An Integrative Approach to HPA Axis Dysfunction: From Recognition to Recovery.

The hypothalamic-pituitary-adrenal (HPA) axis plays a central role in the stress response and is implicated in a wide range of chronic health conditions. This review explores evidence-based perspectives on HPA axis dysregulation, its pathophysiology, diagnostic strategies, and integrative therapeutic approaches. Key contributing factors include psychological stress, genetic and epigenetic influences, dietary factors, gut health, immune system interactions, inflammation, toxins, and hormonal influences. Diagnostic methods such as serum cortisol levels, diurnal salivary cortisol profiles, and other tests are outlined. Therapeutic approaches emphasize the importance of the patient-provider relationship, stress reduction techniques, lifestyle modifications, dietary interventions, supplements, adaptogenic herbs, and other integrative therapies. Understanding HPA axis dysfunction through an integrative lens fosters individualized care and bridges the gap between conventional endocrinology and functional models, empowering providers to support patients with often-dismissed symptoms of fatigue, insomnia, mood instability, and impaired stress tolerance.