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HPA Axis Dysfunction and Miscarriage

Updated: Nov 29, 2023

After miscarrying, women often find themselves asking: "What did I do wrong?", "What caused this?", "What happened?" and are left feeling hopeless, confused, and wondering what caused their miscarriage to occur.

This is one of the more common issues I see in my patients

who have had miscarriages.

The HPA Axis is the system that regulates the stress response in your body. The Hypothalamic-Pituitary-Adrenal Axis (HPA Axis) involves communication between areas in the brain and the adrenal glands.

How does this communication work?

1. When your body responds to stress- your hypothalamus is taking in all of the information. It tells your pituitary gland 'RED ALERT- YOU ARE STRESSED'!

2. The pituitary gland sends a signal to your adrenal glands also saying 'HEY WE ARE STRESSED RIGHT NOW'.

3. Your adrenal glands respond by producing cortisol and epinephrine (aka adrenaline). This gives your body the energy to respond to the stressful event.

Why is this detrimental?

Short term stress is okay- like being nervous right before a presentation or when someone startles you, but long term stress can put a toll on the body.

This can affect your body’s natural ability to produce cortisol in a normal fashion. In healthy individuals, cortisol will be low at night and will spike right when they wake up in the morning. This increase will slowly taper off throughout the day.

You may have heard of Adrenal Fatigue before. What people really mean to call it is ‘HPA-Axis Dysfunction’ but they don’t fully understand the disconnect of communication between the brain and the adrenal glands therefore they call it ‘Adrenal Fatigue’.

Chronic stress can come from not only working too much, not getting enough sleep, or fighting with someone, but can also stem from underlying infections, hormonal imbalances, and/or nutritional deficiencies.

You’re probably wondering how this applies to miscarriages.

When the body is under ‘stress’ and is stuck in this constant loop of fight-or-flight, or constant stimulation to the HPA-Axis, other areas of communication in the body can become impaired.

Your body also has a HPG-Axis- Hypothalamic-Pituitary-Gonadal Axis. The same areas of the brain are involved as in the HPA-Axis, but communication is being sent to the ovaries/testes instead.

If there is constant stimulation down one pathway, it may take away energy, nutrients, and resources necessary for signaling the other.

Which means, if the body is stuck in fight-or-flight mode, the proper hormones may not be released from the ovaries- progesterone and estrogen, and it may be difficult for a woman to get pregnant or maintain a pregnancy.

So what do we do?

We pinpoint what is causing the constant ‘stress’ in the body. This varies from woman to woman, so a thorough history and unique approach should be taken with each patient.

Cortisol testing is cheap and easy to perform and can give us an idea as to how your body is responding to stress. Addressing underlying stressors can help ability to #conceive and decrease risk of #miscarriage.

Work With Me 👇

If you are looking for preconception counseling, are having difficulty conceiving, and/or have suffered from miscarriage(s) you can click here to sign up with a complimentary 15 minute phone call with me. We can discuss your goals at that time and determine whether or not we will be a good fit for each other. We will discuss necessary nutrients, dietary options, as well as lifestyle and exercise programs catered to YOU specifically to help you reach your health goals.

About Dr. Zaremba

Dr. Zaremba received her bachelor's degree from Western Michigan University in Biomedical Sciences and minored in Chemistry and Psychology. She completed her doctoral training at Palmer College of Chiropractic. During her time in school, she took post-doctoral training through The Clinic on Disease and Internal Disorders (CDID) earning her a Diplomate from the American Board of Chiropractic Internists (DABCI).


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