-balance in check, we can support our bodies’ natural ability to respond to stress. Coming down off a “stress high” (or low, really) can be really challenging to do, but working with a functional medicine provider to use herbs, supplements, and lifestyle techniques for managing the HPA axis can make a world of difference.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post How to Recover from Adrenal Fatigue Naturally appeared first on Dr. Alexandra MacKillop.

“Okay, okay, hypothalamo-whatta-whatta?“

If that’s what you’re thinking, you’re in good company. The hypothalamic-pituitary-adrenal-thyroid-gonadal axis is quite the tongue twister. But don’t worry, it sounds more confusing and overwhelming than it is. In short, the HPATG-Axis is the system of hormone balance in our bodies. To understand how to balance hormones naturally, we need to first understand what hormone balance looks like through this great, big web of connections.

In a nutshell, the HPATG-Axis phrase refers to is the fact that a part of our brain called the hypothalamus communicates with our adrenal glands, thyroid, and ovaries (aka gonads) through a series of hormones produced by the pituitary gland (also located in our brain). In physiology, we often talk about those interactions separately, referring to them as the hypothalamic-pituitary-adrenal axis, or the hypothalamic-pituitary-thyroid axis. But in reality, they’re all connected, and this post will explain everything you ever wanted to know about how and why. (Okay, maybe not everything, but the basics…)

The HPATG Axis (AKA Endocrine Axis)

HPATG physiology can basically be summed up like this: the hypothalamus talks to our pituitary gland using hormonal signals, telling the pituitary gland when and how to stimulate our thyroid, our adrenal glands, and our ovaries. All of those glands send hormonal messages back to our brain with information about how much activity is going on, and whether or not there are any problems. In response, the brain tells the body to amp up activity in each of those sites, or tone it down. This is called a negative feedback loop.

When we face periods of stress (or rather, when we face too much stress for too long), our HPATG axis is completely intercepted. This is where we can run into imbalances in our thyroid hormones (such as hyperthyroidism or hypothyroidism), adrenal hormones (such as “adrenal fatigue”), or fertility problems, (such as hypothalamic amenorrhea). These problems can occur one at a time, or all at once, leading someone to feel really sick, and probably also really confused! Stress is a biggie when it comes to a properly functioning HPATG axis. In most cases, if you’re wondering how to balance hormones naturally, we need to start by addressing stress because stress is the single most powerful influence over the HPATG axis.

Stress and Stress Management

When we think about stress, we typically think about the psychological or emotional—deadlines at work, an overly packed schedule, a bad breakup, or a death in the family. But stress comes in many forms, and can even be triggered by good life events…

• Under eating (not enough calories or carbs)
• Nutritional deficiencies
• A significant/sudden change in diet/eating habits (especially yo-yo dieting)
• Over exercising (or a sudden change in the type of exercise)
• Lack of sleep or change in sleep schedule (i.e. night shift)
• Illness or injury (including surgery)
• Travel (even if it’s fun!)
• Moving
• Starting a new job or educational program
• Getting married
• Certain medications, or drug use
• Depression or anxiety
• Emotional distress (like the loss of a loved one)
• Psychological distress (like work deadlines or studying for exams)

Many of these things are normal parts of life, and when we are following a pattern of self care, our bodies are able to accommodate the stressors without falling into dysfunction. But when our self-care routine falls out of balance (or we begin struggling with disordered eating) we detract from the foundation of health. When that happens, everything else starts to crumble. One of my favorite ways to explain this relationship between stress and self-care is the bucket analogy:

Self-care fills our bucket, but stress drains our resources. When the bucket gets low, we start to notice symptoms of burnout. When the bucket gets empty, it leads to hormonal disaster, interrupting our whole HPATG axis at a biochemical level in our brains (big red stress arrow on the infographic at the top of this post). Ultimately, learning how to balance hormones naturally means learning how to identify and cope with the small, daily stressors in our lives.

Dysfunction, one axis at a time

The reason we often talk about the HPATG axis in terms of its separate components (HPA, HPT, HPG axes) is because unilateral dysfunction is common. For example, an autoimmune disease called Hashimoto’s Thyroiditis can lead to destruction of the tissue of the thyroid gland and subsequent hypothyroidism. When this happens, the thyroid loses its ability to produce thyroid hormone. When the pituitary gland realizes that thyroid hormone levels are so low, it amps up its secretion of thyroid-stimulating hormone in an attempt to tell the thyroid to do a better job. The problem is, the thyroid itself has been damaged—it can’t do its job until the autoimmune reaction is addressed. (Here’s where stress pops up again: if you’re wondering how to balance hormones naturally in terms of your thyroid hormones, you still need to pay attention to the stress piece because stress is one of the primary drivers of autoimmune disease.)

Low levels of thyroid hormone create a further stress response in the body, signaling back to the brain that something’s off. This consequently affects the signaling between the pituitary gland and the adrenals/ovaries as the body tries to balance things out. Low levels of thyroid hormone, for example, creates a dangerous environment for a growing baby, and so the reproductive system is one of the first to get shut down (via the HPATG axis). On the other hand, pregnancy causes the body to re-prioritize its hormonal resources. When a woman is pregnant, the body needs different levels of thyroid hormone, cortisol, and other hormones to carry the pregnancy to full-term. These body signals these changes through the same negative feedback loop. (All of this takes place without us ever having to think about it. You’ve got to admit, God’s design is pretty amazing!)

The HPATG Axis and Healthcare

When a patient complains of problems like fatigue, weight gain or weight loss, thinning hair, or irregular periods (just to name a few), the solution is never as simple as writing a prescription for birth control pills or Synthroid. There’s always more to the story, and that’s why its so important to identify the root cause of the problem when considering how to balance hormones naturally. In my practice, I do this primarily by talking with my patients in detail about their health history, and taking a closer look at the lab work. From a functional medicine perspective, it’s never safe to assume that the other components of the HPATG axis are functioning properly, even if we’ve already identified that one of them is out of sync. That’s why holistic healthcare means addressing the whole person, and not just using a symptom-by-symptom, band-aid approach.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

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Sign Me Up!

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Want more Grab a copy of my new book, The Postpartum Check-In !

Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post How to Balance Hormones Naturally (Understanding the HPATG Axis) appeared first on Dr. Alexandra MacKillop.