Why Am I Tired All The Time?

A Brief Introduction to Stress, Fatigue and HPA Axis Dysfunction

Most of us are intimately familiar with stress.  Modern life demands everything from us:  We are both parenting and caring for elderly parents, maintaining careers and meeting deadlines, keeping up with financial demands, nurturing relationships and all the while striving to maintain good health.  We are attempting the impossible and without the traditional community structure of family and friends to lend a hand, many of us have “overdrawn” our energy stores and have become exhausted, depressed and depleted.

Stress and Fatigue

Stressors to body (and specifically the Neuroendocrine system) fall into three separate categories:

  1. Stress from pain and hidden inflammation 

  2. Dietary stress 

  3. Emotional Stress.

Pain is common especially as we age.  It is a part of many disease constellations and is a hallmark of inflammation.  Pain may also be present due to a history of physical trauma.  Gut pathogens and food sensitivities can cause hidden inflammation which also generate stress to the neuroendocrine system.

Dietary stress can be in the form of unregulated blood sugar, food intolerances and poor quality food.  Simple carbohydrate ingestion leads to rapid spikes and crashes in blood sugar which ultimately creates dysregulation via insulin and cortisol responses. 

Emotional stress is generated in our perception of an event rather than the event itself.  This could be the stress of a divorce or the death of a loved one.  It can also be unprocessed trauma or even the daily stress of an overbooked life.

The Gift of Fear

Fear is the gift that kept our ancestors alive while being pursued by a predator.  You may have seen a nature show where a zebra is being chased by a lion and when it escapes, the zebra goes back to grazing like nothing ever happened.  While our brains evolved for a similar cycle of acute stress and reset/recover, under modern conditions we are never able to truly reset and recover so we continue to run and run and run….

The HPA Axis

The HPA axis, or the Hypothalamic-Pituitary-Adrenal axis, is a complex system of endocrine organs, hormones and other signaling molecules in our bodies responsible for managing stress and regulating our energy levels. It's like a built-in alarm system that responds to stressors, both real and imagined.  Adrenaline, also known as Epinephrine, enables us to run or fight.  Cortisol elevates our blood glucose to give us the short bursts of energy needed to accommodate a fight or flight situation.  Most other bodily systems are temporarily disabled during this time.  All of the body’s energy is needed to escape and survive.  If you run out of your glucose stores, your body has the ability to “borrow” energy from different systems.  This would not be problematic in an infrequent and short-lasting scenario but you may be able to imagine the outcome of stress that was open ended.  

This borrowing of energy is called “Catabolic Physiology” and in a chronic state it puts other bodily systems at risk by taking building blocks (amino acids) from the gut lining and muscle in order to generate more stress hormones and more energy.

This high cortisol, high adrenaline state that we find ourselves in, inevitably leaves us dragging during the day to get through the endless tasks and then wired and tired at night: Exhausted but unable to rest.  So our circadian rhythms become flipped, further driving the cycle into total burnout.

How can Functional Medicine help?

The good news is that Functional Medicine has practical and long-lasting solutions for HPA axis dysfunction.  

Here are some tools available:

  • In-home test kits that measure your Cortisol and DHEA levels during the day to determine how well your body is adapting to stress.

  • Food, adaptogenic herbs and specific nutrient supplementation to support and stabilize the Neuroendocrine system.

  • Individualized programs that address lifestyle medicine.

Changes in habit are at the heart of Functional Medicine.  If you book a consultation we can discuss strategies to manage stress and improve sleep hygiene.  Correcting HPA axis dysfunction requires regular quality sleep and time for rejuvenation.

Your body is wise and possesses its own medicine

If you are interested in getting back on track with your health, book a consultation and we will get started on outlining a personalized protocol for you.  We will sit down and discuss, at length, your medical history then decide what testing may be appropriate for you.  After that we will troubleshoot shifts in habits that you can make to guide your body back in the direction of balance.

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