HPA Axis
How long do you typically put patients on the supplement plan for HPA dysregulation, and when do you typically retest?
Dr. Amy Nett: This depends a lot, I think, on the severity of the symptoms and what the underlying issue...
A little unclear on the physiology of a patient who has low free cortisol and low cortisone. Okay, so low free but on the higher end of metabolized cortisol.
Dr. Amy Nett: That sounds to me like a rapid clearance. That would be an increased clearance. If you have...
When we learned the HPA supplement protocols, there wasn’t a focus on duration of treatment. So when to stop the supplements in the near long term. I feel like this is kind of a black hole for me.
Dr. Amy Nett: Yeah, exactly. There is more to the question, so I’m going to come back to it. It’s...
Getting a little confused about cortisol, cortisone and all of the interrelations. Is there a chart or a book or an article that has these all on one page?
Dr. Amy Nett: Yeah, there is. So a couple places—one, Precision Analytical has this amazing chart which I think we’ve...
Regarding cortisol-to-DHA ratios on the DUTCH test, approximately what ratio is considered normal and what is considered indicating catabolic or a high cortisol compared to the DHEA?
Dr. Amy Nett: It’s a great question, because Chris talked about that this week on one of the presentations and...
Regarding the case studies part one, is there missing information on the DUTCH testing for the first case? I don’t see values for free cortisone that is being referred to in the example nor melatonin levels.
Dr. Amy Nett: I think that that case was just using an older DUTCH test where the free cortisone wasn’t...
I understand that if cortisol and cortisone are normal or high and cortisol metabolites are low, that could indicate hypothyroidism. But is this always the case and if not, what would you use to encourage the body to metabolize cortisol?
Dr. Amy Nett: Yeah, so it could be, so you’re saying high cortisol, okay. Cortisol and cortisone normal or...
Part three of the HPA case studies, page 2, she says, “Inflammation also increases cortisol-to-cortisone ratio, so inflammation causes the body to convert cortisol to cortisone. If this is the case, how come on page 7 when the case study person has low free cortisol and metabolites, but high cortisone, why isn’t this thought to be the reason?
Dr. Amy Nett: Inflammation can actually favor free cortisol over cortisone. Low free cortisol and high cortisone might actually suggest...
Are the adaptogenic herbs safe to use for cases of low and high cortisol? Or are the adaptogenic herbs safe to use for cases or low or high cortisol except for panax ginseng?
Chris Kresser: Yeah, I mean it kind of depends on which form of cortisol, like whether free cortisol is high...
