Depression is linked to disruptions in the body’s neuro-endocrine pathway, called the hypothalamic-pituitary-adrenal-thyroid (HPA) axis.

The HPA axis is a complex communication system between the hypothalmus, the pituitary gland, and the adrenal glands. . Although the thyroid gland and the reproductive glands are not mentioned in this term, our thyroid and sex hormones certainly play an essential part in maintaining the integrity of our neuro-endocrine system. Imbalances in any one or more of these glands can significantly impact on the rest of the communication system.

The hypothalamus is a region of the brain that controls an immense number of bodily functions including but not limited to emotions, behavior, pain and pleasure. It is the link between the endocrine and nervous systems

The pituitary gland is divided into two distinct portions: the anterior (front) pituitary and the posterior (back) pituitary portions.

The anterior pituitary produces six very important hormones. Each has a different and distinct function necessary for maintaining health and well-being. One hormone of special interest for the topic of depression is called Adrenocorticotropin. Adrenocorticotropin is responsible for stimulating the adrenal glands to produce DHEA and the well-known stress hormones called cortisol.


What happens in the HPA axis ?

HPA Axis depression

When a person experiences stress, the hypothalamus sent a signal to the pituitary gland, which in turns produce a hormone called Adrenocorticotropin (ACTH). ACTH then stimulates the adrenal glands to produce more of its hormones including cortisol. Chronic stress can lead to an elevation of cortisol and a reduction of the “feel good” neurotransmitter serotonin. If we fail to manage the stress, this condition can eventually lead to adrenal exhaustion, during which the adrenal gland fail to product cortisol in response to ACTH stimulation, causing a decreased level of cortisol.

There have been numerous studies exploring the relationship between cortisol, serotonin and depression. As with many of the body’s physiological responses, balance is the key. Individuals suffering from depression often exhibit an inability to maintain a healthy balance in the neuro-endocrone communication system. Disrupted balance in the Hypothalamic-Pituitary-Adrenal axis may result in hormones and neurotransmitters levels higher or lower than the desired range for optimal functions and result in symptoms like depression, altered metabolism, anxiety, insomnia, low libido, fatigue, etc.

To successfully address depression, it is important assess your hormones and neurotransmitters level. These can be best determined by salivary and urinary laboratory testings. The results allow your physician to evaluate your neuro-endocrine function, and be in a better position to outline a tailored treatment for your unique biological make-up.

Compliments from Functional Medicine University.


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