I understand that if cortisol and cortisone are normal or high and cortisol metabolites are low, that could indicate hypothyroidism. But is this always the case and if not, what would you use to encourage the body to metabolize cortisol?

Dr. Amy Nett:  Yeah, so it could be, so you’re saying high cortisol, okay. Cortisol and cortisone normal or high, and then the metabolites are low. Okay. So let me see here. I would say other things you could think about because no, this is not always hypothyroidism. Other things you can think about would be probably anorexia or maybe severe undereating could cause this, or more commonly, poor liver function. If that’s the case, maybe consider supporting the liver with something like n-acetylcysteine, maybe milk thistle. You could also do the herbal tincture I mentioned on one of the recent Q&As called Liver Life from, I believe it’s BioRay. They produce a product called Liver Life. And if needed  and if you’re doing methylation stuff, you could also look at methylation. I think the other time you might occasionally see that picture would be in chronic stress. So look at lifestyle and look at detox pathways and see if some of those help. So but no, not always hypothyroidism.