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HPA Axis

I am a night shift worker, 9 p.m. to 7 a.m. shift, working a schedule of roughly seven nights on and 14 nights off. During my off time, I switch to a daytime schedule. Needless to say, I have some difficulty sleeping. I recently conducted the DUTCH Complete Test at about five nights out from my work schedule. While my cortisol level demonstrated some large swings, spiking to top end of normal at the second morning point and bottoming out to the low end of normal at the evening point and coming up to the high end of normal at the before bed point, it remained diurnal. Unfortunately, melatonin was well below normal at 1.2. My question is whether it’s better to supplement with melatonin or try to provide melatonin support through food. I currently only supplement with melatonin during my work weeks.

Chris Kresser: Yeah, it’s a really tough situation. I think I mentioned that having a more consistent shift schedule, where...

Do you see potential HPA pathology with clients who decide to go back to sleep or hit the snooze button after their initial morning awakening?

Chris Kresser: That’s an interesting question. What we do see is a U-shaped curve in terms of sleep duration. We...

From an HPA axis perspective, what, if anything, would you suspect is going on with the following symptoms, which I’ve had described to me by several patients over the years: (1) energy crashes or symptom exacerbation at weekends or during holidays, and (2) extreme tiredness or mood problems as a reaction to waking up in the morning during, in the patient’s words, ‘the wrong sleep cycle’?

Chris Kresser:  I don’t think they’re necessarily the same thing, although I agree with you that they’re both probably signs...

In the HPA-D unit, Chris explained that pregnenolone cannot actually be stolen to make cortisol, thereby decreasing DHEA, since they’re made in two different areas of the adrenal cortex, and if I have this, DHEA is typically low when cortisol is high probably due to enzymatic activity. Can you explain a little bit more about what’s actually going on with pregnenolone, if anything, when we’re under stress?

Chris Kresser:  There’s still a whole lot we don’t understand about pregnenolone and particularly about DHEA. I mentioned that in...

How much variation do you see in cortisol on the DUTCH test when, for example, you didn’t sleep well one night, assuming normally you sleep well or had some other form of acute stress?

Chris Kresser: We would expect to see variation. Cortisol is a hormone that responds in a matter of minutes to...
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