HPA Axis
For children and young teens, what techniques have you used recommended for HPA-D treatment for stress reduction? I’ve helped kids learn meditation, but I’ve not had great success with some families who are already overwhelmed, and the child doesn’t have complete control over what they do. I’m encouraging lifestyle changes but would love to have something where kids see a quicker response. Perhaps bio or neural feedback.
Chris Kresser: Yeah, that’s probably a good option in some cases where the family situation isn’t conducive to meditation or...
When working with someone who has SIBO and HPA-D, I had understood from the SIBO point of view, in order to help the MMC, it’s a good thing to have four to five hours minimum between meals and 12 hours of no eating overnight, but then the HPA-D may need to support more frequent eating. How do you approach this, and what would be your advice as the SIBO is also likely contributing to the HPA-D? So is it just important to focus on getting rid of that first?
Chris Kresser: I don’t know how important either of those strategies is on an absolute level. I think it really...
Can you remind me of the length of treatment for HPA axis dysfunction? Is it based on symptom relief only, or do you retest DUTCH after a period of time?
Chris Kresser: I definitely retest DUTCH, and like the gut protocol, it depends on the extent of the issue. A...
For women who have anovulatory cycles and no LH surge on ovulation predictor kits, how do you accurately time DUTCH collection?
You don’t really worry about it so much in that case.
25-year-old female with anxiety and depression, which is a very cyclical pattern tied to her menstrual cycle. Can you suggest some lab tests to order in treatment to consider? She’s already on Vitex or chaste tree berry, eats Paleo, exercises, and sleeps well.
Dr. Amy Nett: Of course, if they’re cyclical, you’d probably want to look at hormone levels, and since you have...
I have two 30-year-old female patients. They’ve been waking up in their early morning hours around 2:00 to 4:00 a.m. and struggling to go back to sleep. Both have been eating a Paleo reset diet. One has struggled with sleep for years and hasn’t noticed any difference since changing to Paleo, and the other noticed many positive changes like decreased joint pain but has been sleeping much worse since starting the Paleo reset diet. Second part of the question: Both of these women are thin and closer to underweight more than overweight. In your experience, would your first step be to go towards investigating blood sugar regulation, HPA axis, or something else with these patients?
Dr. Amy Nett: A side note here, if one of your patients is sleeping worse since starting the Paleo reset...
I have a client who has PTSD from a dog attack three years ago. Nightmares are an issue. Wondering how she can get a good night’s sleep. She wakes up noticeably stressed. Anything specific you can suggest?
Dr. Amy Nett: PTSD, I would think about doing some therapies like EMDR, which is eye movement desensitization and reprocessing....
A 60-year-old female on bioidentical hormones. Last year had high TPO antibodies and went gluten-free, still ate dairy not Paleo. This year came back for fungal overgrowth on an organic acids test, decided to treat yeast with caprylic acid and RN Microbinate. But her vitamin A, D, and K came back deficient on SpectraCell, but her antibodies are normal. Do you frequently see when treating the yeast, TPO antibodies get better and with not absorbing fat-soluble vitamins? Any recommendations for gut to help absorption?
Dr. Amy Nett: TPO antibodies can fluctuate quite a bit, so I absolutely do see changes in thyroid antibodies with...
Do you have any information on Meridian Valley Lab? What does Chris look for in a lab to ensure high-quality testing? And who do you prefer for hair mineral toxic element analysis?
Amy Nett: Okay, so breaking these down a little bit. In terms of Meridian Valley Lab, they offer a few...
Woman coming in wants to prep herself for getting pregnant—35, birth control since 16. A few months ago, she went off birth control, experienced very bad acne, and so she went back on. Says the acne was the reason she went on when she was 16. This is a very common story of course, and I’m sure many of you have seen this lots of times. Done comprehensive blood. She looks pretty good outside of some functional iron deficiency, lack of protein in her diet, possible HCl, and electrolyte imbalances. Advised Paleo reset and then hormone testing. What tests do you suggest, and should they be done when on birth control or at some point went off the pills? I want to prep well before she goes off BCs so she can have less symptoms and then regulate her conception.
Chris Kresser: Yes. Definitely like a DUTCH test what are you going to be learning about shortly after hormones and...
