The hypothalamic-pituitary-adrenal (HPA) axis is central to homeostasis, stress responses, energy metabolism, and neuropsychiatric function. The history of this complex system involves discovery of the relevant glands (adrenal, pituitary, hypothalamus), hormones (cortisol, corticotropin, corticotropin-releasing hormone), and the receptors for these hormones. (Miller, 2018)
The hypothalamic-pituitary-adrenal (HPA) axis is an extremely sensitive physiological system whose activation, with the consequent release of ACTH and glucocorticoids, is triggered by a wide range of psychological experiences and physiological perturbations (stressors). (Armario, 2006)
The hypothalamo-pituitary-adrenal axis (HPA) is responsible for stimulation of adrenal corticosteroids in response to stress. (Keller-Wood, 2015)
Many painful conditions appear to be directly and/or indirectly induced, reduced or, in some cases, modulated by hormones. The interaction between depression and pain is complex; depressed patients were found to have altered pain perception, though many studies support a higher incidence of depression among chronic pain patients. Headache was one of the first painful syndromes to be considered mediated by thyroid hormones. A thyroid hormone imbalance may influence both inhibitory and excitatory neurotransmitter systems by decreasing or increasing the metabolic rate. (Aloisi et al, 2013).
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