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These may include lack of sleep, smoking, food intolerances, diets high in sugars and processed foods, excess alcohol intake, and hormone or immune imbalances

Should you simply take B12 to prevent a deficiency

(2022) 30:84862.e7

Another important hormone, such as cortisol, exerts a positive effect on gastric ghrelin secretion (64), which seems to depend directly on cortisol itself and not on CRH or ACTH, since although plasma ghrelin concentrations increase in response to stimulation by ACTH (induced by stress or after exogenous ACTH administration), when metyrapone (which blocks cortisol synthesis) was administered, ACTH increases but plasma ghrelin levels decrease (64)