The Hypothalamic-Pituitary-Adrenal (HPA) axis plays a crucial role in the body's response to stress. It regulates cortisol production, a hormone essential for survival. When functioning correctly, the HPA axis helps maintain balance, allowing the body to respond to stress and return to a state of equilibrium (homeostasis).
However, chronic stress, poor sleep, gut issues, and blood sugar imbalances can over-activate this system, leading to HPA axis dysfunction. This condition can impact hormone levels, inflammation, metabolism, and mental well-being. Understanding how chronic stress affects the body is key to restoring balance, reducing inflammation, and improving overall health.
How the HPA Axis Regulates Stress & Hormones
When the body encounters a physical, emotional, or environmental stressor, the brain signals the adrenal glands to release cortisol. In the short term, this prepares the body for a "fight-or-flight" response. However, when stress becomes constant or unmanageable, the HPA axis stays activated for prolonged periods, leading to:
- Elevated cortisol levels → Increased inflammation, blood sugar imbalances, and anxiety
- Disrupted hormone production → Imbalances in oestrogen, testosterone, and progesterone
- Fatigue & burnout → Adrenal dysfunction from chronic stress
- Metabolic changes → Weight gain, cravings, and insulin resistance
If this dysregulation persists, the brain can become less responsive to feedback signals, resulting in stress hormones remaining elevated for too long. Over time, this can lead to hormonal imbalances, inflammation, and an increased risk of disease.
Pregnenolone: The Precursor to All Hormones
Pregnenolone, often referred to as the "mother hormone," produces cortisol, DHEA, oestrogen, progesterone, and testosterone. However, under chronic stress, the body prioritises cortisol production over sex hormones, a process known as the pregnenolone steal.
How It Affects Women:
- Low DHEA levels - Reduced oestrogen and testosterone production
- Oestrogen dominance - Increased risk of PMS, PCOS, and infertility
- Low progesterone - Irregular menstrual cycles, mood swings, and sleep disturbances
- Hair loss & acne - Androgen imbalances caused by chronic stress
How It Affects Men:
- Increased aromatase activity - Converts testosterone into oestrogen, leading to imbalances
- Low testosterone levels - Fatigue, mood changes, muscle loss, and reduced libido
- Weight gain & insulin resistance - Elevated cortisol levels drive metabolic dysfunction
Consequences of Chronic Stress on the Body
1. Increased Risk of Inflammation & Autoimmune Disorders
Chronic stress is linked to elevated inflammatory markers and contributes to conditions like:
- Atherosclerosis (hardening of arteries)
- Rheumatoid arthritis & other autoimmune conditions
- Irritable Bowel Syndrome (IBS) & gut dysbiosis
2. Cardiovascular Risks: Stress Cardiomyopathy & Heart Disease
Prolonged stress weakens the heart muscle, a condition known as stress cardiomyopathy. This can lead to irregular heart rhythms, high blood pressure, and an increased risk of heart attacks.
A shocking example is "Karoshi", a term used in Japan to describe sudden death due to work-related stress. Research has shown that high-stress individuals have a significantly higher risk of strokes and heart attacks.
3. Increased Anxiety, Depression & Brain Changes
Chronic stress alters brain function, leading to:
- Structural changes in the brain - Increased risk of anxiety and depression
- Reduced cognitive function - Brain fog, memory loss, and difficulty concentrating
- Dopamine & serotonin imbalances - Mood instability and low motivation
4. Blood Sugar Imbalances & Weight Gain
Stress triggers the release of glucose into the bloodstream, leading to:
- Higher insulin levels - Increased risk of insulin resistance and type 2 diabetes
- Fat storage (especially in the abdominal area) - Weight gain and metabolic dysfunction
- Cravings for sugar and processed foods - Driven by dopamine and cortisol fluctuations
Managing HPA Axis Dysregulation & Reducing Stress
By prioritising stress management, sleep, nutrition, and movement, you can restore hormonal balance, reduce inflammation, and support long-term well-being. Start small—focus on daily habits that reduce stress and promote relaxation.
1. Prioritise Sleep & Circadian Rhythm Balance
- Aim for 7–9 hours of restful sleep each night
- Reduce blue light exposure in the evening
- Establish a consistent bedtime routine
2. Balance Blood Sugar to Support Hormonal Health
- Eat whole, nutrient-dense foods with protein, fibre, and healthy fats
- Avoid processed carbs, refined sugar, and excessive caffeine
- Maintain stable blood sugar levels to prevent insulin spikes
3. Reduce Chronic Stress with Mind-Body Techniques
- Deep breathing exercises – Try box breathing or diaphragmatic breathing
Meditation & mindfulness – Lowers cortisol & enhances resilience
Tapping & Emotional Freedom Technique (EFT) – Helps release emotional stress
4. Regular Movement & Exercise
- Engage in strength training & moderate-intensity exercise
Incorporate yoga or stretching to lower cortisol levels
Avoid excessive cardio, which can increase stress hormones
5. Social Connection & Mental Well-being
- Spend quality time with loved ones
- Engage in hobbies (e.g., cooking, gardening, painting, woodworking)
- Avoid prolonged isolation, which worsens stress
The Full Circle of Wellness: The Other Six Pillars
