How to look for HPA axis dysfunction on a HTMA test

If you’ve been following the trends in functional medicine, you may have heard of the phrase ‘HPA axis dysfunction’ or ‘adrenal fatigue’ or ‘HPA axis stress’ before.

But do you actually know what that looks like? Maybe you’re wondering if it applies to you and your situation. If you’re experiencing persistent fatigue, low energy, moodiness, brain fog, difficulty waking/sleeping, blood sugar crashes, racing mind, it is possible that this may apply to you. However, it’s best maybe to show you what ‘adrenal fatigue’ or HPA axis dysfunction actually looks like on a HTMA (hair tissue mineral analysis) test!

First of all, what is HPA axis dysfunction?

HPA stands for your Hypothalamus-Pituitary-Adrenal axis, which is basically how your brain communicates with the rest of your body and organs. Any type of stressor triggers the Hypothalamus to tell the Pituitary gland to send out corticotropin releasing hormone, which then tells the adrenal glands to produce adrenocorticotropic hormone to release glucocorticoids. This sends a feedback loop back to the Hypothalamus—if the stress is dealt with, you experience only an acute inflammation response, which is healthy. If the stressor is not addressed or there is an ongoing stressor, that feedback loop continues down to the adrenals to pump out cortisol. This is your main stress hormone responsible for raising blood sugar and pressure. Overtime, persistent, elevated cortisol can disrupt your hormonal balance and gut flora. Your body may then produce too much cortisol or in chronic situations, not enough cortisol as your body gets burnt out. This irregular pattern is what is known as HPA axis dysfunction.

I know, that was sort of a mouthful and it may sound all too confusing unless you’ve studied the neuroendocrine feedback loop! So to make it easier to understand, let’s have a look at it from a functional perspective!

Patient 1: low Calcium/Magnesium ratio, low Sodium & Potassium, overall inability to cope with stressors (adrenal fatigue)

Patient 2: high Calcium/Magnesium ratio, low Sodium/Potassium ratio, and 2 high-2 low pattern indicating high stress or alarm stage of HPA axis stress

Here are two examples of different forms of HPA axis dysfunction. The first graph shows overall flattened stress response capacity (Low Calcium, Magnesium, Sodium, Potassium). The second graph shows a 2 high 2 low pattern of the first 4 minerals. What does this mean?

For the purpose of this article, we’re only looking at the first 4 minerals: Cal-Mag-Na-K

These essential minerals are the primary buffers for mitigating and managing stress or stimuli. Cal/Mag is your stress response and Na/K is your ability to cope or deal with that stress.

So when we see Na/K both low, this tells you that the body is no longer able to keep up with the stress demands or stimuli. And likewise, when Ca/Mag is super elevated, that tells you that the body is undergoing a lot of stress and it recruiting more of that calcium and magnesium from your cells to power up.

And not only are the mineral levels themselves important, but the ratios between the minerals tell us a lot more in terms of what’s going on. For example, if your Na/K ratio is high, this could mean that your body is trying to hold onto sodium for energy reserves, but this can elevate blood pressure and continue the cascade of being in ‘fight or flight’ mode.

There is honestly so much to the HTMA test and what it can tell us about how our bodies are functioning and what stage of HPA axis stress we’re in—whether we’re in a sympathetic or parasympathetic state.

With that said, the HTMA test is one of the best foundational labs to begin with if you want to utilize functional medicine lab testing as a part of your healing journey. It is easy to complete (all done from the comfort of your home) and provides you ample amount of information about your health.

The HTMA test is included in my Stress & Energy Reset program, which is the perfect starter program if you are experiencing symptoms of ‘adrenal fatigue’ and want some quick answers and solutions for how to reset your body. However, if you’re looking for deeper support, the test is also included in my 3mo Restore and 6mo Rebalance programs (with additional tests available)!

If you are interested in getting lab testing done or ready to work together, book a free connection call with me to determine with path is best for you! OR apply directly to my programs for a quicker response.

Book a Connection Call

Apply for Coaching

Do I have 'Adrenal Fatigue'?

What is Adrenal Fatigue and how do I know if I have it? Here are some pointers in how you can tell at what stage of stress you are in and what you can do about it.

Adrenal Fatigue

You may have heard of the common term ‘adrenal fatigue’ when it comes to understanding the reason why you might be feeling low energy and overall mojo.

Well, the term ‘adrenal fatigue’ is technically not a medical diagnosis, but what is essentially happening is that they’re actually being overused. When you’re stressed, you produce more cortisol to meet demands. However, over long periods of stress (high cortisol output) or sympathetic nervous system dominance (fight or flight mode), your adrenal function becomes taxed and are unable to keep up with this demand.

What are the Adrenal Glands?

The adrenal glands are these little glands that sit on top of your kidneys and they work with your Hypothalamus and Pituitary Gland to control and monitor stress levels and energy production. This is something called the HPA Axis (Hypothalamus-Pituitary-Adrenal Axis).

The adrenal glands produce glucocorticoids when the body signals the Hypothalamus that there’s a stress input. These glucocorticoids are essentially cortisol-driven glucose, which are released when the body needs sugar in the body to meet physiological demands. This is also what raises the cortisol hormone in the body to signal fight or flight mode.

Cortisol is used for many functions, but the most important is for energy and stress. It’s what helps you manage daily life demands.

What’s the significance?

When your body is under repetitive, consistent stress, [whether that comes from physical stress (exercise), mental stress (anxiety), or pathological stress (infection or virus)], or a combination of stressors over a long period of time, your adrenal function gets taxed. Your HPA axis feedback loop is no longer able to keep up with the stress induced by physical, mental, emotional, pathological, or environmental demands.

All things play a role into how much stress your body may be filtering through. Diet, lifestyle, exercise, heavy metal exposure, emotional balance, trauma awareness, and environmental toxins all play a role in the ‘stress bucket’.

This is why it’s so important to assess and manage stress levels every single day, regularly.

How do I know if I have healthy adrenal function?

Well, let’s take a look at how many of these things you can relate to:

• I feel ‘tired but wired’ especially at night

• It takes me a while to fully wake up in the morning and have energy

• I don’t really feel hungry when I wake up

• I tend to crash midday

• I can’t seem to lose weight even if I train 5-6x a week

• I am noticing hormonal fluctuations like irregular periods and hair loss

• I am noticing muscle weakness or loss

• I tend to get constipated

• I have a hard time focusing or concentrating

If you are experiencing any of these symptoms, it could be a sign that your adrenals need extra support.

Your body is no longer keeping up with your stress demands and is depleting the essential minerals and amino acids in the body in order to keep up. This may explain muscle weakness, hair loss, hormonal imbalances, and lack of energy to do the things you used to do.

Your energy stores are being used up, even though your adrenals are working overtime, pumping out cortisol! Overtime, this may lead to burnout where your 4-point cortisol levels flatline. When this happens, you don’t have enough cortisol, minerals like calcium and magnesium, or amino acids to give you the energy you need to function properly.

What can you do about adrenal fatigue?

1. I recommend running a Hair Tissue Mineral Analysis Test (HTMA) to check for mineral levels, which indicate which phase of adrenal stress you’re in.

2. If you’re also experiencing gut and hormonal imbalances or symptoms, try running a Functional Medicine Detox to open your detoxification pathways for healing.

3. Prioritize sleep hygiene and get to bed around the same time within a 30min window. This helps reset your diurnal rhythm, which works in conjuction with cortisol levels.

4. Balance blood sugar throughout the day and before bed to also support your cortisol/diurnal rhythm. You want cortisol to be highest in the morning and lowest at night. Having a nutrient dense breakfast can help, so quit fasting!

5. Work with a certified practitioner who can help you run and interpret lab results and offer individualized feedback in terms of what supplements to prioritize and how to optimize your nutrition and lifestyle to reset your adrenal function.

If you’ve been struggling with fatigue, hormonal imbalances, and overall lack of mojo for more than 6 months, it may be time to take a deeper look at what’s going on.

In my Integrated Healing Program, we use Functional Medicine Lab Testing to pinpoint the root cause of why you may have resistant stress, fatigue, or adrenal dysfunction. You’ll have a chance to work 1:1 with a certified Integrative Health Practitioner to address nutrition, lifestyle changes, functional supplementation, and more. To get started, go to kelseychen.com/integrativehealth.

To learn more about how to support your body, follow me on IG and Tiktok @tinybutmightywellness