Posted 2/5/2020 3:11 PM (GMT 0)
My functional medicine gynecologist talks a lot about how to fix the HPA axis. The implied first step is to remove any offending pathogens. A lot of people end up with HPA axis dysfunction as a result of Lyme, EBV, or any other serious illness. Sometimes you might hear it called adrenal fatigue, but no hormone system (e.g. the adrenals) gets out-of-whack all by itself. You can (and should) do all the things I mention below at any point in your treatment for other illnesses. And most of it is just common sense.
Adaptogens - ashwagandha, passionflower, rhodiola, eleuthero, licorice, holy basil, etc. You might need to try a few of these before you find one that's helpful, and start slowly (with a very low dose) in case they make you jittery or sleepy.
For folks with menstrual cycles - vitex (chaste tree)
Nutrients that are precursors to hormones - minerals, omega 3s, B vitamins, healthy fats, vitamin D, sufficient protein. Look into seed cycling if you are a person with a menstrual cycle.
Stress - Seriously, remove as much stress as possible. This includes inconsequential stress like suspenseful movies, and reading all the awful news every day. Divest from toxic relationships as much as possible. Let go of some of the expectations you set for yourself. Go to therapy if you have any history of trauma (spoiler: basically everyone does) because trauma can be a low-level stressor to your hormone systems, even if you are not aware of it or feel like you have dealt with it. Also, do things every day that make you laugh and bring you physical pleasure.
Mindfulness, meditation, yoga, mind-body work, breathing exercises - Do these things. They are not suggestions. Even if you just fire up a guided visualization exercise for five minutes on YouTube, make sure you fit it in.
Sleep. At least 8 hours per night. Use melatonin or another sleep aid if you need it, and sleep alone if necessary. This is important. Your hormone systems will not be in balance if you do not sleep enough.
Exercise - Gentle exercise is the name of the game, nothing strenuous until your adrenals are fine again. Walking, yoga, pilates, etc. Make sure you move each day, even just to stretch.
If you reassess after a few months and are not better, then try an adrenal glandular supplement. I like the safety profile of Dr. Wilson's Adrenal Rebuilder. If an adrenal glandular does not help, then consider supplementing hormones.
Supplementing hormones should not be the first thing you try! But this is the Western medicine view, and what an endocrinologist or conventional gynecologist or PCP would tell you to do. They also might recommend an antidepressant. These things might help you feel better in the short term, but they will not address the problem. That said, sometimes it's okay to opt for potential symptom relief and deal with the underlying problem later if you feel like you have other priorities. Go with bioidentical hormones if possible.
It's good to know the levels of all of your hormones, through testing (T1, T3, T4, FSH, cortisol, testosterone, estrogen, progesterone, pregnenolone, DHEA, etc.) before you consider supplementing hormones. Tests that take samples over the course of a few days are best because these vary so much over time. For some, the symptoms of a low level and a high level are the same, so it can be tough to know whether your body is making too much or too little just based on symptoms alone, and you would not want to add a hormone of which you're already making too much. This is why adaptogens are so helpful - they raise what needs to be raised and lower what needs to be lowered.