HPA Syndrome – Cortisol and DHEA – Examples of Importance


Let’s consider some of the numerous ways that cortisol and DHEA regulate your health.

Brain High levels of cortisol are lethal to brain neurons and seriously impair memory. Research suggests that excess cortisol production may set up the opportunity for conditions such as dementia and Alzheimer’s disease. Cortisol affects the hippocampus, the part of the brain that stores memories. If cortisol is elevated for prolonged periods, the hippocampus does not receive adequate glucose, which it desperately needs to function. Excess cortisol in the brain also slows nerve impulse transmission and can lead to the death of brain cells. In addition, excess cortisol inhibits a brain process critical to memory function called long-term potentiation—a specific communication of neurons.

Compensatory mechanism: One function of cortisol is to break down body tissues, if necessary, to make a steady supply of glucose available to the brain. Cortisol also breaks down body tissues to provide extra glucose to the muscles to help the body cope with stressful situations. However, if cortisol levels are elevated for prolonged periods, the result could be an accelerated catabolic state; the body breaks down its own muscle, connective tissue, and bones.

Glycemic Control: A major consequence of chronic stress is the impairment of glucose (blood sugar) control, also known as glycemic control. A steady and balanced level of glucose is critical to energy production at the cellular level. If you have an elevated cortisol-to-DHEA ratio, your sensitivity to the pancreatic hormone insulin decreases. Insulin helps control the amount of glucose dissolved in the blood and prevents blood sugar from rising to an unhealthy level. The body’s primary energy source becomes severely compromised when sensitivity to insulin is impaired. Your health deteriorates and, aside from common symptoms such as nervousness or fatigue, you might not even be aware of the damage underway.

Another concern related to poor utilization of glucose is called gluconeogenesis. This occurs when your HPA glands are forced to produce cortisol and your liver is forced to produce cortisone, a hormone with anti-inflammatory and immunity-suppressing properties. The liver’s production of cortisone is an adaptive emergency backup system that helps keep your body functioning. Unfortunately, excess production of cortisol and cortisone can destroy muscle tissue. Your brain needs a constant supply of glucose to control your body function via the nervous system. If necessary, your body will destroy heart muscle to get the glucose that your brain requires.

An analogy may be helpful in explaining this. Imagine that your body is a car. As a car, you normally travel at steady speeds. Suddenly, your fuel runs out. Your engine quits and you coast to a stop. Because you’re a car, you have no backup system. When the fuel is gone, you simply stop. Your body acts in a similar way, except that it has a backup system. When glucose runs out, your body coasts to a stop, but you have the backup process of gluconeogenesis. It continues to function, but at the price of living off its own “chassis.”

Immunity: An elevated cortisol-to-DHEA ratio harms the integrity of the body’s mucosal barriers. Mucosal barriers provide the body’s first-line immune defense against pathogens seeking to infiltrate the body’s internal environment. Mucous membranes, known as the mucosal barrier, line your body’s cavities and contain immune cells called secretory immunoglobulins. Secretory immunoglobulins are released to neutralize undesirable organisms, providing your body’s first-line immune defense. The mucosal barrier protects your body’s internal environment from pathogens that can enter through body cavities, such as the mouth and nose. Cortisol and DHEA direct immune cells called immunocytes that produce the secretory immunoglobulins specific to our mucosal barriers. When the ratio of cortisol to DHEA is elevated, the production of immunocytes—and secretory immunoglobulins—is suppressed, thereby compromising the body’s first-line immune defense.

The Chronic Stress Response also has a negative effect on another type of immune cell called a natural killer (NK) cell. NK cells have two vital jobs: destroying cancer and any infected cells, and protecting against chemicals, poisons, and other infectious agents. If NK cell activity is compromised, sooner or later disastrous consequences will likely occur. Chronic stress adversely affects other immune cells and chemical messengers. Interleukin 2 (an immune chemical messenger) and T lymphocyte (a class of immune cells) levels both decrease along with a decrease in NK cell levels.

Liver: The HPA glands play a major role in the liver’s ability to detoxify your body from heavy metals, chemicals, poisons, the by-products of infectious agents, and waste products in general. An elevated ratio of cortisol to DHEA impairs the function of detoxification pathways by inhibiting the activity and mobility of critical enzyme systems.

Metabolism: The HPA glands oversee the burning and distribution of fat, the metabolism of protein and its subsequent distribution to parts of the body in need of repair and regeneration, and the metabolism of carbohydrates to produce glucose. Do you know people with excess fat around their hips, thighs, or waist but are seemingly normal in weight otherwise? They may even be slender, except for those “problem” areas. Beyond making people uncomfortable about their physique, this kind of accumulation of fat is a telltale sign of HPA dysfunction, which impairs the body’s ability to burn fat.

Recovery: Under healthy conditions, cortisol levels follow a daily circadian rhythm, which means the levels fluctuate on a 24-hour cycle. Cortisol levels peak in the early morning, then gradually decrease over the course of the day, reaching their lowest levels around midnight. The movement of the sun dictates this rhythm. If cortisol levels are too high at night, the body is unable to “shut down” for its physical and psychic regeneration. A high level of cortisol at night inhibits the release of human growth hormone to repair the body’s tissues, a process that normally occurs while we sleep.

Sex hormones: The HPA glands play a major role in producing ovarian hormones. Through the effects of cortisol and DHEA, and in conjunction with hormones released by the pituitary gland, the HPA glands help “pace” the ovaries. Ovarian pacing means controlling the timing, distribution, and output of the female hormones estrogen and progesterone, which are produced in the ovaries.

Thyroid modulation: The HPA glands direct the function of the thyroid gland. If you have an abnormally high ratio of cortisol to DHEA, your thyroid output is diminished. In fact, HPA syndrome is often the underlying cause of hypothyroidism. Many misguided doctors waste their patients’ time and money—as well as their health—by focusing solely on the thyroid gland. The patient is often suffering from HPA fatigue, and treating the HPA syndrome would resolve the low thyroid. This illustrates the importance of a thorough and accurate diagnosis.

The above are just some examples that demonstrate the interdependency of the HPA glands with other systems and organs of the body. This is just the beginning. A seemingly infinite amount could be written about the vast influences of cortisol and DHEA on human health. What’s important is that you do everything in your power to manage stress—inside and out—and nutritionally support your HPAs to avoid HPA Syndrome. Healthy lifestyle choices and Functional Wellness are fundamental to achieving this goal.