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HPA Axis

From the HPA DUTCH section, the example of glucocorticoids creating low cortisol, low metabolites. The patient used hydrocodone, not steroids. Was that a typo or is the use of opioids a pathway that somehow leads to low cortisol?

Dr. Amy Nett: Yeah, so opioids actually inhibit HPA axis at multiple levels. I think I realized that when I...

The DUTCH test is supposed to be done around days 19 to 22 of a woman’s cycle. However, what if it’s timed wrong and it’s done three to five days late? Is the test then useless?

Dr. Amy Nett: No, the test isn’t useless. You just are going to have to consider that the test is...

On the DUTCH test, it only says no caffeine after lunch on day one of the test. I assume this means until the next day to the final collection. Can people get a false reading from caffeine withdrawal effect?

Chris Kresser: Yeah, I’ve been meaning to ask Mark Newman about the instructions there. I think that’s intentional. With all...

If someone has very low cortisol and low cortisol metabolites, would exercise be a way to raise it if they weren’t too tired?

Chris Kresser: I would be very cautious with exercise in a patient with very, very low free and total cortisol....

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: Some of this might be personal, so I’m not going to read it, but the gist of the...
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