DiscoverCounselor Toolbox PodcastBiopsychosocial Aspects of HPSA-Axis Dysfunction (Thyroid)
Biopsychosocial Aspects of HPSA-Axis Dysfunction (Thyroid)

Biopsychosocial Aspects of HPSA-Axis Dysfunction (Thyroid)

Update: 2021-02-131


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Biopsychosocial Aspects of HPA-Axis Dysfunction


– Define and explain the HPA-Axis

– Identify the impact of trauma on the HPA Axis

– Identify the impact of chronic stress/cumulative trauma on the HPA-Axis

– Identify symptoms of HPA-Axis dysfunction

– Identify interventions useful for this population

Based on

– Post-traumatic stress disorder: the neurobiological impact of psychological trauma

Dialogues Clin Neurosci. 2011 Sep; 13(3): 263–278.

– Lifestyle Factors Contributing to HPA-Axis Activation and Chronic Illness in Americans

Archives of Neurology and Neuroscience. 2019 Oct.; 5(2) ANN.MS.ID.000608. DOI:10.33552/ANN.2019.05.000608

What is the HPA Axis

– Hypothalamic-Pituitary-Adrenal Axis

– Controls reactions to stress and regulates digestion, the immune system, mood and emotions, sexuality, and energy storage and expenditure

– The signs and symptoms of HPA-Axis dysfunction reflect a persistent, abnormal adaptation of neurobiological systems to trauma or chronic stress.

– In addition to trauma, multiple lifestyle factors have been associated with HPA-Axis dysregulation including

– Noise

– Stimulant use (caffeine, nicotine, ADHD medications)

– Insufficient quality sleep

– Media exposure

Consequences of HPA-Axis Dysfunction

– More than 50% of Americans suffer from one or more chronic conditions associated with disturbances of the HPA-Axis with an estimated cost of $3.3 trillion annually including:

– Major depressive disorder (20%)

– Generalized anxiety disorder (18.1%)

– Sex hormone imbalances (25%)

– Diabetes (9.2%)

– Autoimmune disorders (23%)

– Chronic pain

– Metabolic syndrome (30%)

– Cardiovascular disease (44%)

– Hypothyroid (4.6%)

– IBS symptoms such as constipation and diarrhea

– Reduced tolerance to physical and mental stresses (including pain)

Overview of Healthy HPA-Axis Function

– When exposed to a physical, environmental or social stressor, the HPA-Axis is activated and prompts the “fight or flight” reaction.

– Glutamate and Norepinephrine are released

– The hypothalamus releases corticotropin releasing factor (CRF) and arginine vasopressin (AVP) to stimulate the anterior pituitary to produce and secrete adrenocorticotropic hormone (ACTH).

– ACTH causes glucocorticoid (cortisol) synthesis and release from the adrenal glands

Overview of Healthy HPA-Axis Function

– Cortisol’s primary function is to

– Increase blood glucose and modify fat and protein metabolism to fuel the fight or flight reaction

– Modulate immune and brain function to effectively manage stressors.

– Cortisol initially causes a potent anti-inflammatory response which allows the organism to react to the stressor without being pain or fatigue.

– Glucocorticoids interfere with the retrieval of traumatic memories

– As cues of the threat wane, the body increases inflammation by releasing proinflammatory cytokines to accelerate wound healing

Stress Response

– The response of an individual to stress depends not only on stressor characteristics, but also on factors specific to the individual.

– Perception of stressor

– Proximity to safe zones

– Similarity to victim

– Degree of helplessness

– Prior traumatic experiences

– Amount of stress in the preceding months

– Current mental health or addiction issues

– Availability of social support

– Compared to positive events, negative events, or “stress” causes greater awareness and recall of event details leading to stronger encoding of negative or stressful events.









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Biopsychosocial Aspects of HPSA-Axis Dysfunction (Thyroid)

Biopsychosocial Aspects of HPSA-Axis Dysfunction (Thyroid)

Charles Snipes