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It is thought that the stress response is principally coordinated by hormones of the hypothalamic-pituitary-adrenal (HPA) axis, however strong correlations between stress-induced alterations in these hormones and mental illness are lacking, and not all effects of chronic stress can be simulated with exogenous administration of HPA hormones (9, 10)

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This review offers the readers a broad perspective on the topic on ME/CFS, with a particular emphasis on the interplay between the gut microbiome and disease mechanisms