Transcription
Hello folks and welcome. I am Dr. Dan Kish and this is our spring mentorship miniseries. This is the final session in the miniseries and we're going to talk about adrenal resilience and the stress response and how you can test for and correct the HPA axis lab supplement protocols, the whole deal.
So, I'm going to go through some PowerPoint slides to present the general concept and then we're going to take the second half of the session to review one entire case and I'll show you how to set up a protocol so you get a feel for it. Is this enough to learn how to do this? No. I mean, I'm sure if any of you are surgeons that, you know, the first time that you saw, you know, a 45-minute presentation about surgery, you didn't like jump in and start to do a surgery like the next weekend. You got to study this stuff for a little while. But today, it's just the idea is just to present the concept. If you love the concept, then you should take some of our classes and I'll teach you how to do this for real. And you'll learn how to safely use the supplements, what the contraindications are, what to do when things go wrong, you know, how to really get into depth on it. So, I don't want to misrepresent this class as like, okay, now you're qualified to do adrenal protocols. I spent probably two or three years studying with the originator of these protocols, uh, before I felt even a little bit confident.
Okay. So, who am I? If you're the first-time person, this is the Kish Institute. I am Dan Kish. We've been training functional medicine doctors since 2006, which is a long time. Uh, almost 20 years now I've been running the Kish Institute, which is that's quite a milestone. We'll have to have a big party next year, I guess. And uh, we've trained thousands of people in how to do this. I trained a whole group of Mayo Clinic practitioners, and I'll show you a little blurb about them in a second. And we've done all kinds of things in this industry, but the goal has always been consistently since 2006, to find potential superstars, that's you, out there, who could really make themselves into a great functional medicine practitioner or who are already perhaps a great functional medicine practitioner, but they want to incorporate higher-level lab interpretation skills and higher-level patient communication and patient management skills. To find those people and to get them fully trained so you can have a super successful clinic. Super successful clinic. That's really the goal. And uh, we've been able to do this uh for quite a while now.
And my my um, kind of personal journey in all this has been that I had a series of three really impactful mentors throughout my career. And we're going to talk today all about Dr. Timmons and his work. I spent eight years working with this guy. Um, I lived in his house for a while in the basement apartment of his house. We were really close and he taught me everything I know about adrenals and everything I want to show you right now. And then I had another practitioner, uh, doctor who was a specialist in brain chemistry and another person, Richard Lord, who is one of the developers of many of the labs that we use in functional medicine. And so my goal right now at this point in my career is to try to give back the information I've gained and to consolidate it and to present it to you all.
So, we did do a study on the Mayo Clinic on exactly what we're talking about today. And if you want to read it, I put it in the notes there so you can download a copy of it. If you can't figure that out, just type into Google Kish. That's me, K A L I S, Bergstrom. That's Larry Bergstrom, Bergstrom. He's the director of integrative medicine at Mayo in uh Arizona. Kaish Bergstrom Mayo study. And this will pop up. A functional medicine approach to treating fatigue, stress, and digestive issues in women. So, we did this study with Mayo. This was the group, Sue and Larry and a couple of other folks that were from Mayo that took my class, my mentorship class. In fact, Larry Bergstrom maintains the distinction of being the only doctor who's taken that training program twice. He really did. He really liked it. So, he did a research study and we looked at all the things that we're talking about today. And the study used the exact same protocols that I'm going to teach you right now. Okay. Exactly. And you can read about the study if you want. Just Google that, pull it up. It's for free online. Uh, it's back in 2016 we did that.
So today I want to present the basics on the adrenals and how you integrate an adrenal program into the overall structure of a protocol when you're looking at more than one lab. So in the Kish Institute mentorship training program, we teach three labs, right? Or three kinds of labs. Stress hormones and sex hormones. So hormone evaluation, but big emphasis on the adrenals, GI or microbiome testing, and then metabolomics or organic acids, whatever you want to call that. So adrenals, GI, and organic acids. Those three tests can be integrated, need to be integrated with every new patient. It was like the baseline of testing looking at the stress response, looking at the microbiome, and looking at the person's mitochondria, brain, oxidative stress levels, all that kind of stuff with organic acids. So, today we're going to isolate and really focus on the adrenals, but I want to show you how that can be applied to an overall case where you're doing all three tests.
And can registered dietitians take my courses, too? Absolutely. In fact, we have a couple RDs in the class right now as we are speaking in the mentorship. Oh, and speaking of the mentorship, it's starting like now in a few days. The April 14th start date is fast approaching. If you have any interest in being the best in the industry at learning how to interpret labs, at patient management, at structuring an entire functional medicine practice, you should sign up and take this class. We've been doing this for almost 20 years. We have graduated a lot of really great practitioners and it's just not, you know, Mayo Clinic people that have taken this class. It's like regular people off the streets who are dietitians, nurse practitioners, medical doctors, chiropractors, acupuncturists, naturopaths, uh, DOs. We have everybody in this group for all these years. We've had a few super high-level people, but by and large it's the regular folks that just want to get a functional medicine practice going. It takes about a year. Uh, you get $1,000 off if you use this discount code. You can scan that QR code. You know, contact the office, talk to one of the staff, talk to one of our team members, and um, you know, learn more about the class if this is really what you want to do with your career.
And the people in this group are highly motivated. We are all meeting together every week. You're presenting your cases. You're listening to the other students' cases. There's faculty here. There's faculty there. There's me teaching. There's a huge massive online curriculum. By the time you get through the year, you'll have a minimum of like 450 cases under your belt from having listened each week to case after case after case. And you listen to a case, you're like, I don't know what that means. You go look it up in the curriculum and you listen to the curriculum and then you hear it in the class and it's an immersion experience in lab interpretation and patient management skills. I look at it as a lab interpretation class, but when I talk to a lot of the graduates at the end of the year, I say, "Hey, how'd you do in the class? What did you really get out of it?" They're like, "You know what I really got out of it was how to manage cases, how to like structure this whole thing, you know, because that's a really hard thing to figure out for most people."
All right. So, if you guys are into it, contact the office and we will keep rolling on. Let's see. Someone else is asking if I've already done the full program but want to review lab results and protocols. Yeah, so we do have something for that, Tammy. So, um, contact the office and I'll tell you, we have an ongoing mentorship membership. You can join the membership. It's like $299 bucks a month and that gets you into lab reviews every week. That's gets you get the whole exposure to the curriculum still. So we have an ongoing thing also.
So here are the adrenal glands. There's a really good book if you haven't read it. It's cited here. Tom Gilliams. Okay. Tom Gilliams. The book is called Stress in the HPA Axis. So if you haven't seen that book, you haven't got it. It's like $30 or $40 bucks. Go online and buy it. Gilliams. Tom Gilliams. And he has great explanations, great graphics, great examples of what's happening with this stress response. And obviously the adrenal stress response, it's designed for a short-term acute critical situation where your body has to do everything it can to mobilize and get the heck out of where you are, okay? Or to grab a spear and throw it at the tiger that's chasing you, whatever it is that you're going to be doing. But short-term stress responses now are invoked day after day after day. And in some people, they just can't turn it off. They literally can't turn it off. And so when you get into that stress response, there's a whole bunch of things that happen simultaneously. Your blood pressure goes up. Your immune system gets suppressed because you don't have to worry about your immune system when you're running away from a tiger. Not at that moment anyways, right? You get a complete change in your metabolism and your body basically starts to break itself down to fuel itself so it can survive another day. That's basically what's happening. This massive increase of all these stress hormones, epinephrine, norepinephrine, dopamine, cortisol, DHEA, they all go up.
And there's three major triggers that we see that that can set this into motion there. Ironically, the most devastating trigger is emotional stress and spiritual disconnection. And you know, emotional stress usually takes the form of some kind of big loss. Someone that you love dies or you go through a divorce or you're a kid. This just happened the other day. This just happened in my practice a few days ago. The girl is like 16 years old. I'm like, "When did this autoimmune problem start?" She's like, "It started when I was 12." And the mom's like, "Yeah, that's when we got divorced." When her parents got divorced, you know, and so it could be that kind of loss just throws people's systems off and sometimes they don't recover. You can obviously have a diet-related issue, some kind of blood sugar instability is the most common. And then you can have any kind of pain or inflammation and most of the time the inflammation is hidden. So emotional, dietary, and inflammatory stresses, those are what set the adrenal glands off. And if they're chronic, it's chronic inflammation or long-term emotional stress or long-term dietary issues, then the stress response just goes and goes and goes and your body can't turn it off. You just can't stop.
So, there's ways that we try to reverse this. Like, one of the most important things you can do is just get people to have proper exposure to food and light. I mean, it sounds so easy, but just kind of eating properly and getting outside every morning is like half the battle and starting to exercise, you know. So obviously we want to do all these lifestyle things and if there's a big emotional loss, you want them to go into counseling and if they're spiritually disconnected, you want them to develop a spiritual life. So you want to do all that but we're not going to get really into that today because we're going to talk about labs today. But we're assuming in the background you have a spiritual life, you have an emotionally balanced life or you're working towards that. You know, you have a great diet. You exercise every day. You're doing all those things yourself so you can transfer that knowledge to your patients.
So now on the practitioner side, what we need for you guys is lab ordering skills. You need how to understand the supplements, how to select them properly, how to dose them properly, and then how to adjust programs as things go along. This is what takes a year in the mentorship. I can show you like the basic things to do now, but as soon as I'm done with this class, someone's going to, you know, email our office and say, "Can you use these supplements for a woman with breast cancer?" And I'll be like, "Absolutely not. These are hormones. You can't give a woman who has breast cancer hormones." So, there's just stuff like that that you need to learn over time. And if you want to be a competent practitioner, then you know that's kind of what you have to do.
All right. And then, uh, three skills to develop: lab interpretation, coaching, and motivating patients. And then just how to present the labs, you know, like it's it's harder than you think because you get the lab test back even if you understand it. You have to explain it to the patient, you know, and and you have to design a program that they can actually do. I think that's where a lot of people get tripped up is they they interpret the lab, they kind of figure that out, okay, but maybe not great, but pretty good. And they're good at coaching. They're nice doctors or acupuncturists or whatever they are, you know, they're kind of nice, good people and they're they can do the coaching thing, but then they're not really sure how to explain the lab in a way that's meaningful to the patient. That takes a little while to learn. It really does. And it's more complicated than you would think because you can't explain the lab to the patient in the way that you got it explained to you. You know what I mean? Because like I'm explaining the lab to you in a way that I want you to be able to interpret it so you know what to do. But then you need to explain to the patient in a way that they get motivated to buy all these supplements and make all these changes in their life so they can get better. And that's a a skill that you can practice. And at the end of the year of the mentorship, everybody gets good at that. I would put a one-year Kish mentorship grad up against any functional medicine doctor out there who's been in practice for five or 10 years in terms of laboratory skills and patient management stuff because you hear four or 500 cases throughout the year. So you just I mean if you hear something 500 times and you don't figure it out, you got a problem, right? I mean everybody figures it out by the end of the year. But if you do 20 cases in a year, you're never going to figure this out. And if you do 20 cases this year and 20 cases next year and 20 cases the extra, you know, the year after that, how long is it going to take till you get to like 500? Like I don't know what's the math on that. Like a really long time, right? Five times five. It would take you 25 years to get as many cases as you could get in a year. And you're not going to learn it if you're doing it in a piecemeal slow way like that. And that's what would happen if you test like two people a month for this year on the adrenals. You're going to get like 24 cases at the end of the year. And it's going to take you 20 plus years to get your skills down. You take the mentorship class, you get 20 patients a week more because we do like four hours a week and we have like at least six cases. Yeah. You're getting at least 30 cases per week in the mentorship class that you're seeing. They're not your patients, but you're seeing and dealing with them. And they're real patients of real practitioners who are really trying to figure this out just like you are. And that volume of testing triggers something in the human brain and you're like, man, a year into this, I got this. I've seen this exact lab six times. I know exactly what to do. And then when it comes into your clinic and you see that lab, you're like, I know exactly what to do. We had three of these in class and boom, boom, boom, you write it out. You go in there, you're confident, the patient picks up on that confidence. You're like, "This is going to work because Heather did it in class and I saw her follow-up test." You're not saying that, but you're thinking, "Heather did this in class. I saw her follow-up test. The patient got better. I'm going to this is going to work for me, too." That's kind of what we're trying to do with mentorship.
And then in terms of the bigger picture of you being successful, a clear clinical model. You got to have a model that you can explain to patients. You just have to have a definitive model. This is what I do. This is what functional medicine is. This is what you're going to do. And then patients feel held and kind of contained. It's like you're providing a container for them, a structure for them. It's if you're a parent, it's not unlike having a child where you're providing the basic structure of their life, right? Like, no, don't stick your finger on the hot stove, you know, they're you're pretty and then when they're teenagers, it's like, no, you're not going to drive after you drink. I'm going to come pick you up at the party. You know, you're providing structure. It's kind of what we're doing for patients.
All right. So, now on to the adrenals. Three stages. There's a stage where the cortisol levels are high. There's a stage where they're dropping and then there's a stage where they're very low. That's not too complicated and we'll show you that in a sec. On the supplement side, we're going to go through a basic protocol. I'll show you the supplements, all the common ones that we use. The lifestyle changes we mentioned, right? Diet, exercise, sleep, meditation, spiritual practices, all that kind of stuff. Oh, and for those of you that came late, as a reminder, there's a mentorship class starting in about a week. If you want to really learn how to do this, sign up. You won't regret it. I promise. People love the class.
All right. So, first of all, it's not an adrenal problem. It's a problem with your brain. It's the HPA axis. The H is the hypothalamus and the P part is pituitary. That's your brain. So, we see hypothalamus and pituitary. That's where the problem is. These are not adrenal protocols. These are protocols to change the way stress hormones are calibrated and calculated and processed and the way the instructions are going out from your brain to tell your adrenal glands what to do. So the brilliance of Dr. Timmons, who's my teacher, whose protocols we're going to look at in a minute, was that he realized, oh, these are not adrenal treatments. You could give pantothenic acid for the adrenals. You could give ashwagandha for the adrenals. You could give magnesium and B vitamins for the adrenals. These are protocols for the brain. We're resetting how the brain communicates with the adrenal glands because it's not working right by definition. If you're stuck in the stress response, this needs to be reset from the top. You can at the same time, and we do at the same time, do adrenal support, but it's you want to differentiate in your brain. One thing you're doing is resetting the communication links and the signaling that's coming from the brain to the adrenals. The other is you're just giving stuff that's good for the adrenals. You don't need to do a lab to give stuff that's good for the adrenals. I, you could just list it off. You could probably just chat GPT or whatever. Magnesium, B6 for sure, B5, vitamin C, rhodiola, ginseng, ashwagandha. There's things that are just good for the stress response. Those are well known. Those are part of the program. But the special sauce here, the magic that makes these programs extra extra amazing is that we're actually addressing the communication links. How? By using a couple of products: DHEA, pregnenolone, phospherine, and licorice root. Those four are the extra special ones.
I'm going to skip through some of this basic stuff because we're hoping you know that. And uh, we're going to get into the treatments. Here we go. All right. So DHEA, pregnenolone, those are the key ingredients in making these programs work and the dosages vary depending on the lab. There's something called phospherine, which is used for high cortisol states and something called licorice root, a special kind of licorice, not DGL, not DGL, the other kind of licorice that's designed for low cortisol states. And you can also use glandulars in low cortisol states. So the brilliance of Timmons in the 1980s, he and another researcher scientist, natural medicine crazy person named Dr. Elias, went to Germany to a trade show and they learned about these salivary cortisol and DHEA test kits that were being done. They brought the technology back from Europe to Los Angeles and they set up a lab in Dr. Elias's garage in LA. This later went on to be a very well-known lab uh in the 80s and 90s that was called Diagnostics and their goal was to figure out what can we do from a naturopathic perspective that's going to change the HPA axis on a follow-up test and they used everything under the sun that they could find and they finally after many years of research realized low dosages of DHEA, pregnenolone, and licorice root in various combinations worked incredibly well, better than anything else that they could find. That's what and then they realized what they were doing in retrospect was resetting the HPA axis. So that's the special part of what we're doing here. HPA axis feedback loops, we're changing them. You can also support the adrenal glands generally. That's the vitamins and minerals and that kind of stuff. And you can improve catecholamines too. Just use tyrosine. I mean, that works pretty well, right? And then as part of this, you also have to reduce inflammation, figure out the emotional, dietary, inflammatory stresses. So the adrenal programs are really in a sense are kind of superficial because you need to go one layer deeper and figure out what's stressing the adrenals. Is it the microbiome being screwed up? Environmental toxins? You know, there's other variables here. We're just covering off on the adrenals for now.
Okay. And here are the four. And you learn how to use these four in the next year and you will be super super successful. In fact, I ran into a very famous functional medicine doctor who took my training program in 2006 when he was in medical school. He has gone on to become extremely famous and I won't mention his name, but I ran into him last year at a conference. I'll call him Joe. That's not his real name. I say, "Hey Joe, what's going on?" He's like, "Hey." And then we were talking about something. I don't know. We were going to go maybe have lunch, but I don't think we did. And we were just chatting in the hall, you know, at this conference. He's like, "Yeah, you know, I still use those adrenal programs." I'm like, "No way." He's like, "Yeah, I do." I said, "They really work, don't they?" He started laughing. He said, "They do." So, here's like this guy that went on to be super famous. He's still doing this on a regular basis because they work really, really well. DHEA in a liquid form, low dose based on a lab, pregnenolone in a low dose based on a lab. Licorice root in a liquid form for low cortisol states and phospherine in a capsule form for high cortisol states. That helps you change the blood levels of the DHEA, pregnenolone, and all these hormones that are being produced and allows you to sort of simulate what should be happening. The brain sees this for long enough and it starts to think it's doing it and then the feedback loops are reset. You're literally changing the cell signaling back to normal. It's like hitting a reset button. And I don't know about you, but there's been many times in my life where my computer is like like screwed up or my phone like my phone is just doing something it should not be doing and I'm messing with it. I'm messing with it and then I think, oh, I'm just going to turn it off. And you turn it off and it resets itself and you turn it back on and it works just fine. Right? That is what we're doing. Basically, we're turning off the stress response. DHEA, pregnenolone, licorice, and phospherine. And they work better in liquids. The DHEA, pregnenolone, and licorice root far better in liquid forms. Okay. Far better in liquid forms. And uh, the phospherine is never is not made into liquid. So that's just done with a capsule.
So on the DHEA side, it helps with immune function, muscle mass, it helps thyroid hormone support. It helps cardiovascular health. But mostly what you're going to see with people is just their sense of energy and wanting to live and you know, just coming back to life. And pregnenolone is even better. Pregnenolone, most people can't even pronounce it. It looks like pregnenolone. Sometimes people say pregnenolone or something like that like it's canalone or something. It's pregnenolone. It's how you pronounce it. It's the best supplement of all time. It is the direct pure precursor to cortisol. It improves everything for everybody and it so rarely causes any side effects. It gives people who are tired more energy. It gives people who are wired some sense of calm. If people are wired and tired, it helps fix both. If you learn how to use pregnenolone, I mean, this would be one of the secret magic things that you have the rest of your career. And nobody uses pregnenolone.
So Timmons and Elias, like I told you, they were dominant in functional medicine in the 1980s and early 1990s. And I learned how to do this work in the early 90s. And then they both died. I mean, it happened. They both died pretty young. And uh, the labs that they had started, you know, kind of didn't have them anymore. And so people this just wasn't taught for, you know, generations. And I came around 2006 after they'd both passed away and I got permission. I asked I asked uh Dr. Timmons' son. I was like, "Brian, I really want to teach your dad's work. Are you good with that?" He's like, "Of course I am, Dan. He loved you." And I was like, "I know." He was like my dad. He really was like a father in a lot of ways. I went to Dr. Timmons' house with Brian, his son, and we went through the garage and we pulled out all the old stuff and I was like, "Game on, man. I'm going to teach Dr. Timmons' work." And that's what we're doing right now, right? And if you take the mentorship class, you will get every single thing Dr. Timmons ever taught me and then some. Okay? And my spin on that over all these years, I guess you would say as well. So sign up now. Don't forget.
Now, let's take a look first as a quick reminder here. The I just want to show you the study first. And it's funny because I had it all queued up. So around uh I don't know 12, 15 years ago, a group of practitioners from the Mayo Clinic took the mentorship class and they really liked it a lot, like more than I would have thought they would even liked it. Like I said, Larry took it twice and then eventually conversation led to, we should study this. I was like, well, that's a good idea. And so we went out and we started this research study. And I just want to show you in the study, if you download, you can go here, you can Google it online, you can download it from the notes here. It's free. Uh, let's see here. And in the study, if you flip through it, you'll see the exact protocols that we're talking about right now. And you'll see a whole variety of cases played out and all the data and all the statistics and everything that we did. It also included GI testing. So you'll see the GI treatments as well. So if you get you really get into this, you can take a look at that.
So we're going to go through one case here and I'm going to show you this is a Genova adrenal test. Many other lab companies have them. You know, I just happen to use Genova and I pulled this one out from some recent cases that were submitted. And we want to show how to design an adrenal program for one and then how to tie that into GI and organic acid testing so you have a more comprehensive view of how this works. Okay? And then go ahead and ask questions because we're right on schedule here. I know I went fast on the slides. We're going to do one case and then we'll have questions.
So here again is a patient and it almost doesn't matter what their symptoms are. So this person could be depressed, they could be anxious, they could have an autoimmune disease, they could have, you know, survived a horrific childhood, they could be a recovering or recovered alcoholic. It doesn't really matter if they're 20 or 50 or 70 years old. I mean, they're basically you're going to do a pretty similar series of protocols and there's going to be some variation, but not that much. And I would say we when we look at these cases in class, most people have what we call the big five, right? Which is that they're overweight, they're tired, they're either depressed or anxious, they have GI problems, and some kind of sex hormone issue, low sex drive, hot flashes, night sweats, PCOS, something like that. So fat, fatigue, depressed, sex hormone problems, and uh, GI issues. That's almost the rule for the majority of the people that we work with. And why is that? Because these systems are all tied together, you know, and you don't just have one of these problems in isolation. Once the adrenals blow up, it means that there's typically some kind of a microbiome problem. There's going to be some kind of metabolic issue. We'll look at that in a minute. And then you have to kind of unravel this whole thing as a package.
So, just for the adrenal side of this, let's take a peek here and go ahead and type in your questions as we're going and I'll get to them at the end, okay? As soon as we can. So, on an adrenal, this kind of an adrenal test, there's also a Dutch test. Those are super popular. You could absolutely run a Dutch. You get the same kind of results. A little bit different, but similar. Um, you're looking at the DHEA levels, which you can see here are low. And then you're looking at cortisol over here. You can see there's a low cortisol to start the day and then it's high, high. So this is what we call stage two. Stage one, the cortisols are high all the time. You're running high cortisol all the time with low DHEA. At stage two, you're starting to see a dip in one or more of the cortisols. And then at stage three, you're running low cortisol all the time. All right. Where do these stages come from? Um, these teachings came from a very late-night session I had with Dr. Timmons. I was his junior teacher for many years and it was 11, 11:30 at night. I can I can just see myself. I was at the front door of his house. I was walking out. I was like, "Okay, Bill, is he in the morning?" Because we had a seminar that was starting the next morning, like one of these, you know, three-day in-person seminars because we didn't have an internet back in these days. There was no internet. So, everyone had to actually meet in person to do these things. And and I'm like, you know, we've been teaching this for a while, Bill. I just got to be honest. You know, you have these 11 phases and no one really can follow you. And when I talked to the doctors on Monday morning after they've been through our three-day conference, they're just confused. And so I I just asked, you know, could I didn't want to insult him, but I said, could we just have three stages instead of 11? And he's like, sure, we can do that. He used to call me Danny Boy. We could do that, Danny Boy. I'm like, okay. So, what would they be? He's like, well, high cortisol, dropping cortisol, low cortisol. And like done. And so then we started that weekend to teach this three phases model. It's not accurate if you look at really what happens to the adrenal glands. It's like a thousand times more complicated than this. But it was a way for us to teach new practitioners how to do this without confusing it. And more importantly, and I didn't realize this at the time. I didn't realize this till many years later. It was even more importantly a way to explain to a patient what's going on in a way that's not confusing to the patient. Everybody can handle three different stages. High cortisol, dropping, and low. And again, if you look in depth at the science behind this, that's completely a fabrication. It's Dan and Bill late at night trying to figure out how can we communicate this better to doctors, but it works pretty well and it's kind of caught on now as a thing, which is kind of funny.
All right. So then you also have the cortisol awakening response that should be around a 50 plus or minus 10. This person's at a negative one. So clearly that is not okay. When you wake up in the morning, you should have a spike of cortisol within the first 30 minutes. It should go up about 50% and it should drop right back down. That's a normal person waking up. This person rather than going up 50% is going down 1%. They're dropping. So they're waking up in the morning and thinking, man, I am tired. I don't want to get out of bed. Okay, I am tired. I don't want to get out of bed. And this again is a Genova adrenal stress profile or ASP. I like this particular lab company for a lot of reasons, but specifically for the adrenals because it's a really clean, simple, easy test to look at and understand and explain. Okay.
Fat, fatigued, depressed, sex hormone problems, and GI issues. Those are like a package. By the time your adrenals are this screwed up, what do you think has happened to your gut lining? It's you got to have a leaky gut if your DHEA is low. Why? Because you're catabolic. That's the whole thing about being in an adrenal problem is you're breaking stuff down. Why? Because you're running away from the tiger. You need to have energy. You need to have quick energy to run away from the tiger. So, you're just breaking everything down. You're taking muscle tissue and you're taking your gut lining and you're grabbing those amino acids from those proteins and you're using it for energy. So you got to have a leaky gut. The other thing that happens when cortisol levels are messed up is your secretory IgA, secretory immunoglobulin A drops or it can go high. It could go either way. This is say it changes. It goes out of range. And so when sIgA gets screwed up because you're stressed, that's your immune response in your gut. So, when you're this stressed, you can almost guarantee a leaky gut because you're catabolic and you're breaking your gut tissue down as well as your muscle tissue for fuel, right? Just to fuel your body. And your sIgA is screwed up. Either high or low. Either way, it's screwed up. So, your immune response in your gut isn't working well. And that's just like a recipe for that is a GI problem. It's not a recipe for one. It is a GI problem. And once your DHEA, cortisol get this screwed up, you pretty much have to have an estrogen, progesterone, or testosterone problem. You can't have one steroid hormone be way way off like this and the others are all just fine. It just it just can't work like that. The pathways are too connected. And then your metabolic function, what does cortisol do? When cortisol is high, you're burning glucose at a super rapid rate and you're not burning fat. That's one of the, you know, cortisol being out of range is the same thing as insulin being out of range, right? Cortisol is a glucocorticosteroid. It's a blood sugar stabilizing hormone. Glucocorticosteroid. That's one of its main roles, maybe its main role in some ways. And cortisol and insulin are playing off one another. And if you have a cortisol problem, you have to have a blood sugar problem because cortisol is a glucocorticosteroid. You have to. And so now we're right into the smack dab middle of insulin resistance. And that's all the weight gain and all that other kind of metabolic junk that happens. And a lot of times when people are this screwed up with their cortisol, you know, they can't lose weight. Don't have to be a doctor to know that. Just watch any kind of late-night TV show and you'll see, you know, oh, you can't burn fat. Maybe you have a cortisol problem.
All right. So let's take a look here at a program. Uh-huh. Let's see if I can make this display a little bit better. Sorry, I'm not. My view here is Oh, there we go. View. Um, there we go. Okay. Okay. So, we're going to have a program. So, we said that there were this is a stage two. Remember, there was low cortisol in the morning. And then others were high, others high. Uh, we also had low DHEA. So, what do you do? Well, you start off with DHEA drops. I use the brand called Biomatrix. That is Dr. Timmons' brand. I just talked to his son Brian last week. Brian's still running the company. Super cool. So, I definitely want to support them and the family who brought us all this work. Plus, not a lot of people make DHEA drops. So, kind of stuck using Biomatrix. You can get Biomatrix off of Fullscript if you're a Fullscript person. Uh, let's see. There's stage two, we decided. So, you give three drops three times a day. Each drop is about 1.2 milligrams. So that's like three or four milligrams of DHEA each dose. That's not a lot. I don't even think they sell like a 3 milligram pill. It's a tiny tiny little bit. Why? Because we're trying to reset the brain. We're trying to trick the brain into thinking that it's making the DHEA again. It's a ruse. It's a trick. It's a scam. It's a con. It's not 50 milligrams of DHEA to replace the DHEA. It's a couple of milligrams three times a day trickled into the bloodstream. We're sneaking it in there so that the body sees this DHEA and there's no internal mechanism for understanding it's coming from somewhere else. You also use pregnenolone. So for stage two, let's say around 10 drops of the pregnenolone three times a day. Same thing. It's about 1.2 milligrams per drop. Okay? And so that's like 10 plus milligrams of pregnenolone three times a day. Tiny tiny dosages we're doing here and that's going to impact cortisol to a large extent and on purpose and this is a good thing. DHEA and pregnenolone will improve testosterone and estrogen and progesterone also in these low dosages. It's very safe to do. But remember I said in the beginning, this is not like the kind of thing you rush out and do without some further training. Like you can't do this with a breast cancer or prostate cancer patient. That would be really dangerous and irresponsible. So, you got to think it through and you got to get some proper training, but we're just trying to show you um how to get started.
Now, this person had high cortisol breakfast, lunch, and dinner. You remember that? So, we want to use some phospherine. Uh, no, the no, it was lunch. I'm sorry. The breakfast was low. So, the morning was low. It was lunch and dinner and evening were high. So the phospherine you would give let's say one with lunch and one with dinner and maybe one with bedtime, but maybe not. Let's say at least one with lunch and one with dinner to lower those cortisols later in the day. You could also use the licorice root. This is not DGL. Have to say that because you're going to screw that up otherwise. Not DGL. And it's again Biomatrix carries it. You can get it from Emerson or E or um Fullscript or whatever distributor, you know. Uh, and the only low cortisol was in the morning. So, you only want to give that first thing in the morning. That's 10 drops. So, DHEA, pregnenolone, phospherine, and licorice. Those are the four secret sauce special ones that are implied designed only in the program to affect the brain. Then separately, you just want to be nice to the adrenal glands. So, you want to use stuff that's good for the adrenal glands. I usually use a pack. I'll use like an Energize pack from Pure. That's one pack a day. Or I'll use the Twice Daily packs from Designs. Those are two a day. Some kind of pack that has the fatty acids, the uh antioxidants, all the other kind of stuff that you need. B vitamins. You need a lot of B vitamins. And then you need to do some extra vitamin C. Usually that comes in a 500 milligram and you want to do a couple of those three times a day. Now you can also add. I'll put in these are question mark things because the list is getting kind of long already. But you could add in something like Adrenone from Designs for Health. That's a, you know, adaptogenic herb support product. You could even add in like Adrenals, that's from Pure. That's a glandular. But when the list gets this long, sometimes people get a little turned off and it's a little too much. So I'd say the core product, core products are DHEA, pregnenolone, phospherine, and licorice and some kind of pack. You can add in and will help a lot to have the vitamin C, adaptogenic herbs, and maybe a glandular, but that's, you know, probably too much stuff for most people. But at least you want the first four or five things. And the energy, the energy, where where'd that go? Oh, yeah. Energize pack is from Pure, Pure Encapsulations. It's just a pack with all the vitamins, minerals, antioxidants, some fatty acids, you know, and then Twice Daily packs from Designs for Health. Those are the same exact thing, but they're from Designs. They are fish oils, B vitamins, antioxidants, minerals. Okay, really basics. The basics here. And I don't use the glandular as much. Let's just take them off so not to confuse you here. All right.
So now and then what do we do in the mentorship class that several of you are going to sign up for the brave among you. It's like the Navy SEALs training for functional medicine practitioners. Like you got to be like special. You got to be like I'm going to make this happen. I want my life like a Navy SEAL. I've known a few of them in my practice. I my practice used to be in San Diego. I had a few of them that were patients and they're like special people. They're not like the loud ones. They're not like some guy that walks into a bar yelling. They're always kind of quiet and they're kind of intense and they're like uh steel. That's the kind. This is like Navy SEAL training that we're doing in functional medicine. We're going to turn you guys into like the best of the best. Okay.
So, let's see. Um, so forget the glandular because we don't use that very often. But now here's where things get a little dicey. So now we've got this person, they've got an adrenal problem, but what else is going on? Because that never happens in isolation. So, we're going to also look at their gut. This is a GI MAP test. GI MAP. Super popular GI MAP. And we're looking at the GI now and saying, okay, no parasites. That's good. No H. pylori. That's unusual. Oh, but look at those commensal bacteria. Low, low, low, low, low, low, low, low, low, low, low, low, low, low, low, low, low, low, low, low. That's how many lows there are. Okay, not good. So, the microbiome is wiped out. There's some dysbiosis. These are the dysbiotic organisms. And um, remember I said that sIgA is generally going to be screwed up in accordance with the uh adrenals. Here's your sIgA. So that's the immune response. A little bit of blood in the stool, too. That's kind of a referral out to a GI specialist. And then stercobilin high. So their gallbladder is not working great. This person's got a lot going on. So we then have to go back and think, okay, now we're layering, right? This next layer is well, we have this adrenal problem, but we have this gut problem, too. So.
What are we going to do? Well, we're going to start with adrenals. Always. Always. Not don't start with the gut. Don't start with the gut. I know it's tempting. Don't do it. Just don't do it. After a few months, one or two months, you start with adrenals and lifestyle. Adrenals is code word for lifestyle, right? Because it's the stress stuff. So you start with the adrenals. That means start with stress treatment and lifestyle. Diet, exercise, sleep, meditation.
The first couple of months, what do you do? Start with the adrenals. That's code word for lifestyle. Stress management. Diet, exercise, sleep. Getting all that figured out for that first couple of months. What do you start with? Adrenals. That's code word for lifestyle. Don't start with the gut. Never start with the gut. Never start with the gut. It's too early. They're not ready yet.
Then after you're into this a couple months, then GI protocols start. Because what's happened now? You're two months into it. The adrenals are doing better. Their lifestyle is starting to come together. They're eating better. They're sleeping better. Their energy is better, they're feeling better. Now, you're going to do some gut treatment. In this case, you're going to want to do a dysbiosis treatment, gallbladder support, you got to deal with a blood. I don't know what that's coming from, so you got to figure that out. And then you want to do a microbiome restoration. Okay, so that's step two. Step one, start with the adrenals and lifestyle. Then here's step two.
Now we're keeping that going. We're not going to all of a sudden say, "Oh, now you can eat crappy food and, you know, yell at everybody all day long." No, you're still meditating. You're still eating right. Now, we're going to start to work on your GI also. Oh, Sylvia is asking. Oh, Sylvia's asking. Sylvia, I'm sorry to pick on you. Um, I could make up another name, but I already said your name, Sylvia, but no one knows your last name, so I won't say your last name. But Sylvia's asking if you have H. pylori, you would still start with the adrenals. Read the Mayo Clinic study. Eight out of the nine women that had H. pylori were successfully treated with this exact protocol. You got to, got to, got to, got it. Especially if it's H. pylori. Why? Because of all the infections, H. pylori is the most dramatically associated with stress. It's the stress that's causing the problem, not the infection. So, you got to get the stress response under control. Then you'll be able to kill the H. pylori. You have to do it that way.
I've watched way too many action movies, a lot of them about World War II, and that's always the case. When they're going to attack, one side's going to attack the other side. They don't just send the guys running across the field. No, they bomb the other side or like if it was in the war in the Pacific, they bomb the Japanese on the island for like a day and then they launch the Marines onto the beach, right? They don't just throw the Marines in there. No, they're bombing, bombing, bombing. So, the preparation is really what is going to ensure that you're going to win the battle. So, if you're trying to kill H pylori, you want to make it work, you can't just like go after it. That would be like launching your guys onto the beach before you bomb the heck out of the beach for a day. No, you got to get things ready by knocking the other side down and by strengthening your side. And when we work with the adrenals, what are we doing? We're strengthening the gut lining, right? Because remember we said the adrenal problem causes leaky gut. We're strengthening the gut lining. We're strengthening the immune response as we work with the adrenals. And then when you go to attack the H pylori, you've got like twice the number of, you know, guys on your side and you can crush the H. pylori. If you go into attacking H pylori immediately, good luck. You know, you're just going to gradually decrease the odds that what you're going to do is going to work. But that is true for all GI situations. The longer you wait, the more of an advantage you get.
Here's the third test. This is a GOVA metabolomics. We also do a lot from uh DSL labs. Have organic acids and an omics test. Same, same. Okay. So, whatever you're doing for organic acids, oxidative stress high, mitochondrial function a little bit, methylation not so great. Now, we're looking at this. We're thinking, okay, so the dysbiosis markers are high. That makes sense. We know this person has dysbiosis. Uh, a lot of the B vitamin markers are high. That means that the B vitamins are deficient. Uh, a little bit with carbohydrate metabolism and a little bit with toxins. So now we're seeing, remember we said the adrenals are related to blood sugar regulation. Here's carb metabolism represented in a different way. Pyruvic acid is high, alpha-hydroxybutyric acid is high. A bunch of these are high. So there's a problem with carb metabolism. In fact, there's even a problem with succinic acid and a problem with fatty acid metabolism. So, you got to kind of fix all that, right? So, basically, you want to fix fat burning, carb burning, and energy metabolism also. And then every single one of the toxin markers is elevated. See that? That whole section. So, we probably should deal with that, you think? And then this one here, quinolinic, which is related to neuroinflammation, is high. So that's enough. I don't know. We don't have to find everything that's wrong with this test because we just, we'll be overwhelmed. I'm already a little overwhelmed. So let's go back here. Let's just lay it out. So we got step one, uh, step two. Let's make these unbold so we can see this better. Here we go. Is that better? Let's take that out. You got step two. Now we're going to do step uh three. And boy, there's a lot to do there, isn't there?
So, what do we have? We just said we have uh fat burning, fat metab, fatty acid metabolism, or we could just say fat burning, or we could call it beta oxidation. It's all the same thing. There's a problem there. There's a problem with carb burning. The citric acid cycle had a little bit of a glitch. There was some neuroinflammation and there were uh every toxin marker, all toxin markers high. Okay. So, we're going to run the adrenal program in total for six months. Around month two or three, when the lifestyle is in place, what's that? Diet, exercise, sleep, meditation, adrenals, and lifestyle started off. Around month three, we're going to go after that dysbiosis, get that microbiome fixed, get the gallbladder fixed. So, that's going to take, you know, three, four months probably there. As soon as the gut program is done, the moment it's done, and we're now we're like around month five. Let's just fix this poor person's metabolism. Fat burning, carb burning, citric acid cycle, get the neuroinflammatory markers down, fix all the toxins, and get all the detox stuff done. So, that's going to be a separate program. And I'm just going to write because we're short on time here. I'm going to wrap it up. I'm just going to write GI protocol here because we don't have time for it. Uh, but you're going to do that. And then as soon as that's done, you're going to start with NAC 900 milligrams. What's that for? Liver support, right? And then you're going to do some uh what else was Oh, they had all the toxin markers. So, let's say we add in some Amino Detox. It's from Designs. So, really getting the detox path. Wait, sorry, my thing skipped around there. Really getting the detox pathways going now. And then maybe something like uh L-GB, that's liver gallbladder support, also from Designs. So we have a nice little package there to help support the liver and detoxification. So this is liver detox, toxin clearance after the gut program is done. And then we said the quinolinic was high. So they need some anti-inflammatories. I use Curcumin Veil a lot. That's from uh that's from Designs for Health. That's a really great anti-inflammatory. You know what else is super good are um and no one ever talks about these are SPMs. Those are like the best anti-inflammatories, aren't they? If you don't know what an SPM is, look it up. So, now we have an anti-inflammatory kind of brain protection/liver clearance, liver detox protocol. So, there's three different things. We run the adrenals for six months. We fix the gut starting around month three. When that's done, we're going to fix the liver, metabolic stuff, get the toxins out, and that's going to be three to six months. So, it gives you an inkling of how all these different programs can be lined up into integrated protocols. And it's all three labs. So, it's an adrenal lab, a Dutch test, a GOVA test, wherever you like to get your adrenals from. A GI test. This happened to be the GI Map. Could be a GI Effects or any other GI test and then some kind of metabolomics test. Again, this happened to be from GOVA metabolomics, but you could all use use also an OMIX test from DSL or an OAT test. Those are all basically interchangeable.
Okay, so now let's go to questions. And for a final reminder, we are having our mentorship training program where we get to go through your cases just like I did, case after case. You see four or 500 of these. By the way, you're going to learn it by the end of the year. There's also an online curriculum that you study. So, you learn all the tricks of the trade of how to interpret labs. And then during the live calls, you're working with myself and my faculty who are just the most amazing human beings to really get into the weeds on each individual case that you have and figure out what you're going to do for that person. Retesting, submitting that. It's wonderful when we get we had this uh last week when I was teaching. We had a doctor and she submitted the original test and then the retest. That was so profound. There was this woman who would had literally been weeks away from dying on the first test and then there was a medical intervention that happened, you know, separately. There's a surgery that happened that saved this woman's life and then six months later we saw the retesting after all the redoing of all the supplements. It was just incredible. So, you get to see all these cases play out. It's just pretty fun. Okay. All right. So, now I'm going to look at questions here and we had a few minutes and I'll cover as many as I can. Okay, I'm going to go back up to the top. See what we can get through here. I might not be able to get to all of them. So, uh, yes. So, in terms of practitioners that can take this class, uh, nurse practitioners, medical doctors, osteopaths, chiropractors, naturopaths, acupuncturists, registered dieticians, nutritionists, some health coaches. If you're a health coach, you know, usually it's better to talk to me first and we make sure it's appropriate for you. Um, let's see. Anytime you would not give pregnenolone, you don't want to. Well, this is the the famous Richard Lord quote. Any nutrient can be a toxicant. So, any nutrient can be a toxin. So, if you're going to use something like pregnenolone, you really have to study it for a couple months and understand all the contraindications to it. All the times when you don't want to do it. You know that that takes some time to learn all this. Okay. Uh does pre affect progesterone lab results? Yes, it will. It will change progesterone lab results. Um, let's see if cortisol is out of range. Can we assume it's also elevated throughout the night? Uh, well, if cortisol is high, you don't know if cortisol is high at night unless you test it at night. But if cortisol is super high when they go to bed, that's what you're treating. You're going to give the phosphoserine at dinnertime to lower that high uh bedtime cortisol. It doesn't really matter what it's doing when you can't see it in the middle of the night because you're going to treat the ones that you can see. Um, if both cortisol and DHEA are high, that's a special circumstance. You don't see that very often. Um, but depending on how high they are, that's a normal HPA response. So, what should happen when you're stressed is cortisol goes up and DHEA goes up to match it. So, if they're both high, it could just be normal or it's a little tricky or it could be somebody if it's a female especially with PCOS type problems because some people just make too much DHEA regardless of what their cortisol is doing. It may be independent of that. So, that one can be several things, but it's not super common. Could be PCOS. I would be on the lookout for PCOS. If you see a high DHEA, uh, if cortisol, DHEA, and testosterone, estrogen are high, then you got a problem. Yeah, you that's a whole separate problem that you need to deal with. So, if you see high DHEA, everything I said for this last hour gets thrown out. I'm going to say that three times. If you see high DHEA, everything that we just discussed is off the table. If you see high DHEA, you can't do anything that we just talked about. I think I said it three times. All right. Uh let's see. How long do you do the DHEA and PREG for? About six months and then stop and retest. If someone has high blood pressure, then you do not use licorice. You don't really need a substitute. You can use some, you know, other adaptogenic herbs. You could use Rhodiola or or Ashwagandha or something like that. But you don't need to find a different kind of licorice, you know. Uh let's see. Let's see when let's see when speaking of when is it resulting low? Can these results can these result high and be also adrenal stress? Yeah. So, if DHEA is high, it's a special circumstance and we have to, we don't have time to talk about that, but I'm going to say it for the fifth time. If DHEA is high, you don't do any of the stuff that we just talked about. Everything we just talked about is only for low DHEA people. Um, so if if someone has uh, you know, a marker that shows blood in the stool or their calprotectin levels are super high, then you have to use your own judgment about, you know, when to make a GI referral. You don't want to over-refer people, but if you spot something that's a medical issue, you should know what the ranges are and when to refer and have um, you know, a GI specialist that you work with that can take cases and and, you know, help you with the rest of the evaluation or just send them back to their primary care doctor for a follow-up test. Uh, let's see. So, yeah, so Heather, we do we do all three tests as soon as a patient walks in the door. You get a stress test, a GI microbiome test, and some kind of metabolomics. That's like the getting started series of tests. And you can take it from there. You can do more, but that's a really great basic workup, you know. So, a lot of questions about when do you refer out? Every I don't ever, well, I don't ever refer out because I refer, I pre-refer. So, in other words, every patient that I work with has to have had a full medical workup for whatever their condition is before I work with them. So I don't end up referring out a lot because I require that people have the workup with the conventional medical doctors before I start to work with them. Then once in a while I'll find something that I then need to refer. But most, that's unusual in my practice because everybody that I work with has to have seen a competent medical practitioner that's done a full workup for whatever their condition is. Okay. So we kind of get that out of the way first. Um, you can do genetic testing. That's a little bit outside the scope of today's talk, but yeah, we do the 3x4 test if you guys are interested in that. Um, let's see. We have any more time left. Oh, we're a little bit over time. I see one or two more questions here. Let's see. Uh, they're also in perimenopause. Uh, you would also do hormone metabolites. Well, for any female, you could do hormone metabolites. In fact, on go listen to the miniseries that I just did on Monday. We talked all about estrogen metabolites. So absolutely yes, you should do the hormone metabolites for all females that are menstruating or who are post-menopausal. So I guess for every female who's not a young girl, like let's say anyone over the age of 16 or something like that, 15, 16, you should do the hormone metabolites. So you can see what's going on there. That's just being safe, right? Uh, what if the person is estrogen dominant due to stress? Will the pregnenolone increase progesterone, therefore get them out of the estrogen dominant state? Yes, Valerie. 10 points for Valerie. Yes, that's a yes. That's a yes. If the patient is estrogen dominant due to stress, the pregnenolone will increase their progesterone and lower their cortisol, by the way, and get them out of the estrogen dominance. So, yes, yes, yes, yes. Pregnenolone is a way to get someone out of estrogen dominance. That works incredibly well. I've done that thousands of times in my own practice. Um, if they're already supplementing with DHEA, um, you can just do the test as they're on it and see if they're taking the right amount. That's probably the easiest way to deal with it. If you join us late, we're starting a new mentorship in a week. You'll get a recording of this shortly. And oh, here Terry's asking, "So, how long do you have access to the curriculum?" So, you have access to the curriculum for a full year. If you then want to stay in the group, we have a membership. You can join the membership group and most people do and you can have access to the materials and the live calls for an extra couple years if you want. Okay. Uh, and the ongoing support, it takes most people at the end of the year, honestly, are not quite ready. H it's like 1550. I would say half the people at the end of the year are like, thanks Kish, that was great. I'm moving on. The other half are like, can I stay? I'm like, yeah, we have a membership thing. You know, now you're done with the mentorship first year training. You could join, you know, as a member of the group. You still get access to the curriculum as long as you want. You still get access to the live weekly calls and probably about half the people stay in for another year or so because they don't feel like they're quite ready yet, especially with organic acids because it takes a long time to learn that. So, it's probably 50/50. Uh, and the time commitment to doing the class is there's a weekly one-hour call. There's weekly curriculum that you need to go through. It's a couple hours. There's an additional three or four hours each week of optional things that you can do and it's a typical minimum three to five hour a week commitment, I think for most people. All right. So that was Terry asking those questions and Terry, I'm happy to speak with you or one of my team members can if you have more questions. All right. Okay. Take care gang. We'll talk to you all soon. Oh, and no CEUs. Uh, no, we don't have any CEUs. You know why? Because I talk about specific products all the time. So, we're like, there's no way we could qualify for that. It's very practical. We're going to give you actual name, brands, and dosages, and that means you can't do the CEU thing. All right, take care everyone. Bye for now.