You know the feeling…you’re utterly exhausted, you finally get in the bed, conk out and around 3 am, hello–you’re wide awake.
No need to worry if this happens only occasionally, especially if you can get back to sleep relatively quickly. But if something is waking you up in the middle of the night frequently, it’s time to take measures to figure out why.
There are a number of reasons why we wake up and cannot fall back asleep. I’ve discussed these in a previous article “Why Can’t I Stay Asleep?” You’ll find tests and solutions for each of the nine major causes of insomnia there.
In most cases, we find that it’s not just one, but SEVERAL reasons why we have trouble sleeping.
While we all want to find that one thing (or pill) that will magically allow us to sleep through the night, those of us who struggle with insomnia usually discover that we need to address several neglected areas of our life.
Let’s look at one of the major causes of insomnia, HPA Axis Disorder, in a little more depth. It’s one of the most common disorders we see and can be a bit tricky to resolve.
HPA Axis Disorder
HPA Axis Disorder or Hypothalamic-Pituitary-Adrenal Axis Disorder was formerly known as ‘adrenal fatigue‘. You’ve heard the term, I’m sure.
Scientists now understand that this disorder involves more than just your adrenal glands. All three of these endocrine glands, the hypothalamus, the pituitary and the adrenal glands interact with each other to modulate many systems such as digestive, immune, neurological, metabolic and reproductive health.
HPA Axis disorder is more than just ‘fatigue’.
When we are under stress, the adrenal glands immediately increase the production of cortisol. Cortisol is the known as the “stress hormone” for a good reason.
It influences, regulates or modulates many of the changes that occur in the body in response to stress, including, but not limited to blood sugar levels, metabolism needed to maintain healthy blood glucose levels, immune responses, inflammatory actions, blood pressure, heart and blood vessel tone and contraction, central nervous system activation and more.
When the adrenal glands are continuously overworked and levels of cortisol become too elevated, you can feel ‘wired and tired‘.
Can you relate to that feeling? Exhausted but still too charged up to sleep?
Symptoms of HPA Axis Disorder
As the disorder develops, you may ping-pong back and forth between feeling ‘wired and tired’ to completely fatigued. No matter how many hours you sleep, you still feel fatigued. Eventually, you can become stuck in the exhaustion phase.
These are common symptoms of HPA Axis Disorder:
- Salt cravings
- Low libido
- Thyroid disorders
- Difficulty handling stress
- Fertility issues
- Light-headed upon standing up
- Poor focus
- Less enjoyment and happiness with life
- Worsened blood sugar control
- Increased insulin resistance or Diabetes
- Increase visceral fat (belly fat)
- Decreased immunity (get sick easily)
Cortisol suppresses the enzyme that converts inactive thyroid hormones into active ones, significantly slowing metabolism and increasing weight gain.
It is metabolically impossible to lose weight when cortisol is high, as our metabolism comes to a screeching halt.
When the adrenal glands are in a constant state of alarm, the pituitary gland becomes sluggish from overwork. As a result, the reproductive system suffers leading to low progesterone in women and low testosterone in men.
In fact, it is this disorder that underlies most menopause symptoms!
Even more, elevated cortisol also runs down the liver’s ability to detoxify discarded estrogens. Those estrogens circulate back into the blood stream in a more toxic form.
You get it. Chronic stress causes body-wide mayhem.
Cortisol responds rapidly to the food we eat. It is elevated with a diet high in sugar (remember all carbohydrates break down into sugar).
Normally, cortisol should be highest in the morning and lowest at night. Any disruption in this cycle results in dysfunction and sleepless nights.
Blood glucose levels, on the other hand, are normally lowest in the early morning hours.
However with an HPA axis imbalance, cortisol levels may not be sufficient to maintain an adequate blood glucose level during the night causing middle of the night awakenings from hunger.
Low glucose signals an alarm that disrupts sleep so the person can wake up and refuel.
One way to assess cortisol levels and circadian imbalance is to run an Adrenal Stress Index (ASI) panel lab test.
This is a saliva test kit you can do at home and ship it back to the lab. The test looks at cortisol levels throughout the day along with other stress markers and gives an idea of the degree of cortisol dysregulation.
In most cases, insurance does not cover this test. Many healthcare providers recommend the Dutchtest panel from Precision Analytical.
The following adrenal stress tests are available for you to order yourself from our lab test partners:
BioHealth Kit–Cortisol Diurnal Rhythm–saliva kit sampling 4 x during the day and includes DHEA-S $199
Dutchtest Kit from Precision Analytical–Cortisol Awakening Response–saliva kit sampling 5 x during the day $274
Ulta Lab Tests
Cortisol 4 point Saliva $132
Adrenal Stress Profile-Saliva $159
How to Resolve your HPA Axis Disorder
So what can you do about it?
First of all, understand that other underlying imbalances can be at play here such as: Thyroid Disorder, Blood Sugar dysregulation, Food Allergies/Sensitivities, Poor Digestion, and Circadian Rhythm imbalance.
Blood Sugar dysregulation and HPA Axis disorder typically go hand in hand.
Trying to fix your HPA axis without addressing these other issues is futile!
You will want to work with a healthcare practitioner who is experienced with treating adrenal fatigue. Check out Dr. Sarah Ballantyne’s 3-part series on Adrenal Fatigue.
The further that adrenal fatigue progresses, the harder it is to manage.
Here are some tips to start working on HPA Axis disorder:
- Remove the source of the chronic stress, if at all possible. Throw the bum out, quit the stressful job, move away from the in-laws, whatever it takes!
- Sleep as much as possible. Don’t feel guilty about it, you need to heal yourself.
- Eat an anti-inflammatory diet such as the Paleo Diet or an Auto-immune Protocol.
- Avoid Xenohormones which are any type of external hormone that can affect the HPA Axis.
Xenohormones are in the meats we eat that have been given hormones. Eat organic, grass-fed meat only. Xenohormones are in phytoestrogens found in soy, legumes, some nuts and seeds. They are common in body products and makeup and in some detergents, pesticides and plastics (make your own body products or buy them from sources like Thrive Market).
- Cut out caffeine in all its forms.
Caffeine is a known stimulant of the immune system and adrenal glands. Consuming it leads to an increase in our daily release of cortisol and is known to increase psychological symptoms such as anxiety. Let your body be tired, so you can sleep.
- Use gentle exercise like yoga, Tai Chi, or walking. Meditation works wonders. Over-exertion will only make adrenal fatigue worse.
- Basic supplements to support adrenal function are: Omega 3 fatty acids, Vitamin C, Vitamin B2 (Riboflavin), Vitamin B5 (Pantothenic Acid), Vitamin B12 (Methylcobalamin), Vitamin E and Magnesium. Whole food sources of these nutrients are better assimilated than supplements, but supplements may be necessary to alleviate deficiencies of these nutrients.
- Adrenal support supplements such as desicated adrenal gland and the hormone Pregnenolone. While Pregnenolone is available without a prescription, you should never take any hormone without consulting with a healthcare practitioner and reviewing your entire hormone cascade through appropriate lab testing.
- Herbal support (and especially adaptogenic herbs used for their normalizing effects) can be very effective and includes: Ashwaganda, Licorice Root, Rhodiola, Holy Basil, Gotu Kola, Siberian Ginseng, Asian Ginseng, American Ginseng and Golden Root. Your choice of adaptogen is determined by your body’s need for relaxation or stimulation.
You’ll want to seek out a healthcare practitioner who can guide you through this process, particularly with lab testing and supplementation.
Additional Resources: The Metabolic Approach to Cancer, Dr. Nasha Winters and Jess Higgins Kelley, 2017
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Joli Tripp and Mind Blowing Wellness are not medical doctors nor licensed medical professionals. No comment or recommendation should be construed as being a medical diagnosis. If you suffer from a medical or pathological condition, you should consult an appropriate healthcare provider.
These statements have not been evaluated by the Food and Drug Administration. The products mentioned are not intended to diagnose, treat, cure, or prevent disease.
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