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HPA Axis Dysregulation (Adrenal Fatigue)

HPA Axis Dysregulation is when there is a cortisol (stress hormone) imbalance in the body which has caused (or soon will cause) your adrenals to lose function. An experienced practitioner can help you support your adrenals and HPA axis naturally.

Adrenal Support Nutritionist Toronto

Adrenal fatigue is the more common but outdated term for this since we now know that the adrenals are not the only ones to blame. It is now called hypothalamic-pituitary-adrenal (HPA) axis dysregulation to accompany the entire pathway between your brain and your adrenal glands. We still refer to it as adrenal fatigue out of habit. 

Are you a Type A personality? Over-achiever? Are your peers often confused how you do it all? If yes, your adrenal glands and nervous system may be in need of some assistance!

What Are The Adrenal Glands? 

The adrenals are two small organs that sit above your kidneys and produce adrenaline as well as steroid hormones like aldosterone and cortisol. They help regulate blood pressure, immune response, blood sugar and nervous system. Cortisol production is necessary and extremely helpful when under small bursts of stress. It’s when you are chronically stressed that problems arise. 


The diagram below by the Functional Diagnostic Nutrition ® School shows the progression of cortisol when someone is under chronic stress. The adaptation (green) phase is ideally where you want to be because this means your adrenals are functioning optimally and producing the right amount of cortisol. 


As stress elevates, you move to the acute (yellow) phase where your adrenals are over producing cortisol. Since cortisol blunts pain and reduces inflammation, many people don’t feel too bad in this phase. However, if this level of stress continues, you move into the compensatory (orange) phase which is where cortisol levels look normal but your adrenals are really starting to get tired. If you are in this "normal" range and don't have any symptoms then you are considered optimal (adaptation phase). Lastly, you move into the exhaustion (red) phase where your adrenals have become completely burnt out from producing so much cortisol that they can no longer function. This phase is when stress has been present for awhile and is known as adrenal fatigue. Severe symptoms like the ones listed below and mineral deficiencies are prominent here.  

What Does Adrenal Fatigue Feel Like?

HPA Axis, adrenal and cortisol dysregulation
Functional Diagnostic Nutrition

Extreme Fatigue 

Sleep Issues



Strong Cravings (especially sugar, salt) 

Low Libido 

Poor Memory 

Skin Issues 

Digestive Issues



Wired & Tired


Cortisol is a hormone that when dysregulated, the rest of your hormones and systems can’t function properly either. It steals progesterone, shuts down digestion, suppresses the immune system and thyroid function, disrupts the mucosal barrier, causes blood sugar imbalances and so much more. 

How Do I Test Cortisol and Adrenal Fatigue? 

There are two functional tests we recommend often in our practice for clients dealing with adrenal fatigue. First, the DUTCH dried urine hormone panel will show us your adrenal hormone levels (with metabolites) and tell us which stage of HPA axis dysfunction you are in. We will be able to analyze your cortisol/cortisone progression graph like the one above and correlate it with your condition/symptoms. This gives us multiple cortisol and cortisone (inactive cortisol) markers throughout the day so we get more info in to your CAR, blood sugar, adrenal health and overall circadian rhythm. This is far more beneficial than looking at the one cortisol blood marker your medical doctor would do. Second, we may use a Hair Tissue Mineral Analysis test to look at nervous system, metabolic state and mineral depletion which are all key components to adrenal fatigue. This will allow us to implement nutrition strategies and natural techniques to improve your stress response and reverse adrenal fatigue if present. 


Stress is unavoidable in today’s society with all the environmental toxins, inflammatory foods, stimulants and our overall high paced lifestyle. However, there are ways to minimize the impact stress has on us. 

How Do You Minimize Stress? 

  • Identify and reduce your Mental/Emotional Stressors (fear, relationship conflicts, lack of purpose, big life change etc.), Physical/Biochemical Stressors (trauma, fractures, poor posture, digestive distress etc.) and Chemical/Biochemical Stressors (inflammatory foods, pesticides, EMF, radiation etc.)

  • Learn how to say no & eliminate unnecessary commitments 

  • Stop procrastinating and make a task list everyday 

  • Clean up your environment and declutter your work space

  • Practice mindfulness and do one thing for yourself everyday

How Do You Improve Your Stress Response? 

  • Eat enough nutrient (especially mineral) dense foods

  • Daily movement

  • Aim for 10 hours of sleep / night & get to sleep by 10pm

  • Practice mindfulness & positivity

  • Learn how to truly relax

Absolutely! Internal and/or external stress is one of the main root causes of acne as it's very inflammatory and disruptive leading to excess sebum production. The most common ways we see stress cause acne are through insulin and hormone/digestive issues. When cortisol rises, blood sugar rises followed by a sudden crash. This blood sugar dysregulation can increase 5a reductase activity which increases DHT, thus increasing sebum production and acne. Secondly, when someone is chronically stressed, their progesterone levels are going to fall and estrogen is going to rise. This imbalance in sex hormones alone can trigger acne. And it doesn't stop there. When stress is present for long periods of time, it will slow thyroid function which then lowers stomach acid production, weakens your immune system and causes intestinal permeability. Once these gut barriers are down, you are a lot more susceptible to bacterial overgrowths and parasites/yeast overgrowths all leading to digestive dysfunction and potentially acne. It will be hard for your liver to keep up with the toxic overload from these infections because when your thyroid is suppressed from stress, your liver function slows down too. When your detoxification organs like your liver become sluggish, toxins will be released through your skin causing acne. 

How Does Adrenal Fatigue Cause Acne? 

A lot of people think that you always want cortisol to be as low as possible and then you won't experience acne. As explained above, low cortisol (adrenal fatigue) means stress has been present for a long time and your organs are failing. This comes with a lot of issues like mineral and nutrient depletion. When stress is chronic like this, the receptors in sebum producing cells become highly sensitized to the stress hormones released. This increases the production of sebum leading to acne. We also tend to see an increase in testosterone when people are suffering from low cortisol and adrenal fatigue, therefore increasing their risk of developing acne. Our adrenal fatigue clients often have a hard time retaining the nutrients needed to repair skin cells and keep their skin glowing. Remember, nutrient deficiencies are a primary cause of acne. Your skin is going to look similar to how you feel; dehydrated, tired and inflamed thus creating an acne prone environment. 

How To Fix Low Cortisol Acne? 

It's important to still work on minimizing stressors in your life and healing your stress response as mentioned above. Low cortisol does not mean you are not stressed and have a healthy stress response. It's quite literally the opposite. You need to add in more organ and mineral support when in this exhausted phase of stress. We often use an adrenal glandular from Ancestral Supplements and Mitolife shilajit in our shop to help revive people in this stage. We have seen adrenal elixirs and liver elixirs be very beneficial at restoring balance and improving skin health. It's important to work on repairing circadian rhythm simultaneously through optimizing sleep and light exposure. Lastly, we make sure to properly nourish their individual metabolism through food and maximize the specific minerals and nutrients they need most. 


Check our 1:1 membership with our nutritionist, to find out which phase of the HPA axis you are in, provide adrenal support, and create a plan to reduce both internal and external stressors in order to clear your skin. We offer online appointments for those in Toronto, ON and worldwide! If 1:1 isn't for you, check out our signature acne clearing program to get to the bottom of your health issues. 

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