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HPA axis: what is pregnenolone steal?

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Pregnenolone steal is not a term commonly used by medical professionals and doctors. Yet if described to them, they would happily admit that it is a real phenomenon that affects millions of people.

In fact, it affects every person (and especially every woman, since female hormones are more sensitive than male) who has ever been stressed.

In my bestselling book Sexy By Nature, I detail my own struggle with pregnenolone steal and how I ultimately overcame it.  You can check that out here.  I also have written extensively about other women’s hormonal issues, including PCOS, which you can read about here.

Pregnenolone steal is a problem because it is one of the primary ways in which the body can be physically handicapped by mental stress.

This is not good news for anybody.

Pregnenolone steal: the human stress response

The human response to a stressful situation occurs in two places.

First, it occurs immediately in the sympathetic nervous system. This increases heart rate, increases breathing rate, initiates sweating, dilates pupils, jacks up blood sugar, and inhibits digestion. It is the immediate “flight or fight” response. It’s largely a nervous system activity.

Second, it occurs in hormone form.

The hypothalamus, the “hormone command center” of the brain, decides to be stressed out, and gives marching orders according to its feelings.

Immediately, the adrenal glands respond by pumping out cortisol (the main stress hormone) and adrenaline. The secretion of cortisol is a fast action, but it is a bit slower than the first-up, lightning-fast reaction of the nervous system I described above.  It also endures for longer.  This is true especially if the stress doesn’t run it’s course quickly, for example, if you hate your job.

Cortisol has many of the same physiological effects as activating the sympathetic nervous system does, at least on the surface. It spikes blood sugar, inhibits digestion, and, importantly, puts a halt to immune activities.

Pregnenolone steal: why and how

So how does the body so easily produce enough cortisol to flood the system like this in times of need?

It steals it! Literally.  It “steals” pregnenolone. Pregnenolone is a precursor hormone. It is used by the body to make both stress and sex hormones. In times of stress, the body diverts a lot of the pregnenolone toward stress hormone production and away from sex hormone production.

This enables lots of cortisol production, but it inhibits the production of just about everything else.

Cholesterol is the mother molecule of the endocrine system. Mitochondria, controlled by the adrenals, convert cholesterol into pregnenolone.  From pregnenolone, virtually all of the rest of the hormones are produced.   From here, one of two things can happen:  the pregnenolone can be converted to progesterone or it can be converted to DHEA.  DHEA is the precurosor to all of the other sex hormones, at least those produced by the adrenal system.


This means that a stressful situation will steal all of the pregnenolone from its normal production of DHEA and shunt it into cortisol. The body will prefer this pathway to the detriment of all other adrenal pathways.

You might object to how detrimental I’m making this sound because you understand that most of the sex hormones are produced in gonadal tissue. This is correct! However, there are a handful of complicating factors that make what could have been the reproductive system’s saving grace ultimately problematic:

First: non-dominant sex hormones (such as testosterone in a woman or estrogen in a man) are often produced in the adrenal glands at higher levels than in the gonads. For example, the largest source of testosterone in the female body is the adrenal gland, even though a woman does produce small amounts of testosterone in her ovaries.

Second, the production of sex hormones in the adrenals is still important for the overall level of sex hormones in the body, particularly for achieving hormonal balance  The adrenal glands are capable of immediately responding to hypothalamic signalling, such that when the hypothalamus gets a signal that a certain hormone is too high or too low in the bloodstream, the adrenals can make up for the difference.

Third, certainly yes, the pituitary still exists to send signals to the gonads. But cortisol imposes negative feedback on the HPA axis. Cortisol signals to the hypothalamus to downregulate signalling to the pituitary.  So with cortisol in the system, the production of hormones in gonadal tissue decreases, too. This is the primary long-term pathway by which stress inhibits reproductive function.

Pregnenolone steal, therefore, is at face value a simple phenomenon:

The body gets stressed, and it shunts hormone production into pathways that are meant to be helpful in times of need.  There are levels of complications beneath this action, but in the end it boils down to– as so much of my work does– the fact that stress inhibits reproduction on a variety of fronts.

Stress can be managed, especially if it isn’t chronic.  For example, a good magnesium supplement or epsom salt bath can do wonders to help relieve stress.  Aromatic oils and even getting enough sunlight (or Vitamin D3 through a supplement) can also help.

If you have chronic stress and issues with fertility, it is worth looking into where and how you can cut stress out of your life.

You can read more about the effect of stress on health – a whole lot more – in my best-selling book on the topic, Sexy by Nature, here. In it, I describe how I personally overcame my pregnenolone problem and got my fertility, libido, and clear skin back.


So, just as a heads up - some links above may be my affiliate links, which means I get a small commission if you click on it and make a purchase. Doing so is no additional cost to you, but helps me tremendously. Your support is SO greatly appreciated, so thank you in advance if you choose to do so. Check out my entire disclosure to know exactly how things work.

Managing director of Paleo for Women and author of Sexy by Nature.


  1. Pingback: My Quest for Primal Fire (or Health) - Page 58 | Mark's Daily Apple Health and Fitness Forum page 58

  2. Ah! Such a needed blog post. You answered a lot of questions that have been simmering in the back of my head as I do more of my own research. The explanation of hormones from adrendals v. gonads especially cleared up a few things up for me. And the last paragraph is just reiterating what’s been becoming more and more important – better management of stress. It seems so obvious that life without stress is better, but we usually think of its management as optional. It’s also harder to quantify than diet and exercise management, so it gets left behind. Anybody who has spent considerable time improving diet and exercise without all the results they want has to know there’s another big component to health missing.

    It’s a hard realization, but I’m slowly but surely taking sleep, meditation and enjoyable (not stressful) exercise seriously. Also … feel free to laugh, because I’m doing it anyway … I’m experimenting with no sexual stimulation for a while. That’s right, not only no sex, but no masturbation. I can because I’m single and I’m desperate enough to see if it helps. The more I researched adrenal fatigue, the more I realized that maybe I needed to forgo orgasm for a while maybe just to heal and let my hormones restore themselves. This article also further convinced me it could be a good idea: http://www.herballove.com/article.asp?art=552

  3. Pingback: Paleo for Women | Low on Progesterone? Why Stress Reduction Might Be the Only Way to Hack It

  4. Okay, so I recently found out through lots and lots of blood work that my cortisol levels are like 100 times what they should be. Enough the lab called my doc and said we have never seen such results. So more tests were done with same result and also apparently my body has stopped making any pregnenolone at all. Again, a call to the doc from the lab, results were less than a trace. More tests. So, among everything else I am starting iodine drops for auto immune thyroiditis and pregnenolone suupplement and Vitamin D among other things. Does this sound right to you? I am not good at taking pills, any pills, and yet I am up to eight a day and as soon as I get the nerve up, the iodine drops, too. I just want to know, does this sound right? Everything you wrote sounds familiar and answered some questions but I have so many. I just want to feel… normal? Not sure what that is but it is my goal. I cannot exercise due to painful arthritis, I am 53 and starting to shuffle. I don’t want to shuffle. It has been four weeks since I had any grain, ANY grain and cut so far down on sugar but that is actually harder for me than all the grains. Am I doing this right? Should I take the pregnenolone supplement, iodine drops and so forth? Eeeek and thank you for any info you can pass my way.

  5. Pingback: Fawne Hansen ~ What Is Adrenal Fatigue? | Shift Frequency

  6. Pingback: On the Road to Cortisol Crazytown!

  7. have you considered trying reiki? A complementary therapy that chanels energy to bring balance and deep deep relaxation. This will naturally help to reduce cortisol and therefore be likely to help bring other hormones levels back into balance. No side effects.. Worth a try don’t you think?

    Zen Reiki Cambridgeshire UK

    Zen Reiki

  8. Pingback: Is it die-off or a flare-up? Or is the approach just not working? | Canaries in the Coalmine

  9. I am in stage 3 of adrenal fatigue. I want to start taking pregnenolone because nothing has worked for me so far. Is this the way to go? Any comments are greatly appreciated. Thanks

  10. Thank you for this great enlightening endocrine post! I suffer from a non uncommon but rarely diagnosed connective tissue disorder called (Hypermobile type) Ehlers-Danlos Syndrome, which seems to come with a comorbidity we’re finding all too common (once recognized also) called Mast Cell Activation Disorders, which can range from the more rare myelo-proliferative Mastocytosis (you have too many mast or “allergy” cells in parts of the body), and the newly recognized but very poorly known Mast Cell Activation Syndrome, which you are left with after ruling out Mastocytosis but the patient still suffers just the same as one with masto (often). (Mast cells are “allergy” cells that line the body’s tissues, prepared to ward off infections and invaders. Why you turn red at the site of a cut or bug bite from histamine production by MCs.) It is terribly hard to diagnose, as it’s not only poorly known, but there’s no single easy test for any of the forms and it is very individual in presentation. (Easy flushing red, itching, IBS – all forms/issues, nausea, hives, other odd rashes, increased IH headaches, so much more.) Anyway, leading MCAD researcher Dr. Theoharides has discovered that some mast cells line the hypothalamus in the brain, and when triggered (which happens too easily with all forms of MCAD – they are all trigger happy, whether you have too many or the “normal” number) activate the Hypothalamus to release CRH, thus activating the adrenals also. (I.e, having any form of MCAD lends to your stress levels and reactivity, worsening the cycle of adrenal fatigue.) All of my colleagues in our support groups (many) find we are very sensitive to stress which triggers mast cells also (flushing, etc.), and end up hyper-adrenergic from this and the excess histamine it also generates (when other mast cells join the party). And a large proportion of us find we are “POTSy”, and crave salt, which someone on another post indicated might be a sign of adrenal fatigue and “pregnenelone stealing” which led me here. We all struggle to keep our electrolytes balanced, often low potassium and sodium.

    You may have just given me an other piece of the puzzle that can help us to ameliorate some of this trouble. Btw, quercetin is a known mast cell stabilizer, which is why you’ll see it in many natural OTC allergy products. Eating low histamine and as “trigger-free” (for you) as possible (work with a naturopath to suss out your food and other sensitivities while maintaining optimal nutrition if can) helps us a lot, plus some anti-histamines for some. I’ll just add lastly that Dr. Theo also just tied MCAD to autism, which is commonly comorbid with ADD as I shared in my post here: http://ohtwist.com/2015/04/03/mcad-linked-to-autism-april-2015/

  11. I began treatment for pregnenolone steal 3 months ago ,and the results are nothing short of astounding!! Having energy is a novelty for me. Athough I was very stressed, it was the total lack of energy that was the most debilitating feature. And it is wonderful to finally be acne free after 25 years of it. It has taken 24 years of searching to find an explanation. Thank you for giving a clear description of how this occurs.

  12. I have chronically elevated cortisol level because of overtraining. Somewhen I trained very hard and stupidly and nowadays are problems. Cortisol should be morning 15-22 when I have 25. Testosteron schould be 2,5-8 and he is 1,5. And so this take yet 2 years for me. 4 months ago I understood my problem and changed completly my foods, added all vits, magnesium and omega 3,normalized stress, and try more sleep, but wake up in the middle of night and have problems to fall asleep.after 4months is maybe 10 percent better but to fully recover long road. Im very depressed how long can it take. I dont know how its stage of adrenal fatigue, I lifted weights around 3 years, 3years of stress. My symptoms are: low libido,loosing weight, low energy/strength,some brainfog, dizziness,increased resting heart rate, salty needs, headaches after working, muscle pains,feeling cold,dry skin, mood swings. Its all unnormal.Did anybody have something similar? Im depressed because I dont know how long time can it something take. Im only 20 years old, male and suicidal attempt after. Thanks for any helpful answer

  13. hyperactivity with ADD

    What do you think:

    ive learned pituatory relates to our spirit. when i get hyper…talk too much…with adreniline pumping…i feel a high from the adrenaline..but then a disconect from my calm spirit is what im left with. it takes a good 20 min to get re attached to my spirit and feel more aware of others. more aware of the real moment. more attractive to my friends and co workers. i hate tge hyper me that happens. it starts out happy about a topic and then a sort of overload occurs and multiple thoughts dump in and im talking too much…fleeting thoughts. pissing people off.
    adenals block pitituatory which blocks my spiritual alignment. perhaps my answer is figure out nutrtional and behavioral things that stop the adrenals from firing so much. look forward to suggestions.
    challenge. i crave stimulants to help with ADD slow brain processing which is dopamine related. adderal improved my brain power but it can trigger adrenals.excuse type o…using droid

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