Chris Kresser: Next question from Helen, “For those with limited funds for testing, do you find that [the] Dutch test or cortisol gives a good start [to] figuring out what’s ailing those that are not feeling well because they’re not their usual self and their basic labs are normal?”
To be honest, if funds are really limited, we often won’t use the Dutch test because it can generally tell you what you already know and it can be important, but if someone’s really feeling off, if their sleep is disturbed, they’re tired when they wake up in the morning, they’re having difficulty falling asleep or staying asleep or whatever, you can be pretty sure you’re going to see something abnormal in the Dutch test. As per what I was saying before about the best lever for intervention in that situation, I would really, either yourself or with a health coach, if you are working with one, really dial down on the behavior lifestyle pieces that [are] going to generally produce the biggest bang for the buck in terms of cortisol and sleep and energy levels. So often, when you dig down into that, you find that they are staying up at night with their iPad [in] their lap in bed, reading the news, or they’re getting only six hours of sleep or they’re not doing anything to manage their stress during the day, or they have their phone in their bedroom and it’s beeping and flashing at night when they’re sleeping and they’re even waking up and answering their texts. A lot of times, people aren’t going to volunteer this information right off the bat, especially if they know it’s not the right thing to be doing and you might disapprove, and humans really fear judgment, and shame is a powerful emotion and most people want to avoid it. So that’s where [a] health coach can be really helpful, and it’s where just asking open-ended questions and even just starting by saying “there’s no judgment here; we all struggle and I just want to get as much information as I can so I can help you as best I can.” Or even sharing some of the things that you found in your practice that contribute to those issues and asking them if any of those might apply to them, and just keeping it like that, curiosity without judgment; you often find that that’s at play to some extent, and that’s a very good entry point.