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Schematic overview of the hypothalamic-pituitary-adrenal (HPA) axis. Stress activates the secretion into the portal circulation of the corticotropin-releasing hormone (CRH) and other ACTH secretagogues (e.g., vasopressin) then, ACTH stimulates the adrenal glands to synthesize and releases norepinephrine and glucocorticoids, primarily cortisol. Glucocorticoids, in turn, act back on the hypothalamus and pituitary (to suppress CRH and ACTH production) in a negative feedback cycle.
