Laboratory, Endocrine, & Neurotransmitter Symposium

August 28-30, 2020

Bellevue, WA

Gain additional clinical insight and treatment considerations to evaluate some of the most prevalent and challenging conditions that patients present with, including depression, anxiety, altered mental focus and stamina, sexual dysfunction, sleep disturbances, addictions and dependencies, weight management, and chronic disease. Get notified when registration goes live!


Wellness Wednesday

Webinar Series

Belly Fat and Elevated Androgens in Women

By: Heather Hydzik, ND

April 1st, 2020

Join our clinical staff and special guests on the first Wednesday of every month at 9:30 AM and 12:00 PM PST. This free, live webinar series will cover a variety of neuroendocrine topics that will enhance your knowledge, with clinically applicable testing and treatment considerations.

In this month's webinar, you will review insulin resistance, metabolic syndrome and PCOS in women, obtain in-depth understanding of hormonal and metabolic pathways associated with elevated androgens in women, and learn about adipose tissue and its role in hormonal imbalance. Attendees will also obtain current testing and assessment strategies and learn successful treatment considerations to employ in practice immediately. Sign up today!


HPA Axis and Immunity: Why it’s a Good Time to Modulate Stress


By Ruth Hobson, ND | March 18, 2020

As the world braces itself for COVID-19, it’s almost impossible to avoid feeling a sense of fear. While toilet paper, hand sanitizer and food fly off the shelves and public events are cancelled, many are turning to their physicians for guidance during this time of uncertainty. The Centers for Disease Control and Prevention (CDC) guidelines for limiting exposure (social distancing, handwashing, wearing a mask, etc.) are excellent ways to decrease contact with viral threats. While this information is helpful there are still a lot of unknowns, which can create anxiety. Most have seen the “keep calm and wash your hands” gif created by the CDC, but the majority of people have disregarded a key component to this message. Keeping calm is one of the best natural defenses for immunity.

As functional medicine practitioners already know, the health of the HPA axis plays an important role in immunity. Salivary cortisol testing is a valuable tool for evaluating HPA access health, and can play an important role in evaluating one’s physiological preparedness to weather this pandemic.

The HPA axis orchestrates a symphony of actions when an individual encounters stressors. It’s important to note that stressors can be different things to different people. While most think of external things like deadlines or arguments as stress, internal stressors like food intolerances or perceived threats – real or imagined – can also activate the stress response. The HPA axis is designed to handle short term stress. Once activated, an immediate release of the catecholamines epinephrine and norepinephrine occurs. This surge enables the individual to get away from the threat. Next, cortisol spikes to control metabolic processes necessary to keep the individual moving away from the threat. This concept has been described as “running from the tiger,” the tiger being whatever stress one is encountering. Once the threat resolves, the HPA axis downregulates these signals and the individual returns to a homeostatic state. This response is a normal, healthy part of life. But what happens if no matter how hard or long an individual runs, the tiger always seems to be there, as the case seems to be for many living in the modern world? The HPA axis begins to show signs of dysfunction and can set up a host of health conditions including chronic inflammation, disrupted circadian cycles, and increases in mental health concerns. Dysfunction of the HPA axis can also lead to decreased immunity – very worrisome in light of the current pandemic.

Cortisol plays an important role in the development of immunity by influencing the release of cytokines. During an initial viral challenge, cytokines mediate the innate and adaptive immune response via pro-inflammatory cytokines and the activation of immune cells like macrophages. In addition to contributing to the development and progression of immune cells, the HPA axis exerts a negative feedback mechanism to suppress immune cell overproduction which can contribute to tissue damage.

Adaptogenic herbs, aptly named for their ability to help modulate the stress response, might be an important addition to your antiviral alternative medicine arsenal. This class of herbs not only works to boost the HPA axis, but many also have immune-boosting properties. Astragalus can reduce inflammation and increase the Th1 response during viral exposure. Licorice root, an herb with a long history of use to support HPA axis health, has been shown to inhibit SARS-coronavirus in vitro. But herbs aren’t the only modulators of HPA axis health with antiviral properties. Inflammatory markers have been linked to depressive symptoms and acute psychosocial stress. Mindfulness meditation, a common treatment for those with HPA axis dysfunction, has also been shown to modulate immune function of inflammatory cytokines, Tcells, and Bcells. Cognitive behavioral therapy (CBT) has been shown to improve symptoms of depression and anxiety and may also play a role in modulating inflammatory markers associated with the chronic stress response. 

Functional medicine doctors have many tools to help their patients feel prepared for the unknowns of the COVID-19 pandemic, both physiologically and emotionally. Evaluating HPA axis preparedness via salivary cortisol testing is a logical place to start optimizing the stress response which can contribute to a balanced immune response and a prepared mental state. Adaptogenic herbs and lifestyle strategies such as meditation and CBT can also contribute to a healthy HPA axis and immune response.


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2. Block KI, Mead MN. Immune System Effects of Echinacea, Ginseng, and Astragalus: A Review. Integrative Cancer Therapies. 2003;2(3):247-267. doi:10.1177/1534735403256419

3. Hoever G, Baltina L, Michaelis M, et al. Antiviral Activity of Glycyrrhizic Acid Derivatives against SARS−Coronavirus. Journal of Medicinal Chemistry. 2005;48(4):1256-1259. doi:10.1021/jm0493008

4. Thibodeaux N, Rossano MJ. Meditation and Immune Function: The Impact of Stress Management on the Immune System. OBM Integrative and Complementary Medicine. 2018;3(4):1-1. doi:10.21926/obm.icm.1804032



Disclaimer: All information given about health conditions, treatment, products, and dosages are for educational purposes only and do not constitute medical advice.