Dr. Debbie Rice

Episode 86 – What is Cortisol? with Dr. Debbie Rice from DUTCH Test

Episode Highlights

00:01:38 Guest Background
00:03:27 Acute vs Lifestyle stuff in medicine
00:07:48 What is Cortisol and its function?
00:13:58 Right amount of cortisol in your body
00:16:03 Correlation between cortisol and testosterone
00:19:14 Exchange between cortisol and melatonin
00:21:08 How  does caffeine affect cortisol?
00:28:06 High cortisol increases fat in the lower abdomen?
00:31:47 Foods that rise the cortisol levels
00:45:50 5 key takeaways

Links

Transcript

Welcome to the Fitter Healthier Dad Podcast, where you can learn how to improve your diet, lose fat and get fitter in a sustainable and fun way without spending hours in the gym. Here’s your host, Darren Kirby.

Darren: Welcome back to the podcast, guys. This is the number one podcast for dads in their 40s who want to improve their health and fitness. And this is Episode 86 and today we’re joined on the show by Dr. Debbie Rice from Dutch Test. And we’re going to be discussing the details around what cortisol and the importance of it, particularly for men who are 40 plus. Dr. Rice is a naturopathic doctor who uses multiple modalities, including diet and lifestyle, botanical medicine and conventional approaches that meet the patient, whether in their health journey. Dr. Rice’s passions also include activism for access to health care, yoga and exploring nature. Hey, Debbie, thanks very much for joining me on the podcast today. How are you?

Debbie: I am doing well. Thank you so much for having me. I’m excited for our conversation.

Darren: Yeah, absolutely. And yeah, I’m pleased you agreed to come on to the podcast and talk about a topic which I’m very interested in personally. And I believe the audience will also get a lot of benefit, actually, from understanding cortisol and cortisol levels and the upsides in the downsides from it. But before we get into that, can you give us a bit of background on yourself and Dutch test?

Debbie: Sure. Yes. Well, my name is Debbie Rice and I am the assistant medical director here at Dutch. So the lab itself is called Precision Analytical, also known as the Dutch Test. Dutch actually stands for Dried Urine Testing for Comprehensive Hormones. So I know a lot of people think they’re like, where does DUTCH come from? That’s where it comes from. And I am a naturopathic physician. I am licensed through an accredited university here in Portland, Oregon. I have a small practice on the side, but my big commitment is to the lab. And that’s mostly because I love hormones and hormone testing and that’s what the Dutch test is. So, yeah, I and I will say the Dutch test is, you know, in the world of functional medicine, we have all sorts of modalities and tools to utilize. And the Dutch test is very specific. And so that’s kind of where I’ve been able to hone in on testing and treatment.

Darren: Yeah, yeah. I mean, the whole kind of for me at least, the whole point of naturopathic medicine and the functional medicine areas seem to becoming more mainstream now than they perhaps were when you got involved with them. And, you know, it’s almost like they see this kind of shift taking place from being more aware of your health up front as opposed to when we get sick. So what was your take on kind of where we sit? Obviously, we’ve got the whole coronavirus thing at the moment, which is terrible, but where are your take on medicine and the way that we deal with our health currently.

Debbie: So I think that there are, I would say, kind of two camps. Right. Like when we look at medicine in general and why people go to the doctors, we have the acute stuff and then we have kind of the lifestyle stuff. And, you know, functional medicine falls more on that kind of lifestyle, what I call gray area of medicine, where acute care and emergency medicine are obviously super helpful and beneficial, but they are very targeted and very good at dealing with emergency situations. You know, you have the flu, you broke your arm like those kinds of things. They’re very equipped, very helpful with that. But we missed the part of, well, what was the process leading up to that? And when you go home, what happens then? And how are you managing your health on a day to day basis where I think a lot of us just kind of get into a pattern of processed foods and eating out and doing this because we don’t have time, you know, like all of us are pressed for time. We all have very busy schedules. And so our overall health ends up kind of falling off to the side. And we don’t really pay attention or think of that until something happens that shifts us to like, oh. OK, well, maybe I need to think about my sleep pattern, my eating pattern, my exercise, you know, all of that. So, I mean, there are certainly certain populations that are more focused on that, like our athletes and. Yes, but I think in general, that gray area gets missed a lot. And that’s where functional medicine can really fill in the holes if you go to the doctor because you feel X, Y and Z. But the doctor says, well, I ran all the tests and everything looks normal. It’s like, OK, well, the doctor’s telling me I’m normal, but I don’t feel normal. That gray area functional medicine can certainly do a little bit more investigating things that, you know, tease what’s happening with your life kind of apart and see what we can do to help support that and improve that.

Darren: Yeah, I think that’s a really important point, actually. The gray area point, you might say is because, you know, sometimes what you say, because we are so busy and rushing through life, we kind of ignore that kind of a gray area. And it can actually be a gray area in your kind of how you’re feeling in your performance. It because it can be like a bit foggy or, you know, people use the word groggy or they don’t feel themselves, but they kind of, like you say, brush it off to one side and just kind of carry on going about their day and use whatever is available to them to kind of pick them up or make them feel better. Whereas I feel that if we’re a little bit more introspective and we pay more attention to the way that we feel and the way that we are, and certain days, weeks and months, we’re able to kind of build up more of a pattern as to how we perhaps should be feeling or performing and stuff like that. And I think when we do that and then you use the functional medicine element of it, I think you can really shift your perspective on what health actually is.

And obviously, you know, at the time that we’re in right now, health, we’ve never had a bigger threat in my lifetime, at least to to act on. I have and I think now is a prime time for us to really start to kind of take that deep dove, that deeper looking to kind of how we feel and how we perform. So obviously today, you know, you came on, you’ve come on the podcast today. So we’re going to talk about Cortisol now. For me, Cortisol is a kind of a bandied around term that’s used in the kind of sports and fitness space. And a lot of people know it can be raised by caffeine and it can ease the stress hormone. And also it can particularly men. It can cause us if we have elevated levels of cortisol just to store fat. So we know what I’ve just said there, how much of that is correct and how much of it is incorrect and what can we learn from Cortisol?

Debbie: Yeah, that’s a great question. And I would love to say that cortisol is simple, but it’s not. And everybody’s response to cortisol or how their body uses their cortisol is going to be different. Right. Because your definition of stress may be different than my definition of stress. And one of the things that we have to remember, too, is that cortisol, our stress response will happen, whether it’s real or perceived. So you know what I mean? So whether a saber toothed tiger is actually chasing you or you just feel like it’s chasing you, your stress response is still going to be there to keep you safe. Yeah. And so I think when we look at cortisol, I mean, everything you said is absolutely correct. It is one of the stress hormones and it’s probably the most common stress hormone that we know. Cortisol is, you know, I feel it cortisol before cortisol gets a bad rap because, you know, a lot of us think cortisol bad. But that’s not the case. Right? Like all of these hormones, I call them the Goldilocks hormones because you have to have them in the right amount and everybody’s going to be a little bit different.

And with that right amount is going to be. But if you have too much, it’s an issue. If you have too little, it’s an issue. Now, the challenging part of that is like trying to chase or cortisol and figure out what it’s doing and how it’s doing and why it’s doing that. So cortisol is our daytime hormone, right? So it’s very important and influenced by our circadian rhythm. So when we look at your sleep wake cycle, that’s going to be a huge influence there. And how our cortisol response throughout the day and we want to be able to create an environment that our adrenal glands and that cortisol producer feels like, OK, I can handle this, versus like either freaking out all the time or have been freaking out so long that now your core is. I was like, I’m like, I don’t have any more left to give. And that’s where finding that balance of too high to lower just right is going to be very important.

Darren: Yeah. So finding the balance, though, is, to my mind is difficult. And like you said then, which is really important, is very much on an individual basis. So how I mean, you know, we can talk about stress, we can talk about caffeine and things like that, which obviously can influence the levels of other things. Could we be aware of other than obviously having a test to kind of realize that maybe they’re getting slightly elevated or not?

Debbie: Yeah, yeah. And that’s a great question, too, because there are a lot of people that kind of disconnect from themselves just so that they can do what they need to do. Right. And so it’s being able to kind of sit back into your body and realize, OK, how am I feeling? Am I tired when I wake up? Do I feel like I’m dragging myself through the day? What is my brain motivation like? Right. Like, do I have to talk myself into being motivated through the day or do I just have that motivation to go? Do I feel low? Like is my mood good? How is my mood? Do I feel like I even like want to face the day and even looking at OK, so you’ve been able to get yourself through the day and you’ve been able to get to your workout, say you do your workout and you just feel completely like you have to have at least a day to recover, both like your muscles and just from feeling brain fog and tired. That’s a big thing. But I think the bigger things that we look at, are you feeling hyper stimulated when things happen to you? Like are you hyper reactive when things happen? You know, this happened and then this happened and this happened and everything just piles on and you get overwhelmed and your response is more than it would have been. Or you also just feel kind of buried and tired and in a lower mood. So I feel like those imbalances are either too much or you’re just kind of like up here and everything is enough to send you. Yeah. You know, railing or it just kind of keeps bothering you and you’re just like, oh, OK. Another another thing like it’s just heavier and heavier to get out of my fog to do what I need to do.

Darren: Yeah. Yeah. That’s really, that’s really key because you know, I think from it definitely from a male perspective of self control from our perspective, you know, we and I think a lot of this is due to upbringing and how kind of you dealt with when you were a child, in so much as my belief is that if you as a child, if when you hurt yourself or you didn’t feel right, you kind of brushed off, you’re more inclined as an adult male to brush that off, you know, like you just said. Whereas if you have had more balance in your upbringing and you’re more likely to be introspective and ignore those signs. And I feel that men particularly will ignore that stuff, like will ignore the kind of, you know, dragging themselves out of bed, all their response to a kind of stress from what they perceive to be a stressful situation and and not stop to think because we kind of it’s almost like a hunter gatherer mentality, isn’t it? You men have to go out. They have to slay the day and I push through and all that kind of stuff. And I have definitely become way more introspective and how I’m feeling now. So, yeah, I think that’s such an important point for people to realize who are listening to this. And that is, you know, if you do feel a little bit stressed because the kids are kicking off or you you you respond in a certain way at work and that’s not how you would normally respond, then, you know, that’s maybe just the fact to say, hold on a minute, how am I feeling? Why am I feeling this?

Debbie: Well, and that’s a great point, too, because I think there is a put like by the time a man has come into my office, it’s because there are some significant symptoms. Right. Right. And so being able to, you know, our body creates this kind of pattern. And so there is this inertia in a pattern or routine that you do. And, you know, you get to this point, you’re like, well, how did I get here? And so the question really is, OK, yeah. I mean, there’s tons of things that we can do to evaluate and support this. But the bigger thing is what was the path that led you there? Right. And being able to identify that. So trying to check in with yourself is not a bad thing. It doesn’t mean that you are weak or that you are not able to do what you’re supposed to do. It’s really taking a step forward in your health care so that in the future. You don’t have these big, major things to deal with when we look at how cortisol, its immediate response is supposed to help save you from anything dangerous, right. So it has a very beneficial effect at first. But if we keep getting that cortisol push, cortisol, push, cortisol, push every day, you’re continuing to push that cortisol, you start to have this chronic output of high cortisol. And this is where we look at those kinds of longer term symptom presentations. And for males in general, the big things are low mood or depression, sadness, weight gain and inability to have that same kind of muscle mass or muscle response when you’re working out OK and erectile issues or libido issues. Those are the yeah. Those are the big things that bring men into my office. Right. Right. And so by the time because that’s when things are like, OK, now something’s wrong. Right. But it’s like, OK, well, let’s maybe try to get you before that happens, you know, so that we can. You keep that good quality of life for you instead of having to redo all of this stuff to get you back there.

Darren: Yeah, and I think I think that’s another thing. And I always used the car analogy. Right. So, you know, it’s kind of, you know, making sure you are aware of the amber light coming on before the red light comes on, which completely stops you dead, right? Yes. And some of the stuff that you’ve described that with low libido, with mood, muscle mass, that, from my knowledge, sounds a lot like what happens when guys have a low testosterone. So what’s the correlation between cortisol testosterone?

Debbie: Yeah. So our body is evolutionarily smart, right? So cortisol is definitely going to be that hormone that is there for that fight or flight response. And just because of evolution, whether it’s a saber tooth tiger running after you or it’s your boss putting these deadlines or whoever is putting those deadlines out there for you, your body is going to have that same evolutionary response. Right. It’s going to push out that cortisol so that you can run from that saber tooth tiger, be it whatever it is, when your body is in that fight or flight mode, it shuts down all of these other things that are not supposed to happen while you’re running from a saber tooth tiger. Right. So when you’re running from that stress, you have increased blood pressure, you have increased focus, you have increased glucose release from the liver so that your muscles can function. So your body puts it on that. It’s like, OK, all systems go, we’re doing that. What it shuts off is your rest and digest and reproduction and immune function. Right. So when we look at that directly correlated to sex hormones or testosterone, when you’re running from that saber tooth tiger, your body’s like, this is not a good time for you to start making babies. Right. Like we’re running from the saber tooth tiger. Don’t get distracted. Don’t get distracted here. This is our main priority. So when that happens, you end up having this down regulation of your immune system, of your sex hormones for males. That’s looking at your testosterone and digestion, too. So. Right. So then how well are we absorbing our nutrients that also help to make your hormones? Right. So it’s this whole cascade of effects that happens when your body is just like running wild.

Darren: Yeah, yeah. That makes perfect sense. Now, you’ve explained it like that. The fight or flight running away from the colony. Pronounce it from the tiger. Big bad. Yeah. Yeah. And yeah. Why would you have high testosterone levels in that scenario? That just makes complete sense because you have to get out of danger. But yeah. So that’s a really interesting story. But in terms of in general how throughout the day cortisol will function, assuming that we are in good health and we have the right level and we are not perceiving to be in a stressful state, because my understanding is elevated cortisol levels in the morning is actually quite good for us.

Debbie: I would say not too elevated. Right. Like you want to have a good elevation. So nighttime we have melatonin. Right. And as we start to wake up. Right. Like our little pineal gland ends up getting these little signals, that light is happening. Things are stirring. Right. Like I can hear the birds chirping and all of that stuff. So it starts to signal in your brain, OK, it’s time to wake up. And so your cortisol starts to increase when you’re getting up and ready for your day. And we do expect the highest peak of cortisol to happen after you wake up. So we really want this cortisol to have this nice rise in the morning, get you ready for your day and then fall throughout the day. And then once it falls, then it’s night time and melatonin takes over. So this is a nice exchange between cortisol and melatonin. So we do want to have this nice rise of cortisol. And now we don’t want it too high because that can again be problematic and we don’t want it too low. Dr. Carey Jones always says if you can’t get the first hour of your day right, how do you expect the rest of the day would go? And it’s a really good point, right? Like if you can’t get that appropriate cortisol response that we’re expecting, that that physiologic response that we’re expecting the rest of your day is probably not going to go as awesome as you want it to. So that cortisol awakening response is going to be really important. And it’s highly influenced by your day to day routine, by your quality of sleep, by the demands that you feel from day to day. And it can also be influenced by mood. And it’s hard to know which causes which. But there’s a big correlation between mood and your waking cortisol as well. So that’s big. Consideration to, you know, like if you can’t get that cortisol appropriately responding, it’s also going to affect that ability or that mood kind of motivation that you have to take on the rest of your day.

Darren: Yeah, yeah. That always makes logical sense. And so. As we progressed throughout the day, and my understanding, particularly around caffeine, is that that can have a really big impact on our cortisol levels and obviously high amounts of caffeine. Caffeine is a stimulant and it’s good to maybe get going. It has polyphenols if you’ve got the stuff, coffee from the beans directly ground. Yeah, but obviously we don’t want to keep having lots and lots of caffeine for lots of other reasons, but specifically around cortisol. How does caffeine affect that?

Debbie: Yeah, and that’s a great question. And I feel like there’s when we look at the effect of caffeine, I don’t feel like caffeine. Like if you’re having an eight ounce cup of coffee every morning and you do that every morning, it kind of helps it can help you get a little bit more focused and up and ready for your day. Does that negatively affect your cortisol? Probably not in the research. If you have a daily small cup of caffeine in the morning, that’s OK. Right. Like it’s not going to offset your cortisol. Now, if you’re the person that’s like, well, you know, I have caffeine like three times a month, you’re probably going to feel that like full of caffeine when you have it. But if you have more caffeine after that initial small cup of coffee in the morning, this is where we see it actually build your cortisol levels and increase your cortisol levels. And most of us will end up having that like two o’clock cup of coffee, PM, three p.m., maybe five p.m., depending on your work schedule. And if you’ve already had your morning cup of coffee, you end up having this exponential response on cortisol. So research shows this. It’s in the research, right? Like you can have like a normal cup of coffee. It’s probably not going to have a huge detriment to your cortisol functioning in the morning. Right. But if you end up having a second cup even two hours later or more, this is where you start to see that increase, that push and cortisol. And that’s not what we want in the afternoon. Right. So in the afternoon, we’ve already started to have our decrease in cortisol so that we can have that nighttime support.

And if you have that push of cortisol in the afternoon and at nighttime, you’re getting this misfiring or mis signaling of what your cortisol should be doing. And then if you’re doing that on a daily basis or even more of a regular basis, your cortisol starts following that pattern. And again, we fall into if you’re not getting your cortisol down, your melatonin doesn’t know that it’s time to help you sleep. So then melatonin is affected. And when it comes to testosterone, so in males, our testosterone is made during your sleeping time. Right? So if you’re not sleeping, if you’re not getting good sleep, if you’re not getting good quality sleep, your testosterone never gets the chance to do its job. Right. And so that’s where cortisol can negatively affect your sleep pattern and testosterone. But then again, you also have research that shows that if we have consistently elevated males, have consistently elevated levels of cortisol, you know, it suppresses that testosterone production. So you have a couple of things going on. Overall, cortisol being elevated all the time again. Right. So you’re running from that sabertooth tiger not to reproduce, not sexy time. And if you are suppressing your melatonin, then your melatonin doesn’t allow it like during sleep time. Just in general, that’s our time to like our body goes through and cleans out everything, recharges everything, not just testosterone, but specifically for males. That’s where you get your testosterone machine going. If you don’t get the same. To do that, you have another great double whammy, right? So you have high cortisol and low sleep productivity of testosterone.

Darren: Yeah. So if it is really a snowball effect, isn’t it really when you take a robot off and say, but my one question when you were talking that I was thinking about. So how does that work when we are working out for example. So because in my mind what you just said is one way of working out what it’s good for us. It’s stressing the body, isn’t it? Yes. So does that mean that cortisol levels are elevated even further or how does it work from that perspective?

Debbie: Yeah, that’s a good question. You will get a little bump of cortisol when you’re working out and testosterone, if you like, if you are in a healthy range of cortisol, depending on what time you work out your recovery. Just it’s not the same kind of effect as caffeine. OK, so you’re still getting this really good, healthy benefit of cardiovascular support, muscular support, as long as you are not already either burnt out or overstimulated. So if you have a good cortisol pattern, your recovery is going to be a big part of how your body is responding to that workout, too. So whether you work out at 5:00 in the morning or 5:00 in the evening, right. Everybody might be a little bit different in how they feel. Some people love working out in the morning, and that’s great. Some people feel better and they work out after work just because they feel like that’s where they get their push, as long as it’s not negatively affecting their cortisol and their cortisol is well balanced. And you could test that. Right. So you could see how your body is in general. Yeah. And how the body recovers from that. That’s a great question.

Darren: Yeah, that’s that’s that’s super interesting, actually, because for me, I generally know all of the time I generally have a cup of black coffee before I work out about half an hour before I workout, because I see that that gives me the stimulation, the sticky going, because I’m really against sort of these pre workout drinks. I really don’t like them because of the nonsense that goes into them. Absolutely. My perception was that by having the coffee and then working out, I’m actually doubling the performance. What you said that doesn’t have the same response. Doesn’t have the same impact.

Debbie: Yeah. Yes. Just because they’re different. Different signals. Yeah. Yeah. That the body gets. Yeah. And I know that there are some people that will like instead of black coffee they’ll just take a caffeine pill to work out. Now that said, if you feel better with caffeine and working out, it may also be that your pattern for working out has to shift more towards the morning time for you to improve that cortisol response. Yeah, so that may also be a consideration depending on the person.

Darren: Ok, yeah, that makes sense. So, when we talk about cortisol and storage of fat, how, how does that work. Because I read a lot of stuff and I’ve heard people talking about the fact that if you have elevated cortisol levels then there is, you know, studies to show that you can still fat around your lower abdomen, low belly. When that happens, you give some insight into that.

Debbie: Yeah. So it’s hard to know for sure which one comes first is the high cortisol. And a lot of times it’s likely if you have a generally good lifestyle, that there was a stressful thing that happened. And because of that stress response. Right, because cortisol enables more sugar released into the bloodstream and you end up getting this overload of sugar. And if you never really kind of shift out of that stress response, your body ends up getting all of the sugar and then it’s like. All right, well, I don’t know what to do with all of this. Then it starts to store it and so it becomes this cycle, right? Like now you’re storing this sugar and then you’re creating sugar into these fat cells and your fat cells actually sequester cortisol. So it’s almost like they become their own little endocrine factory where they’re also pumping out cortisol. So you get this, like an ongoing cycle that can be really difficult to break. But a lot of times it’s because of that initial stress response that your body just can’t calm itself down. And then it just starts this whole routine of storing that sugar, even though initially it was so that it could give you energy. Right. If you’re not balancing that stress response, well, then it becomes your middle tire.

Darren: Yeah, yeah, I know exactly what you mean. I mean, that is interesting because I recently learned that also with the advent of a spike in insulin in the bloodstream, actually, enabling our fat cells to store that sugar easier. Is that correct? Yeah.

Debbie: Yeah. So insulin is what I call the he’s the one that goes down in your system. When sugar enters the body, there’s a whole cascade of hormone responses that happen. And insulin is like the flag, the flagler that runs through your bloodstream and is like, hey, all the cells open up your little storage tanks because sugar is coming through. And the way that we’re designed is, OK, we need to grab that sugar into the cells because we don’t know when we’re going to need it again. And so insulin is a little flagger that runs through and it’s like, all right, everybody, open your doors. And so then sugar goes to the bloodstream and then it gets dumped into the cells. And so that’s where you start to get a healthy response, is insulin does its job. You get the sugar into the cells and then you use that sugar and unhealthy responses. You get too much sugar. And a lot of times it’s because of one stress, but also a lot of our foods, especially for eating a lot of processed foods. The things that help to keep those processed foods stable are sugars and things that help to improve the taste of it are sugar. So we end up getting sugar on top of sugar, on top of sugar. So our body gets overloaded with all of those sugars and we don’t have the same kind of output physically to use all of the sugar from those cells. And so that’s where you get that up. Regulation of that insulin and then sugar storage.

Darren: Yeah, that might make sense. So. In terms of when we talk about food and cortisol, obviously we’ve spoken about caffeine, but are there any other foods other than kind of the generic processed foods, if you like, we can pose a spike rising in levels.

Debbie: So that’s a great question, because I felt like it would be awesome if there was just this awesome this little list that was like, don’t eat this. Do you eat this? What we find, though, is that inflammatory foods are going to increase an inflammatory response which can increase cortisol. So each person might be different. Right. Like, I might not be able to have dairy, but so-and-so may be able to have dairy. So when I have dairy, my response, my inflammatory response increases. But this other person’s response may not. And so on that individual basis of what that looks like for inflammatory foods that may be individual and have an effect on your cortisol, the other thing about cortisol is so cortisol, an insulin work as partners because our body gets our energy from two main sources, cortisol and our blood sugar. Right. So the food that we eat. So if we’re not eating well balanced for our body throughout the day, you can also get these spikes and drops and cortisol as well. So it’s also about the timing of food and that’s going to be different for every person. Right. Like some people do intermittent fasting and their bodies love it. And that’s great. You know, their body, their insulin has been able to balance that. It’s been able to find a good pattern for you. There are some other people that just do horribly on an intermittent fasting diet, and that’s because their body is not able to manage their blood sugar well, and that can negatively affect that cortisol response. So it’s not just about the food that is in your system which can trigger or not that inflammatory, your cortisol response. It’s also about the timing of your food throughout the day, because that’s going to really affect how that cortisol response as well.

Darren: Yeah, I think that’s very interesting because I think I thought for a long time that timing is very key around food consumption of what you were consuming at certain times when you know you’ve now confirmed that. And I think that’s the other important point, as well as around the intermittent fasting. Obviously, at the moment it’s very popular. A lot of people are doing it. But it’s so important to not be mocked quite a few times by another guest who always said that there’s not one size fits all and he didn’t believe that to be true. And know I’m saying, well, I believe it is because we’re all individuals. You know, you have to look at what happens and everything else like that is all completely lost. So I think timing is very, very important. I mean, the studies have shown that intermittent fasting was, but it’s about coming back to what we said in the beginning about having this introspection and having this awareness about what works for us, not having the placebo effect necessarily because everybody else is doing it right. We’re doing it. I feel amazing. Right, because you can. Oh, yeah. Oh yeah. Oh sure. Yeah. So absolutely. Yeah. So when we obviously the only real way I guess to understand your cortisol levels is to have a test. But in terms of the testing, is it a test that really needs to happen over a period of time or what’s the most efficient way to understand where your levels are?

Debbie: Great question, because there are a couple of ways that you can test for cortisol and cortisol function throughout the day. Serum or blood testing for cortisol, I would say, is used a lot for some people just because insurance covers blood work. But what we have to remember with any kind of cortisol at a blood draw is that is one point in time. Right. And cortisol is a diurnal hormone, meaning it has a wave effect throughout the day. So it doesn’t stay consistent throughout the day. Right. So, again, for cortisol, we expect that rise in the morning and that fall throughout the day. So if you get your cortisol drawn in the blood, it’s going to be at that point in time, 8:00 a.m., two p.m., whenever that is. So it only lets us know where the cortisol is at that point in time. We don’t know what the pattern looks like. And when it’s drawn in serum, it’s actually protein down. So it’s not what’s free and available for the body to use. So it’s not a great presentation of what your body has available for you to use. So a blood draw gives you some information, but it depends on what you’re looking for. There is also salivary testing for cortisol and most of the time with saliva testing, it’s done. Throughout a twenty four, like a 12 to 24 hour period, so you’ll do a saliva swab or spit in a tube four or five times throughout a day. And what the point is of trying to get that when you wake up, you know, about two hours later, around dinnertime and around bedtime, and they’re looking for that diurnal pattern. So what that daytime pattern looks like, that’s going to be a better representation because we get multiple points throughout the day.

So we can see what that wave or that pattern is for cortisol, which is good, and that’s the free cortisol and saliva. So that tells us what’s free and available for your body to use what’s active and how your body’s using it throughout the day. Yeah, the Dutch test, which is dried urine, means that you pee on these little strips multiple times throughout the day. So, again, four or five times throughout the day. So we can get that kind of diagonal pattern. We can see what the results are doing with the Dutch test. You get the free cortisol, which is important, what’s free and available for your body to use. But on the Dutch test, we also get the total cortisol production. So in that 12 to 24 hour period, when you do the collection from waking to bedtime or in the Dutch collection, you can do it overnight. Right. So you start at dinnertime bedtime. If you do wake up in the middle of the night, as soon as you wake up and then two hours later, we’re still looking for that diagonal pattern. Right. Like what’s happening at night time, what’s happening when you wake up in the morning. The dust has also given us at the end of how much cortisol is actually produced. So we’re looking at not just what’s free and available, but also what is made. So is your body making and using an appropriate amount of cortisol? So I look at the dust just as a little bit more complete with regard to what your body’s making, how much your body is making, what your body is doing with that cortisol, how it’s using your cortisol throughout the day.

Darren: Yeah, that makes sense. And so, as you know, thinking because I was testing more, I had to continue blood glucose monitoring on the year and I had raised insulin levels in the morning. And is that correct? With in coming in line with cortisol, someone’s cortisol levels are raised and therefore that creates a spike in insulin, is that correct?

Debbie: It’s quite possible. And we wouldn’t know for sure until we tested it. But when we do have you know, because insulin tries to help signal your body when your body needs glucose. Right. So depending on how long your body has been fasting and whether your insulin needs to spike to let some of that glucose out, how well managed your glucose is influences when your cortisol is going to have those spikes throughout the day. So if you are having consistently raised insulin, you’re likely going to have a similar glucose response, right. Ok, so I’m sorry, cortisol response.

Darren: OK, yeah, that makes sense. So. When we obviously let’s say, for argument’s sake, we’ve had the tests and we realized that the levels are quite high, that is quite elevated. Well, the general recommendation is that we can use it in order to kind of bring that within a level of acceptance. Really?

Debbie: Yeah. So the biggest thing I’m going to look at is what’s your daily pattern? What are your daily stressors? What can we do with your day to day lifestyle to help improve that? If you are overstimulated in the morning, we will look at how your sleep is. Are you sleeping well? What is your sleep pattern? How do you feel when you wake up? And do we support that by doing more of, like a calming thing? Do we need to do more of a meditative thing in the morning for you? Do we need to do less coffee in the morning for you? We need to do less stimulating things in the morning for you to help stabilize that response. Or if you have a lower response, maybe we actually need to get you moving. Right. Like we want to get sunshine on your eyes, right. So you can get that cortisol response. We want to get your body moving so you can get your horizontal raise to be able to do that. And there are certainly nutraceuticals that are nutritional supports, herbs and or amino acids that can also influence that cortisol response for you. So there are definitely natural options that can help improve or optimize that cortisol response for you. But definitely also looking at what’s happening lifestyle wise to get you to that point and help optimize or adjust that for you.

Darren: Yeah, and I think that’s the interesting point, isn’t it, really is about understanding how you are living your life, little things, because we are very quick to dismiss little things that we do in life. Or, you know, the classic one Iowa series. Well, I don’t eat that much, you know, I don’t know. I don’t eat, but I don’t eat badly like me. Well, badly and yeah. Right. Yeah. And you start to analyze it, you know, you can really eat some small little changes in your lifestyle, can you. Massive results. Kutuzov I don’t. Yeah, I agree. I mean sleep is becoming more and more being spoken about how important it is. And I track my sleep with multiple devices funnily enough. Yeah. I’m really , really interested. And to find out how I’m sleeping in terms of my REM sleep more. Yes. Because it has a huge impact and it snowballs throughout the day. Right. Because we hope not to have enough sleep, you know, you are naturally going to start to search for stimulants, maybe sugar. Yes. Yes. Kind of thing. So, yeah, I think it’s really important that we kind of recognize that you don’t necessarily need to have all these huge changes to your life. Just reflect on where you’re at and what you’re doing right now. Right.

Debbie: And even I would say one of like a big culprit, especially for busy parents. Right, is like the kids finally go to bed and then the parents go and watch, like Netflix and binge on a show together because that’s their time. Or they can finally have a beer or a glass of wine to relax. And it’s like, those are important, right? Because it’s it’s you spending time with somebody or even just some, like, downtime for yourself. But if it cuts into your good sleep and says that even during that time, you’re like, well, I also have like some food or whatever, you know, those small habits can make a big difference with how your sleep quality goes, which again influences what your cortisol does the next morning. And it’s hard because you’re like, but don’t I deserve a break? Absolutely. But we also know if you’re afraid. But if you’re doing that every night. Right. And so it’s being able to reflect on that. Am I doing this nightly? How often is this happening? How do I feel the next day? What is the long term effect of all of that? And because I know sometimes it ends up being like, well, you know, it was only supposed to be Friday nights that that was our thing. But then it’s now every night and especially with a virus and quarantine and all of that. Right. I can’t tell you how many people have been like, well, you know, quarantine happened. It was almost like a vacation. So we all went nuts. So, yeah. You know, and it’s true. And then it’s like, oh, my gosh, trying to find a pattern. And everything that has just completely changed is also challenging. Right. So it is being able to step back, evaluate even just the day to day patterns and what’s one change but to also help or not, you know, like what’s your benefit? What’s your detriment?

Darren: Yeah. And then then I think it’s almost like, well, OK, you weigh up, you know, if you. Doing fine, but just accept that you’re probably not going to have the best night’s sleep and therefore you’re probably not the best off to die the following day. I know. I know. If she’s really well, I found from tracking wisely that if I eat within three hours of me going to bed, my heart rate is only slightly elevated. But because the digestive system is still processing, I have a good night’s sleep.

Debbie: Yes. You’re not the only you are not the only person who has told me that it’s an even though digestion is rest and digest. Right. Your body still has to be doing something. And really like when you’re sleeping, your body should be shut down so that your brain can go through and clean all of its neurons and clean all of it. So it goes through and does the whole thing like let’s clean everything and recharge everything. And it can’t do that if it’s still working on the testing thing.

Darren: Definitely not. Definitely not. So that’s really, really interesting, too. Before we wrap it up today, are there five key things you think that people could take away from the podcast today to kind of just implement or consider changing in their daily lives to make sure that they’re on top of that? Which is a great question.

Debbie: I think a huge thing is your sleep wake cycle, making sure that you are protective of your sleep like my. Yeah, one of my highest priorities is making sure that people evaluate their sleep and honor their sleep. Right. The second one would be also making sure that their blood sugar is stable throughout the day, that you are eating correctly for your body. You know, I have those people that are like, well, you know, I only have so many calories, but they’re all at dinner time. And so does that work for you or does it not? If there are symptoms going on, evaluate that for you, making sure that you are moving your body daily. So not saying that you have to, like, run a marathon every day, but that you are moving. Right. Like they are saying now that, you know, being sedentary is like the new smoking. Yeah, because. Yeah, right. And it’s true because like if your body’s not moving, you’re not getting blood flow, you’re not getting muscle activation. If you’re not getting muscle activation, your brain gets sad. So, you know, like our bodies really respond to that. So making sure that you’re moving, even if it’s a walk around the block or some gentle yoga, but implementing movement and healthy movement for you every day, hydration is another big one. So I think making sure that you are hydrated, a lot of people are like, well, you know, I drink four cups of coffee a day that doesn’t count, does not count as hydration. Your bubbly water also does not count as just your only sole source of hydration. Right. So our bodies are very, very sensitive to that. And then the fifth one, I would say is create fun, make sure that you have joy in your life. So if you’re just kind of nose to the grindstone and that’s what you’re doing every day and you don’t have time for sleep or eating or fun. Yeah. What are you doing? Something to look forward to.

Darren: Yeah, I agree. And that’s a very interesting last point. You might because somebody else made that to me a few weeks ago now and they say that I don’t lose the ability to play. You know, if you have young children, you know, when they’re kind of 18 months, three years old, that’s all they do is incorporate it into their diet. And as we get older, more responsibility, more serious, whatever it is, we lose that ability. And then, you know, it really helps with our mood and our outlook and that perspective if we just do that right so much.

Debbie: Yes. Yes. And this will be like my five points. B, because there has been research about, you know, hugs and just being able to have a hug per day like they were saying, I can’t remember the exact numbers, but something like three hugs a day makes you maintain sanity where like 12 hugs a day make you thrive. And so, wow, you know, when we’re social creatures, we’re meant to socialize. And I know that right now, it’s also very difficult. So the people that are in your lives, you know. Give hugs, because that also helps.

Darren: Yeah, definitely, I love that. So before we wrap up then, Debbie, is there anything that I didn’t ask you that you feel like I should have asked you which would benefit the listeners?

Debbie: Oh, one of the things that I will say is as much as we can. Kind of guess what’s happening for somebody with their cortisol? But their stress response is never guess, always test. Yeah, right. Especially when it comes to cortisol, because there could be like, oh, well, it could be that this is happening, but we might be totally off. And being able to test your levels offers more accuracy in evaluating what’s going on and appropriateness for your treatment plan, too. So, yes, never always test.

Darren: Now, I love that tagline. I think that’s really important. And I feel that way in a time now where testing and having that insight into what’s going on has never been more accessible to us. And I will caveat that to make sure if you are going to get tested, you have a practitioner that understands this as well as you can go on a real big tangent and absolutely always won’t be positive.

Debbie: Yes. One hundred percent agree. Like, if you’re going to do the testing, have somebody that can really guide you, somebody that that you trust as well.

Darren: Yeah. Awesome. Well, thank you very much for coming on to the podcast today. Thank you for your time. And yeah. Enjoy the holidays. I don’t know what it’s like over there, whether you can meet family or whatever, but yeah, a little bit.

Debbie: Yes, we are. We’re definitely limited. But thank goodness for technology. Right. At least I can see people’s faces through their face, you assume. And that’s made a big difference to you as well.

Darren: Yes. Thank you very much, Debbie. And take care and I’ll speak to you soon.

Debbie: Thank you. You as well.

Darren: But thanks for listening to the Fitter Healthier Dad Podcast. If you enjoyed today’s episode, please hit subscribe. And I would really appreciate it if you could leave a review on iTunes or other things mentioned in the episode will be in the show notes and a full transcription is over at fitterhealthierdad.com

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