HPA Axis Dysfunction Symptoms

Chronic stress is a common cause of high cortisol in the United States, although conditions like Cushing’s syndrome, adrenal tumors, and even some medications can also cause elevated cortisol. High cortisol levels can lead to:

In general, high cortisol levels also often leave us feeling “wired but tired” and frequently overwhelmed. 

On the other hand, low cortisol levels can be just as problematic. Your body needs the natural release of cortisol throughout different parts of your day for optimal function. HPA axis dysfunction is a common cause for low cortisol levels, however, other conditions like Addison’s disease or chronic fatigue syndrome can lead to low levels as well. Symptoms of low cortisol levels include:

Both high and low cortisol levels can lead to significant health problems. High cortisol levels can lead to symptoms like high blood pressure, rapid weight gain (especially in the face and abdomen), feeling “wired but tired”, and increased risk of diabetes. It can also exacerbate anxiety and interfere with sleep. On the other hand, symptoms of low cortisol include extreme fatigue, muscle weakness, weight loss, low blood pressure, and a decreased ability to handle stress.

A cortisol test measures the level of cortisol in your body. Unfortunately, conventional medicine does not regularly support or fully understand how to treat HPA axis dysfunction. Learn more about the difference between conventional and functional medicine. As a result, most conventional providers and insurance do not provide cortisol testing. However, cortisol testing is an extremely valuable tool to evaluate for HPA axis dysfunction as a possible root cause of various symptoms (like those listed above).

Cortisol follows a circadian rhythm and rises quickly upon waking and lowers slowly throughout the day with the lowest point just before bedtime. Because of cortisol’s rhythmic pattern, testing at only one point in the day does not provide a full picture. Rather, collecting multiple data points throughout the day is the best way to accurately assess your cortisol pattern. For this reason, blood tests are not practical and would require multiple blood draws. However, saliva or dried urine samples offer a practical and accurate method for assessing cortisol patterns (1). When we need to further assess HPA axis dysfunction, we use a six point salivary cortisol test including CAR (cortisol awakening response). Root Access Members will be able to order this at-home kit starting October 2024. 

HPA axis dysfunction can significantly impact various aspects of health, from sleep and mood to digestive health and weight management. Understanding the symptoms and seeking appropriate cortisol testing can lead to effective management and treating the root causes of these symptoms.