Is Your Nervous System Stuck in Fight or Flight?

In this solo episode, Dr. Mindy Pelz breaks down nervous system dysregulation and HPA axis dysfunction what it is, why so many women are stuck in chronic stress, and how it shows up as fatigue, anxiety, insomnia, belly fat, and mood swings. Drawing from a 2025 review in the American Journal of Medicine, she explains the six most common causes of HPA axis dysfunction and shares seven practical, science-backed ways to regulate your nervous system naturally. If you've felt wired, overwhelmed, or exhausted lately, this episode will help you understand why and what you can do about it. To view full show notes and resources, visit: 👉 https://drmindypelz.com/ep327 Join our community at: 👉 https://resetacademy.drmindypelz.com Please note our medical disclaimer.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:04Mindy Pelz?

  Dr. Mindy here, and I want to talk to those of you that are really affected by fatigue, depression, anxiety, insomnia, or challenges handling stress. Because this is not that uncommon, especially in this day and age. But what is important to know is that you actually have more control than you've been taught on how to overcome these symptoms. And it all falls under the category of nervous system dysregulation. And I know that sounds like some kind of fancy term, but I want to break this down for you because really, the technical term for this level of dysfunction that's contributing

• 0:46Mindy Pelz?

  to these symptoms is called HPA axis dysfunction. And there's a 2025 review in the American Journal of Medicine that really published this amazing review on an integrative approach to HPA axis dysfunction. How do you go from recognizing it to recovery? That's what we're going to unpack in this video so that you can start to feel better. Deal? Here we go. So first, I think we have to take a closer look, not only at this study, but we have to really look at what nervous system dysregulation is. And I think it's a really important conversation, especially in this day and age.

• 1:29Mindy Pelz?

  Because if you understand when you're dysregulated and you understand when you're regulated, you also understand how to boost your energy, boost your moods, sleep better. That's how important this concept is. So let's start off with what is nervous system dysregulation? It all comes to this part of your endocrine system called your HPA axis. H stands for the hypothalamus, P stands for pituitary, and A stands for adrenals. And this HPA axis, its job is to identify if there is a threat. So let's go back to our primal days. I've been teaching you all about the primal days for years now.

• 2:13Mindy Pelz?

  But the HPA access back in the hunter-gather days was meant to kick in when we had a threat. So if a tiger was coming after us, a lion was going to eat us, we had the signal from within to get up and move. And that signal is actually called cortisol. And a lot of you are working to bring your cortisol levels down. So what happens when this HPA access gets triggered is you see a threat. And your brain registers it as a threat. And then it sends chemical messengers down to your adrenal glands and says, "Make cortisol. We've got to move."

• 2:54Mindy Pelz?

  Now, remember that cortisol is the hormone that is meant to make you move, which is why it's so damaging. My belly fat people out there that I've been teaching you over and over again, like, "How do I help you see that belly fat can often be cortisol that is left unused?" Because cortisol is, when it comes on the scene, we're supposed to move. We're supposed to move away from the threat. But what happens with HPA access dysfunction is that this system, this alarm bell within our body, is on all the time. It's a very much, I used to teach my patients this all the time, that it was, it would be like you're driving in your car

• 3:38Mindy Pelz?

  and somebody has duct taped your gas pedal to the floor. And you are just going as fast as you can. And you keep trying to slam the brake, but the gas pedal is duct taped to the floor and you can't undo the gas pedal. That's what's happening with the HPA access. It's somewhere, and we're going to talk about six things that cause your nervous system to become dysregulated. But somewhere, this HPA access thinks it is still in fight or flight. It is still, the stressor is still there. And the damaging thing about nervous system dysregulation

• 4:20Mindy Pelz?

  Is that it can actually, you can feel it, you can feel the, the, the inner rumblings of it, just sitting on the couch, if you are stuck in this dysregulated place. So, let's talk about what the six most common causes of nervous system regulation, and hopefully you'll see yourself in this. So, first, what the 2025 reviews said is that these six things, when they are repeated over and over and over again, put you in HPA access dysregulation. So, first one is chronic stress. Now, I just want to say that chronic stress is like one of those things that everybody's like, "Yeah, yeah, I've got chronic stress."

• 5:04Mindy Pelz?

  But what happens with HPA dysregulation is that your nervous system forgets to turn off the fight or flight reaction. So, let's use this day and age right now. It's a tough moment in human history. We, we've got a lot of intense news being thrown at us every single day. I think most people right now are stuck in some form of nervous system dysregulation. And what's happening is that you get a wave of stress, and then you wake up the next morning, you get another wave of stress. So, all day long, your nervous system says, "We're gonna stay in fight or flight because safety is not around."

• 5:47Mindy Pelz?

  And all you're doing is going to your phone, and picking up your phone, and looking at the news, and re-agitating this nervous system. So, the first thing is that, to understand, is that you can be stuck, like the gas pedal on the floor, in a state of fight or flight, even though you're sitting comfy cozy on your couch in your living room, because it's what your brain is taking in.

• 6:17Mindy Pelz?

  And if you are continually stressed for a really long time, whether it's work, or relationships, or some other problem, that, you know, right now, it's world problems, that part of your HPA axis will start to weaken, and it never shuts off, and all your body is doing is making cortisol 24/7. So, chronic stress, chronic bad news, chronic obsession over the next thing you've got to, next mountain you've got to climb, or the next work problem you've got to fix, that keeps you in a dysregulated place. Second thing, and this one's really big, childhood trauma. And, and the crazy thing about childhood trauma

• 6:59Mindy Pelz?

  is something could have happened to you at five and six years old, and it's still got that gas pedal of the nervous system slammed to the floor. Because once your body has, a signal has been initiated that there is a trauma to run away from, you actually have to train it how to move out of that state. In the back half of this, this video, I, you know, I'll be talking about how you untrain it to start to see regulation and safety. This is an important part of this conversation. Now, with the, with trauma, I just want to use myself as an example, because I think we've all had lots of trauma in our life,

• 7:42Mindy Pelz?

  but I really experienced this recently when I was in Pacific Palisades, where the LA fires were. I rushed out, a lot of you have followed me through that journey, a lot of you have read Age Like a Girl, where I explain that journey in the intro. But I rushed out the morning of January 7th so quickly from this neighborhood I was living in, this neighborhood that I grew up in, and I never went back. And I, for months, my brain was caught in some kind of feedback loop where it felt like it needed to keep running.

• 8:21Mindy Pelz?

  It thought I was, for months, it thought I was still running from fire. And I literally had to go back to the Palisades two months after that event and so that my brain could see that the fire was over and that the town had been completely decimated so that my brain could start to move on. Same thing happens with childhood trauma, and I know we've all had a lot of different childhood traumas, a lot of it's, a lot of, especially the women listening, I just want to honor that a lot of you have had sexual abuse trauma, very common for women. Not everybody had the greatest adults growing up.

• 9:01Mindy Pelz?

  And we can still be stuck in fight or flight because your body thinks it's still running from that event that maybe hit you 20, 30 years ago. That's how strong the memory of the body is. And we're going to keep talking about this, so just as I walk through this. So, number three, reason, common cause of nervous system dysregulation is poor diet. So, this one is a really important one. Remember how we used to always say that, you know, people, certain people couldn't go and get Chinese food because it had monosodium glutamate in it and you would have an anaphylactic

• 9:44Mindy Pelz?

  shock, some people, if they ate Chinese food. And that, what we now know is certain synthetic versions of monosodium glutamate is actually a neurotoxin. And these toxins actually rev up your nervous system and move you out of a regulated nervous system and into a dysregulated nervous system. Which is why it's really important that when we are under times of extreme stress, the time we want to eat the worst food is actually the time we should eat the best food. Because if I'm under work stress, if the world is falling apart, if my relationships are falling apart, and then I go to ultra-processed foods.

• 10:28Mindy Pelz?

  There are so many chemicals in those foods that are neurotoxins, and it'll just rev up this HPA access and put you deeper into a state of dysregulation. What the study, the 2025 review, said is that a diet high in sugar and fat, this is bad fat, this is canola oil, cottonseed oils, can exacerbate a stress response and contribute to HPA access dysregulation. Chronic consumption of these diets has been shown to alter key stress hormones, leading to a sustained activation of the HPA access. Now, the study did go on, and I will backfill in with some of my own expertise,

• 11:12Mindy Pelz?

  is there are some deficiencies that these foods cause that actually keep you stuck in fight or flight even more. And you can supplement in with these deficiencies. So, three of the most important deficiencies that happen when food starts to, neurotoxins, let's just say, enter our nervous system, is it depletes you in omega-3s, magnesium, and B vitamins. So, making sure you backfill in with those supplements can be really helpful. I'll put in the notes, my favorite. Sometimes we have discount codes, and if that feels like something you want to access, you can go there. Okay, number four, your gut microbiome. And now, I've been saying this for a really long time,

• 11:56Mindy Pelz?

  but this study showed that dysbiosis, an imbalanced gut bacteria, can activate the HPA access, leading it to be in an altered stress response. So, and it continues and says, "Conversely, chronic activation of the HPA access can negatively impact your gut microbiome." Okay, so basically, what the review is saying is that if... I don't have a good, healthy gut microbiome. I can have a poor stress response. And when I have a poor stress response, I get too much cortisol into the system. And then too much cortisol gives me a worse gut microbiome.

• 12:41Mindy Pelz?

  So it's a feedback loop. This is why, and again, we're going to go through the solutions here. But this is one of the reasons that I'm such a fan of you all eating more plants, more fiber, more fermented products. Things that I wrote about in both Fast Like a Girl and in Eat Like a Girl. I have lists and recipes there if you want to dive into those. But who, put it in the comments. Like, do we ever think, God, I'm just exaggerating. I have these exaggerated stress responses. Or I'm walking around with depression and anxiety. It must be my microbiome. I just think this is one we don't talk enough about. And so if you want to learn more about it, put in the comments and I'll make sure to do more videos on it

• 13:25Mindy Pelz?

  because it's really critical. Okay, the fifth reason you can get stuck in this dysregulated place is hormones. And I talked about this in Age Like a Girl. When estrogen and progesterone goes down, you start to see a massive swing in neurotransmitters. In Age Like a Girl, I call it estrogen's girl gang. And so we have to understand that those hormones and neurotransmitters were like a buffer for stress responses. But if you, if you put this all together, if you're a 48-year-old woman right now that's looking at the news, trying to navigate the news, you've already had some kind of childhood trauma. You've had chronic stress.

• 14:08Mindy Pelz?

  Your microbiome's off from years of birth control use and antibiotic use and stress. And now your hormones are going down because you're going into menopause. This moment may feel like you can't even take it. And if you're one of those women, put it in the, in the comments because we are here to help you and to support you supporting yourself through this process. But, but that's what menopause does is it pulls those hormones down and then you feel a little raw and then stress hits you more acutely. Okay, number six, and this is one I did in my clinic all the time, is we detoxed people because toxins can also keep you locked in a state of dysregulation.

• 14:53Mindy Pelz?

  And some of the worst toxins for nervous system dysregulation is alcohol, smoking, recreational drugs. Those are biggies, but we detoxed so many heavy metals in my practice. I will tell you that heavy metals can also, like mercury is an agitator. And so mercury fillings, mercury in fish, if you're eating a lot of fish. Mercury used to be in flu shots. So if you're getting a flu shot, make sure it's thimerosal free, which is the fancy name for mercury. So when mercury's in the system, our nervous system's just a little more agitated. So if you add that to the list of things,

• 15:35Mindy Pelz?

  now you can see why handling stress is a little difficult and why it might not be your fault. It might be these six things are out of balance. Let's help to put them back in balance. So now, a lot of you might be listening to this and you might be thinking, okay, well, how do I know? And I've gone through this myself. A lot of times I've been like, is my stress response overly exaggerated right now? Or is this situation actually that bad? So here are five signs you would know you have a dysregulated nervous system. So the first is impaired stress resilience. And this is when even the littlest thing hits you and you have a major flare up.

• 16:20Mindy Pelz?

  And I really believe that this is a lot of the perimenopausal journey, that we are going through this massive neurochemical shift. And so the little things are going to make us really have a strong reaction and that is okay. Again, I want to help you figure out how to balance that. But I want you to be aware of it first. Okay, second thing, mood disturbances. So depression, anxiety, sudden irritability. You know, how many times have you had an irritable moment and you think it's your husband's fault? Or you think it's your work's fault? Or you're blaming it on the news? But actually, there's a HPA access, a nervous system that got stuck.

• 17:04Mindy Pelz?

  And it's like a record that just keeps repeating itself. So sometimes we need to look at those behaviors, those mood disturbances, not as things in my life aren't going well, or the world is falling apart, but we need to look at them more as like, what is, how did my nervous system get stuck? And how can I get it regulated again? I just did a beautiful podcast with my dear friend, Dr. Sarah Sazal, who is a Harvard educated OB. And we talked about this moment in wellness. As many of you know, the Epstein files came out, and Peter Attia was on the Epstein files.

• 17:47Mindy Pelz?

  And it shook the wellness world. And one of the things that we talked about in that podcast, I'll leave a link here, is how to spot a dysregulated person. And one of the things Sarah said is she could tell he was dysregulated because he was easy to agitate. He would get irritable on interviews. And he would try to control, and he would try to talk over people. He would try to give you absolutes, like you have to do this, or don't do that. That is a dysregulated mind. And so it was a really interesting conversation, if you want to dive into that. But mood disturbances aren't always a problem of the moment.

• 18:31Mindy Pelz?

  They could be an internal system that's locked in this dysregulated place. Okay, the third thing you would know if you are stuck in a dysregulated nervous system is that you would have chronic fatigue. So your brain uses a lot of energy, and it's exhausting to be on high alert all the time. And so the result is you can be exhausted from just trying to manage everything that's coming at you. Fourth thing is your immune system. You start catching colds a lot because chronic stress can bring, really suppress your immune system and then poor sleep, especially if you're waking up at 2 to 3 in the morning. Those are five pretty telltale signs that you're locked in this dysregulated place.

• 19:16Mindy Pelz?

  Okay, what do we do about it? Here we go. I'm going to give you seven ways you can balance your nervous system and get yourself back into a regulated place. And I just want to put this out right now. I think this is the best thing we can all do in this incredibly horrific moment in history. I think we need to commit ourselves to these seven things so we can regulate ourselves. Because what the world needs right now is regulated humans. It's massively important. So first is sleep. Now, it's kind of a juxtaposition because I just said if you're dysregulated, you can't sleep. And then I said to regulate yourself, you've got to sleep. So what does this look like? I think the first thing is prioritizing it.

• 20:00Mindy Pelz?

  And this is one that I'm recently coming off of because of the trauma that I went through over the last year. I've really, that's the last thing to get back on track has been my sleep. So prioritizing sleep to me means going to bed at the same time, waking up at the same time. So I've really shut down my social scene, my traveling, so that that's what prioritized sleep looks like to me is I'm going to bed at the same time and I'm waking up at the same time. Those of you that are menopausal just know there's a whole chapter in sleep on here that's really, really good. So you have resources there if you're having trouble sleeping. Couple of things I want to say

• 20:42Mindy Pelz?

  because if you are stuck in a dysregulated nervous system and the cortisol is just pouring into your system all the time, sleep can be really hard. So you want to make sure that the hours leading up to sleep, you're not watching any agitating news or shows so that that nervous system doesn't get reminded that it can't relax. So what you do going into sleep really matters. Try to create some sleep habits and a sleep environment that tells your body, think of it from your body's angle, tells your body that you can start to relax now.

• 21:19Mindy Pelz?

  Okay, second thing you can do, and this has been really helpful for me, is you can do adaptogens. I did a whole video here on ashwagandha, and you all loved it. And there's some incredible science behind how ashwagandha can bring cortisol down. I'm finding it very helpful for sleep as well. So what the science says is that you want to do 125 to 500mg twice daily of ashwagandha. And rhodiola rosea is the other adaptogen that science is saying can really bring down cortisol levels, and you want to do 200 to 600mg a day.

• 22:00Mindy Pelz?

  Again, we will put some of our favorite tried and true products in the notes, so you can go find it there. The third thing that could be helpful to pull you out of this dysregulated nervous system is magnesium and omega-3s. Again, poor diet, chronic stress, it starts to deplete you of these nutrients. When you're depleted of these nutrients, you start to be stuck in fight or flight. This is not good. So it's a self-fulfilling prophecy. So what the research says is that a good starting amount of magnesium is 400mg a day.

• 22:40Mindy Pelz?

  And the type of magnesium that will support a healthy nervous system is magnesium glycinate. So 400mg a day, I like to take my magnesium at night.

• 22:53Mindy Pelz?

  This review that I keep coming back to also recommends omega-3s for being able to get your nervous system regulated again. And the reason they say this is that the integrity of the membrane that surrounds your brain cells needs omega-3s. And if we've been eating a diet high in omega-6s, which is the ultra-processed diet, then we need even more omega-3s. So these are like your fish oils, or if, you know, I've done some videos on sardines, that was really popular. So even some of your healthy sardines and fatty fish, I try, for example, when I go out to eat, I always look for cod.

• 23:39Mindy Pelz?

  Wild-caught cod on the menu because it has a ton of omega-3s. Or I'll look for wild-caught salmon so that I can try to get it in through my diet. But the study said that people taking omega-3s daily for eight to 10 weeks helped regulate the stress response better than people who didn't take that level. So consistency matters and it can be a really helpful way. And you can get it through fish or you can get it in a supplement. Okay, fourth thing is exercise. And I think this one's really another self-fulfilling prophecy because we're like, I'm exhausted, I'm depressed, I have no motivation, and now you're telling me to exercise?

• 24:23Mindy Pelz?

  Well, it doesn't have to be, you don't have to like hire a fitness trainer and start a whole new exercise program. What the research shows is that you aim for 150 minutes of exercise a week. And that's about 20 minutes a day. And it seems to be a sweet spot for the nervous system. And what's interesting for those of us who have been dedicated to fitness our whole life is some of us are actually putting ourselves into a dysregulated nervous system because we're working out too much and too hard. So if you're going to use exercise to calm your nervous system, 150 minutes a week,

• 25:08Mindy Pelz?

  20 minutes a day, that could be a walk. A walk in nature, now you're stacking habits, you're bringing cortisol down even lower. And some of you who have been fasting a lot, you've been doing everything right. Like I know, I was that person, I'm often that person, like tell me I want to do everything right. We have to remember that like need to be perfect or the need to not mess up also locks the nervous system into this dysregulated state. So let's be playful about it. And 150, maybe you do 20 one day, maybe you do 15 the next, maybe you do 40 the next. Let's just get into a pattern of I'm going out to walk. I'm going out. You all know I love surfing. I'm gonna go out and surf.

• 25:53Mindy Pelz?

  I'm gonna go to the gym, whatever it is, to regulate my nervous system. I'm gonna go yoga, to yoga, to regulate my nervous system. That is a very different approach to exercise than just saying, "I'm gonna go to the gym to lose weight," or "I'm gonna go to the gym to stay in shape." So remember, the intention behind your movement activities really matters because some of you need to do less and you need to focus on regulation and how to regulate the nervous system through a less aggressive workout. Okay, fifth thing we can do, we talked about how diet took you, it put you in a dysregulated place. Well, you can use diet to regulate yourself.

• 26:36Mindy Pelz?

  And this study notes that there is this vicious cycle, like everything else, where a poor diet leads to more agitation of the nervous system. But over time, poor diet can also start to change your microbiome. You can, it can balance your nervous system quite a bit. So here are the big things you want to do with diet. You want to avoid the ultra-processed foods, especially right now in this moment. Avoid sugar, refined carbs, the bad oils like canola oil and vegetable oil. I mapped them all out in Eat Like a Girl. And you want to, and think of, think of food as having energy. So you want to add in some of the live food, which is really plants.

• 27:21Mindy Pelz?

  So try to get as many different greens as possible. Try to reach for an apple instead of a potato chip when you're under chronic stress, so that you're putting an energy into your system. An energy that's going to heal and help and balance you. Nature heals, and it heals when we look at it. It heals when we listen to it, and it heals when we eat it. That, we are so blessed to have nature around us all the time, and it's there for us not to conquer, or even just sit and enjoy. It's there to help us regulate our nervous system. That is the purpose of nature. So make sure that you're looking. Looking at it from not only a lens of going out into nature to calm the nervous

• 28:03Mindy Pelz?

  system, but eating nature so you calm the nervous system. Okay, sixth thing is meditation. Of course, we know this, as somebody who struggles to meditate, but I'm committed to it every morning, 15 to 20 minutes, I meditate every morning. Sometimes it is excruciating, sometimes it is easy. But what the study said is that meditation has a really positive effect on reducing cortisol levels. So, just like I showed you, it can be a series of things that lock you into a state of fight or flight. You might have to use a series of things to unlock you. Like, you might need to start eating better, you might need to start moving a little bit

• 28:44Mindy Pelz?

  differently, you might need to start prioritizing sleep, you might need to take some time in the morning to meditate. I do think, I can tell you for myself, as somebody who's committed to regulation, that I often, when I feel like I can't handle stress, I go back to these basics I'm giving you right now. And sometimes it's like, I just need to go back to slow, be more intentional with my eating, my moving, and how much I engage in thoughts that get me all wound up. And meditation isn't always about the moment, it's also about learning how to calm your mind, so that when you get to a stressful moment, you have access to that toolset. Okay, and then the last one is social support.

• 29:29Mindy Pelz?

  I think this is a really important one right now, as we all navigate this really difficult moment in history. We need to lean into each other. Community is incredibly important. And, you know, there is so much evidence that the happiest people are the ones that have the most positive relationships. This doesn't mean you have to have a romantic relationship, it can be a friend relationship. But studies are showing that really healthy social support, they call it "social buffering", can really help mitigate how stress comes into your body.

• 30:08Mindy Pelz?

  So, I can tell you for myself, this week, as I'm doing this video, I did this podcast with Sarah Sazal on the Peter Attia situation, which made me have to go into the Epstein files and read some of the things I never thought I would read. And out of that has come a lot of conversations with friends, especially friends who have been sexually abused. And it feels good just to talk about it. I learned this from Julie Gottman, one of the premier world marriage experts, that shame only persists in silence. And so if you're being triggered by the news of the day, find that good friend you can talk it out with.

• 30:52Mindy Pelz?

  A lot of the girlfriends I've been talking to this week are like, "I don't know what to do with how I'm feeling right now." I even had a friend call me and said, "I couldn't take..." She was sexually abused as a young child repetitively. And she's like, "I couldn't even take in all of the information that was being thrown out about the Epstein files." And so I ended up going to a bottle of wine. And she's like, "I'm really mad at myself for doing that." And so I just said to her, "Let's stay close. Let's stay connected as we all try to navigate the stress of the world right now." But when we look at dysregulation of a nervous system to regulation of a nervous system, it's really important that we understand

• 31:36Mindy Pelz?

  the nervous system was never meant for the gas pedal to be down all the time. And this is where the disease, this is where the mental health challenges, this is where the relationships fall apart, is when we haven't learned how to regulate ourselves. And my hope is in this particular episode, you are learning what the difference between dysregulated and regulated is, and you're getting a glimmer of how you can regulate yourself. Now, if you want a further discussion on this, come find me on Substack. I'm over there really diving deep into this. Leave questions, comments, stories here.

• 32:15Mindy Pelz?

  And understand that I strongly feel like we are a community. We can do this together. But it's really important to understand yourself so that you can understand other people. As always, I hope that helps.

• 32:30Mindy Pelz?

  Thank you so much for joining me in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love to know about it. So please leave us a review, share it with your friends, and let me know what your biggest takeaway is.