Is the HPA Axis the Elephant in the Room For ME/CFS and FM?

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Just got this from Chris Kresser - who despite all his work and knowledge has been dealing with health issues on and off for quite a while.

Haven't checked it out but thought I would pass it on..


Hi everyone,

I’ve been seeing patients with complex health problems for almost 8 years, and as many of you know, I struggled with chronic illness myself for over a decade before that.

If there’s one thing I’ve learned over that time, it’s this: it is impossible to recover your health (or achieve any health-related goal) without addressing HPA axis dysfunction. Period.

But what is HPA axis dysfunction (what some call ‘adrenal fatigue’)?

As I explain in a recent webinar I did with my staff RDs, Laura Schoenfeld and Kelsey Marksteiner, it goes far beyond “stress” or “adrenal fatigue”. HPA axis dysfunction affects nearly every cell and tissue in the body, and is associated with everything from skin conditions to digestive problems to hormone imbalance to depression.

Here’s the thing: HPA axis dysfunction could be a major cause of your symptoms even if you don’t feel stressed out.

That’s because common problems like inflammation, blood sugar dysregulation, and circadian disruption (not getting enough sleep, exposure to artificial light at night, not enough natural light exposure during the day) can throw your HPA axis out of whack and wreak havoc on your health.

Ignoring HPA-D is the single biggest mistake both patients and clinicians make when trying to overcome chronic illness. Don’t let this happen to you! If you missed the webinar I did with Laura & Kelsey, you can access the free replay here.

We discuss causes and solutions for HPA-D in detail. We also talk about Laura & Kelsey’s fantastic Paleo Rehab program, which has helped hundreds of people to regain their energy, vitality, and well-being.

The Paleo Rehab program is designed to help you implement the diet and lifestyle customizations we use with patients who have HPA-D—along with tools for overcoming the stress that is causing it to begin with.

The replay is free only until end of day Tuesday 3/22, so don’t wait. Once you understand how important the HPA axis is to health, I think you’ll see why I believe so strongly that it’s the “elephant in the room” for so many people.

Take a few minutes now to watch it.

In Health,
Chris Kresser
 

Remy

Administrator
I'm so glad to see him calling it HPA dysfunction rather than adrenal fatigue.

The adrenal glands do not have little muscles. They do not get "fatigued".

They either respond properly to the brain signals...or they do not. What we have is not an adrenal problem, it's a brain problem.
 

Who Me?

Well-Known Member
One of the first things I remember hearing about when I got sick in the 90's was the HPA axis.
 

Who Me?

Well-Known Member
Supplying hypothalamus, pituitary, and adrenal glandulars helped me immensely until other healing kicked in.
I got some hypothalamus glandular and felt great until I didn't. About 4 pm I got very speedy and a headache. Thankfully it eased down. I have been saying now for how long I need to split the cap and take half?

Someone please kick me in the butt so I do this!!
 

IrisRV

Well-Known Member
I'm so glad to see him calling it HPA dysfunction rather than adrenal fatigue.

The adrenal glands do not have little muscles. They do not get "fatigued".

They either respond properly to the brain signals...or they do not. What we have is not an adrenal problem, it's a brain problem.
Same here. The first CFIDS specialists I saw (the Hunter-Hopkins Center) were big on this hypothesis about 10 years ago. I haven't heard much since then, so I thought perhaps it had fallen by the wayside.

HPA axis dysfunction certainly seems likely in ME/CFS. I suppose the questions are where it fits in the chain of causality, are there treatments, and are those treatments effective if we don't get at what is causing the dysfunction.
Supplying hypothalamus, pituitary, and adrenal glandulars helped me immensely until other healing kicked in.
This seems like a good idea, but how do you know you are getting the right amount at the right time? Wouldn't too much of one and too little of another upset some balance and make things worse? Not questioning the effectiveness, just wondering how to make it work without making something worse.
 

Remy

Administrator
I suppose the questions are where it fits in the chain of causality, are there treatments, and are those treatments effective if we don't get at what is causing the dysfunction.
The hypothalamus is the hub for autonomic function. It's the crossroads between the brain and the body. It's not protected by the BBB so it can monitor and relay what is happening in the body to the brain and the brain can take action to maintain homeostasis.

Considering how our autonomic function is pretty much shot to crap, it stands to reason that the hypothalamus is a major player. The question still remains though. Why?

You can replace end hormones that are deficient. You can try to symptomatically manage conditions like POTS and OI. These treatments run the range from mildly effective to moderately effective, I'd say.

But is it possible to repair the damage? Well, I'd say yes because people do achieve remission. But it's awfully hard to manipulate, that's for sure.
 

Who Me?

Well-Known Member
I started with hypothalamus because like Remy says, it all starts there.

I figured if I could get that working better then other things down the line would function better.
 

Strike me lucky

Well-Known Member
The hypothalamus is the hub for autonomic function. It's the crossroads between the brain and the body. It's not protected by the BBB so it can monitor and relay what is happening in the body to the brain and the brain can take action to maintain homeostasis.

Considering how our autonomic function is pretty much shot to crap, it stands to reason that the hypothalamus is a major player. The question still remains though. Why?

You can replace end hormones that are deficient. You can try to symptomatically manage conditions like POTS and OI. These treatments run the range from mildly effective to moderately effective, I'd say.

But is it possible to repair the damage? Well, I'd say yes because people do achieve remission. But it's awfully hard to manipulate, that's for sure.

If you write down the functions of the hypothalamus , we can tick off so many that dont work. Also helps us explain why some peoples symptoms are diffetentvto others.

Is the hypothalamus permanently damage or temporarily damaged by ongoing inflammation/infections. I wonder if theres other hormones and neurotransmitters that we dont know of or how they affect down stream issues.

I think this is why many drs/researchers currently studying cfsme call it a neuro immune disorder. The hpa axis is apart of the neuro side of things. But theres something missing in this puzzle. I feel im at the point where theres nothing else for me to try unless i won lotto and could get ampligen. Id be pissed if that didnt work after spending alot of money on it??
 

Seanko

Well-Known Member
A big problem with coming up with a working ME/CFS hypothesis is multiple dysfunction of the immune. nervous & endocrine (hormonal systems). The systems do not work independently of each other.

It is very difficult to look at things in isolation because a small change in one area leads to a chain reaction which works its way throughout the body. Think of it as series of dominoes toppling.

For example an immune stressor eg a flu virus triggers subtle and not so subtle changes in levels of hormones, the autonomic nervous system, brain, blood flow. The body goes into sickness mode until the threat is perceived to have been dealt with.

With ME/CFS the body is over reacting to a perceived stressor. If this continues chronically over a period of time then the endocrine (including the HPA axis) & nervous systems break down.
 
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Cort

Founder of Health Rising and Phoenix Rising
Staff member
I'm so glad to see him calling it HPA dysfunction rather than adrenal fatigue.

The adrenal glands do not have little muscles. They do not get "fatigued".

They either respond properly to the brain signals...or they do not. What we have is not an adrenal problem, it's a brain problem.
"the adrenals don't have little muscles"....:joyful:
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Supplying hypothalamus, pituitary, and adrenal glandulars helped me immensely until other healing kicked in.
Isn't that something. Nancy Klimas is dead set against them (warns against a pathogen sneaking in from the animals) but I tried them numerous times early on. I knew they must work for someone because alternative docs I saw early on used them a lot. At that point, though, I think you could have poured ATP directly into my cells and it wouldn't have worked. I seemed to be impervious to treatments.
 
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Cort

Founder of Health Rising and Phoenix Rising
Staff member
I got some hypothalamus glandular and felt great until I didn't. About 4 pm I got very speedy and a headache. Thankfully it eased down. I have been saying now for how long I need to split the cap and take half?

Someone please kick me in the butt so I do this!!
:punch: :punch: :punch:
 

bobby

Well-Known Member
With ME/CFS the body is over reacting to a perceived stressor. If this continues chronically over a period of time then the endocrine & (including the HPA axis) & nervous systems break down.
that is what I think too. 'fixing' the HPA axis isn't gonna fix anything, cause it's not the core issue, it is an effect of something else going wrong.

@Remy What you say about the hypothalamus makes a lot of sense to me. I wonder if there is some sort of medication that could influence the hypothalamus?
 

Remy

Administrator
that is what I think too. 'fixing' the HPA axis isn't gonna fix anything, cause it's not the core issue, it is an effect of something else going wrong.

@Remy What you say about the hypothalamus makes a lot of sense to me. I wonder if there is some sort of medication that could influence the hypothalamus?
It's another million dollar question...Take a look at this article at Selfhacked...it explains CRF (corticotropin releasing factor) which is released from the hypothalamus and seems to be responsible for the dysregulation problems, in whole or in part. CRF mediates the hormonal and autonomic response to stressors. The bad news is there isn't any easy fix, so far. Anyone want to fall in love? ;)

http://selfhacked.com/2015/10/29/why-your-health-problems-worsen-after-stress-the-role-of-crh/

Galantamine is said to reset the HPA axis but I've never tried it to comment on it. It's used in Alzheimer's patients typically.

Cycloset is recommended by Jack Kruse to boost AM cortisol. It's a dopamine receptor agonist.

One of the cardinal features of environmental mismatches and altered epigenetic switches is a low dopamine level in the HPA. This results in an abnormal diurnal pattern of AM and PM cortisol and melatonin. It is often associated with a low vitamin D too. Low dopamine levels are seen in lower light levels and cause autumnal weight gain by the changes seen in the conversion of Vit D1 to D2 and to D3. Many people think dopamine is just tied to the reward of food when it is directly responsible for altered light cycles on the skin and at the eye in the SCN. This is how proper circadian signaling keeps our cells growth pattern normalized. This is also why obesity is considered the first step to cancer......step two is T2D, and the final step is cancer generation itself. They are symptoms of declining circadian signaling of dopamine in the brain. The worse your dopamine level the more likely it is for you to develop and epithelial cancer.
Cycloset was a disaster for me though. Later I found out that it can drop NE up to 50%. I felt like all the life drained out of me on this med (plus nausea) and it took me a long time to come back to baseline. Big disappointment.

When you take supplemental cortisol, it can turn off CRH through the negative feedback loop. But taking HC comes with it's own set of challenges, of course, too.
 
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bobby

Well-Known Member
You mean rx vs glandular?
I was just asking in general - I have no clue about any of the possible options... I also wonder why I haven't really heard a lot about any options to influence the hypothalamus... (but see Remy above)
 

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