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A Functional Medicine Protocol for Hyper Responsiveness Adrenal Dysregulation

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A Functional Medicine Protocol for Hyper Responsiveness Adrenal Dysregulation

Stress is a universal experience, and we're feeling its effects. According to the 2022 "Stress in America" poll by the American Psychological Association, 76% of Americans have experienced the health impacts of stress in the prior month. Chronic stress causes an increase in the body's stress response mechanism, leading to hyper responsiveness adrenal dysregulation. In this article, we'll cover what hyper responsiveness adrenal dysregulation is, its symptoms, causes, how to test for it, and a functional medicine treatment protocol.


What is the HPA Axis?

When you experience a stressful situation, your body responds with a stress response. A significant component of the stress response is the hypothalamic-pituitary-adrenal axis or HPA axis. It is so named because it consists of hormone feedback loops between the hypothalamus, the anterior pituitary gland, and the adrenal glands.

The HPA axis responds to stress by releasing hormones from the adrenal glands. Cortisol is the primary hormone released and is often referred to as the body's stress hormone. Other adrenal hormones released during the stress response include aldosterone, norepinephrine, and epinephrine, which you likely know as adrenaline.

These hormones regulate the autonomic nervous system, cardiovascular, metabolic, and immune functions, behavior, and reproduction in response to stress. In an acute stress response, this can result in increased blood pressure, rapid heart rate, dilated pupils, and blood being diverted away from digestive and reproductive organs and towards large muscles and the heart.

These functions make you more focused, stronger, and faster in the face of a life-threatening stressor so you can defeat or escape the threat. That's why the stress response is often called the "fight-or-flight" response. It's a survival mechanism.

When the HPA axis and stress response function optimally, your body experiences acute stress and immediately elicits the stress response. When the stress is resolved, the HPA axis returns your body's biology to normal in its non-stressed state. Severe or chronic stress often poses problems for the HPA axis.

What is Hyper Responsiveness Adrenal Dysregulation?

Long-term, chronic activation of the HPA axis leads to dysregulation of this intricate stress response mechanism. If you experience severe or chronic stress, the HPA axis remains activated, and your adrenal glands continue releasing stress hormones.

This results in chronic activation of the autonomic nervous system (ANS), cardiovascular, metabolic, and immune functions mentioned above. When these functions are activated in acute, short-term stress, they help the body survive. When they are continuously activated, as in the case of chronic stress, it causes dysfunction in these systems and breakdown of homeostasis, or balance, in the body.  

Hyper responsiveness adrenal dysregulation occurs when the HPA axis elicits too much release of hormones from the adrenal glands. Long-term high cortisol levels in the body lead to inflammation, obesity, insulin resistance, diabetes, osteoporosis, anxiety, and other conditions such as cardiovascular disease.

At the extreme end of the spectrum, chronic exposure to excess cortisol leads to the development of Cushing Syndrome.

Hyper responsiveness adrenal dysregulation also results in chronically activating the sympathetic nervous system, which is a branch of the autonomic nervous system. Activation of the sympathetic nervous system turns on the body's fight-or-flight stress response.

Long-term sympathetic nervous system overactivity leads to sleep disorders, cardiovascular disorders, diabetes, metabolic syndrome, kidney disease, depression, ulcerative colitis, anxiety disorders, and sexual dysfunction.

Signs of Hyper Responsiveness Adrenal Dysregulation

Hyper responsiveness adrenal dysregulation leads to many signs and symptoms, which are often general and may even be mistakenly attributed to another condition. Signs and symptoms include:

  • Weight gain, especially in the abdominal region
  • High blood pressure
  • Headaches
  • Dizziness
  • Blurred vision
  • Rapid heart rate
  • Arrhythmias
  • High blood glucose levels
  • Increased urination
  • Increased thirst
  • Excessive eating
  • Anorexia
  • Menstrual irregularities
  • Low libido
  • Easy bruising
  • Severe fatigue
  • Muscle weakness
  • Sleep dysfunction
  • Depression
  • Anxiety
  • Facial rounding (moon facies)
  • Enlarged fat pad on the back of the lower neck (buffalo hump)
  • Head hair loss in women
  • Wide purple-colored striations on the abdominal skin
  • Constipation
  • Digestive dysfunction
  • Hyperhidrosis (sweating too much)
  • Anhidrosis (not sweating enough)

What Causes Hyper Responsiveness Adrenal Dysregulation?

The most predominant cause of hyper responsiveness adrenal dysregulation is stress. Severe psychological and physical stress activate the body's stress response, which can remain activated if the stress isn't resolved or addressed, and results in the overproduction of adrenal hormones.

Other factors cause stress on the body and result in hyper responsiveness adrenal dysregulation. These include malnutrition, anorexia, pregnancy, obesity, chronic alcoholism, uncontrolled diabetes, major depressive disorder, sleep deprivation, and intense physical exercise. Overexercise is also often associated with another cause of hyper adrenal dysregulation: functional hypothalamic amenorrhea (FHA).

In addition to genetics playing a potential role, conditions that cause a hyper adrenal response include adrenal gland tumors, pituitary tumors, adrenocortical carcinoma, and pheochromocytoma.

Large doses of steroid medications can also cause hyper responsiveness adrenal dysfunction.

From a dietary standpoint, a Western diet (consisting of high amounts of refined carbohydrates and saturated fats and low amounts of fruits and vegetables) and caffeine intake are associated with an increased release of cortisol. High sugar intake is also associated with an increased Cortisol Awakening Response (CAR), which indicates HPA axis dysregulation.

Certain nutritional deficiencies are also important to note. Magnesium and omega-3 fatty acid deficiencies are associated with a hyperactive HPA axis. Vitamin D deficiency is also associated with dysregulation of the HPA axis.

Functional Medicine Labs to Test for Root Cause of Hyper Responsiveness Adrenal Dysregulation

In addition to a comprehensive blood workup, your functional medicine practitioner may order several functional labs to determine if hyper responsiveness adrenal dysregulation is responsible for your symptoms and identify an underlying root cause.

Adrenal Hormone Testing

The DUTCH Plus™ test measures sex and adrenal hormones and their metabolites. It also measures the daily cortisol rhythm and the Cortisol Awakening Response (CAR). For those who suffer from sleep disturbances, an insomnia cortisol sample is offered to measure cortisol levels at night. This provides valuable information about the HPA axis.

Micronutrient Testing

A micronutrient test is a valuable tool in detecting whether any nutritional deficiencies or insufficiencies are contributing to the root cause of hyper responsiveness adrenal dysfunction. The SpectraCell's Micronutrient Test measures 31 vitamins, minerals, amino acids, and fatty acids to assess overall nutrient status. This test includes the nutrients involved in hyper responsiveness adrenal dysregulation, including Vitamin D, magnesium, and omega-3 fatty acids.

Vitamin D testing, as offered by Doctor's Data, may also be run separately and is often performed with other routine blood tests.

Genetic Testing

The 3X4 Genetics Test + Blueprint Report offers information on 134 genes that provide insight into 36 health areas, including hormones. Based on the genetic information, a report is generated that provides personalized recommendations on nutrition, physical activity, weight management, and stress management to optimize health and well-being.


Functional Medicine Treatment Protocol for Hyper Responsiveness Adrenal Dysregulation

A functional medicine treatment protocol for addressing hyper responsiveness adrenal dysregulation always takes a patient-centered approach to improve health and well-being. A strong focus is placed on stress management and reducing physical and mental stress.

Mind-body therapies are wonderful ways to reduce stress and help the body cope with the effects of stress. These therapies reduce the sympathetic fight-or-flight response and reduce the levels of cortisol in the body.

In cases where overexercise, anorexia, or FHA contribute to the root cause, a more balanced approach to movement is encouraged, and therapies like talk therapy or cognitive behavioral therapy (CBT) are valuable treatment options.

Therapeutic Diet and Nutrition Considerations for Hyper Responsiveness Adrenal Dysregulation

A therapeutic diet and nutritional considerations for hyper responsiveness adrenal dysregulation include reducing processed sugar and caffeine and incorporating anti-inflammatory, nutrient-dense foods. Including fiber, protein, and healthy fats in all meals and snacks is also essential for getting enough energy and maintaining stable blood sugar levels.

Adhering to a Mediterranean diet is a healthy way to improve HPA axis regulation and improve blood glucose control. A Mediterranean diet includes seasonal fruits and vegetables, herbs, whole grains, legumes and beans, and healthy fats, especially olive oil. While the focus is on high-fiber plant-based foods, poultry, seafood, eggs, dairy, and red wine are also consumed in moderation.

Supplements Protocol for Hyper Responsiveness Adrenal Dysregulation

A functional medicine supplement protocol to address hyper responsiveness adrenal dysregulation tailors the recommendations to each individual's unique root cause. The following supplements are commonly used to address this issue. However, it's important always to follow the guidance of your healthcare practitioner.


CatecholaCalm™ is a supplement by Designs for Health containing Vitamin C, B vitamins, and magnesium, important nutrients in regulating the stress response. It also includes herbs, such as ashwagandha, valerian, passion flower, and lemon balm which are adaptogenic herbs known to improve catecholamine hormone metabolism. Ashwagandha is also well known for its ability to lower cortisol levels.

CatecholaCalm™ Recommendation

Recommendations for this supplement include taking 3 capsules per day or following the advice of your healthcare practitioner.


Omega-3 fatty acids are vitally important for overall health. They reduce inflammation, support cardiovascular health, improve brain function, and are also shown to regulate the HPA axis. They are an important consideration in supporting the body at any time, especially when inflammation and dysfunction in the HPA axis are present.

Omega-3 Recommendation

A recommendation for Omega-3 supplementation for reducing cortisol and inflammation includes 2.5 grams daily for 4 months.

Multivitamin Multimineral Supplement

A high-quality multivitamin multimineral supplement provides a broad base of important vitamins and minerals for optimal health. Finding a supplement, such as the Designs for Health DFH Complete Multi™ with Copper, that includes magnesium and zinc is a great way to address hyper responsiveness adrenal dysregulation. This multivitamin also contains Vitamin C and B vitamins to support the stress response.

Zinc is an important mineral for many functions in the body. It plays a role in growth, development, reproduction, and neurologic, immune, hormone, and gut functions. Zinc is also essential for regulating the stress response, making it an important consideration in the supplement protocol for adrenal dysregulation.

Magnesium is another vitally important micronutrient for optimal health and well-being. It is a mineral involved in more than 300 biochemical reactions in the body, which regulate many aspects of health, including muscle and nerve function, blood pressure control, and blood glucose levels. It is also vital for the stress response and HPA axis regulation. When it comes to magnesium supplementation, the oxide and sulfate forms of magnesium are not absorbed as well and are less bioavailable to the body than other forms of magnesium.

DFH Complete Multi™ with Copper Recommendation

Recommendations for this supplement include taking 2 capsules with lunch and dinner or following the advice of your healthcare practitioner.

Vitamin D

Vitamin D has so many benefits for the body. Vitamin D reduces inflammation, regulates glucose metabolism, and reduces cortisol levels. As discussed earlier in this article, vitamin D deficiency is associated with dysfunction of the HPA axis. If testing indicates a vitamin D deficiency, it may be included in your supplement protocol.

Vitamin D Recommendation

To raise blood levels of Vitamin D to normal, a "loading dose" is often necessary. A typical loading dose is 50,000 IU once per week for 2 to 3 months or 3 times per week for 1 month. After normal levels are achieved, a maintenance dose of 800 to 2,000 IU of Vitamin D3 per day is required to maintain optimal levels.

It's important to consider all sources of supplemental nutrients. For example, in this protocol, the multivitamin contains 1,000 IU of vitamin D3. So after the loading dose of vitamin D is achieved, the multivitamin may satisfy the daily vitamin D3 requirement, and an additional supplement may not be necessary. Continuing to monitor blood levels of vitamin D with testing will indicate whether the multivitamin is a high enough dose to maintain normal vitamin D levels.

When to Retest Labs for Hyper Responsiveness Adrenal Dysregulation

When it comes to retesting labs to monitor the treatment effectiveness in hyper responsiveness adrenal dysregulation, it is recommended to retest Vitamin D levels after 3 to 6 months of treatment with Vitamin D supplements. This time frame is also appropriate for retesting a Micronutrients Panel and adrenal hormones.



Chronic stress causes dysfunction in the HPA axis, which can lead to hyper responsiveness adrenal dysregulation. If you've experienced severe psychological or physical stress, you know how much it can impact your health.

Your functional medicine practitioner will suggest functional lab tests to identify a root cause for why you aren't feeling your best in order to provide an individualized treatment protocol that supports your best health.

A functional medicine protocol for hyper responsiveness adrenal dysregulation considers all factors contributing to your health picture, including stress, physical activity, and nutrient status. Treatments include lifestyle modifications, therapeutic dietary recommendations, and supplements to support your return to health and promote well-being.

The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
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