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HPA Axis

HPA Axis

I mentioned in a postmenopausal DUTCH case study on one of the June calls that I might consider doing functional methylation testing. If I find a methylation issue popping up on the DUTCH test, what type of testing you do and what you do about it? I know we’re not going over this in class, but ideas on where to go from there.

Dr. Amy Nett: So if you’re doing a complete hormone profile, like the DUTCH complete hormone profile, there is a...

What makes cortisol and cortisone get metabolized more or less quickly if someone has low free cortisol and cortisone but high metabolites of both forms, for instance? Why might that be? If someone has high cortisol and low metabolites, what might be preventing it from being metabolized?

Dr. Amy Nett: Okay, so last week—I think we talked about this last week a little bit. So, I think...

I’m confused about your answer to Justine in the Q&A last week about case number three in Week 29. You said that insulin favors cortisol over cortisone. So insulin potentially favors cortisol and that it produces increased clearance of cortisol. But in case number three, the patient had low cortisol metabolites and high-normal free cortisol. To me, that doesn’t make sense with your explanation.

Dr. Amy Nett: Okay, so let me go back and pull that case up. Week 29, case three. Okay, so...

Vital Adapt was recommended, and I’m confused why that would be used because in the teaching Chris said that it was used in cases of low free cortisol, but hers is on the high end of normal.

Dr. Amy Nett: Yeah, that’s fair. I think this is one of those things where clinical judgment probably came into...

In case number four for Week 29, the patient had insulin resistance, but she presented in kind of the opposite presentation with high total metabolites, low free cortisol, and more cortisone.

Dr. Amy Nett: Okay, so let me go back and look at that one. So, case number four. Okay....

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