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HPA Axis

HPA Axis

During the discussion of the DUTCH Hormone Test, you mentioned that gut issues can contribute to low free cortisol levels. Can you go over that connection again?

Chris Kresser: Sure. Gut issues could contribute to high cortisol, low cortisol, a combination of high and low cortisol, dysregulation...

There’s a patient that presents with a facetious hyperthyroid state because of too much thyroid medication, and Chris is saying that the patient has levels of cortisol that are too high but low levels of cortisone. I thought that when patients had hyperthyroid states they usually presented with the opposite. I’m confused. I think I understood the physiology that would make more sense. He states that oftentimes people with hyperthyroidism have troubles converting cortisol to cortisone, but he also said in the earlier cortisol/cortisone slide that patients with hyperthyroidism often present with high cortisone levels, so I don’t understand.

Chris Kresser: Well, it is all very confusing. I think, as a general comment, you have to remember that there’s...

From the HPA DUTCH section, part five, under ‘Why is cortisol elevated in obesity?’ I’m not clear on the hypothesis that obesity causes impaired cortisol-to-cortisone metabolism. This would not explain why cortisone metabolites show up in the urine. Wouldn’t there be less cortisone metabolites if the original cortisone conversion process is impaired?

Chris Kresser: I debated on how much detail to go into with this. The HPA axis is incredibly complex, and...

Do you have any updated info or comments on whether GABA crosses the blood-brain barrier and whether it’s useful for HPA-D or anxiety?

Chris Kresser: So, there appears to be some disagreement here, but the consensus, as far as I can understand it...

What’s your take on maca as a supplement for HPA-D? It’s an ingredient in some adrenal support products such as Integrative Therapeutics HPA Adapt. I’ve tried it on myself, but it disrupted my period. Being Chinese, we call it ‘unable to tolerate the yang’ or ‘a weakness that isn’t suited for replacement therapy with yang.’

Chris Kresser: Yeah, I look at it from that perspective too. Maca is pretty potent, and it can have a...

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