top of page

Concussions and the Hypothalamic Pituitary Adrenal Axis

Concussions have been a hot topic in research, the sports world, and the medical community for decades. More and more individuals are becoming aware of the effects, symptoms and consequences a concussion will have on the body.

Traditionally, patients who suffer from a concussion are advised to rest, lay in a dark room, and take anti-inflammatory medications. We now understand that this is not the most effective method of healing for a concussion. This advisement was originally created based off the involvement of the endocrine systems in a concussion and the dysfunctional stress response that follows the injury.

The Stress Response

Immediately following a concussion, there is an acute activation of the hypothalamic pituitary adrenal axis (HPA axis). This axis is the brain’s direct communication with the body’s endocrine system, also referenced as part of the extended autonomic nervous system. (To learn more about the extended autonomic nervous system click here!)

After the initial injury, the body releases extremely high amounts of cortisol in response to the inflammation caused by the injury. However, this response is short lived; it typically lasts 24-48 hours following the injury. Once this activation and its acute response has passed, research has shown that the body’s serum cortisol levels become very low and the body has difficulty normalizing its own cortisol levels.

Why is this a concern?

Cortisol is a vital hormone to the body’s function and fundamental processes. As a result, when we have low cortisol, it can cause a variety of problems such as: orthostatic problems, sleep/wake cycle dysfunction, adrenaline surges, digestive problems, food absorption issues, blood sugar dysregulation and more.

Additionally, cortisol is one of the body’s prime fighting agents to inflammation. If the body has low cortisol, it cannot efficiently eliminate the inflammation and generate a proper immune response. This phenomenon causes a cascade of symptoms and syndromes to arise post-concussion.

Why is this advice no longer given to individuals suffering from a concussion?

When patients are told to lay down in a dark room and are given anti-inflammatory medications, this does help to reduce inflammation, yes! However, the original problem still exists. The body cannot adequately create enough cortisol on its own, and by laying in a dark room, the brain is removed from any beneficial stimulation that helps facilitate the healing process.

Therefore, the body’s fuel delivery system is impacted, its ability to respond to stress is deficient, its immune system is altered and there is a lack of stimulation. All of these factors negatively affect the brain’s ability to heal as well as limits its amount of neuroplastic changes. When addressing a concussion, it is very important to lower the inflammation present in the body, repair adrenal function, and help heal the areas of the brain damaged by the injury.

At CFNC, we are very familiar with a concussion’s affect on the brain, the autonomic nervous system and the HPA axis. We utilize movement, targeted rehabilitation, and therapies to help create positive neuroplastic changes to enable healing. We use supplements in conjunction with hyperbaric oxygen therapy, which is used to support the body’s immune system, adrenal system, and reduce global inflammation. At CFNC, we feel that it is of utmost importance that when dealing with a concussion or post-concussive symptoms, we address the body comprehensively by evaluating and treating ALL of the systems involved.


bottom of page