Wired but Tired? The Hidden Physiology of HPA Axis Dysregulation

You wake up groggy. You crash mid-afternoon. And just when your body should be winding down for the night, your mind is wide awake. For many high-performing, health-conscious people, this daily loop of wired but tired isn't a willpower issue — it’s a physiological stress response gone unchecked. At the center of it all? Cortisol — your body’s primary stress hormone.

When cortisol is in balance, it helps regulate energy, inflammation, metabolism, and mood. But when it’s chronically elevated, cortisol can disrupt almost every major system in the body — from your gut and brain to your hormones and immune function.

Let’s break down how cortisol works, what causes it to spike, and what you can do (starting today) to bring your body back into rhythm.

Cortisol 101: A Key Player in the Stress Response

Cortisol is released by your adrenal glands in response to signals from the brain — specifically, the hypothalamic-pituitary-adrenal (HPA) axis. When you encounter a stressor, the HPA axis triggers a cascade that ultimately floods your system with cortisol to help you respond: increased alertness, elevated glucose for energy, and a temporary dampening of non-essential functions like digestion and reproduction.

Under normal conditions, cortisol follows a circadian rhythm:

• Peaks in the early morning (to help you wake up)

• Gradually declines throughout the day

• Reaches its lowest point at night (to allow for sleep)

But with chronic stress exposure, poor sleep hygiene, and a disrupted nervous system, this rhythm gets dysregulated — and cortisol can remain elevated well into the evening, keeping your body in a prolonged state of “fight-or-flight.”

Signs Your Cortisol Is Too High

The symptoms of high cortisol are diverse, because cortisol touches nearly every system in the body. Here are some of the most common clinical signs:

• Midsection weight gain (due to cortisol’s effect on fat distribution and insulin resistance)

• Insomnia or difficulty falling asleep, especially with a second wind in the evening

• Anxiety or mood reactivity, often with difficulty regulating emotions

• Muscle breakdown and fatigue, even with regular exercise

• Frequent illnesses, due to immune suppression

• Elevated blood pressure and blood sugar

• Irregular or absent menstrual cycles

• Brain fog, forgetfulness, or poor focus

  
  

Over time, persistently elevated cortisol can contribute to more serious dysfunctions, including HPA axis dysregulation, estrogen dominance, thyroid suppression, and chronic inflammatory conditions.

What’s Causing the Spike?

Elevated cortisol is often the result of multiple physiological stressors — not just emotional strain. Common contributors include:

• Blood sugar dysregulation (skipped meals, sugar/caffeine dependence, high-carb snacking)

• Sleep deprivation or circadian rhythm disruption (e.g., late-night screen use, irregular bedtimes)

• Overtraining (especially high-intensity workouts without adequate recovery)

• Inflammation or gut dysfunction (chronic GI issues, poor nutrient absorption)

• Psychological stress or trauma (particularly if unresolved or ongoing)

• Lack of parasympathetic input (your body stays in sympathetic “on” mode)

In How to Hack Your Stress Response, Dr. Barbara Johnson explains how stress isn’t just about what’s happening to us — it’s about whether our nervous system knows how to downshift. Without intentional support, many people live in an upregulated state, with their stress chemistry stuck in overdrive.

Evidence-Based Ways to Lower Cortisol Naturally

Cortisol dysregulation doesn’t require extreme interventions. In fact, it often responds best to consistent, foundational changes that realign your biology with its natural rhythm.

Here’s what the research — and clinical experience — supports:

1. Stabilize Blood Sugar Throughout the Day

Blood sugar crashes are a major driver of cortisol release. Aim for:

• Protein-rich, nutrient-dense meals every 4–5 hours

• Minimizing added sugars and refined carbohydrates

• Pairing carbs with fat and fiber to blunt spikes

• Limiting caffeine on an empty stomach (it triggers cortisol release)

In How to Naturally Balance Your Hormones, Dr. Johnson explains how blood sugar balance is a daily hormonal reset button. It not only reduces cortisol output but also supports thyroid, insulin, and reproductive hormone harmony.

2. Support Your Circadian Rhythm

Cortisol and melatonin work in opposition — when cortisol stays high into the evening, sleep suffers, and the whole HPA axis becomes dysregulated. Reset your rhythm by:

• Getting natural sunlight within 30–60 minutes of waking

• Reducing screen exposure after 8 p.m.

• Creating a consistent wind-down routine

• Avoiding intense exercise or high-carb meals late at night

• Using gentle adaptogens (like ashwagandha or phosphatidylserine) if clinically appropriate

3. Train Your Nervous System to Downshift

Because cortisol is regulated by the HPA axis and nervous system, any tools that activate the parasympathetic (rest-and-digest) response can help bring levels down. This includes:

• Mind-body therapies like meditation, tapping, breathwork, and somatic movement

• Polyvagal practices that activate the vagus nerve (humming, cold exposure, co-regulation)

• Therapy or trauma-informed care if past stressors are still unresolved

In her blog, The Solution to Your Anxiety is More Than Just a Pill, Dr. Johnson emphasizes how anxiety and stress physiology are deeply connected — and how healing is possible when we treat the body, not just the mind.

High cortisol isn’t a character flaw — it’s a survival mechanism working overtime. When we understand the science behind it and support our body’s natural rhythms, healing becomes not just possible, but sustainable.

You don’t need a perfect routine. You just need a consistent one. And the first step is listening to your body, not overriding it.

For more information on your hormones or hormone supplementation at The Johnson Center, click here to contact us. If you have any more questions about your path to optimal health, email our office at thejohnsoncenter@gmail.com or call 276-235-3205.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach locations. We also offer telemedicine for residents of Virginia and North Carolina!

🔬 Looking for an in-depth guide to nervous system regulation and hormone balance? Explore more at Dr. Barbara Johnson’s blog or download her hormone-balancing checklist here.