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What is the HPA Axis

Hi, this is Dr. Emily Parke with your Functional Health Minute. Today I’d like to take a few minutes to talk about the adrenals. There’s an old term that gets thrown around quite a bit still called adrenal fatigue, but what we really found medically is that the adrenal glands themselves are fine in most cases.

HPA axis dysfunction

Now, there are two actual medical disorders, one in which the adrenal glands produce too much cortisol, and that’s something called Cushing syndrome. There’s also a disease called Addison’s disease in which the adrenal glands don’t produce enough cortisol. Most of all other cortisol issues are really what’s called HPA axis dysfunction, hypothalamic-pituitary-adrenal axis dysfunction. In other word, there’s a glitch in the signaling from the hypothalamus to the pituitary or from the pituitary to the adrenals. That is really what contributes to most patient’s symptoms.


Now, for example, cortisol, which is one of your body’s main stress hormones, has a natural rhythm throughout the day. Cortisol is, for example, highest in the morning. It’s part of what helps you wake up, and cortisol is supposed to be the lowest at night before you go to bed. It’s part of what helps you fall asleep. Cortisol drops and melatonin rises, but there can be dysfunctions in that cortisol rhythm that can give patients lots of different symptoms. For example, if cortisol is too high before bed or in the middle of the night, it can cause you to have difficulty falling asleep and/or staying asleep, but if cortisol is too low first thing in the morning, this is really significant morning fatigue, trouble getting up and started during the day.

I hope this helps explain a little bit about the old adrenal fatigue and the new HPA axis dysfunction description of what’s actually going on inside your body with cortisol. This is Dr. Emily Parke with your Functional Health Minute.



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