If tired, foggy, losing hair, and feeling “off,” your body might be telling you something deeper is going on. One possible root cause? Adrenal insufficiency, dysfunction or dysregulation—often described in popular health conversations as adrenal fatigue. Actual adrenal insufficiency is a condition also known as Addison’s disease, and it may be due to pituitary gland deficiency of ACTH.
Currently those on GLP-1 hormones are found to have some similar symptoms, but this is not something that is specifically due to use of those diet medications or from dieting itself.
GLP-1 receptor agonists have been shown to stimulate the HPA axis, resulting in increased circulating cortisol and corticosterone in both rodents and humans. However, none of the cited studies directly measured DHEA or DHEA-S levels in response to GLP-1 so more research there is necessary.
🔬 What Is Adrenal Fatigue?
“Adrenal fatigue” refers to a state of hormonal depletion or imbalance driven by prolonged stress. Your adrenal glands—which sit above the kidneys—are responsible for producing stress hormones like cortisol, DHEA, or aldosterone and in some cases the effects can cascade into the sex hormones, testosterone and estrogen precursors. If these systems are constantly activated by physical, emotional, or toxic stressors, they can become dysregulated, leading to a cascade of symptoms including:
- Persistent fatigue, or just ‘feeling additionally tired’
- Poor recovery from exercise
- Low libido
- Brain fog
- Premature aging signs (skin laxity, thinning hair, weight gain)
🧪 The DHEA Connection
One of the most overlooked—and crucial—hormones in adrenal health is DHEA (dehydroepiandrosterone). DHEA is a steroid precursor, meaning it helps build other hormones like estrogen and testosterone. Its balance is essential for maintaining:
- Libido and sexual function
- Genitourinary health (e.g., vaginal dryness, atrophy, or VVA)
- Skin elasticity
- Bone density
- Mental clarity
- Muscle tone and cardiovascular endurance
- Hair growth (including pubic and axillary hair)
Low DHEA can present with a variety of vague symptoms, but one very visible early clue is loss of pubic hair—even before you notice scalp thinning or vaginal symptoms.
⚖️ Hormonal Imbalance Can Go Both Ways
Interestingly, both low and high levels of DHEA can lead to hair loss. In adrenal insufficiency or fatigue, DHEA is often too low. But in conditions like PCOS, DHEA may be too high, triggering androgenic effects like acne and scalp hair loss.
🧠 Brain, Breast, and Menstrual Effects
DHEA also interacts with the hypothalamic-pituitary-adrenal (HPA) axis—the control center for hormone signaling. This means imbalanced DHEA levels can affect menstrual cycles and fertility.
Additionally, breast tissue changes such as sagging, tenderness, or discomfort can signal shifts in adrenal hormones. Breast development in puberty starts before DHEA peaks, but in adulthood, these tissues remain sensitive to hormonal fluctuations.
👀 Pubic and Underarm Hair Loss = Hormonal Clue?
Yes. Loss of pubic or axillary hair may be one of the earliest visible signs of DHEA depletion or adrenal dysfunction. This is because DHEA stimulates androgenic hair growth in these areas. While scalp hair loss can occur due to thyroid issues, aging, or genetics, body hair loss is more hormone-specific and worth evaluating further.
If you notice thinning or patchy loss of pubic hair, even without vaginal symptoms or noticeable fatigue, talk to your healthcare provider. It may be your body’s first signal of an underlying hormone imbalance. Immediately post partum has a completely different mechanism and is evaluated differently.
💊 DHEA Therapy and Testing
Determining adrenal fatigue can start with cortisol and DHEA levels via blood testing. If the morning cortisol is normal you may have a mild case of adrenal dysregulation. In cases when the morning cortisol is under 5ug/dl then more complex testing is necessary. If you have low normal DHEA, replacement may still be indicated. In select patients, bioidentical DHEA replacement—either oral or vaginal, as there is no oral pharmaceutical product—can be used to relieve symptoms like:
- Vaginal dryness and atrophy
- Hot flashes
- Libido decline
- Mood instability
However, dosing must be personalized. Too much DHEA can shift the balance toward androgens, causing side effects like acne or hair shedding.
✅ conclusions
Adrenal dysregulation is real—and more nuanced than the outdated “adrenal fatigue” label suggests. Whether you’re noticing subtle changes like pubic hair loss or more systemic signs like brain fog and exhaustion, don’t ignore your body’s early warnings. Hormonal testing, especially of DHEA, cortisol, and testosterone, can provide essential insight. If you are treating hair loss, treatments will always be more effective if you can treat underlying causes.
