Jenny's Struggle with HPA-D (Adrenal Fatigue)

Exhausted. That About Sums It Up.

Jenny was so stressed out. Her life had a lot of potential to be great—beautiful family, happy personal life—but like all too many of us, she dreaded going to work. She had a controlling, demeaning and abusive boss, habitually making comments that embarrassed her. Her chronic stress began to create physical manifestations that increased on a daily basis. She began to experience the following symptoms:
  • Stress eating
  • Weight gain
  • Alternating loose stool and constipation
  • Stomach problems and abdominal pain
  • Constant thirst and frequent urination
  • Extreme fatigue
  • Anxiety
  • Insomnia
  • Loss of sex drive
All of these things caused Jenny to be angry and irritable, compounding the stress. Simply put, Jenny felt lousy and exhausted, and she needed to make a change. 

Functional Evaluation to Determine the Reason for HPA-D (Adrenal Fatigue)

We started by applying pressure to the different digestive points. With tenderness ranging from 0 to 10, ten being most tender, Jenny scored an 8 on her stomach acid point and a 6 for other digestion points (liver, gall bladder, pancreas). She also scored a 10 for her small intestine points and 7 for her large intestine. This indicated a severely inflamed gastrointestinal system and was an immediate red flag.

Jenny also completed the Nutri Q, a 321 question/answer nutritional assessment. I asked her to keep a food journal as well, in order to have a clear understanding of her daily diet.

Lab Testing to Identify Body System Imbalance(s)

  • Adrenal stress profile: Cortisol levels measured four times throughout the day indicated low levels causing circadian rhythm disruptions. The profile also indicated low levels of he anabolic steroid dehydroepiandrosterone sulfate (DHEA-S). 
  • Thyroid testing (ordered by primary care physician): TSH and T4 were both normal.
  • GI Map testing: 
    • Gut Dysbiosis – indicated too much opportunistic bacteria, not enough beneficial.
    • Low sIgA (secretory immunoglobulin A) – indicated a suppressed immune system meaning the body had lost its first line of defense against foreign entities.
    • High Zonulin -- indicated increased intestinal permeability or “leaky gut.”
VIEW TEST RESULTS

Findings: Hypothalamus Pituitary Adrenal Dysregulation (HPA-D)

Jenny exhibited symptoms of HPA-D (formerly known as adrenal fatigue) with abnormalities in cortisol and irregular circadian rhythms. (see my 21st Century Epidemic Blog Post) This explains her decreased ability to handle stress, female hormone issues, low libido, chronic fatigue and insomnia. 

The root cause of HPA-D is  emotional stress, dietary stress, and/or pain or hidden inflammation. If a woman, young or old, has female hormone issues, she has an adrenal problem. If she has an adrenal problem, something is stressing her adrenals. Optimal regulation of the hypothalamic-pituitary-adrenal (HPA) axis is critical for a successful response to any stressor as well as in non-stressful situations. Dysregulation of the HPA axis in basal conditions, or in response to acute or chronic (including psychosocial) stress, is closely related to the onset and/or progression of many diseases. In Jenny’s case, chronic emotional stress from her profession and diet issues were the root cause of the dysregulation.

As indicated by her adrenal stress profile, Jenny also exhibited low levels of dehydroepiandrosterone sulfate. DHEA-S is secreted from the adrenal cortex and plays a significant role in the body’s immune system by serving as a building block for sexual and other hormones. It also determines general levels of wellbeing and mood. The low amount of DHEA-S found was a likely contributor to Jenny’s lack of libido.

The GI Map testing, as well as her responses to the Nutri Q and the notes in her food journal, indicated Jenny was also experiencing a certain amount of dietary stress throughout her digestive system. She embodied the standard American diet: high in carbohydrates and processed foods, low in healthy fats, proteins, and vegetables. This type of diet can be the root cause of blood sugar handling issues and lead to the development of diabetes. Based on her tests, Jenny showed signs of blood sugar handling issues, digestion and detoxification issues, and problems in both the small intestine and large intestine. This dietary stress was causing pain and hidden inflammation throughout her digestive tract.

Jenny was imbalanced in all three of her body systems. Digestion was impacted by her dysbiosis and leaky gut. Neuroendocrine was impacted by her GI issues, her poor diet and inability to digest. And because of all this, her body was not producing the correct ratio of hormones, thus affecting its ability to properly detoxify.

Lifestyle Change Recommendations

  1. Paleo diet with a balance of macronutrients consisting of quality protein, plant based carbohydrates, and healthy fats.
  2. Meals every 3 to 4 hours.
  3. Intermittent 14-hour fasting windows in order to increase insulin sensitivity and decrease inflammation. 
  4. Low impact exercise (yoga, swimming, resistance training). If fatigued after workouts, recommendation to decrease frequency, duration, volume and intensity. 

Individualized Treatment Plan

  1. Daily supplements to address HPA-D and circadian rhythm needs:
    1. Pregnenolone
    2. DHEA 
  2. Dietary supplements to support the adrenal glands:
    1. Adaptogenic herbs
    2. Magnesium
    3. Whole Vitamin C
  3. Herbal supplements and probiotics to address gut dysbiosis and bring about GI health 
  4. Nutrients and Bone Broth to heal the GI lining 
  5. Colostrum to increase the low immune system (SIgA)

Results

With strict adherence to the above protocol, Jenny experienced a tremendous upswing in her health. In just two weeks, she noticed she was digesting food better and no longer experienced bloating, gas or abdominal pain, and her bowel problems were lessening. By the end of the first month, her thirst and trips to the bathroom decreased, as well as her cravings for sweets and processed food. Because of this, she lost weight and was down two pant sizes in about 6 months! And after the first two months, she had more energy and no longer found it a chore to go to the gym—she actually looked forward to it. She continues to have less anxiety and feels more equipped to handle stressful events and comments from her boss at work. She is also sleeping better and feeling refreshed upon waking. Some mornings she still wakes up earlier than she would like, however, this is less frequent. And she has experienced a returning sex drive. It’s not quite like it was in her 20’s and 30’s, but it’s an increased desire, which makes her (and her husband) very happy. 

NOTE: While this client gave us approval for sharing details, all names have been changed to protect the identity of the client.
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