What Is the HPA Axis and Why Does It Matter?

The HPA axis is the communication system between the hypothalamus, pituitary gland, and adrenal glands. Its main purpose is to manage the body’s stress response through the release of cortisol and adrenaline. This system also affects mood, digestion, reproductive hormones, immune function, and metabolism (Guy-Evans, 2025). Prolonged or intense periods of stress can lead to HPA axis dysfunction. When this system is dysregulated, it can have wide-reaching effects on all of the body’s hormones. While there isn’t currently a medical treatment for this condition, there are many ways you can naturally support your HPA axis (Cleveland Clinic, 2024).

Cortisol naturally fluctuates throughout the day to regulate arousal. It peaks in the morning and slowly drops throughout the day. In people with HPA dysfunction, their cortisol pattern doesn’t follow the natural rhythm and is typically elevated at night. Saliva hormone testing, which is available through Renewed Hope Nutrition, can reveal your cortisol pattern and identify sex hormone imbalances. Saliva hormone testing is considered the best way to evaluate hormones, because the test reveals the amount of active hormones available to the body (Guilliams & Edwards, 2010).

Sex hormones are often imbalanced in people with HPA axis dysfunction, since cortisol depletes pregnenolone and DHEA. These hormones protect the body from damage due to elevated cortisol, but when cortisol never drops these hormones are quickly depleted. DHEA and pregnenolone are vital for sex hormone regulation (Guilliams & Edwards, 2010). 

Healing HPA axis dysfunction begins with regulating cortisol levels. Stress management techniques, blood sugar management to improve insulin sensitivity, proper sleep hygiene, and inflammation reduction are the best ways to support recovery from HPA axis dysregulation by supporting a healthy cortisol pattern. Specific supplements can also be used when prolonged stress has created deficiencies in nutrients used in the stress response (Guilliams & Edwards, 2010).

Stress management includes a variety of practices that activate the parasympathetic nervous system and calm the stress response. Physical activity increases endorphins, which naturally boost your mood. Regular moderate activity can help balance the HPA axis, but avoid intense or prolonged workouts, which can increase cortisol. Fostering strong, healthy relationships with friends and family reduces stress and improves mental wellbeing. It’s also important to create a kind and supportive relationship with yourself through self compassion and practicing a positive mindset. Breathwork, spiritual practices, journaling, meditation, and mindfulness all serve to relax the mind and body. Body work and energy work can also be used to balance the mind and relax the body. Healthy stress management is key to HPA axis regulation. Experiment with these options to find the best technique for you (Guilliams & Edwards, 2010).

Imbalanced blood sugar, whether hyperglycemia or hypoglycemia, contributes to elevated cortisol. In people who have insulin resistance, another contributor to HPA dysfunction, blood sugar management can improve insulin sensitivity (Guilliams & Edwards, 2010). For better blood sugar balance, eat a balanced meal within one hour of waking; make sure each of your meals and snacks contain fat, fiber, and protein; pair carbs with fat, fiber and protein; eat carbohydrates last; limit carbs to no more than one serving per plate; and space your meals and snacks three to four hours apart. Taking these steps can drastically improve blood sugar regulation and support recovery from HPA dysfunction.

Consistent quality sleep is key to regulating the circadian rhythm and balancing cortisol (Guilliams & Edwards, 2010). Proper sleep hygiene includes sleeping seven to nine hours nightly, following a consistent sleep schedule by going to bed and waking up at the same times every day, engaging in relaxing activities before bed, avoiding electronic screens at least 30 to 60 minutes before bedtime, watching the sunrise and sunset, keeping your bedroom cool, dark, and quiet, avoiding caffeine after 12pm, limiting alcohol, eating your last meal three hours before bedtime, exercising regularly, and avoiding intense physical activity within three hours before bed. Slowly implement small changes until your sleep quality has been optimized. 

Inflammation increases physiological stress and contributes to HPA axis dysfunction. Following an anti-inflammatory whole food diet, avoiding toxin exposure, and engaging in healthy lifestyle practices can help lower your inflammation levels (Guilliams & Edwards, 2010). The most common sources of inflammation are processed foods, cigarettes and alcohol, poor blood sugar regulation, lack of exercise, and environmental toxin exposure. Switching to an organic whole food diet and avoiding smoking and drinking are the first steps to lower inflammation. If you don’t currently have an exercise routine, consider slowly increasing your activity level until you’re getting at least 30 minutes of moderate activity daily. Functional testing can be completed to determine if you have toxins in your system, which helps specify the most appropriate detox plan for your needs. Such testing is available through Renewed Hope Nutrition. 

The stress response requires a large amount of the body’s nutritional resources. The main nutrients impacted by stress include vitamin c, niacin, pantothenic acid, folate, biotin, calcium, potassium, zinc, copper, and iron (Guilliams & Edwards, 2010). Monitoring these levels through lab tests, hair mineral analyses, and supplementing as needed can help you restore balance to your HPA axis.

Healing from HPA axis dysregulation is a slow but rewarding process. Making small changes now can help you rebalance your hormones and improve your overall health. Contact Renewed Hope Nutrition to schedule an appointment for functional lab interpretations, saliva hormone testing, toxin testing, and holistic health recommendations.

References

Cleveland Clinic. (April 12, 2024). Hypothalamic-Pituitary-Adrenal (HPA) Axis. Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/body/hypothalamic-pituitary-adrenal-hpa-axis

Guilliams, T. G., & Edwards, L. (2010). Chronic Stress and the HPA Axis. The Standard, Vol. 9, No. 2. Retrieved from https://www.pointinstitute.org/wp-content/uploads/2012/10/standard_v_9.2_hpa_axis.pdf

Guy-Evans, O. (May 9, 2025). Hypothalamic-Pituitary-Adrenal Axis. Simply Psychology. Retrieved from https://www.simplypsychology.org/hypothalamic-pituitary-Adrenal-axis.html