Many of you may think that I am the hormone and metabolism expert, but let me tell you what... today's guest is truly THE expert! Dr. Carrie Jones is able to teach in a very relatable way the ins and outs of not just understanding human metabolism, hormones, and the human potential as a whole but also actionable items to implement in your life immediately.
Dr. Carrie helps hormonally challenged people feel less crazy. She does this primarily through real talk education, sarcasm, funny analogies and the occasional swear word. A functional medicine women's health and hormone doctor who believes in the importance of both men and women understanding their hormones in a simplified manner so they can feel more empowered to take control of their own health especially when they are told everything is "normal" but they don't feel "normal."
Check out Dr. Jones on Instagram @dr.carriejones
Jade: [01:17] Welcome to today’s show, everybody! Today, I have a special treat for you. It definitely was a special treat for me. I got a chance to sit down with one of my favorites in this field, Dr. Carrie Jones. Dr. Jones is a naturopathic doctor like myself, and she also has her masters in public health. You know, many people see me as kind of like, Jade, you’re sort of the hormone/metabolism expert, and I would consider her more of an expert in hormones than me. She’s one of the people that I learn an awful lot from and have just come to really just love her whole vibe and the way she educates. And she was gracious enough to come on the show and give us a lot of pointers. This is one of these discussions many of you, many people who listen to my podcast, are very advanced health and fitness enthusiasts, and I think the vast majority of people are actually professionals in some way. We have health coaches, personal trainers, physical therapists, chiropractors, medical doctors, naturopathic doctors. So, Carrie and I went in depth on some things to give you some advanced understanding. I think you come to expect that from this particular show, but one of the things I love about Dr. Carrie Jones is she is able to teach in a way that is very relatable, even for those of you who may not be super expertise in this area; so, I think there’s going to be something for everybody in here. She’s also the medical director for the DUTCH Test, and I just want you to be aware of that because this is something that many of you will want you to sort of look at and understand, and we discuss that a little bit. Definitely check her out. On Instagram is where she spends most of her time and does a huge amount of education for us all. She’s @dr.carriejones, C-A-R-R-I-E-J-O-N-E-S, @dr.carriejones on Instagram. Make sure you go and follow her. Enjoy the show. She’s absolutely wonderful, and definitely go over there and tell her you listened to the show and give her some feedback; tell her she’s wonderful and thank her for her time. I really hope that you enjoy the show with Dr. Carrie Jones. Let’s get started.
[03:40] Dr. Carrie Jones! How are you, my friend?
Carrie: [03:43] I am fantastic. How are you?
Jade: [03:46] I’m good. Thank you so much for being here. So, for those of you who don’t know Dr. Carrie Jones, she – you know, a lot of people see me as the hormone expert – but she is actually what I would consider the real hormone expert, and someone who has been education all of us in this field. I wanted to have you on to really get some of this stuff clear and discuss some of the stuff that’s super confusing around hormones. But, let’s just start out with the simple stuff and just basically tell us how you got into this work, a little bit about your background. Then, I’m going to grill you on some things that people have been dying to know about hormones.
Carrie: [04:25] I hope I have an answer! So, much like yourself, I’m a naturopathic doctor, and I have my masters in public health, and women’s health, hormones, gynecology’s literally the only thing I’ve ever wanted to do since I was a little kid. I knew I wanted to be a doctor in the field of women’s health. I did a little detour – I thought I wanted to be an OB-GYN, and then I realized what it takes to actually deliver a baby. I’m like, you know what, I think I’d rather just get you pregnant and pass you off… and then come back to me once those midwives and those OBs got you under control. So, it’s what I did, it’s what I studied. It’s funny, my boss says we’re a inch wide and a mile deep. So, if you’ve got knee problems, don’t ask me if you’ve got kid problems, I have no idea. If you’ve got a hormone question, I probably can help you solve it.
Jade: [05:11] Isn’t that funny in our field? I often times say the same things; like, people ask me a lot of stuff, and we do get a wide breadth of knowledge, but we do tend to – a lot of us do tend to go very deep in particular areas, and you and I have kind of done that. My area is essentially metabolism and hormones for weight loss; yours is deep dive into all things hormones and endocrinology. So, we’re both endocrinologists in a sense. I would call us functional endocrinologists. But, you’ve been at the forefront of teaching many physicians and other healthcare providers about the new ways of testing hormones, and also about the ways that we should be thinking about hormones kind of differently. People who listen to this podcast are pretty savvy, so you got a lot of professionals that are going to be listening to us. Mainly personal trainers, but also MDs and NDs, and then some very savvy lay individuals. So, I want to cover some things that will be, you know, some things that may even stump you and I together that we’ll discuss; but, one of the first things I want to jump into with you that I’m curious about, and I have an interest in this, is the idea of stress and stress hormones, and how they are impacting things. Specifically, one of the things I want to address first, and we’ll kind of jump right into this, is this idea of stress hormones and pregnenolone or progesterone steal. Is this actually a real thing?
Carrie: [06:37] NO!
Jade: [06:38] Ok, so no. Give us a brief primer on this, because I have a funny story to tell you after this. Give us a brief primer on where this whole thing came from, stress hormones and how they impact sex steroids, and the idea of progesterone steal, if you don’t mind.
Carrie: [06:55] So, I was taught it just like you were. I was taught this steal and where it came from was when you look at a steroid pathway, and you’re looking where it starts at cholesterol, and you just follow the arrows all the way down to testosterone or progesterone or cortisol or estradiol, wherever you’re going, that steroid pathway – usually I have one right around here – but-
Jade: [07:13] I know, we all have it somewhere on our wall.
Carrie: [07:16] It’s like right here somewhere in this mess. It’s just an 8½ by 11 piece of paper, so everybody assumes when you follow those arrows, that’s what happens in every single cell in the whole body and you can just interject where there’s an arrow; so, if you see pregnenolone – I was taught if you just take pregnenolone then you can influence that particular arrow. Until I revisited biochemistry and physiology, and physiology says when you go to make a sex steroid hormone, cholesterol is the first step, no matter what, for most all of these hormones. So, if you’re trying to get a cell in your ovary to make progesterone, which is the lutein cell, then it’s going to start with cholesterol. The star protein binds to cholesterol and kicks off the whole cascade. And it happens in the mitochondria, transitions into the endoplasmic reticulum, circles back to the mitochondria, and then goes out into circulation. So, that’s an ovarian lutein cell. Now, let’s pretend you’re in the adrenal glands and you need to make cortisol, so that the zona fasciculata will make cortisol through the same series of steps: star protein, cholesterol moves through pregnenolone, progesterone, but cortisol; and as far as we know, those mitochondria in the endoplasmic reticulum aren’t stealing from one another. Because you can’t just give pregnenolone and raise progesterone 1:1, it’s not like, here, here’s pregnenolone, it’s going to magically turn intro progesterone. It can’t. It’s not the backbone, it’s not first step. So, as far as we know that progesterone and pregnenolone steal does not happen, because those cells are not stealing from one another. My mitochondria and my ovaries, my mitochondria and my adrenals don’t have some, like, sneaky back end, back alley discussion going on where they’re swapping and stealing… as far as I know. Maybe they do and they’re not telling me.
Jade: [09:10] Yeah. And, you know, it’s such an interesting point. Same thing for me, the idea that, for me, as I always understood, is you have progesterone that’s being released by the ovaries, let’s say; it’s circulating through the blood, and the adrenal glands suck that up like a sponge and then shuttle it in to these mitochondria, and then, make cortisol out of it because you need cortisol. And this is not necessarily something that, it sounds like, you, the expert, and me sort of looking at this, necessarily agree upon; but a funny story is that I was recently at the Institute for Functional Medicine Conference, and they actually – I was shocked they were still kind of teaching that particular model. I do think clinically speaking, it can get us in the right ballpark about what’s happening with stress steroids and relationship between sex steroids and stress hormones, but it’s not actually probably physiologically what’s going on. So, walk us through what exactly is happening then, and what’s the relationship. Like, stress does lower these hormones, correct?
Carrie: [10:10] Yep, 100%, but it does it at the brain. So, let’s think about it. You’ve got – and we’ll just stick with women, but it happens to men too, but women are just a little easier to describe – so, when you make cortisol, it will circle back up to the brain. Let me back up. Reproduction is what women are put on this planet for, whether you want to get pregnant or not. I am not implying that. It is what women do. It’s why we get a cycle every month, or we’re supposed to. So, the brain literally judges everything we do as are we healthy enough for reproduction to continue forward? If you are in a massively stressed out state, you have lots of cortisol floating around, the brain goes, oh hell no, nope, we should not get pregnant this month. What happens is there’s a negative feedback loop up in the brain at the hypothalamus and the pituitary, and the cortisol will go up to the brain and then subsequently, the brain will slow down the two hormones that encourage estradiol and progesterone production, FSH and LH. Now, FSH and LH are made in different amplitudes and frequencies. Your cortisol may just shut down your LH enough that you don’t make progesterone, but you still make estrogen. So, it can make you really estrogen dominant. Or for a real stressed out person, and plenty of your listeners will raise their hand at this, they’ve gone through stressful situations, whether it’s a divorce, something at work, the holidays, their kid got sick, and they will skip their period all together because the amplitude frequency of all the brain hormones, FSH, LH, just go down quite a bit, and they’re not ovulating, they’re not making estrogen, they’re not producing, you know, they’re not pushing the follicles forward. So, 100% cortisol affects these hormones, it’s just not a steal; it’s more a negative feedback.
Jade: [12:02] Love that. Love that. So, you can see why I have Dr. Jones on the show, because she is just expert at this. So, then it brings me to sort of the next question in this. As we stay on the whole idea of cortisol, let’s talk a little bit about adrenal fatigue, or this whole concept that the adrenals essentially get tired out. Again, it’s one of these things that may give us some useful clinical understanding, but it may not be the actual thing that’s going on. So, what is actually happening there with stress and then the adrenals?
Carrie: [12:37] I mean, adrenal fatigue is sexy, right? It’s easy to understand; people are like, I have bad fatigue, and cortisol’s made in the adrenals, it must be what I have, adrenal fatigue. Unless somebody has Addison’s Disease – Addison’s is the true autoimmune where you don’t make cortisol – what really happens, again, is that HPA axis, your hypothalamic-pituitary-adrenal axis has a feedback loop. Much like there’s an ovarian feedback loop, there is a cortisol feedback loop. So, when you are in a really stressful state making lots of cortisol, it will cycle back up to the brain, and the brain will go, ok, that’s enough, that’s enough, we’re done, and the hypothalamus and the pituitary will stop making the two hormones that subsequently make cortisol. So, you get this progressive downgrade to make cortisol. It’s more from like a waterfall rush down to a trickle. So, you probably made a lot of cortisol at some point in your life and then, over time, the feedback loop kicks in and your cortisol production goes down. You don’t fatigue as in you don’t lose cells – it’s not like the ovaries where the ovaries go through menopause. Your adrenals don’t go through menopause. You’re not losing follicles like you do in the ovaries. But, you can definitely have this feedback loop, and this feedback loop can last for a while if no changes are made. So, it’s from a brain down, but adrenal fatigue sounds sexy. It’s really easy to say, rolls of the tongue, makes for a great book title.
Jade: [14:09] Yeah, and a lot of us in this field, right, we certainly – I certainly don’t have a problem with the term. It does kind of explain things, but I do have, once you get into talking with practitioners, that’s not actually what is happening. So, it sounds like, if I’m understanding you correctly, and just for everyone listening, it sounds like what you are saying is that there’s no ovarian fatigue so to speak, there’s no adrenal fatigue so to speak, there’s no thyroid fatigue so to speak. It’s essentially brain fatigue, let’s say, and specifically, hypothalamic fatigue, and these hypothalamus, pituitary, adrenal, thyroid, and ovarian axes that are being negatively impacted by chronic stress, particularly cortisol.
Carrie: [14:54] Yep. Absolutely. And that’s what’s so exciting, was the new sort of… as medicine moves forward, as functional medicine moves forward, I’m seeing more and more practitioners, more and more supplement companies, more and more labs, realize – I mean, it’s physiology, it isn’t new; it’s not like in 2019 the human body was like, you know what, we’re going to switch and start going for the brain. This has been our physiology since the dawn of day. Now, though, that people are realizing when we address the adrenals, it’s not like we microfocus in on the adrenals, we have to step back and look from the brain-down. And I love that so many companies and, like I said, practitioners are like hey, what’s going on with the brain? Let’s look higher because that’s really where it’s coming from… or not.
Jade: [15:40] Let me ask you this about – because when I think about – and I want to see if you agree with me or if you want to correct some of my thought on this, when I think about stress, and people tell me, hey, Jade, I’m stressed, I tend to think about if you’re feeling stressed, that’s not typically cortisol; it’s typically adrenaline if you’re feeling it, if you’re kind of feeling anxious and wired. Cortisol is sort of like this stealth stress hormone. You gotta have both of these. Typically acutely, you kick off adrenaline first and cortisol is somewhat delayed. Are both of these hormones negatively impacting the hypothalamus? Is it sort of one or the other? What’s happening there, because I think when people go, oh, I feel stressed out and I feel anxious, they typically think cortisol, which is probably correct, but that’s probably not the hormone that’s making them feel that way. I just wondered if you have any thoughts on that.
Carrie: [16:30] No, it’s true, but it’s also… it’s even bigger than that. Because think about it, when you have a lot of adrenaline and a lot of cortisol, what’s the big inhibitory hormone that goes down – GABA. So, GABA’s your big anti-anxiety hormone, and what happens when you’re feeling stressed out? You feel anxious. It’s like pistons in a car – it’s like these go up, your cortisol, your adrenaline, your glutamate, all your trigger (?), and then the calming GABA, maybe serotonin, starts to go down, and it becomes this dance, and unfortunately, become really dominant in the fight or flight side, and not so strong in the rest and digest side. And as a result, you feel overwhelmed, you feel stressed out, you feel burned out, you feel not as resilient as you used to. So, absolutely, cortisol gets the blame – we talk about it all the time – but it’s really actually all these hormones playing together. Then, if we add in the other hormones, like for men, testosterone, all these hormones, your cortisol and adrenaline can affect your testosterone production. Testosterone’s really helpful for men for energy, motivation, mood. What happens when they feel stressed out? They’re not motivated, their mood sucks, and their energy goes down. It’s very similar to women. They don’t ovulate, they don’t make progesterone – progesterone’s a very calming hormone because it affects GABA – now you’re doubly anxious and can’t sleep. It’s just like this big web that just spins around and around. But it kicks off with adrenaline first and foremost, and then cortisol a little bit delayed later.
Jade: [18:01] So, let me ask you the question I know you get asked a lot, and I get asked this a lot too. It’s basically this thing of like, look, my weight is, you know, I’m having trouble with my weight. I’m dealing with metabolic slowdown or whatever it is, I can’t lose weight. I think there’s something wrong with my hormones. Then, typically, what they immediately think, or someone thinks, is that has to do with testosterone, estrogen, and progesterone. Well, you just alluded to there’s this whole chemical symphony, or chemical soup of hormones. I just want to get your sense, and just to kind of set us all straight - when you think of hormones, and you think of what they are actually doing in the body, which ones would you prioritize, or which ones are you thinking about in relation to health, fitness, and fat loss? Because we usually jump right to the steroid sex hormones, but there’s a whole other host of hormones. It sounds like you’re definitely prioritizing the stress hormones, and I’m wondering what else you prioritize, and where in that hierarchy are you really starting to look at sex steroids?
Carrie: [19:03] Absolutely. So, it’s really interesting. Sometimes I look at them all at once. I’ll look at – we haven’t mentioned – but like, glucose and insulin. Leptin. Not many people give a lot of love to leptin, but leptin is a hormone made in the fat tissue, and it can be really interesting in the way it affects not only a woman’s reproductive cycle, but also a way that it affects the ability to trigger fat release in the body. Thyroid has a huge – that often gets the big blame, right? So many people are like I can’t lose weight, I’m tired, it must be my thyroid. They get their thyroid tested and they’re like, hmm, it’s not my thyroid, but what could it be? So, absolutely, all of these hormones playing in a symphony have to be pretty dialed in for the most part, I find, while people are working on their diet, their lifestyle, and what they put in their mouth, and how much energy they exert, and those sort of things. You can work on estrogen and progesterone all day long, you can give all the progesterone or chaste tree you want, but if your insulin is in the double digits, and your blood sugar is swinging all over the place because of your eating choices, you’re not going to lose weight. It’s just not going to happen.
Jade: [20:13] You know, I agree 1000% on that, and one of the things that I look at with this and my hierarchy would be, and I’d see what else you’d add because I agree about leptin. I would essentially say when most people are thinking about hormones, it’s a lot of the ones that, from my perspective, we don’t even hear much about, like the incretins, the hunger hormones – leptin being a big one – but GLP and GIP and these other things; and then, maybe adrenaline and cortisol and thyroid. Then, sort of last, but of course not least, are sort of the sex steroids, for me, although these things definitely impact other hormones. That’s why it’s so tough to have this conversation about one hormone vs. another hormone, because they’re socializing like people. I often times talk about estrogen as being, you know, it definitely reduces the impact of cortisol; so does progesterone. Estrogen definitely sensitizes the body to insulin. So, it’s not that they matter, but I love that you’re essentially saying look, if your insulin’s going sky high because you’re eating stuff like crazy, or your cortisol is going sky high because you can’t control stress, these things are going to make it very difficult for estrogen and progesterone to help you at all.
Carrie: [21:24] And it’s just going back to the basics, right? If I have somebody in front of me who’s struggling to lose weight, and they’re like, I think it’s my hormones, I want my estrogen and progesterone checked, we can, absolutely, if that’s what you want to do; but at the same time, I’m like, you’ve just told me you’re not sleeping, you just told me that you’re on your phone and tablet late at night, you just told me what you do and don’t eat, you just told me you have 2 glasses of wine every night before bed, you just told me – so all of these basic stuff, you don’t hydrate, you don’t like water, so you don’t drink it. You know, you live on caffeine in the morning because you’re tired. If we just go back to the basics, I bet even just correcting things like hydrate and sleep will probably fix a lot of your hormones in general.
Jade: [22:05] That’s kind of what I want to get into. Obviously, you’re the expert in testing, so I definitely want to get into that in a minute; but also, what I want to talk about is this idea that when you’re thinking about balancing hormones, and I know this is like - it’s tough when you’re doing interviews like this because you’re kind of put on the spot clinically - but if you had to say the 1, 2, or 3 things that you would say hey, if you made these changes, a lot of people are going to clear up some of their imbalances and their hormones. What would you say those are? I know you named a few, but I want to pin you down on 1, 2, or 3.
Carrie: [22:36] Specific. It’s actually a lot of the things you say, which is why I love following you so much and I have for years, because I’m like, “Yes! Yes! I say the same thing. Twinning!”
Jade: [22:45] I’m like that with you all the time too.
Carrie: [22:47] Hashtag twinning. Yes! I would say my biggest thing now is I really look into the circadian rhythm research. So, you’re supposed to be up in the morning, down at night. Humans should naturally follow the darkness and the lightness. What I’m finding is that I tell people like, look, when you get up in the morning, I want you to get some full spectrum light, whether it’s you buy a light box off of Amazon that’s full spectrum, or you live in a sunny location, in like California, and you can actually go outside and get some sun exposure, open up your drapes, what have you. Do that first thing in the morning. Then, at night before bed, about 1-2 hours before bed, I need you in dim light, I need you off your phones, your tablets, I need you using your blue light blocking glasses and winding down, and it’s hard. It’s really hard. It’s hard for me, but when I do it, when I get off my screen at night, and when I use my – I live in Portland, Oregon, and it’s currently raining – all this brightness you see is fake.
Jade: [23:42] I was going to say, it looks like the sun’s out where you are.
Carrie: [23:44] Heck no! We got a little mini ring light. Like, c’mon now. But I have a full spectrum light that I use in the morning. It, honestly, makes a world of difference. And as I dive into circadian rhythm, it has a huge impact on reproductive rhythm as well; so, for those women who are struggling with irregular cycles, or no cycles, or trying to get pregnant, or they don’t ovulate in a timely manner or very well, like man, if we just nailed your sleep, it would be – I bet it would fix 50% of your reproductive issues. So, sleep is like my number 1, absolutely. The number 2 thing is hydration. I’ve been looking into hydration and its effect on cortisol, especially in athletes. Randomly, I came across a study in PubMed, and of course, that made me go down a rabbit hole.
Jade: [24:29] Love when that happens.
Carrie: [24:30] Right? And then, just to show, there’s all these studies, of course, because NFL, NHL, all these major multimillion/billion dollar industries in sports have the money to do this research. They need their athletes to be in tip-top shape. And to show that dehydration, even a little bit of dehydration, affects sports performance significantly, and I’m like, man, that’s at an elite level. Imagine if you’re just the average joe or jane doe who just gets to the end of the day and they’re like, oh, I had two cups of coffee, man, I haven’t had anything else to drink; or people listening to this right now are like, oh, I’ve only had one glass of water today. I mean, that’s actually really, can be pretty stressful to the body, and the brain! We’re talking about the brain. It’s the brain that needs the hydration first and foremost. Then, the third thing is movement. You gotta move. All the time you’re talking about like, just go for walks. What do you call that kind of movement, when you just… you call it something.
Jade: [25:33] Leisurely and leisurely walking.
Carrie: [25:34] Leisurely! Yeah, that’s it! There you go.
Jade: [25:37] Every time I’m in England lecturing, they go, it’s leisurely. Leisurely, leisurely. Whatever you call it.
Carrie: [25:44] Leisure. It’s like when I say estrogen, they’re like, it starts with an ‘o’.
Jade: [25:50] I know, exactly. It’s fun lecturing overseas.
Carrie: [25:53] Oh my gosh. So, that’s my third thing. I’ve been a fan of that since I was probably a kid. I am nosey, I like to look in my neighbors’ windows, I like to see what my neighbors are up to, and so I am a big fan of going around my neighborhood and getting my 10,000 steps in, because it makes a huge difference.
Jade: [26:09] I love those answers, and it’s funny, I love talking to other experts because the one that I would no be aware of, and would probably be way down on my list, is hydration. Now, I love that, because I’m just like oh, yes, absolutely, of course, and then we get to go in that direction. For everyone listening, I think it’s really wonderful to kind of see someone like Dr. Jones bring those things up, because you’re dealing with someone who sees lots of patients, reads lots of research, and does lots of education in this area, and there was nothing super esoteric about any of that. It’s very simple stuff. But, to get a little bit esoteric and a little bit more on the other side, what would you say in terms of dealing with this stuff just from a simple supplement point of view, before we start getting into testing and potentially bioidentical replacement and stuff like that. What are the things you’re typically doing when you’re like, you know what, some of these lifestyle factors are not necessarily kicking it in to gear, I’m going to use x, y, or z. What are your go-tos?
Carrie: [27:10] So, I think I would lump it into groups. The first thing, for the most part, is omega-3s. I’m a big fan of fish oils, and I usually do higher doses for a lot of people, 2,000-5,000mgs a day is what I usually do. I find that with – just because cells are lipid bilayers, and people are so inflamed, fish oil/omega-3s are a really good way to just help ease up on that inflammation, help that lipid bilayer. When you have an estrogen that’s in the cell and it needs to get out of the cell when it’s going through detoxification, it requires a transporter. In the cell it’s water-soluble, but the cell layer, of course, is lipid bilayer. That transporter, as it moves, it needs the fluidity of the cell. It needs the membrane not to be stiff to pull that estrogen out and get it across. But, that transporter also transports all sorts of chemicals and drugs and everything else that’s been transformed into water-soluble. So, I tell people if you’ve got stiff cells, if you feel stiff, if you look stiff, if you, you know, like if I know you’re inflamed, then I need that transporter to have healthy cells to move across, and I need those same cells to do things like make progesterone. I need cellular health on lots of different levels and lots of different glands, so omega-3s is a big one of mine. I do a lot of sort of brain – since we’re talking about it – brain HPA axis adaptogens. With just the amount of sheer stress in our day and age that people are exposed to everyday, I find that using things like bacopa, using things like gingko, using things like ashwagandha and rhodiola and cordyceps, I’m big into the mushrooms. Reishi, lion’s mane, maca, which is not a mushroom, but I use a lot of maca in patients. I just find that having an extra… band-aid, or safety net is probably a better word, makes a big difference for a lot of people. You know, people that are like, I meditate, I sleep, I say no, I set boundaries, and I’m still really, like, I still can’t escape all the stress. I’m like, alright, let’s look at some of these. [inaudible] adrenal adaptogens.
Jade: [29:26] Where do you categorize vitex in that, because I consider it an adaptogen, but a lot of people don’t consider it as such.
Carrie: [29:34] I call it an ovarian adaptogen. I call it an ovarian adaptogen, and I actually read, I think a paper, recently where they called it that. I was like, nuh-uh, I coined that years ago!
Jade: [29:44] You can’t take that.
Carrie: [29:45] You can’t take that! I’m trademarking that. Yeah, so I tell people, because technically, vitex is supposed to affect dopamine, which affects prolactin, which is how it affects progesterone production – but what I find is it does so much more. I think it’s just the greatest little herb about brain to ovarian health. That’s what I tell people. So, I use it for lots of stuff.
Jade: [30:05] Yeah, I love vitex too. It’s one of the ones that it seems to be clinically one of the ones that I can… there’s very few things you can be like, you know what, try vitex, or try this thing, and have some benefit, and I typically get great benefits. Although it does seem to be an herb that takes a little bit of time to work.
Carrie: [30:23] 3 months.
Jade: [30:24] I don’t know if you see that as well.
Carrie: [30:26] Yeah, I tell women give it at least 3 months. Don’t get to the end of the your first cycle and think this is bogus. Because it takes 3 months to get from a primordial cell all the way up to the chosen follicle that’s going to release the egg, so like, we gotta work with your rhythm that your ovaries are doing. So, yeah, big fan of chaste tree/vitex.
Jade: [30:45] Same. Any others? Actually, you mentioned ashwagandha, one of my favorites. Rhodiola’s another one of my favorites.
Carrie: [30:50] Be careful, though. If you found that rhodiola’s really drying, depending on the dose – do you ever get that?
Jade: [30:54] Oh, you know what I have found with both of those is that rhodiola’s supposed to be a little bit stimulating, and that’s what you tend to see it helps with energy. I can also see it being very sedating in a small minority of people, and ashwagandha the opposite. So, I often times warn people about those things. Ashwagandha tends to be very calming, but I’ve seen it be very stimulating in some people, and you get this kind of effect with these adaptogens. They’re wonderful, but I would say, I don’t know, I’d probably say maybe 5% of people, it’s been rare, but it happens enough clinically that I warn people about that.
Carrie: [31:27] Yeah, definitely. It’s also a good reminder for people. Like, herbs are still – I mean, they’re medicinal, right? So, they could really affect what’s going on, hopefully in a positive way, which is what we’re trying to do, but sometimes in a negative way. I was at a conference once with a girlfriend of mine, actually my very best friend, and she’d been telling me that she – two separate conversations that did not relate – on the one hand, she said that I started adaptogens, but this one I’m doing is rhodiola-based, and then on separate conversation, she said I’ve been experiencing really dry mouth and dry eyes, what do you think’s going on? And then, we happened to be in a lecture with a herbalist, and the herbalist was going through the adaptogens, and he hit rhodiola and he’s like rhodiola can be very stimulating, and it can be extremely drying, it’s really good for those women who get night sweats, but not good for people with dry eyes or dry mouth. We were like, ohhh!
Jade: [32:17] Interesting, right? That’s interesting. That’s why it’s great to get a bunch of people with clinical experience, right? For those of you listening, we often times talk about research all the time, and Dr. Jones and I are definitely research junkies. I know that about you, you’re kind of a nerd like I’m a nerd reading research. But, I often times pick up some of the most wonderful tidbits just from people’s clinical experience, and it makes a big difference. One of the ways, by the way, that I’m doing this, and I want to get your thought on this, when I think about restoring hormonal function, typically I go lifestyle stuff first and always. In fact, if you don’t do that, pretty much nothing else works. Then, I’ll typically move into things like nutrients and things like that. You know, zinc, magnesium, some of the ones that most of these hormonal enzyme systems use. Then, I move into the herbal realm, which we just talked about, specifically adaptogens, and partly because I’m addressing what you talked about with the hypothalamus sort of being the command and control center of all of this. And then, I move into prohormones, and then hormones, and I’m wondering where you go with that next. Do you jump right to hormones at that point if the herbs aren’t doing the trick, or do you ever use prohormones in any way?
Carrie: [33:29] I do, and sometimes I’ll do it right from the get-go. It depends on the person, it depends how depleted they are, it depends how desperate they are, and it depends how – if I’m going to hit them with a baseball bat or if we’re just going to nudge them along because they’re a really sensitive person. Sometimes I have people that are like I will do anything, I’m at my wits’ end, but I don’t have the energy, and I use the prohormones like, look, we’re going to use them as a band-aid while we’re using the lifestyle, the nutrients, the adaptogens. I mean, sometimes I’m just using everything at once with the idea and the intention that I will gradually be pulling them away. Like, as you get better, and as you’re making these changes, and it’s sitting in for you, then I’m going to gradually pull this back, and you’re going to continue to feel better because you know what to do. But, if I’ve got somebody who maybe can’t use hormones or they’re not ready for hormones, I agree, like you, I’ve got it sort of at the end of my hierarchy. But it depends on the person.
Jade: [34:25] Yeah. So, which ones would you be using primarily? I’m sure DHEA’s in there.
Carrie: [34:30] I use a lot of DHEA. I do use a lot of DHEA. I did not use a lot of things like pregnenolone. So, pregnenolone – people ask, well, if don’t believe in the pregnenolone steal, why do you give pregnenolone? I’m like, well, it’s still very calming, so pregnenolone works on the brain. When pregnenolone goes through first pass in the liver it turns into something called allo, A-L-L-O, allo. And allo cross the blood brain barrier and supports GABA, and GABA’s our calming hormones. So, a lot of people take pregnenolone because they love how it feels in their brain, they love how they feel calm, how it affects their stress, so I will use pregnenolone. But, I use a lot of DHEA, absolutely. I just warn people of the side effects.
Jade: [35:12] Yeah, it’s interesting. Pregnenolone is one of those things that I have, you know, for women especially going perimenopause, I’ll often times just use oral micronized progesterone. Pregnenolone, I often times find, is just doing the trick just as well, sometimes better. Sometimes you go right to that and it just calms them down and lets them sleep.
Carrie: [35:30] Yeah, and oral micronized progesterone and pregnenolone work for the same pathway. As you know, oral progesterone breaks down into, eventually, allo as well. So, allo and pregnenolone do the same thing, they cross the blood brain barrier, touch on GABA, so.
Jade: [35:45] And you can – correct me if I’m wrong – but I think most of the time now, you can find the oral micronized progesterone over the counter now for many people. Not that we necessarily want them doing that, but-
Carrie: [35:56] The cream topical is over the counter and FDA approved at the moment. There are some companies that do have, for primarily for practitioners, you don’t need a prescription. They’re not compounded, but there are some companies out there that do have it as a dropper, like a tincture, and they can be – they’re in oil, so they can be really, really helpful for women. And I’ll definitely use it in some women. Sometimes I’ll just use cycling progesterone while I’m using vitex as well, B6, and other support to get them ovulating, or get them back on track. Just be real careful with progesterone, for people who are listening. Same feedback loop, it can go back to the brain and go, she has progesterone, she doesn’t need it, and the brain goes, oh, ok, then I won’t ovulate this month. So, if you’re trying to encourage ovulation, do it after ovulation not before. Make sure she’s hit that, whatever day she ovulates, move forward.
Jade: [36:48] So, is this the idea behind not giving something like progesterone all through the month, but giving it just the 14 days prior, right after the ovulation, so that’s kind of what you’re speaking to there.
Carrie: [37:00] Yep, absolutely. And it depends on age. If she’s perimenopausal or menopausal, then I do it way differently. If she’s perimenopausal, she’s not going to ovulate with any regularity. I don’t use vitex much. If they’re in the perimenopause moving into menopause, I don’t find that vitex works that well. Vitex is great for the woman who should be ovulating, not for the woman who’s transitioning out. Same with progesterone. If she’s 46 with irregular cycles and hot flashes, I’m like we’re going to do it most everyday.
Jade: [37:27] Yeah, same with me. I mean, for me, vitex is one of those things younger women who should be normally cycling, who have been under stress, and, you know, I see a lot of athletes who are coming back and not being able to have or return to ovulation, and fertility issues, vitex is wonderful. But, I agree, perimenopause, I start moving more into the hormone therapies. And there’s some, actually, there’s some pretty good studies on progesterone use in perimenopause, and I think that’s becoming way more mainstream now, just progesterone sort of by itself. Well, let’s get into some of the stuff that I just – I want to be educated on, because this is the area where, you know, I’m kind of lost in this. I’ll frame this for everyone, and then you can kind of get me straight, but here’s the way I’ve always seen this. As I was working in my career, working with mainly women – part of the reason I became expert in endocrinology is because I was working with mostly women. What I found, and I kind of want to just see what your take is on this and how you’ve either, this was your experience or not, and then, where to go from there – but what I found is that I ran so many serum hormones. So, estrogen, progesterone levels, snapshot in time, and then I moved to saliva and blood spots, and used a lot of ZRT labs and stuff like that, trying to get cycles. Here’s what I ultimately found: I have to say that overall, with using testing to try to guide me, I was always a little bit disappointed in what I was seeing on the test, and then making recommendations based off of that, and not getting necessarily the clinical outcomes I wanted compared to just using my clinical judgement based on symptomology and then making recommendations. So, what ended up happening for me is, over time, I started running less and less hormone panels because I just didn’t see the direct correlation between here’s what I’m seeing on your hormones, here’s what we can do, the hormones change directly, and the symptoms fix themselves. Normally, I would see it the other way around. I’d almost see it like, here’s your symptomology, I’m going to make a best guess based on what I know that these hormones do, I’m going to make these interventions, and it worked better for me always that way. So, I’ve always had this sort of push and pull where I would love to be able to have a clinical tool that really gives me good information about the hormones in the body that also correlates really well with signs and symptoms. So, you obviously, and I’ll let you tell a little bit about what you’re doing and what you’re educating us all on, but that’s been my dilemma, so I just wanted to get your take on that, and also hear your recommendations around this. And whether you even saw this at all yourself.
Carrie: [40:13] Oh, 100%. The first thing I’ll say, not that you do this, but since I talk to practitioners all day long and look at thousands of tests – well, full disclosure, so, I am the medical director for the DUTCH test, which is owned by Precision Analytical – however, I’ve been in this field, let’s see, I graduated from medical school in 2005, but I was involved in the naturopathic schools since 1999, so, 20 years in this field of hormone serum, saliva, blood spot; I’ve used all of it… a lot. So, the first thing I will remind practitioners is that when you’re looking at a woman’s hormones, you have to make sure you know where in her cycle she is. You don’t do this, but plenty of practitioners will fight me and go what does it matter, it changes all the time. I’m like, that’s the point.
Jade: [40:59] Exactly.
Carrie: [41:00] We need to know where she is, because progesterone only comes out in the 2nd half in the luteal phase. So, if you check her progesterone on Day 4 and it’s near zero, I’m like of course it is, she hasn’t ovulated yet. But, if you check her on Day, let’s pretend, 19, 20, 21ish, assuming she ovulates on Day 14, then you should, in theory, hit her at her peak of progesterone. So, where she is in her cycle definitely matters first and foremost. Second thing is, just like you said, when you are looking at these 1 day tests, they are literally 1 day out of her cycle. She’s a 28 day girl, you’re looking at 1 day out of 28. And I have found this over and over and over again because it – DUTCH, much like other companies… even the saliva companies do this - is that they will run what’s called a cycle; all month long, you collect a sample, one day, every morning, all throughout your cycle, and then it gets graphed out – your estrogen rise and fall, and rise again, and then your progesterone is low, and then it should go up and go down. What I have found over and over is that the 1 day testing can miss a lot because you’re not getting the full macroscopic look of the whole cycle. And they will bring me their bloodwork and show my progesterone is low, or my estradiol looks really low and menopausal, but I have PMS and heavy periods, and fibroids, and all these things that indicate I don’t have low estrogen – what’s the problem? When we do the cycle mapping, what we see is they dip, and we caught them at the dip, and then they bounce back up again, and it’s really super common. In fact, when they bounce, they tend to bounce really quite high. So, that is the struggle with the 1 day test, is you get a snapshot in time and sometimes nail it, and sometimes you caught her on a dip, and then what do you do? Then, I would do the same thing you do. I’m like, well, this bloodwork shows your estradiol’s low, but I don’t think it is, I think just on this one day it is. Thanks for spending your money on this one day. We’re going to address it the way I think your symptoms line up. Now, having said that, bonuses that I like of using urine testing, which is what DUTCH is – we’re a dried urine company – is that you get the hormones, but you get where they go. For example, when you run an estradiol in serum, I can tell you what your estradiol is in serum. When you run it in saliva, I can tell you what it is in saliva. But, I can’t tell you its metabolism pathway. I can’t tell you its phase 1 and phase 2 detox, which is the bonus when you look at dried urine testing, or even those of you who are doing 24 hour urine testing, it’s just more of a pain to collect. So, now I can tell you, if you catch them one day and their estradiol’s quite elevated, and they have all the matching symptoms, now I can tell you are they stuck at phase 1, are they stuck at phase 2, is it an increased aromatization issue. Same for men. Men can have elevated estrogen and have the same detox issues, and then I can focus in on how we can sort of unplug those locked detox pathways. Or I may suggest additional testing. Phase 3 is done in stool testing, which our company doesn’t do, but when I’m consulting, I’ll say hey, what’s going on with your gut. Obviously, we often start with the gut, so fix the gut… that’s the sewer line out of the house; let’s unplug that, and that will greatly help your estrogen move, and then work backwards from there. So, that’s why I do like urine testing – albeit dried, which is obviously biased – or 24 hour as well, because you get these great pathways that we can fix through diet, lifestyle, and supplements.
Jade: [44:36] Yeah. And, of course, a lot of the more conventional practitioners who listen are going to be asking about well, is that diagnostic, what is the science saying about that. So, I know you probably have an answer for that, but to me, this is a true functional – it’s a functional test, which is a little bit different than what most people will be thinking about. But what’s your comment to that where people are saying well, this isn’t necessarily proven, we’ve always used serum, this is what all the research’s based on. What’s your take on that?
Carrie: [45:07] Right now, the research – a lot of the serum, of course, is they consider gold standard. Our company in particular has a published study out that compares dried urine estradiol and progesterone to serum estradiol and progesterone and shows excellent correlation. So, for the people who are using dried urine, the DUTCH test is an example, we have the data to prove that it’s a good correlation to serum. But, for those who are like, oh, I don’t know about that estrogen detox, I don’t know about that estrogen metabolism, I get pushback on that too. I’m like, man, that’s been in the research for YEARS, because urine, right – urine is what we had for years, and if you wanted to look up those pathways, if you look up 2-hydroxy, 4-hydroxy, quinone pathways, you know, breast cancer, DNA adducts, any of these buzz words, you’ll see tons of information on PubMed on how these particular estrogen pathways can potentially increase carcinogenesis, increase DNA damage and mutation, and potentially lead to estrogen related cancers, or cancers in general. So, that research is really strong in the literature.
Jade: [46:21] One of the things about our profession that I do kind of love is that our profession has kind of been all over this stuff for a long time. We tend to do a lot of the art side of things, you know, art and science. I think that, to me, I love that about us. I think that I might hate about us too is that we get a little bit of stuck in sort of the art side when the research’s clarifying things. So, to me, it’s like this constant balance between the art and the science of this. But, I guess my final question about this testing then – so, if you were going to say, alright, you’re a women who’s sort of dealing with hormonal related issues, and we sorted out and learned from you that there’s other hormones that you want to take care of first that are usually addressed through stress management and lifestyle, but now we’re down to the sex steroids and looking at estrogen and progesterone. And like you mentioned, men, estrogen is hugely important too, for erections especially, and so men who are dealing with that want to be looking at testosterone and estrogen. But, now that we’re there, what would you suggest now with the testing? Because do you feel like, alright, everybody should. If we’re practitioners, should we all be looking at – and I have my opinion about this – but should we all be looking at across the cycle? Should that be our new gold standard in terms of, if we want to assess hormones for a woman, we should be looking at the entire cycle, not a step snapshot. Is that where you come down on this, and primarily, we also want to know these detox pathways, so urine is your sort of chosen modality.
Carrie: [47:51] Urine is my chosen modality, because if you’re going to manipulate estrogen and progesterone, and even testosterone, especially, in men or women, testosterone and DHEA go down pathways that can worsen symptoms as well. Like the DHT pathway, right? 5-alpha-reductase, women increase acne and hirsutism and anger and all these things. So, when it comes to testing, if she can afford it, I’m a big fan of testing all throughout the cycle. Let me step back. If her cycles are fairly consistent, but they’re always symptomatic, then I’m a big fan of testing all throughout the cycle is she can afford it. If her cycles are irregular, if she’s perimenopausal, if she’s like, well, some months I’m 23 days and some days I’m 34 days, I don’t know what’s going on, then I am not a fan of testing throughout the cycle. Because a 23 day cycle’s going to be different than a 34 day cycle, so I’m more of a fan of figuring out why she’s so irregular, if it’s not age, and address that, and then come back to the hormones. Figure out the why first and then come back to the hormones. You may fix the hormones in the process of figuring out the why. But, if she’s symptomatic throughout the cycle, if she says – you know, some women are very particular – they’re like I’m symptomatic on Day 13, Day 16, and Day 25 through 28; I’m like, well, that’s more than a 1-day test. Let’s do the whole month and see what’s going on. Or I have women who go, I get migraines around midcycle and at PMS; I’m like, well, then we have to do the whole month because a 1-day test is not going to tell me before ovulation what I need to know. But, if she’s just screening for hormones, if hormones are a problem, but not her biggest concern – you know, a lot of these companies loop cortisol and other NEET (?) markers into it, so I’m like, if we’re just looking for one quick and easy test, I can get a snapshot of your hormones, I can get a snapshot of your detox pathways, I can get real specific on your cortisol, I can look at things like your melatonin and some other organic acid markers, then I will do just the 1-day DUTCH test and start there. I’ve found that to be really quite effective. So, it depends on the person, yeah.
Jade: [50:05] Yeah, that was going to be my next question in terms of prioritizing hormone testing. DUTCH has a test that looks at these big ones, right?
Carrie: [50:13] Yeah.
Jade: [50:14] So, it has a test that looks at all the sex steroids and cortisol and DHEA, and all that, so that would be the regular DUTCH test that people – so, you kind of have this one, all-in-one, very functional test that looks at this. I guess just one brief thing – so, in terms of cortisol, saliva, and cortisol urinary markers, what are your thoughts about that?
Carrie: [50:34] Cortisol is, for sure, the gold standard when it comes to… or saliva is the gold standard when it comes to cortisol testing. Urine, dried urine testing, is a really good surrogate. Matches up really pretty well. We’re trying to get research published on that. But, when it comes to things like the cortisol awakening response, which is the response of cortisol first thing in the morning, it’s the rise in cortisol on you first 20-30 minutes of waking. It’s what helps flip you from conscious to alert in the morning. Then, that’s absolutely cortisol, and so, DUTCH has actually included, we now have saliva swabs. So, instead of tubes that you have to spit in, they’re cotton rolls that you use. We absolutely have that option to do a combination, urine for the pathways, and saliva swabs for easy cortisol collection.
Jade: [51:22] To capture that cortisol awakening response.
Carrie: [51:24] You got it.
Jade: [51:25] Which is huge for – glad you brought that up, because it’s one of those things people always sort of talk about; oh, let me get the cortisol rhythm. You really want that cortisol awakening response. It may be, in my mind, the most important aspect of capturing a cortisol. Of course, you want that rhythm, but you definitely want that cortisol awakening response.
Carrie: [51:43] It’s the biggest indicator for things like resiliency, inflammation infection response… what’s the other – auto-immune – it has a huge impact on auto-immune, mood, all sorts of stuff. And if it’s too high, too low, it’ll affect all those things. People usually know; I’ll ask them, “How do you feel in the morning?” You know, what’s going on in the morning, and they’ll say, well, after 2 cups of coffee and a couple hours, I feel great. I’m like, you got a problem.
Jade: [52:11] Yeah, exactly.
Carrie: [52:12] Your awakening response is not good.
Jade: [52:15] Or their blood sugars are spiked through the roof, and they’re not really insulin resistant for any other reason, but they’re getting this huge cortisol and adrenaline output that’s pumping up their blood sugar, which you often times see in people who are intermittent fasting and keto dieting and stuff like that.
Carrie: [52:29] You got it.
Jade: [52:30] Really interesting stuff. So, I want to be respectful of your time, but I guess – one of the things I love asking professionals like you after you kind of go through this, is just to go through kind of the things that are exciting you now. You’re on sort of – I know you are like me – you’re constantly always studying, and your thought processes are evolving, and you’re constantly lecturing, so questions come up, and insights develop; so, this could be anything that’s a hypothesis or anything you’re just excited about learning about, or something new. Just give us an idea of Dr. Jones’ thought process about how she sees things going, in whatever direction you choose, just to kind of give us some insight, or things that you think we should all be aware of that we’re making big mistakes of that you’ve kind of figured out.
Carrie: [53:20] Well, I would say, since we’re on the topic of cortisol and I lecture so much about the cortisol awakening response, I think that’s the biggest thing that I’m researching right now. Like I said earlier, I’ve been researching a lot into the circadian rhythm, and like you said, most practitioners talk about the grand sweeping rhythm that you should be up in the morning and down at night. Which you should, but as I learn more and more about the specific first 20-30 minutes of what happens after you wake up, it’s so telling of your health right there in the immediate and in the future. By being able to modulate that awakening response, and it’s so easy to do – it doesn’t require a lot of money, but it does require some habit – it can really make a huge impact on people. Just the auto-immune piece alone is just mind-blowing to me. Just for people who don’t know, when your immune system, when you make T cells, when you’re differentiating them, your body runs them through your thymus gland – not thyroid, but thymus – and the thymus gland checks them. To make it easy, for autoimmunity, it’s called self-tolerance; and if you fail self-tolerance, if you were accidentally created as an autoimmune T cell and you shouldn’t be, then, in my head, the body pulls it aside like, little T cell you need to come over here, you have to die. We can’t put you in circulation, that would be bad, we’re going to kill you. So, one of the triggering things to kill these inappropriately made T cells is the cortisol awakening response. When people say to me, hey, my autoimmune symptoms were really under control and now they’re back, I’ll go, “How’s your morning?” And they’re like, “Oh, it’s bad in the morning. It’s real bad in the morning.” I’m like, I think you have an awakening response issue; I don’t think it’s high enough or peaked enough, let’s address that. The people who tell me they’re now waking up in pain, they now wake up inflamed, it takes them a good hour; they’re like, oh, yeah, I wake up really painful and stiff; it takes a good hour, and after an hour, then I get moving. We often think of arthritisy-type stuff, but you need that cortisol. Cortisol’s suppressive to inflammatory cytokines. Right away, I’m like, just by answering a few questions, I’m like I know what your awakening response is not doing. If we can address it appropriately, I can affect so many things – autoimmune, pain, inflammation, infection, blood sugar, mood. Like I said, it’s pretty easy to manipulate. And I mean that in a positive way. We want to manipulate it to be positive.
Jade: [55:43] Yeah, it’s such a good clinical pearl. Is that why you make such a big deal about the circadian rhythm and light exposure and that kind of stuff? Is that where that’s coming from?
Carrie: [55:53] Absolutely. Another big thing is supplement timing. For people who want – like, let’s say you’ve got a patient and you’re like, hey, take this ashwagandha or rhodiola in the morning. What do people do? They get up, they get ready, they take a shower, they eat breakfast, and then they take the rhodiola. But, if you’re trying to impact their cortisol awakening response that happens in the first 20-30 minutes of waking, guess what? You better take that rhodiola in the first 20-30 minutes of waking. The sooner, the better if you’re trying to impact it. Same for the reverse. If you have a too high awakening response, you shoot for the moon, and you’re giving them, as an example, L-theanine, let’s say, phosphatidylserine, I tell people, take it on waking. Literally have it at your bedside, take it on waking, because you have to impact that awakening response right away. Don’t wait 2 hours until you finally get to work and take your morning supplements at 9:00 AM. Take it when you wake up. It’ll make a huge difference.
Jade: [56:46] Such good stuff. Actually, I have one question, just popped in my head. I don’t know if you’re going to have an answer to this, but it might just be interesting for you. With me in particular, I have this very weird thing where if I do any kind of salivary catch for cortisol, it is nonexistent. I have never seen cortisol register on any saliva test for me.
Carrie: [57:07] What is wrong with your salivary glands?!
Jade: [57:08] Exactly, right?
Carrie: [57:09] Oh! But, Jade – see, that’s the thing with other saliva companies, is they don’t test your cortisone.
Jade: [57:17] Yep, yep. So, it’s interesting. I’ve actually never done a DUTCH test on myself, which I will now.
Carrie: [57:24] Turns out [inaudible]
Jade: [57:26] Exactly. Turns out I know someone who can help me out. But, the other thing is, for a long time, and I did have lots and lots of fatigue-based issues. I have hypothyroid, Hashimoto’s, which I’ve pretty much cleared of that. At one point I was like, alright, well, let me just test my serum, and then my serum cortisol is high-normal. You know, sort of high-normal. So, it’s just an interesting sort of thing here with the saliva thing. I just thought I’d throw at you.
Carrie: [57:51] Well, I have a hypothesis and then we can wrap up. So, cortisol’s active, right? Cortisol’s active. It’s what binds to receptors and does the things. Cortisone is inactive, and you have an enzyme that dictates which one you’re going to be. So, you always make cortisol first, and then different glands and parts of the body can keep it active or deactivated. The salivary glands, the kidneys, your intestines, your sweat glands, have really high levels of this enzyme – 11-beta hsd 2 – that deactivates to cortisone. It’s possible that you have an excessive amount of 11-beta hsd 2 in your saliva gland, and therefore, when you do other cortisol testing, your cortisol registers near zero, but your cortisone is probably quite elevated. Which is why on DUTCH test we give you both; we give you cortisol and cortisone because we recognize the kidney has a whole lot of this enzyme for protective purposes, to protect from kidney damage and high blood pressure, and stuff like that. And we will see people who have really high cortisone, which tells me they had cortisol that was high and the kidney’s trying to protect itself. So, that’s my hypothesis.
Jade: [58:56] And that would make perfect sense for me in my clinical sort of picture. Thank you for your genius for that, and I’ll get the DUTCH test and see. We’ll correlate and see how that works. But, I appreciate you so much. You’re such a genius. Thanks for all the work that you’re doing for all of us, and thanks for spending time with us today, Dr. Carrie Jones.
Carrie: [59:17] Oh my gosh, thank you so much. I appreciate it.
Jade: [59:20] Where should I send people to find you? I follow you on Instagram, so give them your Instagram handle, and anywhere else where they can get in touch with you [inaudible].
Carrie: [59:29] I hang out on Instagram all the time, so it’s @dr.carriejones. Come find me, come hang out. All I do is education. I do work for DUTCH, but I’m not trying to sell anything, so yeah, take a look. It’s all endocrinology.
Jade: [59:42] Your account is one – and I have a few people that it’s my education – your account is just fantastic. So, if you want this kind of education, and actually, I would say, way more just really amazing stuff, go check her out on Instagram. Thank you, my friend. I will see you soon. I’ll see you on the social medias.
Carrie: [01:00:03] I’ll see you on the IG.
Jade: [01:00:05] Alright, see ya.