THE HPA AXIS CASCADE
HOW CHRONIC STRESS DISRUPTS EVERY DOWNSTREAM HORMONE
CHRONIC STRESS STATE
HYPOTHALAMUS
⬆ CRH RELEASE
OVERACTIVATED
CRH
PITUITARY
⬆ ACTH RELEASE
OVERSTIMULATED
ACTH
ADRENAL
GLANDS
⬆⬆ CORTISOL
⬆ Blood Sugar
INSULIN RESISTANCE RISK
⬇ Sex Hormones
PREGNENOLONE STEAL
⬇ T4→T3 Conversion
THYROID IMPAIRMENT
⬆ Inflammation
IMMUNE DYSREGULATION
NEGATIVE FEEDBACK BLUNTED
MEASURED BY
DUTCH
Plus Test
Cortisol curve
4x daily
RESTORED STATE
HYPOTHALAMUS
CRH REGULATED
RHYTHM RESTORED
PITUITARY
ACTH NORMAL
PULSATILE RHYTHM
ADRENAL
GLANDS
CORTISOL ✓ RHYTHM
✓ Blood Sugar Stable
INSULIN SENSITIVITY NORMAL
✓ Sex Hormones Balanced
PREGNENOLONE AVAILABLE
✓ Thyroid Converting
T4→T3 PATHWAY OPEN
✓ Inflammation Resolving
IMMUNE FUNCTION INTACT
NEGATIVE FEEDBACK INTACT
CORTISOL RHYTHM — 24hrs
6am
12pm
6pm
midnight
Optimal rhythm — CAR + diurnal decline
Flat/dysregulated — HPA dysfunction
Measured on DUTCH Plus · 4 urine samples
DETECTIVE HEALTH · STEPHEN DUNCAN MSC FDN-P · TEST, DON'T GUESS