Chris Kresser: I haven’t found that to be an important clinical distinction. We talked a bit in the HPA axis unit about the differences between what you would do in a hypercortisolism state and a hypocortisolism state, and there aren’t a lot of good ways for testing outside of a research setting for SAS activation above and beyond the DUTCH testing that we’re already using and some of the other tests we talked about. Really, especially from a behavioral and lifestyle perspective, the changes that you’re going to suggest are largely the same, so I don’t think it makes a clinically meaningful difference.
- Home
- Knowledge Base
- HPA Axis
- We refer to stress-induced pathology as HPA dysfunction, but the reality is that stressors affect us via two primary mechanisms: the HPA axis and the SAS.’ I understand these are intertwined, but my question is, isn’t it rather important to try to work out which one is dominantly out of whack in certain situations such as waking up in the middle of the night because the physiology will be a bit different? If cortisol is too high at night, isn’t that really different to if adrenaline is high at night? I know the long-term solutions will be the same, but in the short term in terms of which supplements to use, is there a difference?
We refer to stress-induced pathology as HPA dysfunction, but the reality is that stressors affect us via two primary mechanisms: the HPA axis and the SAS.’ I understand these are intertwined, but my question is, isn’t it rather important to try to work out which one is dominantly out of whack in certain situations such as waking up in the middle of the night because the physiology will be a bit different? If cortisol is too high at night, isn’t that really different to if adrenaline is high at night? I know the long-term solutions will be the same, but in the short term in terms of which supplements to use, is there a difference?
Related Articles
- For patients who appear to have HPA axis dysfunction on DUTCH but findings are also consistent with hypothyroidism, you would ask to search for a cause for the hypothyroidism and address that too, right?
- You mentioned that keto is not a great idea for those with HPA axis dysfunction. Is there data to suggest keto contributes to elevated cortisol or cortisol resistance? For those who may not lose weight on keto, is this most likely due to HPA-D?
- On the topic of steroids, what are the real long-term and short-term issues when someone is on them?
- I have a client diagnosed with polychondritis of the ear. She came in months ago. I suggested food elimination and she disappeared. She is back now after beginning some food elimination. I suggested the Paleo reset and avoiding nightshades and eggs. What testing would you think of right away? She’s also very sympathetic nervous system type and was interested in what HPA testing you might suggest if you use one.
- Do you have any experience using maca for low testosterone based on DUTCH test results? Patient has low libido, and his cortisol results are high free cortisol and low metabolized cortisol.
- 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.