HPA Axis
Chris had mentioned he didn’t mind answering questions about sex hormones and DUTCH results, so I’m seeing all these markers specifically with the metabolites that I have questions about. So we have three different questions about the sex hormone portion of the DUTCH complete hormone profile. If 16-OHE1 is in the low range, would you be concerned to do anything specific about it? What about 4-OHE1? What about 2-OHE1? Is it more the levels or the ratios that we’re concerned with?
Dr. Amy Nett: Okay. So what I’m most concerned with is, what are the estrogen levels? So there are a...
For a woman, if 5-alpha-reductase is low and she has low testosterone, would you do anything specific about it? I’ve seen 5-alpha reductase come back low on all women.
Dr. Amy Nett: Interesting. So, I actually don’t see 5-alpha-reductase low on all women. I do see women with higher...
So still trying to get a hang of the DUTCH test when the patterns aren’t as clear. So Brent has a 51-year-old female patient. She was 194 pounds and now down to 183 from the last time he saw her. She’s responding to the autoimmune Paleo protocol well, previously was on a 95 percent gluten-free diet. She has less fatigue, fewer body aches, did a full workup but have only gotten the DUTCH and blood chemistry results. Some of the key findings are homocysteine of 11.
Dr. Amy Nett: Which is high because remember, we want to see a homocysteine that’s 7 or below and when...
Also curious about the low normal waking cortisol/cortisone that you see. In that case, you think supporting inflammation methylation nutrient status like detox would be beneficial. So you’re saying, would those things be beneficial specifically for the low-normal waking cortisol? In that case do you think supporting the inflammation methylation nutrient status and late detox would be beneficial with the other patterns we saw?
Dr. Amy Nett: Well, remember that the waking cortisol is a good representation of what overnight cortisol is. So if...
What is your recommendation for clients who are working out every day in very intense training and have HPA axis dysfunction? Also, they have been told that they need to slow down but they feel addicted to exercise.
Laura Schoenfeld: All right, this is another one that I see a lot in my particular niche for my nutrition...
Would you test kids on the DUTCH adrenals for cortisol?
Dr. Amy Nett: I haven’t and I think one time I had, I think twice I’ve had moms who wanted...
The diagnostics values were 13 to 24 is the range. So 15 put this patient at the bottom end of the range. And then DUTCH waking and morning cortisol and cortisone are borderline high and lab high respectively. Afternoon cortisol and cortisone normal, and the night sample was sky high, practically same value as the morning sample.
Chris Kresser: That is interesting. I mean there is a lag for, what, the DUTCH morning sample. But the waking...
