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HPA Dysfunction and Weight Gain

By Lucy Rose Clinic

August 25, 2020

Have you had a lot of stress in your life, find that your sleep is disturbed, are more anxious or depressed, and have also put on weight?

You could have an adrenal hormone issue.

Many practitioners do not connect thyroid and adrenal as the root cause to poor health symptoms, but we know that all cases of fatigue, stress, weight gain and mood changes need BOTH these hormone systems assessed.

Today we are diving into the new Adrenal Fatigue – HPA-d. 

Read on…

The adrenal glands produce a number of hormones, such as Cortisol, which helps us cope with daily stress, keeps up awake and energetic through the day, and allows us to sleep peacefully through the night. Adrenal hormones also help regulate blood sugar levels, aid and maintain blood pressure, modulate the function of basically every organ in your body, and reduce inflammation.

The adrenal hormones are intimately connected to the thyroid, and when one of these systems go out, so does the other.

Symptoms of adrenal hormone dysregulation:

  • Weight gain in the midsection
  • Fatigue: feeling of tiredness all the time or around 3:00pm
  • Sleep pattern disruption: trouble falling asleep or staying asleep
  • Allergies 
  • Depression, low motivated
  • Memory problems 
  • Frequent urination – usually through the night
  • Constipation
  • Blood sugar problems: low blood sugar or high blood sugar
  • Blood pressure problems 
  • Anxiety or nervousness 
  • Brain fog, not being able to concentrate
  • Dry skin
  • Feeling cold all the time, or just having cold hands and feet
  • Loss of libido

Hmmmmmm. Sound a LOT like thyroid symptoms – does it not?

Many people mistaken a thyroid disorder for an adrenal problem, and never discover the TRUE cause to their symptoms.

Bottom line, if your thyroid is sub-optimal – even a little bit – your body uses its back up system to keep you going. The ADRENAL hormones.

Relying on the ‘back-up plan’ indefinitely leads to a complex imbalance technically called Hypothalamus-Pituitary-Adrenal dysfunction (I’ll call it HPA-d from here on). It used to be called Adrenal Fatigue, but the term has had a revamp in recent years.

The term Adrenal Fatigue suggests the adrenal glands themselves are tired and under functioning, but this actually is rarely the true problem. 


The Hypothalamus reads the level of hormones in the bloodstream and sends hormonal signals (CRH) to the Pituitary which in return sends the hormone ATCH, to the Adrenal glands to either reduce the production of cortisol or to elevate it. This connection is called the HPA axis.

Stress induces the release of corticotrophin releasing hormone (CRH)

CRH stimulates the release of drenocorticotropic hormone (ACTH)  from the anterior pituitary

ACTH stimulates the release of glucocorticoids from the adrenal cortex

Not only are adrenal gland hormones effected, but also the thyroid hormones through the HPA-HPT (T for Thyroid) axis. 

Cortisol is a stress hormone, so any kind of stress will elevate it. Chronic stress results in the  adrenal glands being constantly stimulated via the HPA axis.

Fairly new research has discovered that cortisol can pool around the hypothalamus, resulting in low levels of ATCH production, and hence low levels of cortisol. 

This research has also discovered that areas of the brain swell and shrink changing the map of the brain, when chronic stress is experienced for more than 6 consecutive weeks. This can result in sympathetic dominance – meaning that your fight/flight/freeze response is ‘stuck’ in the on position.

How the thyroid tries to ‘help’

When we have too much cortisol in our blood stream, it can block the conversion of T4 into T3 causing low T3 by flipping it into reverseT3. Chronic stress will eventually result in rT3 dominance, and this condition has huge consequences on your thyroid hormones.

By the time you have all the symptoms listed earlier, your thyroid hormones are actually so far out of balance that they are the main reason behind weight gain and a slower metabolism.

How weight gain presents

Adrenal/thyroid weight is generally all over the body, with extra deposits on the mid-section. Sometimes there will be a fat pad on the back of the neck called a Dowager’s Hump – a result of chronic cortisol dysregulation. It can also be due to medications, poor posture,  genetics and osteoporosis.


Assessment requires sensitive pathology. If someone has been in a stress response for too long, they literally cannot tell if they are stressed or not, because to them, they only know one way of feeling, so they think it is normal. 

Some signs that this may be applicable to you are:

  • Have difficulty taking a deep breath low in the belly
  • You are in your head all the time, not connected to your body, and not really aware of subtle symptoms such as aches or pains, or emotional feelings.
  • Have trouble relaxing – always have to be doing something.

If you relate, then you could have some level of HPA-d affecting your thyroid, ruining your metabolism, and having consequences to your health.

The below test shows 3 phases of adrenal adaptation on a 3-point cortisol test from saliva samples. This is the best test to understand your adrenal hormone function.

How to get a complete diagnostic picture

Further testing to understand all the pieces to the puzzle are needed to treat the root cause and facilitate true healing, balance and wellness.

This should include a FULL thyroid test; TSH, fT3, fT4, rT3, and thyroid antibodies. More info.

Nutritional panel – Vitamin D, B12, folate, 5MTHF, iron etc. More info.

Inflammatory markers. More info.

Other hormones depending on symptoms – eg are there hot flashes, menstrual irregularities, low libido? More info.

Food intolerances – especially helpful where there are digestive symptoms, chronic inflammation, or non-responsive to diets. More info.

Functional testing gets to the root imbalances, and aims to discover the driving factors. Once that is established, treatment can be crafted with accuracy, resulting in great healing outcomes – faster.

If you would like to know more about how our testing is different from any other testing you have had, book a FREE 15-minute consult. We would love to meet you!

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