Stress and cortisol add-on

The hypothalamic–pituitary–adrenal (HPA) axis is a central neuroendocrine pathway whose primary function is the release of cortisol, the stress hormone. Dysfunction of the HPA axis can manifest as persistently elevated cortisol levels, an insufficient stress response, or disruption of the normal diurnal rhythm of cortisol. Prolonged elevated cortisol levels may result from repeated physical or psychological stress, genetic predisposition, or epigenetic factors such as early-life trauma.