Adrenal Lab Testing Keys to Correcting a Damaged Metabolism, Healthy Weight Loss

Hello everybody, and I am Dr. Dan Kish. And I am here to talk to you today about adrenal lab testing and the keys to correcting a damaged metabolism, so people can lose weight, have more energy, better sex drive, better quality sleep, stronger immune systems, all the things that happen when you correct the adrenals.

So I want to thank Goova Diagnostics for helping us put on this free webinar today. And I want to thank my teacher in this work, Dr. Bill Timmons. Long past now, he must have died, I don't know, a decade or two ago. Kind of blanked out on that. So when I was a very young practitioner, first starting out, he took me under his wing. And he spent many years training me in how to test and treat the adrenals. He ran a lab, if you're old enough to remember, called Bio-Health Diagnostics, which had some of the best GI and adrenal testing. And, uh, he's quite a character and quite a person. And everything I'm talking about today is directly out of the Dr. Timmons Playbook. You are now the third generation of person to be learning this. Timmons developed this work in the '80s. I learned it in the '90s, and I'm passing it on to you. It has been battle-tested with tens of thousands of patients in thousands of practices in several generations, and these programs work really, really well. And, um, super excited to be teaching you them.

Okay, so we used to spend a whole weekend trying to cover what I'm going to do in about 30 minutes. But I want to give you like the essence of the treatment so you can start to try this on a few people and see what the results are. In general, you need to do these programs on, let's say, 20 patients before you go, "Oh, I get it now. This actually really works. That Kish guy was right, and Timmons was right, and they figured this out like 40 years ago." Things haven't changed a whole lot in the last 40 years in terms of how stress affects the human body.

Okay, so let's jump in. I'm going to cover off on some slides, but we're going to keep it short. And then I lined up a whole bunch of labs, and we're just going to do lab review, lab review, lab review, lab review, protocol, protocol, protocol, protocol, so you can see a bunch of these that start to get familiar with these basic concepts. So for those of you that are brand new and, uh, first webinar you've ever done with us, oh, I am Dr. Dan Kish. I've been in practice for a long time, 31 years. I've been teaching through the Kish Institute that I created back in 2006. We've trained thousands and thousands of doctors in how to build successful functional medicine practices. So I'm interested in the business aspect of your practice. I'm interested in the clinical aspect. And I think most importantly, I'm interested in the patient communication, patient communication skills development aspect of this, so that you guys can develop best-in-class protocols that are delivered in a compassionate and caring way, so patients will do them and get better. That's really the goal. I've worked with Mayo Clinic. I've worked with Richard Lord, the, you know, leading scientists in our industry. And, um, at this point, I've kind of been around for a while. You know, I don't know how 30 years have passed, but so they have.

We've worked with Goova for a long, long time. They are a great partner. They are really, one could say, the original functional medicine lab company. Back in the day, when they were called, uh, they had they had a different name originally, but Great Smokies. But, you know, so they've been supporting our community of doctors for like 40 years, maybe or more. And I went to visit the Goova lab location in in Asheville a couple months ago, and it was kind of like, you know, being at the ground, just being at this epicenter, this beginning of where our whole field started. And they're staying up on the technology. They're doing great quality testing. They're rigorous and scientific, and they really care about what they're doing. It's a great company and it's a great lab, and we as practitioners should support them so that they stay around for us. You know, it's a mutually beneficial kind of relationship. So, um, I support Goova wildly and always have. We are giving Goova customers a 40% discount on this webinar, uh, on this, um, for webinar registrants like yourself, for our upcoming Genova class on interpreting the neutral. And that's starting later this month. If you guys are interested, sign up. You get a huge discount because you're a referral from Goova, and we'll get things moving and get you teaching, learning how to interpret neutral. A little bit different than the subject today, but equally important.

Oh, and I forgot to mention, scan that QR code if you're a QR code kind of person. Then you don't have to, like, get a link and all that. But we'll send out links later if you're fumbling with your phone and you don't have time to do all this. But take a picture of it at least, you know, then you'll have the code there so you don't have to ask us what the code is.

All right, so now we're going to get into it. What's the problem? Patients are overweight and they can't figure out why. I just had one of these patients today, this morning, a few hours ago. She's like, "Dr. Kish, I'm doing CrossFit six times a week, okay? And I'm eating like perfectly, and I haven't lost any weight. I weigh 190 pounds. I want to weigh 160." I think she's like 5'4" something like that. Seems reasonable. She wants to lose 30 pounds, and it's just nothing's budging. And so I said, "Well, maybe you have a damaged metabolism. Let's look at your adrenal lab." And lo and behold, this is like just happened a few hours ago in my practice. This happens all the time. If you have a damaged metabolism because your adrenals aren't working properly, you're not going to lose weight, even if you're exercising and eating right and doing all those other things. It's just going to be a limiter on what's going to happen with your weight. And then if you do have a damaged metabolism because your adrenals are messed up, and you can lose weight, it's going to be because you go on a calorie-restricted diet, which damages your metabolism more, or because you're doing excessive cardio. It'll get you to lose weight in the short term, but that's going to damage your metabolism even more. And then when you start to eat normally and you back off on the, you know, five hours of running every day, the weight is going to come back plus a little bit more. And not only that, but then it's going to be even harder to lose weight in the future because you damaged your metabolism even more. So at some point, patients just have to figure out, "Look, I just have to stop. I have to spend a year testing my adrenals, repairing my metabolism, and then I'll lose the weight once my metabolism is healthy." That's the goal. We want to test for and correct metabolic function as it has to do with the adrenal hormones and fix all that.

It helps if you have a systemized approach to treating the root causes of chronic conditions. And this is one of the brilliant things I learned in those years of working with Timmons. You want a lab-based model you can rely on that's going to be consistent and deliver you results with most of your patients, I think on everybody, but most of your patients. And then you want supplement protocols that you didn't just make up, you know, last night because you were Googling something, but that you know have been used for generations, generations. And so they've the original, you know, Genesis of all this was running labs, trying products, seeing what worked on a follow-up lab. I mean, Timmons and his his partner in crime in this, Dr. Elias, they did that for, I don't know, like almost a decade. They didn't just wake up one day and say, "Oh, we're going to use DHEA and pregnenolone to fix these things." They had to, like, test this. In fact, they built a whole lab company so they could test people so they could figure out what protocols to do. And then I came around in like 1992, '93, '94, '95, right in there, and I was just able to learn these programs that they had spent a decade building. And then I've been teaching and using them, you know, ever since. Maybe I, I figure I got this down probably in '95, you know, so I've been using these protocols exactly as I teach them right now since then. If they don't work, it means something else is going on. That's a whole another subject.

But I want you to get a quick sense, and not too many slides, we don't want to PowerPoint you to death, but just a few slides on how this all works from, like, a practical, patient education science side, and then get into the lab analysis so we can spend the majority of our time hopefully reviewing labs. So I'm going to go through these slides kind of quickly. Okay. Um, so the things that happen to a lot of people is that if their metabolism is healthy, and they start to eat less and exercise more, they're going to lose weight right away. I mean, if your metabolism is working right, that's what's supposed to happen. If you have a damaged metabolism, then that does not happen. And it's frustrating for people because they don't, they think their body is just not working right. They don't know what to do. And the more that your cortisol is out of range, the more that this is going to be a big problem. Okay. And what we're looking at when we see the labs is that we want this circadian rhythm, this spike up of cortisol that happens right when the sun comes up, and this dropping down of cortisol that happens as it gets to be night. We want the person as close to being in sync with this as possible. And so you're measuring for this. And then there's specific programs that you can use to bring this back into a balance. Okay? That's what we're shooting for here, exactly what we're shooting for.

And one of the keys to treatment is that the person has to be awake and outside when the sun is coming up so they can get that exposure to orange light. There are special cells in your eye that only respond to orange and yellowy light that happens when the sun is coming up. It works even if it's cloudy out, but not quite as well. If it's freezing out, you don't want people going outside and freezing to death. You don't want people staring at the sun. You don't want this to be dangerous. This should be a pleasant activity. They should be outside as soon as the sun comes up for anywhere from 5 to 15 minutes, getting it exposure to light. And that sets the circadian rhythm in place. And if you miss sunrise, then get outside as soon as you can in relation to when the sun has come up. It doesn't work to sit in front of a window. It doesn't work to sit in a car and be driving down the road because the glass is going to block the rays that we need here. So outside separately around the noon time hour, you want the person outside walking around again for 10 or 15 minutes so they get exposure to light midday. That's also important, but for slightly different, different reasons. But that sunrise sunlight is critical. You can try to do it with sunset. I find it's much more erratic and harder to get people to do that based on timing and work schedules and whatnot. But just about anybody can get up right around sunrise. And that is a treatment in terms of setting this circadian rhythm. And obviously, that helps dramatically with people that have problems with their sleep. Don't forget that's a powerful treatment. That's not like just something you say to people because it's kind of cute. It's actually a treatment.

And because losing just a few hours of sleep for a few nights in a row can cause almost immediate weight gain, believe it or not. There's all these researchers that look at these things. I don't know who these people are. I've never met any of them. But can you believe that they actually take like a bunch of healthy, in this case, 16 healthy men and women, and they put them through a two-week experiment where they deprive them of sleep, and then they see how much weight they gain? So crazy people do this. Anyways, the goal was to determine in this one study how adequate sleep, inadequate sleep over just a week affects your weight and behavior and psychology. Half the people were allowed to sleep nine hours. The other half stayed up until about midnight and then could sleep for five hours. And they could eat whatever they wanted. And it turns out that people put on weight just in this short period of time. It's so crazy that this actually happens. Okay, so sleep really matters a whole lot. That's kind of the bottom line on that.

And more than you would think, probably. There's something else that helps more than you would think, and I'll talk about that more in detail in a second, which is blood sugar regulation. You don't really have a chance of fixing the adrenals unless you keep blood sugar regulated and keep the whole insulin resistance problem from from happening or reverse it if it's already happened. And that's because of cortisol's role as a glucocorticosteroid. It's one of its major roles is blood sugar stabilization. And so you have to keep blood sugar stable to fix these patterns. In fact, you can have unstable blood sugar being a major cause of a sleep problem, and the person's not going to sleep because they're eating the wrong foods at breakfast. You know, that happens frequently. You can also have high levels of cortisol at night. And there's a specific product you can use. And when we get to protocols, they'll go through that, or products, I should say, to lower cortisol at night. That makes a huge difference for a lot of patients. Now, if the patient has low cortisol at night, you probably don't want to give them all the products that lower cortisol because it's already low. So you have to test, not guess, on this stuff, uh, in order to get, you know, a program that's going to be as maximum effective as possible.

Right, so cortisol also controls and regulates metabolism. So when your metabolism is damaged due to abnormal cortisol, your body will store fat. It won't burn fat. It's not a bad idea if you think about it, because for most of human history, stress has meant not enough food. And, you know, your tribe is in serious trouble, whether you're wandering across the desert, you're out of water, or, you know, your food supply has, you know, dried up or whatever the stresses are that people faced historically. You don't want to burn body fat when you're under stress. You want to preserve fat at all costs. So those that can save body fat when they're under stress survived. And here we are, present day. You know, now the problem, for the first time in humanity's history, is too much food. Big problem. A lot of people that we work with are also suffering from issues around food addiction. Lynn Elliot Harding is a colleague of mine. I've worked with for a long time, probably like 25 years now. And she thinks of food addiction as a chemical dependency disease, which is kind of cool. When I first learned that, not as a behavioral problem, not as a lack of control issue, but as like an addiction, basically, as just like an alcoholic would be addicted to alcohol, or a heroin addict would be addicted to heroin. And the chemical properties of food can cause irrational behavior, depression, and a prolonging of the addiction.

And so one of the things that we need to do when we're correcting adrenal glands is get all the sugar and a lot of the starchy carbs that are poor quality out of the diet completely. And for some patients, that's really, really difficult. And so if you're dealing with weight loss, you're going to have a fair number of people in your practice who are suffering from food addiction. And for those people, you need to test and correct their gut because they're all going to have damaged guts from abusing food most of their lives. And they're almost all going to have liver detoxification issues and things that'll show up on organic acids. So you can't really have an effective weight loss program unless you do all these things: an adrenal lab, which I always would start with, and then an additional GI test and metabolomics test, so that you get the bigger picture of not only adrenals, but GI and what their metabolic function is based on metabolomics. You get all those things corrected, then you're going to be in pretty good shape. But you have to get the sugar out. And again, for a lot of people with compulsive overeating problems, you know, it's going to be an issue. Many, many people in this category are also going to have a yeast or fungal overgrowth, we call Candida. That's why we're doing the stool testing, GI Effects test, to look for that. And if it's present, then you want to treat the Candida, and that'll greatly reduce all the digestive problems and all the inflammation in the gut and allow them to get off the carbs more effectively and all the sugar.

And so in order to get these weight loss programs going, you got to eat the right thing. We're not going to really talk about that in detail today, but, you know, basically, you have to figure out the food. You got to address all the emotionality around all this and and think it through from a bigger picture standpoint. Okay? But we're going to try to focus on the functional medicine and lab part of this. And I want to show you just a basic schematic here where we have root causes. And there's an exercise that we used to do in class. I would suggest you do this at some point. It's just write down every root cause for, you know, health problems, whether it's weight gain or whatever it is. And then what would be in the root causes category? Gluten sensitivity, dairy sensitivity, parasitic infections, emotional stress, physical abuse and childhood, um, toxins, heavy metals, chemicals. There's a whole bunch, you know, there's maybe 20, 30, 40, 50 root causes, but it's not an infinite number. There's a finite number of root causes. Those root causes then eventually cascade and start to impact different body systems. And I really worked primarily with like maybe 12 body systems. We can make it three if you want to keep it simple, which would be neuroendocrine, GI, and detox systems. We have other models where we have 12, but whatever. And then once the body systems are falling apart, then you start to have symptoms. And so when patients come in, they might have a root cause of an eating disorder. Again, a lot of people that are overweight are going to have a problem like this that could lead to adrenal burnout, and that could cause the weight gain right there. So you have to go back to, like, this Lynn Elliot Harding method, you know, of understanding their relationship to food and understanding how the emotional issues we all have with food can lead to these kinds of problems.

You can also have another type of modeling. And I like this, this model a lot. And the idea of showing models is that we want you to have a model in your practice so that you have everything that you do completely structured. So if a patient comes into my practice and they ask my admin, "What does Kish do?" Well, do you want the long version or the short version? Okay. The short version is, he tests three body systems. Oh, what are those? Neuroendocrine, GI, and detoxification. Oh, how does he do that? There's three different tests. What are they? Oh, an adrenal test, a GI Effects, and a metabolomics. Three systems, three labs. Kind of starting to make sense here. And then what does he do? Well, once he sees what's going on with the neuroendocrine, GI, and detox systems, he'll develop a supplement program and a lifestyle change program to initiate, you know, your journey of health or whatever you want to call it. And so having this all mapped out, you don't have to use my system, but you really should have something that you can explain quickly to a patient that they can understand. And there's rationale behind the testing that you want to do and all the work that you want to do with them. The more confident you are in your model, and the more clear it is, the more confidence they're going to have that they're going to get better. And if you go see a functional medicine practitioner and they're like, "I don't really have a model. I don't believe in models." You know, in functional medicine, there's root causes. That's my model. Well, what are the root causes? And then they're, "I don't know." You got to write them down. Go back to that exercise. Write down all the root causes. You got to know this stuff cold so that you have the ability to project success in what you're going to do. Otherwise, people are just going to run from you.

Okay, so again, a typical story. Gluten issue, constant weight gain, weight loss, up and down, yo-yo dieting. Maybe they picked up a GI infection. Now the adrenals are burned out. Now they come in with an obesity problem. But you got to untangle this mess, fix the adrenals, fix the GI, get them off of gluten, do all the coaching and counseling they may need if they're hooked on gluten or they're hooked on sugar, and it's hard for them to stop. That's kind of the whole point.

This is my personal story. When I was 23 years old, I thought it was a good idea to go into a monastery. So I entered a monastery in southern Thailand for two years. And I lived in the jungle, they call a forest monastery over there. It's pretty strict. You wake up at 3:00 or 4:00 in the morning, meditate, I don't know, 10, 12 hours a day, one meal a day, sometimes two meals a day, depending, you know. Um, the first 10 days of every month, there is no talking, no eye contact, no reading, and no writing. Can't believe I did this now. Listing this out, I did this for two years. Anyways, at the end of that time, I went to a a sort of a sister monastery in the far north of Thailand, and I picked up a really horrible parasitic infection, like really bad. I was extremely sick. I thought, "It's not like I was about to die, but it was not looking good." And so I had to get out of there. I had to go back down to the South where I could get some clean water, clean food, some medical care. Um, but I never got rid of the parasite. And so for about 14 years, I had this really bad infection. I didn't really understand what was going on until I fixed it with functional medicine, obviously. So I had problems with weight gain, constant ice cream cravings, and all these sugar-related problems because my adrenals were burned out, because my GI had broken down, because when I was in my 20s, I picked up a parasite, you know? And so as soon as I treated the parasite, like literally the first couple of days, all of those blood sugar problems stopped. Like literally, like on the second or third day of taking these antibiotics for the parasite, this 14-year nightmare just ended. I was like, "Wow, well, that's interesting." Kind of taught me a little lesson on my own body. And it's one of the main reasons why I got so into functional medicine because it really worked for me.

So again, we want you to have a preset system. However, that system is going to be. I like the adrenal GI detox one. When we get down to the adrenal specifically, for patient education purposes, if the people are like, "Okay, well, why am I supposed to do this adrenal test?" Well, because I believe that stress is a factor in every human illness. You know, and that even if you feel great, we should test and correct your stress hormones. There's emotional and dietary and inflammatory stresses that accumulate and cause us to have hormone imbalances. And we can do a simple salivary test to measure all this and get it fixed. Okay.

Oh, and by the way, I forgot to mention, um, you're welcome to type in questions. Um, I will review. I'm going to finish up the slides in a minute. I'm going to review some labs, and then we'll do questions at the end. So just type in whatever is, you know, question you have, and I'll get to as many as I can.

All right, so as a fundamental concept for every condition that we treat, running an adrenal lab on every patient just makes sense. Stress is a factor in GI problems. Stress is a factor in autoimmune issues. Stress is a factor in thyroid problems. Stress is a factor in skin issues. It's a factor in all the different female and male hormone issues. Um, it's almost always present as a variable, and you just want to eliminate this as a variable. It's not going to be a cure-all in any way, but it's a platform which you can then build on, so you can start to fix other body systems.

When we're first under stress, cortisol levels go up. And if they stay up for long periods of time, eventually they can start to decline. And what we're trying to capture with this lab is where is the person on this spectrum? If they have high cortisol on a bad day and then drops back down on a normal day, then they're fine. But if they have high cortisol all the time, then eventually other hormones start to get affected. DHEA levels will drop. And DHEA will be one of your most stable, sort of standard bearers for how exhausted the adrenals are. But eventually, the cortisol levels start to drop too, and you can end out with very low cortisol. None of this even approaches what you would see as a medical issue. This is not that. This is a lifestyle issue. This is, you know, people who are stressed out of their mind. It could be because they served two tours in Iraq and they were in combat. It could be because they went through a really nasty divorce and a custody battle over their kids. It could be because they just finished law school and started their own firm, and it's just been really hard, hard work for a long time. Most of us that went through a professional training program, any kind of school, nurse practitioner school, dental school, chiropractic college, acupuncture college, most of us are pretty stressed out just from the school experience and don't have much time to recover.

In fact, we have almost every practitioner, let's say, every practitioner that takes my one-year mentorship program, tests themselves. And so we review these labs in in class all the time. And it's very rare to see a healthcare practitioner that has great adrenals. I, it happens, but it's special, super special. In fact, we had one the other day, and I don't know if she's on the call. I'm not going to mention her name, obviously, but let's call her, um, Betsy. That's not her real name. And Betsy submitted her lab. And Betsy is a practitioner in my mentorship class. And Betsy's adrenals were perfect, like perfect. And so I'm like, "Okay, what are you doing here?" Because there's really, if you have perfect adrenal function, it's one of four different things that's causing that, or maybe all four. Either you eat perfectly, which is rare. You exercise perfectly, which is rare. You're absolutely spiritually dialed in and just like a beautiful spiritual being that's totally connected emotionally and spiritually, which is unusual. Or you, um, get adequate sleep and always have done. And in her case, she had the sleep and the spiritual stuff and the exercise pretty dialed in. But she said, "Oh yeah, no, I grow all my own food." I'm like, "Who grows all their own food? Who's the doctor that grows all their own food?" She's like, "No, I just grow all my own food and I eat from my garden every day." Problem solved, you know, case solved. Like if you do all those things, your adrenals are going to be in great shape.

So when we're doing these tests, this is very important. This is the most important point of the whole talk. I kind of saved it for this slide. We're not measuring adrenal function. We're measuring what the brain is doing. We're measuring what the brain is doing. Your adrenal glands are not self-regulating. Your adrenal glands don't decide, "Oh, I'm going to do this bad thing to you now." Your brain tells your adrenal glands what to do. So when we test and correct the adrenals, what we're really testing and correcting is the HPA axis, hypothalamic-pituitary-adrenal axis. That's your brain telling your adrenals what to do. So there are many things that we can do that are part of these programs to strengthen the adrenals: pantothenic acid, magnesium, adrenal glandulars, adaptogenic herbs. Those are all great for strengthening the adrenals themselves. However, what I'm talking about today is resetting the HPA axis, treating the brain. And what Timmons and Elias figured out in the '80s is that the things that naturopaths had been using for a long time to correct the adrenals, like glandulars, like adaptogens, like B5, were great. Nothing wrong with them. But where they saw the really profound changes in resetting the HPA axis was with these low dosages of DHEA and pregnenolone, and these slight manipulations of cortisol up or down using licorice root and phosphoserine. I'll show you all that in a minute. But the idea being that you can and should support the adrenals with pantothenic acid, vitamin C, adaptogenic herbs like ashwagandha, rhodiola, ginseng, all that stuff, and even glandulars. Good for the adrenal glands, keeping them healthy. But what I'm more interested in, in with the testing, is what's happening with the HPA axis and how are we going to reset that? And that was the brilliance of what Timmons and Elias did. And so they, it was a very simple process, really. They would run an adrenal panel, try a protocol for three months, and run another adrenal panel and figure out what were the products that reset the adrenals, meaning at the end of three months, on no products whatsoever, you saw improvement in adrenal function. What were those products? And that's what we're going to get into today.

Okay, I'm not against pantothenic acid, vitamin C, adaptogenic herbs, and glandulars, and I use those with every patient also. But you don't need a special webinar to tell you about that stuff. You could just buy that anywhere. I want you guys to learn how to interpret the lab so that you can do the HPA axis correction. So there's, there's like four things you need to learn how to use. One of them is pregnenolone. Totally, most undervalued supplement of all time. Nobody ever talks about it. I've never seen any other practitioner even mention it in my whole 30 years, except for unless they were a Dr. Timmons student. I don't know what happened to pregnenolone. Everyone just forgot about it completely. And it's like the most important thing for resetting the HPA axis. It works so well, so, so well. And it works even better if you get it in a liquid form. Okay, liquid form. Why does it work? Because it does all these things. It sort of is the mother of all these hormones and helps stabilize all these other hormones. DHEA is right up there. And it's a combination of DHEA and pregnenolone that really works, again, in a liquid, in what are called physiological dosages, very low dosages.

So when a person has a low DHEA on one of these tests, we want to stimulate the body to make the DHEA in adequate amounts again. Remember, that was the whole point of Timmons and Elias. They would test somebody, put them on a program, stop the supplements, and then retest and see if they had corrected the production of cortisol and DHEA. You can use DHEA for other purposes, like you can take 50 milligrams of DHEA once a day to help your DHEA, help your testosterone. But that's not going to reset the HPA. The low and Timmons and Elias tried that. It doesn't work. You could try it too for 10 years to see if you get it to work. You won't. Okay? Because the higher dosages of DHEA do not tell the brain what to do, other than say, "Hey, you guys don't really need to make any DHEA now because we got more of it than we need." The ultra-low dosages spread throughout the day, circulating in the bloodstream, instruct the brain to go back online and start to produce the right amounts again. Okay? Higher dosages are good for other purposes, but not for this resetting effect. The lower that the dosages are, within a certain range, the more of an effect you get. In essence. And then I mentioned blood sugar already. You got to do blood sugar control. And then the most important thing beyond anything that's important for all of these things is the right amount and the right type of exercise. If the person's not getting physically fit, then ultimately, you're just not really doing your job right. So you have to get that. But a lot of the patients that we work with in the beginning don't have the energy they need to exercise. So you want to, you know, but recognize that as soon as the adrenal programs kick in and they're feeling better and they have more energy, you want them to invest that extra energy in fitness, in strength training, cardiovascular training, improving your VO2 max, all that stuff. But most of the adrenal patients that I treat don't have the ability to exercise yet. You know, they haven't gotten there. They're not healthy enough yet. So we want to get them there and then flip them over to an exercise program.

Okay, so again, the dynamic duo here: DHEA and pregnenolone in liquid form. You don't have to use any pills to reset, reset the brain. This is the adrenal treatment program, setting the HPA axis.

All right, for those of you that were late, you can register with a large discount of 40% for our upcoming class on interpreting the Goova Neutral. This is a really good class, and I think you should sign up for it if you have an interest in lab testing. Scan that QR code. Enter in GDX24. You get a huge discount, thanks to Goova. Thank you, Goova, for helping us with that. And, um, you'll have a couple months of learning how to interpret the neutral and kind of getting into that, which is a super, super fun topic.

All right, so now we are right on time. I'm going to show you some examples now of what I'm talking about, and then we're going to do some protocols. And I got everything queued up. Should be right here. Um, Mingo, there. So Goova Diagnostics, Adrenal Stress Profile, or Adrenocortex Stress Profile. Call it, everyone calls it an adrenal profile. And it's salivary testing. And I just randomly picked one. This one doesn't look very good. Sorry. Oh, well. Might start off with a bang here. Okay, so it's probably not too hard to see that this person has very low cortisol, uh, because the one I randomly clicked on here is pretty bad. But maybe that's not a bad thing to start with a bad one. Um, so this would be an extremely exhausted person, unable to make adequate amounts of cortisol. And I'm telling you, you can't mess these up. You know, you could just do almost anything, and this person is gonna get a little bit better. Um, even if you just kind of wink at them for a little while. So, um, when the cortisol is low and the DHEA is low, we call it a Stage Three. And that doesn't matter too much. But going to use pregnenolone and DHEA to start to balance this out. Right? And then when it's this bad, you're probably going to want to do some extra testing. Run a GI Effects, see what's going on with their gut. Run a metabolomics and see what's going on with their mitochondria and all that good stuff. And, you know, there's more to it than just this, but this is a fundamental skill to learn.

So let me show you how this would work. Bing, go there. All right, so this is a Stage Three, but really what that means is low cortisol and low DHEA. That's the part that's important. So you can use DHEA in a liquid form. The drops are 1.2 milligrams per drop. And when the DHEA, when the cortisol is this low, we usually keep the DHEA quite low, like just a couple drops. There's also a pregnenolone in a liquid, my favorite product of all time. And that one, with a Stage Three like this, you can get up to 15 drops three times a day. So the liquids bypass the liver, they absorb right through the tissues in your mouth directly into your bloodstream. These are very low dosages. We're talking about a couple milligrams of DHEA three times a day, 15 or 20 milligrams of pregnenolone three times a day. But remember, we're trying to mimic normal production and stimulate normal production so that when the protocol stops, internal production has improved. You can do a million different things to get an exhausted person like this feeling better. What we're trying to do is reset a system. You also then need to include some kind of a multipack. And then there's a bunch of extra things that can go with low cortisol patterns. So I just put low equals licorice root. Licorice root helps improve, uh, bring up low cortisol. And that's in a liquid also. This person is low all day long, so they could do 10 drops when they wake up, 10 with breakfast, and 10 with lunch because their cortisol is so low. That's kind of an extreme one. Some kind of adaptogenic herbs: ashwagandha, rhodiola, ginseng. All the companies have that type of a product. Depending on the strength, do a couple of those. And then when people are extremely low, you can also use vitamin C with flavonoids. That's usually a 500 milligram. And even in a glandular, if you want. And then make sure that the multipack includes blood sugar support. Some of them do. If, if you have one that doesn't, then you just want to include blood sugar, blood sugar support separately. So that would be, uh, lipoic acid, say 300 milligrams, two times a day. Some people also would add in chromium and other things. Most of the companies we work with have a blood sugar support product that you can use. And so DHEA and pregnenolone to improve those levels, low dosages to get the brain to see what's going on, what should be going on, right? So it starts to mimic internal production as it should be again. A multipack with some extra blood sugar support because cortisol is a glucocorticosteroid, is so important. If cortisol is low, licorice root brings them up. Adaptogenic herbs, vitamin C, and glandulars. Okay, kind of generic.

So now look at us. We have so much time. I don't know why it seems like so much time here, but let's look at another one. Uh, now I'm going to introduce, no, that, here we go. Let's look at this one first. So again, Adrenal Stress Profile from Goova Diagnostics. It's a salivary test. You perform the test on an average stress day. Which for most of us is a workday. If the person works five days a week, you don't want them doing the test like on Saturday, you know, necessarily. So just a typical workday. And, uh, let's see here. Where's my little button thing here? Sorry, trying to find it. Hidden somehow. Oh, well. I just have to wing it without. Oops, there we go. Oh, now I found it. All right, it's want to be able to draw on this thing. So now we've got cortisol low, then shooting up, and then staying up. But I mean, it's pretty obvious. This is not great. This is what we would call a Stage Two. There's high cortisol, but with one low, and the DHEA levels are low, right in the yellow zone there. Kind of hard to see that, but it's in the yellow zone. So this is a typical Stage Two. And the protocols are a little different for Stage Two, and I'll show you why.

So in a Stage Three, cortisol is very low. And one of the things that happens when we're stressed is cortisol goes up initially, and DHEA goes up to bring the cortisol down. So DHEA has a natural ability to bring cortisol down. That's part of our stress response. So if your cortisol levels are already really, really low, and you take too much DHEA, it's going to drive the cortisol even lower. So when the DHEA levels are low and cortisol is low, we are careful with the amount of DHEA. But when the cortisol levels are high, like this person, you can bring the DHEA levels way up. Now, it's still only four or five milligrams of DHEA three times a day, but it's double what we were doing before, and that'll help lower the high cortisol. Similarly, when people have high cortisol, they don't need as much pregnenolone. You can cut that in half. And this would be a Stage Two protocol. Now, we just morphed it. Stage Two protocol with, uh, I just say high/low because kind of both high/low cortisol and low DHEA. Now, if the cortisol is high, you obviously don't want to give licorice root because licorice root brings cortisol up. Instead, you want to use phosphoserine, because that lowers cortisol. Usually comes in like 100 or 150 milligrams, 100 to 150 milligrams. And you want to give it around the times when the cortisol is the highest. Like for this person, we could do maybe, uh, lunch and dinner. Something like that. Let's look at the lab again. Oh, actually, should be breakfast, lunch, and dinner, huh? So breakfast dose will bring down that high right there. Yeah. So let me show you that here. Yeah, you could do phosphoserine three times a day. It's kind of a lot, but you could do that. So again, licorice root is good for bringing up cortisol when it's low. Phosphoserine is good for bringing down cortisol when it's high. So we're adjusting that production. And you do that for three months, and then stop and retest, and you should see things are improving. I did three-month retesting for many, many years because that's what Timmons said to do. But now I actually do it every six months because I find this three months is a little early. You know, we still want to use lipoic acid, a multi, blood sugar support. You still can use adaptogenic herbs, vitamin C. Don't generally, you don't give glandulars when the cortisol is high because they'll just raise it. So I would take glandulars out.

So here's our Stage Two protocol. I think we have time for one more, and then we can go to questions. Oh, this one looks good. Oh, no, that's not good. Hang on. Let me find a better one. How about this? Yeah, let's stick with this one. Okay, so now, now I'm introducing one new variable here, which is the cortisol awakening response. It's much better to order this test with the add-on of the cortisol awakening response, right? Why? Because it just gives you a whole bunch of more data. It's not that much more money, and sometimes it matters a lot. Sometimes it'll be the difference between finding the thing and not finding the thing, you know, you know, finding the HPA axis problem or not. So it helps a lot. And you want that cortisol awakening response to be around 50%, meaning that when you wake up in the morning, at first open your eyes, your cortisol should go up and then down in a certain pattern. And they'll rate this for you. And if your cortisol doesn't go up and down when you first open your eyes, you got a problem with your cortisol awakening response. And that means the HPA axis is not working very well. Similarly, you can tell there's three ways you can tell the HPA axis is not working well. One is the CAR. The other is the cortisol itself. And this one's not that bad, not as bad as the other ones, but still, it's high. And then the third way is the DHEA. So this person happens, they have all three. They have borderline low DHEA, hence HPA axis dysfunction. Their cortisol is running high, just a little high, bit high, hence HPA axis dysfunction. And their CAR is a little bit off. It's not bad. Um, I guess they say plus or minus 10 or 20 points. So you could consider this a normal CAR, but from this, you've got here and here, right? The DHEA being low and the cortisol being off. Let me just show you one more CAR so you can see that. Oops, sorry. A lot of buttons to click. There we go. That's not one. Yeah, this one's better here. Look at this. So just looking at the CAR again, it's supposed to be around 50% plus or minus, let's say 10 or 20%. Uh, 10 or 20 points. Yeah. But this one is quite a.

bit lower than it should be, so 15. Maybe 40 is acceptable, 30 even if you're pushing it, but not 15. Um, so that means that they have a low CAR. They're not getting their cortisol up, up enough when they first open their eyes. That in of itself is HPA axis dysfunction. So right off the bat, you know, they need a program.

Then you can look at the third variable, DHEA. Super low, more evidence of HPA axis problems. And then the cortisol rhythm. Normal, normal, normal, super high. So you have three different ways of determining if the HPA axis is off. This patient has all three. Sometimes you may only see one. We've had cases in the mentorship where the cortisol rhythm was normal, the DHEA was normal, but the CAR was like at a 200 or something. So there's, it's worth doing the CAR. I know it's a little bit more expensive, but it's a better test. And let's see, okay, for this one, let's call this a stage two with high cortisol at night. I'm designing one more program and then we'll go to questions and we'll wrap it up.

So we just saw at stage two, but the cortisol was high at night. Remember? So what does that mean? That means we only want to use the phosphoserine at night because it lowers the high cortisol. You can give one or two of them with dinner to lower that bedtime cortisol. Other things you can use to help calm that person down, you could use theanine, you could use some extra magnesium. Uh, some people like 5-HTP. You've got a variety of different things. You could, I don't use 5-HTP unless I test for it. I'm going to take that off. But, um, you could use something calming. You know, there's all kinds of calming herbs and whatnot. But you want to basically focus on lowering that high cortisol at night.

Now, there are stage two, um, and I'll show you a little variety in here. For someone like this, that probably give like 10 drops of the pregnenolone and let's say maybe three drops of the DHEA. But then all this other stuff stays the same. So you're also, you're sort of adjusting your phosphoserine to the times when cortisol is high. You're adjusting your licorice root to the times when the cortisol is low. This current one didn't have any low cortisol, so there's no licorice. If cortisol is high at night, you really want to knock it down. You can add in the theanine and magnesium. And then some of these things stay the same: vitamin C, adaptogenic herbs, uh, DHEA, pregnenolone. The dosages vary. You always want some blood sugar support and something along the lines of the multi-pack.

All right, so again, this is what we have coming up class-wise. There's lots of other classes. We're starting a mentorship program right now, like literally today. I'll bet one of you could just jump into it if there's a spot left. You can ask the staff. Never too late. Like it literally started this morning at 9. So you're like three hours and 40 minutes late. If you want to join the mentorship, you can still sign up, okay? And I'll catch you up with a phone call if you want.

Okay, so let's cut over and look at questions. Um, let's see. Yeah, so CAR, if a CAR, so Sue is asking a question about cortisol awakening response. That's low, super low range. So if the cortisol awakening response is either high or low, it means there's an HPA axis problem. But then you look to the DHEA and pregnenolone to get specific dosing, okay? But definitely tells you that there's the problem you need to treat. Uh, let's see. What if, what if DHEA is low but cortisol is normal? Yeah, that's, um, that's a stage two.

True story. I did my first adrenal lab like in 1994 or five or something. And so I had this new patient. He was totally stressed out, like he was the picture of stress. So I was like, I'm going to do an adrenal stress test. So I ordered the lab and then the results came back like a week or two later. I just still remember Maryann walking into the office saying, "Hey Dan, your test results are here." And I was like, "Okay, thanks." And I looked at it and I was like, "Oh, the cortisol is normal." And I had a panic attack. Total, full-on panic attack. And I was like, "What am I going to do?" I was this brand new doctor. I was like, "This patient is going to think I'm a..." I don't know what to do. And I took the lab report. In these days, it was paper, not internet. This is before the internet was invented, for those of you that are younger than me. And I took it and I put the lab report in the bottom of Glenn Feder's drawer. I don't think I ever told him this. I went into his office and I, I hid it at the bottom of his big desk drawer that was a huge mess. And no, no one would ever find it there because Glenn never cleaned out his desk. And then I told Maryann, "Just call the patient, um, you know, lab's fine." And the patient went away. That was a stage two because I didn't know that normal cortisol and low DHEA is a stage two. No one had told me that. I didn't know. And I panicked. It was another year before I ordered another adrenal panel. It was another year. And I still remember the story. I'm clearly, like, slightly emotionally scarred from that thing.

So let me just show you some examples here of that. We just had one a second ago of stage two. If you don't know the stages, then it just looks like it's fine. Where is that one? I just had it up. Now I can't find it for some reason. Hang on a second. Let me see. You don't want to make that same mistake. Well, anyways, you saw it a minute ago. If cortisol levels are normal and DHEA is low, that's the very definition of a stage two. That's an HPA axis in crisis, okay? That's not like, that's not okay. This is why you need training, you know? Because if you don't take some kind of professional training, you're going to look at these labs and you're going to do it wrong. There's no way you're going to figure this out just looking at the test.

So Lindsay, thank you for asking that question. Can you determine stress level without testing? Absolutely not. Like, you can, I mean, just think about. We had, we had a super famous doctor, he's an acupuncturist, but he's super well-known nationally. Take my class, my mentorship class, a few years ago. And let's call him Larry, that's not his real name. So Larry's like, "Hey Dan, what's it going?" I was like, "Great. I can't believe you're in my class." He's like, "Yeah, Bo, just want to take your class." I'm like, "Oh, I'm so honored that you're even in this class." Like, "Yeah, what the heck." And I was like, "Well, you should test yourself." He's like, "I feel great." I like, "Oh, whatever. I'll do a test." He said, so Larry's lab came back. He was stage three. He felt great. He thought he was on top of the world. He was stressed out of his mind on his testing. And we got him on an adrenal program, completely fixed his adrenals, and he felt like a million bucks. He's like, "I didn't realize how tired I was. I didn't realize all these things that were going on." So even if the person feels well, you can't tell what stage they're in. And if they're exhausted, you can tell even less. And the treatments vary. If it's high cortisol, you lower it. You don't want to give cortisol lowering stuff to someone that already has low cortisol. That's the whole point of the testing.

So when I was working at, at Dr. Tim's lab, this is like late 1990s. Jerry was one of the other employees. He was a screenwriter, from kind of a long story. But he had these shirts made up for everybody. And it was just like one day, but everyone wore the shirt in the lab just because it was kind of funny. And on the front, it said, "Do the test because we're testing company." Answering the phone, "Hi, this is Dr. Kess. Can I help you with your lab? Do the test." And then on the back, it said, "Or die." Like, a little extreme. But, you know, the whole central premise of functional medicine that we want to test, I guess, right?

Uh, so let's see. Anything else? Causes of high DHEA? Uh, high DHEA, you're on the PCOS train, you know? So that's common. You see that frequently. Whole different thing. We don't really have tons of time to talk about that. But that's, uh, you know, an androgen-related problem. Got to get control over insulin resistance because they're all insulin resistant. And then, you know, uh, diet, gluten-free, all that kind of stuff. Get the DHEA down. You never give DHEA if the DHEA test shows high. That's another reason to do the testing because you can't look at someone and tell where their DHEA is at.

Um, let's see. What about 7-keto DHEA? Thank you, Michael, for asking that. I was so excited when it first came out. And I was actually in practice, like literally the day that that stuff was invented. And I was like, "Wow, it's going to solve all of our problems, isn't it?" Because the idea with seven-keto is that it doesn't convert into the other hormones. So we used it, or I used it in my clinic for like maybe six months or a year before I found out that it absolutely didn't work at all for this particular reason, for this particular goal. Remember, this is a very specific goal. We're resetting the HPA axis with liquid DHEA. Seven-keto didn't help even a little bit. Total waste of time. So I stopped using it. It may be great for other reasons. I'm just talking about this one narrow niche here. I'm not saying 7-keto DHEA is bad for other things because I have no idea.

Um, if we have a patient on 50 milligrams of DHEA, have we caused too much suppression with the HPA axis, or is it okay to reduce to physiologic dosages? Just test them and see. So if someone's been taking 50 milligrams of DHEA for a long time, just have them stop for like a week and then do this test and see where their DHEA levels are at. And I'll tell you everything that you need to know. It may be fine. It may be totally fine.

Uh, oh, liquid DHEA and pregnenolone. I use a company called Biomatrix and I get it from Fullscript. Uh, let's see. If you're in the UK and you can't use DHEA and pregnenolone, you just use the rest of the program without the DHEA and pregnenolone, and you're a little more reliant on lifestyle changes. Then, uh, I don't know if cortisol goes up with high dosages of DHEA because I never use high dosages of DHEA. So again, Biomatrix has the liquid DHEA and pregnenolone, and you can get them off a Fullscript. There's probably other companies these days, but that's the one that I use.

Uh, let's see here. Do we have time? Okay, a couple more questions. I'm sorry, I can't get to all the questions. It's just, uh, too many of them. Um, let's see. Do have them stay on the protocol for six months? Yeah, I do. So Christine is asking this. So, um, I do the programs for six months, and then I stop for like a few days, maybe a week, and then have a retest. Or I do the programs for six months, stop. If they feel like they're better, I feel like they're better, we don't even do the retest. We just stop the program. You don't have to necessarily retest if you're, if you know the problems are solved, you know? Uh, so you always, yes, you want to remove them, uh, from the products before retesting for sure. So yeah, with, again, a couple people asking about high DHEA. So that's going to be in the realm of PCOS. Um, and you have to get control over insulin and do all these other things for blood sugar regulation, GI infections. It's all the standard stuff. And high, you know, high DHEA patients respond really well, but not to these protocols that we're talking about, obviously. You don't give DHEA if their DHEA levels are high. That would make them worse.

Can persistent infections result in stage three over time? In fact, I would say yes. As is that Kim? Um, I would say one of the most common causes of, of, of low cortisol or adrenal burnout, whatever you want to call this, would be long-term infections, whether it's parasites, like in my case, Lyme disease, all kinds of different insults to the body like that.

Uh, let's see. Maybe one or two more questions here. Sorry, there's so many coming in. This is great though. It's good that people are asking questions. Licorice root is also from Biomatrix. I always do adrenal testing before the GI. Well, or with it. So in the ideal world, you would do an adrenal, a GI, and a metabolomics test at the same time on every new patient. That's my basic kind of functional medicine essentials test. If that's not realistic for whatever reason, then start with an adrenal test as soon as you can get the patient to do it. Do a GI, and then as soon as you can get them to do a metabolomics, do that. Maybe it's spread out over the course of a year or something.

Uh, why I start with the adrenals because all of this that we're talking about here is code word, secret word for, for what this probably some mentorship student in here that will get this answer right. Like, what are we really doing with the adrenal testing? It's not about these supplements. It's about lifestyle change. So diet, exercise, sleep, and meditation, spiritual work. That's really what fixes the adrenals. So when you do the adrenal test and it's screwed up, you can start to talk to the person about their diet and regulating blood sugar and getting insulin resistance under control. Talk to them about exercise and how to exercise and get fit. Talk to them about everything to do with, um, spirituality and meditation and whatever, you know, groove they want to get into from emotional spiritual work. And about sleep. So the adrenal test gives you the leverage to talk about diet, exercise, sleep, and meditation, which are really the main treatments in functional medicine. So starting with the adrenal lab means starting with lifestyle. This is the ultimate lifestyle test. Are you eating well? Are you exercising right? Are you getting enough meditation and emotional connection time? And are you sleeping well? So we start with the adrenals because we want to start with lifestyle. As soon as you get that dialed in, you do the GI testing and correct GI. And then usually we save detox for later on. I think that's the easiest, uh, sort of sequence in which to follow.

Thank you guys for participating. I know there's a million questions I didn't get to. I'm sorry about that. We're just out of time here. And I hope to see you at another one of these. And I hope that some of you will sign up for our wonderful classes that are starting now. We have this one, and we have our mentorship also that started today. So not too late to get into that if you want. I hope to see some of you soon. Thanks. Bye now.