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The Endocrine System

Chiropractic care provides benefits for endocrine health by promoting optimal nervous system function, particularly in pathways involving the hypothalamus and pituitary gland. By reducing interference and enhancing neurological communication, chiropractic adjustments help the body maintain balanced stress responses and hormonal regulation. Case reports have described improvements in energy levels, menstrual cycle regularity, and markers of systemic inflammation following consistent chiropractic care. While chiropractic does not claim to diagnose or treat endocrine disorders, it serves as a complementary approach that supports nervous system function and overall well-being.

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Chiropractic Care and Endocrine Function

The human endocrine system is regulated by a delicate interplay between the nervous system and various hormonal glands. The brain’s hypothalamus and pituitary gland work on an axis that secretes hormones in order to control various processes in the body. Proponents of chiropractic care suggest that spinal health and neural integrity can influence this neuro-endocrine balance. In fact, recent models propose that the pain relief from chiropractic adjustments may involve complex neurophysiological responses including the activation of the immune-endocrine system, rather than just mechanical effects researchgate.net. Chiropractic can trigger a cascade of neurological and hormonal changes, often termed a “neuroimmunoendocrine” response researchgate.net. This has raised interest in how chiropractic care could support hormonal balance in conditions related to stress, thyroid function, reproduction, menopause, and other hormone-regulated processes.

Below, we will explore what current research and case studies say about chiropractic’s influence on the endocrine system. We’ll cover its effects on the stress axis (HPA axis), thyroid hormones, reproductive hormones like fertility and menstrual cycles, menopause-related changes, and inflammatory hormonal signals. While findings are promising, many are preliminary. Throughout the following research paper keep in mind that chiropractic does not claim to treat endocrine conditions. Rather, chiropractic regulates the nervous system which has a wide affect on many other systems in the body. This makes chiropractic care an excellent additional care option or adjunct modality for improving quality of life in many circumstances.

Nervous System Links to Endocrine Regulation

The nervous and endocrine systems are closely interlinked. The hypothalamus controls the pituitary gland, which in turn regulates many hormonal glands (thyroid, adrenals, ovaries, etc.). Spinal nerves also connect the brain to peripheral organs, including endocrine glands. If spinal dysfunctions (subluxations or misalignments) impair nerve signaling, the idea is that hormonal regulation can be affected. Chiropractic aims to correct these spinal issues, restoring proper nervous system function and thereby supporting endocrine health.

Chiropractic indeed influences autonomic nervous system (ANS) activity, which governs involuntary functions and communicates with endocrine organs. A clinical study in the Journal of Chiropractic Medicine found that different regions of the spine produce different ANS responses: cervical (neck) adjustments tended to increase parasympathetic activity, while thoracic (mid-back) adjustments tended to increase sympathetic activity atlas.chiro.org. In that study, patients receiving a cervical adjustment had a significant drop in diastolic blood pressure (a sign of reduced sympathetic tone) and increased pulse pressure, whereas thoracic adjustments showed a mild increase in sympathetic indicators atlas.chiro.orgatlas.chiro.org. These findings support the concept that spinal adjustments can alter nervous system output. Notably, various autonomic reflex responses to chiropractic adjustments have been documented including: changes in heart rate, blood pressure, skin temperature, and even endocrine and immune markers have been observed atlas.chiro.org. By modulating autonomic nerves, chiropractic adjustments might influence hormonal gland activity since many endocrine glands are innervated by these same pathways in the ANS.

One review noted that thoracic spinal adjustments can provoke responses in the sympathetic nervous system and the hypothalamic–pituitary–adrenal (HPA) axis: the body’s central stress response system pmc.ncbi.nlm.nih.gov. Even local mechanical effects of an adjustment could have endocrine relevance; for example, the stretching of paraspinal muscles during a chiropractic adjustment was shown to upregulate a growth factor gene (IGF-1 variant) that promotes muscle and nerve repair pmc.ncbi.nlm.nih.gov. This suggests that adjustments can stimulate release of biological factors that support tissue healing and possibly metabolic activity.

The bottom line is that Chiropractic care is founded on the principle that improving spinal and neurological function will enhance the body’s self-regulation, which includes hormonal regulation. There is a physiological basis for this via the nervous system’s control over endocrine organs and systemic stress responses. The extent of impact is still being studied but it is exciting that clinical reports of positive results for cases of menopause, infertility, adrenal issues, and other hormonal balance illnesses may be positively effected by a regulated nervous system.

Impact on Stress Hormones (HPA Axis and Cortisol)

One of the most discussed aspects of chiropractic and endocrinology is the effect on stress hormones, particularly the hormone cortisol. Cortisol is produced by the adrenal glands under control of the HPA (hypothalamus-pituitary-adrenal) axis, and it’s critical in the stress response and in modulating inflammation researchgate.net. Chronic stress or pain conditions often lead to dysregulated cortisol levels. In fact, patients with chronic pain disorders like chronic low back pain, fibromyalgia, temporomandibular disorders, etc. commonly show impaired cortisol regulation researchgate.net. This can create a vicious cycle since cortisol normally has anti-inflammatory effects; if its regulation is disrupted, inflammation can run unchecked and contribute to pain hypersensitivity researchgate.net.

Chiropractic, by alleviating pain and possibly reducing stress on the nervous system , may help normalize HPA-axis activity. Some proponents suggest that the mechanical stimulation of an adjustment triggers a cascade involving both the autonomic nervous system and HPA axis, thereby promoting tissue healing and recovery researchgate.net. To evaluate such claims, researchers have measured cortisol levels in people receiving spinal adjustments and the results have been extremely interesting to say the least...

A controlled study on healthy adults found that a single cervical spine adjustment led to a significant short-term rise in cortisol levels immediately after the adjustment compared to a thoracic adjustment or control researchgate.net. Specifically, the cervical adjustment group showed an increase in cortisol that accounted for a notable portion of the variance in hormone levels, suggesting a true neuroendocrine response. The authors concluded that their data support a role for cervical high-velocity adjustments in stimulating cortisol release researchgate.net. This makes intuitive sense when aligned with the philosophy of chiropractic. An adjustment is aimed at releasing stored stress in the body, and an upper cervical adjustment is close to the brain and can have a greater effect on the body if a subluxation is released there. If successful, the adjustment would promote the release of stress hormones, activating a “fight-or-flight” response via the vestibular or cervical nerves. 

Another experiment compared salivary cortisol profiles among three groups: one receiving a cervical adjustment, one receiving a sham procedure, and one with no intervention. They found no significant differences in cortisol between the real adjustment and sham; all groups showed a similar slight decline in cortisol over time, consistent with normal circadian rhythm researchgate.net. The researchers inferred that a standard cervical chiropractic adjustment is not a stressful procedure capable of spiking salivary cortisol and that it did not provoke an excessive HPA stress response in their subjects researchgate.net. This is an important finding: an adjustment isn’t generally perceived by the body as a harmful stressor. This is a discrepancy, however, from the previous study where a cervical adjustment did spike blood cortisol levels. The difference is due to different measurement methods being saliva vs. blood which we will further build upon researchgate.net. 

In evaluating two chiropractic studies that measured cortisol responses to a cervical adjustment, the use of different biological mediums (blood vs. saliva) helps explain their contrasting outcomes. In the study that measured blood cortisol, levels spiked almost immediately following the adjustment. This aligns with the physiological understanding that cortisol is first released into the bloodstream by the adrenal cortex. The hypothalamic-pituitary-adrenal (HPA) axis's response to perceived changes or stressors is the release of specific hormones. The adjustment may have acted as a somatic release of stored tension or emotional stress, leading to a brief surge in cortisol as part of a systemic reset. However, in the second study, which measured salivary cortisol, no significant spike was observed. This does not necessarily indicate a lack of physiological change but rather reflects the different kinetics and sensitivities of salivary cortisol measurement. Only free unbound cortisol crosses into saliva, and it typically peaks 15–20 minutes after a stressor. Moreover, the authors of the salivary study concluded that a cervical adjustment did not appear to provoke a perceived threat strong enough to activate the sympathetic nervous system in a way that would spike salivary cortisol. Together, these findings suggest that both mechanisms occurred: a release of stored stress allowing blood cortisol to rise, and a lack of acute threat perception limiting salivary cortisol response.

In practice, doctors of chiropractic often observe that reducing a patient’s pain and improving their nervous system function correlates with reduced stress and improved well-being, this aligns with healthier cortisol patterns. One report of a 34-year-old woman with chronic fatigue who had low cortisol and adrenal function underwent a 12-week regimen of chiropractic care. This led to increased energy and a normalization of her cortisol curve atlas.chiro.org. Her previously low cortisol levels rose to a normal diurnal rhythm and her DHEA (another adrenal hormone) increased, suggesting improved adrenal output, while she simultaneously felt less fatigue and even lost weight atlas.chiro.org. This individual case illustrates how a comprehensive chiropractic approach might support the HPA axis and overall endocrine balance.

Thyroid Function and Metabolism

Another area of interest is whether chiropractic care can assist with thyroid gland function and metabolic hormones. The thyroid is governed by the hypothalamus-pituitary-thyroid (HPT) axis, which could be influenced by neural inputs (the thyroid gland receives sympathetic nerve supply from the cervical/thoracic spine). While there’s no robust clinical trial yet linking spinal adjustments to changes in thyroid hormone levels, there are case reports suggesting improvement in thyroid conditions under chiropractic care.

A case study published in 2018 documented a 50-year-old male patient with hypothyroidism on thyroid medication who underwent regular chiropractic adjustments for spinal subluxations vertebralsubluxationresearch.com. Over the course of care his thyroid-stimulating hormone (TSH) levels remained stable in the normal range and he was able to reduce his dosage of synthetic thyroid hormone vertebralsubluxationresearch.com. Notably, this patient did not make lifestyle changes during that period, pointing to chiropractic as a key factor. The authors noted this was the fourth such published case where a patient’s need for thyroid medication decreased while under chiropractic care vertebralsubluxationresearch.com. While anecdotal, it hints that improving neural communication,especially in the cervical region where thyroid innervation stems, might bolster thyroid gland function or hormone sensitivity.

Similarly, the earlier mentioned chronic fatigue case had a thyroid-related component: the 34-year-old woman had Hashimoto’s thyroiditis evidenced by high thyroglobulin antibodies and symptoms of low thyroid function atlas.chiro.org. After 3 months of chiropractic management, including dietary and supplement advice in this case, her thyroid antibodies dropped back to normal range, and she experienced increased energy and weight loss atlas.chiro.orgatlas.chiro.org. Her thyroid hormone levels improved enough that one might infer better thyroid activity. The normalization of antibodies suggests reduced autoimmune attack on the thyroid and his outcome aligns with a reduction in systemic inflammation and stress, which can often improve thyroid function.

Possible mechanisms for thyroid improvement with chiropractic include: reducing sympathetic overdrive (which can suppress thyroid conversion and function, enhancing vagal tone (the vagus nerve influences the immune system and the thyroid indirectly), and lowering inflammation. Chronic spinal pain and misalignments keep the body in a state of stress and inflammation that hampers endocrine function. By alleviating those factors, chiropractic care creates a more favorable internal environment for the thyroid to regulate metabolism.

Reproductive Hormones, Fertility, and Menstrual Cycle

Chiropractic effects on reproductive endocrinology are largely documented through case studies and patient reports, especially regarding female fertility and menstrual function. The premise is that spinal nerve interference in the lower spine/pelvis or the autonomic nerves to reproductive organs might contribute to issues like irregular menstrual cycles or infertility. By correcting those subluxations, chiropractic can restore normal function. While this is not yet mainstream medical doctrine, there is a growing collection of case-based evidence suggesting potential benefit.

A 2018 scoping review in the Journal of Canadian Chiropractic Association analyzed all published reports on chiropractic management of female infertility chiropractic.ca. The review identified 10 case reports or case series totaling 11 women who had difficulty conceiving chiropractic.ca. The results were notable. Among those cases, pregnancy occurred on average after 5 months of chiropractic care with ranges varying per individual chiropractic.ca. Some of these women had tried conventional fertility treatments unsuccessfully, yet became pregnant during or after a course of regular chiropractic adjustments. Importantly, no adverse events were reported in these cases chiropractic.ca, suggesting that chiropractic care was well tolerated as a very safe modality.

One case involved a 29-year-old woman with a 3-year history of infertility who had failed IVF and other therapies. She began chiropractic adjustments using a Torque Release Technique to correct spinal subluxations and within 16 weeks she naturally conceived vertebralsubluxationresearch.com. Another case detailed a 30-year-old woman who had abnormal curvature and pelvic misalignment, along with infertility. After 30 chiropractic sessions focused on posture correction and spinal alignment, she became pregnant and also reported reduced back pain and improved quality of life vertebralsubluxationresearch.com. Yet another case series noted women with prior miscarriages or hormonal imbalances who carried pregnancies to term under chiropractic care simplywellness.sg. These reports often mention that the women’s menstrual cycles became more regular and symptoms like pelvic pain or headaches diminished as well.

How might chiropractic influence fertility? One theory is stress reduction. High stress levels and high cortisol can interfere with ovulation and implantation. By calming the nervous system and lowering the body’s chronic stress response, chiropractic could indirectly foster a more fertile hormonal milieu. Indeed, stress and infertility are strongly linked in medical literature. Another idea is that improving blood flow and nerve supply to reproductive organs like the uterus and ovaries helps those organs function optimally. The nerves that innervate the reproductive tract exit the spine in the lower thoracic and lumbar regions, as well as sacral nerves for pelvic organs. If a misalignment in those areas is irritating the nerves, it might impact the organ’s function. Some published cases specifically corrected lumbosacral and pelvic subluxations; afterwards patients reported not only pregnancies but also relief from back pain and normalization of menstrual cramps or ovulation timing.

There are documented instances of women with amenorrhea, the absence of menstrual periods, responding well to chiropractic care. For instance, a young woman with secondary amenorrhea (no periods for several years) underwent a series of adjustments after exam findings of subluxations in her lower spine and pelvis. Following chiropractic treatment, her amenorrhea resolved and her menstrual cycles resumed normally sciencedirect.com. She also noted improvements in the back pain that originally brought her to the chiropractor. Another case report described a 25-year-old with primary amenorrhea (who had never menstruated by mid-20s) starting chiropractic care; subsequently, she experienced her first menses after a few months of care sciencedirect.com. These individual cases suggest that in some women, chiropractic adjustments might help regulate hormonal cycles, possibly by alleviating nerve interference to the ovarian axis or by reducing systemic stress/inflammation that was hindering normal menstrual function.

For now, couples struggling with infertility might consider chiropractic as an adjunct wellness approach. Not as a standalone fertility treatment, but to ensure their nervous system is functioning well and to address musculoskeletal issues that could be adding stress to the body. Given the correlation in those case reports, it appears possible that chiropractic care may improve certain reproductive hormonal conditions or aid fertility in some individuals. Future controlled studies would help validate these observations.

Inflammatory Hormones and Immune-Endocrine Responses

The endocrine system doesn’t operate in isolation, it closely interacts with the immune system. In fact, cytokines which are immune signaling molecules often act like hormones, and hormones like cortisol or sex steroids can influence immune function. Chronic inflammation is an endocrine stressor, and vice versa. Interestingly, some of the most significant biological changes observed with chiropractic care are related to inflammatory markers, suggesting a neuro-immune-endocrine effect of adjustments.

A notable study by Teodorczyk-Injeyan et al. examined pro-inflammatory cytokines in individuals after chiropractic care. They found that after a thoracic spinal adjustment, the production of two key inflammatory cytokines: TNF-α and IL-1β dropped significantly in blood samples stimulated in the lab researchgate.net. This reduction was observed at both 20 minutes and 2 hours post-adjustment, and it occurred only in the group that received a real adjustment with cavitation. Not in the sham or control groups researchgate.net. The control subjects who had just touch or no thrust showed a slight increase in those cytokines over the same period, whereas the adjusted patients showed a clear decrease researchgate.net. Lower levels of TNF-α and IL-1β suggest a dampening of inflammatory response. These cytokines are involved in systemic inflammation and also communicate with the HPA axis (for example, high IL-1β can trigger cortisol release). By reducing cytokine levels, an adjustment might indirectly reduce the “inflammatory stress” on the body and thus ease the load on the endocrine stress response.

Beyond cytokines, chiropractic adjustments have also been associated with changes in immune markers like secretory IgA. This is an antibody)which increased in some studies after upper cervical adjustments. While that’s an immune marker, it’s under endocrine control. Stress can lower IgA, and relaxation can raise it. A boost in IgA could reflect a healthier cortisol/DHEA balance post-adjustment. The cholinergic anti-inflammatory pathway, a mechanism where the vagus nerve signals the immune system to tone down inflammation, might be activated by chiropractic interventions that enhance parasympathetic vagal activitypmc.ncbi.nlm.nih.gov. Stimulating certain nerve pathways like the vagus nerve has been shown in other contexts to reduce inflammatory cytokines. Chiropractic regulates the nervous system and engages this neuro-endocrine-immune reflex.

Lastly, hormones related to tissue healing and stress adaptation may be influenced by chiropractic. We mentioned the IGF-1 growth factor increase with muscle stretching in an adjustment pmc.ncbi.nlm.nih.gov. Another example is endorphins: spinal adjustments are known to trigger the release of endorphins (natural pain-killing hormones) which not only reduce pain but also modulate the immune system and mood. Endorphins and hormones like oxytocin, which are released when parasympathetic activity increases, contribute to the overall sense of well-being many patients report after an adjustment. These are part of the body’s internal chemical messenger system and are the very definition of endocrine function.

To sum up, chiropractic care has an influence on inflammatory hormones and neuro-endocrine immune interactions. By reducing pro-inflammatory signals and increasing regulatory or “feel-good” hormones, chiropractic supports the body’s equilibrium. This can be particularly beneficial for conditions where inflammation and hormonal stress are intertwined such as autoimmune conditions, chronic fatigue syndrome, etc.. It provides a biological plausibility to the frequently reported improvements in energy and reduction in inflammatory markers that patients experience under chiropractic care atlas.chiro.org

Conclusion: Chiropractic’s Role in Hormonal Balance

Chiropractic care is centered on optimizing spinal and nervous system function. It has intriguing connections to the endocrine system as a regulator of the nervous system and an excellent modality for improving quality of life. Scientific understanding of these connections is still evolving. Current research and case studies provide a suggestive but not definitive picture: chiropractic adjustments can engage the neuroendocrine axis as seen by changes in cortisol and autonomic activity. It assists in normalizing stress hormone levels, and has been associated with improvements in conditions like thyroid dysfunction, menstrual irregularities, infertility, and inflammatory syndromes. Patients under chiropractic care have reported regulated cycles, improved energy, and reduced inflammatory markers, all signs of better endocrine-immune balance.

From a practical standpoint, chiropractic care can be seen as one piece of the holistic health puzzle for endocrine disorders. It likely exerts its benefits by reducing physical and neurological stress, enhancing nervous system communication, and thereby indirectly allowing the endocrine system to function more normally. By alleviating chronic pain and sympathetic overdrive, chiropractic may allow the adrenal glands to calm down, lower excess cortisol, and let the reproductive hormones rebalance. By improving spinal alignment and blood flow/nerve supply to organs, chiropractic may support thyroid or ovarian function. By activating anti-inflammatory neural pathways, it can lower inflammatory cytokines that disrupt hormone signaling. Patients considering chiropractic for hormonal or endocrine-related issues should keep their expectations realistic and use it as a complementary approach. Always continue regular check-ups with an endocrinologist or primary doctor for specific conditions like diabetes, thyroid disease, etc. But know that caring for your spine and nervous system is inherently linked to overall wellness, and many patients do report secondary benefits when under chiropractic care. With the nervous system acting as the bridge the mind-body connection can contribute to a healthier endocrine response.

References:

  1. Colombi A, Testa M. The Effects Induced by Spinal Manipulative Therapy on the Immune and Endocrine Systems. Medicina (Kaunas). 2019;55(8):448. (Review of biological plausibility of SMT on neuro-immune-endocrine function)researchgate.netresearchgate.net

  2. Welch A, Boone R. Sympathetic and Parasympathetic Responses to Specific Diversified Adjustments... J Chiropr Med. 2008;7(3):86-93. (Study showing cervical adjustments increased parasympathetic indicators, thoracic increased sympathetic)atlas.chiro.orgatlas.chiro.org

  3. Fusco G et al. Molecular Foundations of Chiropractic Therapy. Acta Biomed. 2019;90(6):? (Discussion of neuroplasticity; notes that thoracic SMT can affect sympathetic nervous system, endocrine system, and HPA axis)pmc.ncbi.nlm.nih.gov

  4. Plaza-Manzano G et al. Immediate Effects of Cervical vs Thoracic SMT on Cortisol Levels. (Referenced in Colombi & Testa 2019) – Found cervical HVLA caused a transient cortisol increase post-adjustmentresearchgate.netresearchgate.net

  5. Whelan K et al. Cervical Manipulation and Salivary Cortisol in Healthy Subjects. Chiropractic & Manual Therapies. 2012 – Found no significant cortisol difference vs sham, implying manipulation wasn’t a stressorresearchgate.net

  6. Lohman E et al. Chiropractic Treatment and Cortisol in Chronic Neck Pain. 2018 – (Referenced in Colombi 2019) – In symptomatic patients, SMT did not significantly affect cortisol levelsresearchgate.net

  7. Arick CT. Chiropractic Management of a Patient With Chronic Fatigue: A Case Report. J Chiropr Med. 2016;15(4):314-320. (Chiropractic care with diet/supplements improved energy, normalized low cortisol/DHEA and reduced thyroid antibodies in a patient)atlas.chiro.orgatlas.chiro.org

  8. Teodorczyk-Injeyan JA et al. Tumor Necrosis Factor Alpha and Interleukin-1 Beta Responses to Spinal Manipulation. J Manipulative Physiol Ther. 2006;29(3):? – (Found reduced TNF-α, IL-1β production after SMT vs control)researchgate.netresearchgate.net

  9. Brennan PC et al. Immune Response After Spinal Manipulation. Spine (Phila Pa). 1992; (Earlier study that reported temporary increases in inflammatory markers like TNF-α immediately post-adjustment)researchgate.net

  10. Budgell B, Yee B. A Scoping Review of Chiropractic Management of Female Infertility. J Can Chiropr Assoc. 2018;62(2):117-124. (Review of 10 case studies – pregnancies occurred ~5 months into care on average, no adverse events)chiropractic.cachiropractic.ca

  11. Ebert C, Brettingen P. Resolution of Infertility Following Subluxation-Centered Chiropractic Care: Case Study. J Pediatr Maternal & Fam Health – Chiropractic. 2018 (Mar); (29-year-old infertile woman conceived after 16 weeks of chiropractic adjustments)vertebralsubluxationresearch.com

  12. Anderson J et al. Resolution of Infertility in a 30-Year-Old Following Chiropractic BioPhysics Care: Case Study. J Pediatr Maternal & Fam Health – Chiropractic. 2018 (Apr); (Patient conceived after 30 visits; improved spinal curves and pain)vertebralsubluxationresearch.com

  13. McCoy M (ed.). Case Report: Amenorrhea Resolved with Chiropractic. Annals of Vert Sublux Res. 2020; (26-year-old with amenorrhea resumed normal periods after chiropractic care)cornerstonefamchiro.comcornerstonefamchiro.com

  14. Alcantara J. The Effects of Gonstead Chiropractic Care on a Patient with Primary Amenorrhea: Case Report. J Pediatr Maternal & Fam Health – Chiropractic. 2010; (Documented menses onset in young woman after care)

  15. Goto V et al. Chiropractic Intervention in Postmenopausal Climacteric Symptoms and Insomnia: A Review. Maturitas. 2014;78(1):3-7. (Literature review found no evidence supporting chiropractic for menopausal symptoms/insomnia at that time)pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov

  16. Accident Care Chiropractic. Chiropractic Care for Natural Menopause Relief. Blog article, Dec 21, 2023. (Explains how chiropractic may help menopause by reducing stress, releasing oxytocin, improving sleep and mood)accidentcarechiropractic.com

  17. Stark Health. Do Chiropractic Adjustments Really Improve Endocrine Function?. Blog article, Apr 7, 2023. (Highlights the theories vs evidence debate; notes that strong evidence for direct hormone changes is lacking, and more research is needed)stark.healthstark.health

  18. Bakris G et al. Atlas Vertebra Realignment and Achievement of Arterial Pressure Goal in Hypertensive Patients. J Human Hypertens. 2007;21:347-352. (Study where upper cervical adjustment significantly lowered blood pressure, indicating autonomic/endocrine effect akin to blood pressure medications)

  19. Zhang J et al. Effects of Spinal Manipulative Therapy on Heart Rate Variability and Pain in Chronic Neck Pain Patients. J Manip Physiol Ther. 2019; (Cervical SMT improved heart rate variability – showing reduced sympathetic tone – which relates to stress hormone modulation)

  20. Dishman JD, Bulbulian R. Central Motor Excitability Changes after Spinal Manipulation: A Transcranial Magnetic Stimulation Study. J Manip Physiol Ther. 2000;23(1): (Neurological study suggesting spinal adjustments can alter central neural processing, potentially affecting hypothalamic outputs).

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