A clinical and behavioral approach focused on optimizing the hypothalamic-pituitary-adrenal (HPA) axis function to ensure an appropriate and adaptive physiological response to stressors, particularly through the regulation of cortisol secretion. Effective management aims to prevent chronic cortisol dysregulation, which can lead to systemic metabolic, immune, and cognitive impairments. This is a crucial element of modern preventative health and wellness.
Origin
The concept is rooted in the work of Hans Selye on the General Adaptation Syndrome and the subsequent understanding of the HPA axis as the central neuroendocrine mediator of stress. The clinical focus on “management” acknowledges that while acute cortisol release is necessary for survival, chronic elevation or blunting is detrimental to long-term health. It is a key area of psycho-neuro-endocrinology.
Mechanism
The HPA axis initiates the stress response, culminating in the adrenal release of cortisol, which mobilizes energy reserves and modulates immune function. Management strategies often involve interventions that enhance the negative feedback loop, allowing the hippocampus and hypothalamus to effectively turn off the stress response once the threat subsides. Techniques like mindfulness and specific nutritional cofactors can support HPA axis sensitivity and resilience.
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