Search Articles
clear search termsCommon Pitfalls in Adrenal/Cortisol Testing. Don’t Fall in them too!
Test; don’t Guess! It’s a common mantra heard among practitioners here at SAFM. I believe it’s particularly good clinical guidance in the arena of hormones. But it’s also important to do testing that clearly reveals what is at play vs. creating more confusion. Check out some common pitfalls and misunderstandings in the arena of cortisol/adrenal testing. You might be surprised!
Myth-busting and Truth-simplifying are things we do every day here are SAFM. Want to learn what savvy practitioners know and use with confidence? Explore the fit our functional medicine training program may be for you. The Adrenal-Thyroid Balance and Dysfunction and the HPATG Axis is covered in detail as part of the curriculum.
Warmly,
P.S. If you know that healthcare Must be transformed to be sustainable and effective, and you know in your heart that You have a calling to be a part of this movement for Healthcare transformation, book a call with one of our Enrollment Advisors today to see if SAFM is for you.
If you haven’t done so already, sign up to receive weekly clinical tips like this via email and you’ll also get automatic access to a free mini clinical course.
Like us on Facebook to get more great clinical tips and to get notifications on my next Facebook Live!
P.S. If you are passionate about transforming healthcare through the power of functional medicine, we encourage you to learn more about our training program here.
To receive clinical tips like this one right to your inbox, click here to receive our weekly newsletter.
Like us on Facebook to stay connected to our rich (free!) content and be notified of our popular, monthly Facebook Lives.
© 2017-2024, The School of Applied Functional Medicine | Company Values | Legal/Privacy | Partners & Affiliates | Contact
web development by: Gordon Multimedia
I am waiting to hear back from DUTCH about becoming a practitioner to be able to order my client a DUTCH test. In the meantime, I have. 63yo female client who is consistently, but not nightly, waking up between 2-4 am feeling hot and anxious. This feels like a classic early CAR. Can I try Cortisolv with her for some rapid relief and then test DUTCH with a few days off the Cortisolv before testing? Would there be any drawbacks to this?
Rather than jumping to a supplement before testing, there seems to be a lot of room for exploration of what kind of behavior is driving the wake-ups between 2 and 4 a on some nights but not on others – tracking food and physical movement, caffeine, and alcohol intake can be a very powerful place to start and will allow you to learn more about your client and raise your client’s awareness of their own body. Even though you say it ” feels like a classic early CAR,” it may not be – the other possibility is very low night-time cortisol that is creating adrenaline spikes that create anxiety and also hot flashes during wake-up time. If the latter is the case Cortisolv may make this situation worse. That’s why looking to non-supplement interventions in this case as a form of rapid relief would be a better option and to your point, focus on sleep is a great place to start. You may also appreciate this post:
https://schoolafm.com/ws_clinical_know/sleep-remedies-that-work-neurotransmitter-and-hormones/
Such an interesting subject! What would you recommend for a hypothyroid client who does not present as overly stressed, whose DUTCH test indicates normal free cortisol levels and a very comfortable diurnal curve but who has sky high total cortisol metabolites? Could this be something to do with methylation and Phase II de- toxification? I am not sure which adaptogen would be most appropriate in this instance and how best to further support methylation (she is already taking Methylated Bs plus B12, magnesium and a diet. Dry high in cruciferous veggies
First of all, keep in mind that “stress” is not necessarily mental/emotional; it can be physiological (e.g. food sensitivities/allergies, infections/dysbiosis, toxicity, insulin resistance). And MANY people are extremely stressed and don’t present that way, often claiming that they are indeed crazy busy and just “manage it well”. But the answer to your question probably lies in the cortisol/cortisone balance data. The total metabolized cortisol is the best estimate of total cortisol synthesis. So this data means: Stress. The fact that her Free Cortisol is lower/better is either because her body (as a compensatory action) is producing lots of CBG to allow less of that cortisol to be free OR because her body is choosing to convert much of that cortisol to inactive cortisone (again, as a protective compensation) to keep her body from being overloaded. If her Free cortisone levels are similar to or higher than her Free Cortisol levels, then most adaptogens likely won’t help much. She’s got to get to the bottom of the root cause and convince her body that it’s safe to calm down. I would use straight ashwagandha. Methylation is likely not *directly* at play with this imbalance, but i may be involved in upstream… Read more »