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Episode from the podcastBen Greenfield Fitness

High Cortisol Mysteries Unveiled, The Adrenal Fatigue Myth, Advanced Lab Blood Testing & More!

Released Saturday, 2nd July 2016
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Note: There is a special addendum at the end of this podcast episode in which Ben mentions the book "Ego Is The Enemy", this sermon on Time & Resources by a man named Toby Sumpter and the practice of iridology. Last month, I released the podcast episode entitled "Why Is My Cortisol High Even Though I’m Doing Ever…".
In that episode with fellow podcaster and health consultant Chris Kelly, we delved into the mystery of why cortisol can be so high in someone such as myself who sleeps well, does meditation, yoga, and lives a relatively stress-free life. It was a fascinating, extremely popular episode, but created just as many questions as it answered about what really causes high cortisol in people, and whether it's something you even need to worry about in the first place!
To delve into the cortisol mystery more, after that episode, Chris Kelly introduced me to Dr. Bryan Walsh, a naturopathic doctor from Maryland, with an amazing series of WellnessFX lab testing interpretation videos on Yo…. Dr. Walsh has an extremely sharp mind, an extensive fitness background, a degree in naturopathic medicine, and a host of additional training and certifications. His wife is a naturopath too, so his children are probably some of the healthiest on the planet. When tough cases or head-scratching lab results arise, Dr. Walsh turns from mild-mannered dad and husband into forensic physiologist, pulling out his microscope to analyze blood, saliva, urine, lifestyle and whatever else he has to, in order to solve the medical mystery. Dr. Walsh ran an extensive series of follow-up lab tests on me, primarily through the laboratory testing services of another functional medicine practitioner - a chiropractor in Atlanta, Georgia named Dr. Brady Hurst. At his company, TrueHealthLabs, Dr. Hurst uses advanced laboratory tools to uncover hidden dysfunctions and uses primarily drugless treatment plans to restore those dysfunctions. TrueHealthLabs has a number of direct-to-consumer tests that are not traditional lab tests and can instead be custom panels that a doctor or patient can order. They even offer some functional lab testing in Europe.
In this episode, Dr. Brady Hurst, Dr. Bryan Walsh and I completely geek out on the high cortisol lab testing results and during our discussion, you'll discover: -The secret ingredients the green morning smoothie that Dr. Bryan gives to his young children... -How to keep your morning green smoothie from getting oxidized or damaged by the blender... -The seven stage home filtration process Dr. Brady uses to filter his water... -The very first additional hormone you should test for if you find out your cortisol is high... -The best lab panel to look at whether or not your body is actually producing adequate antioxidants... -When high HDL (commonly known as good cholesterol) can actually be a bad thing... -How high cortisol down-regulates your metabolism and your insulin sensitivity and puts your body into fat storage mode... -Why thyroid replacement medications or natural thyroid supplements rarely work to fix the thyroid... -When you don't need to actually worry about high liver enzymes on a blood lab test... -The hidden laboratory marker that can tell you if you need to be consuming more sea salt and minerals... -How to tell if your body has excess oxidative stress, and what you can do about it... -And much more!
Resources from this episode: -iSpring Reverse Osmosis filter -Apex Energetics supplements that Dr. Brady uses -Liposomal glutathione -Article: How To Biohack Your Green Smoothie (And Can High S… -DUTCH Urine Steroid Hormone Profile -Ben Greenfield’s DUTCH test results -TrueHealthLabs Oxidative Stress Profile -Ben Greenfield's Oxidative Stress Profile results -TrueHealthLabs Custom Lab Testing - Ben tested the following: a. NMR Lipoprofile b. Oxidized LDL c. ACTH, cortisol, and aldosterone d. LH, FSH e. Free and total testosterone f. Prolactin g. C-peptide -Ben Greenfield's TrueHealthLabs Custom Lab Testing… Extra Notes: After our call, in a flurry of e-mails, Dr. Walsh also recommended the following follow up tests:
  1. Lymphocyte subset panel (CD4/CD8) – Your lymphocytes are relatively low compared to your neutrophils, so I’m not sure it would show much, but this panel shows ratios of lymphocytes, regardless of their total levels, and could offer a little info.
  2. Cytokine panel – I’m a little hesitant on the accuracy of these panels, but they are used in research, so I think they are accurate enough for our purposes. This might show a tendency for a Th1/Th2/Th17 shift, which could be interesting to know. High cortisol is often associated with a Th2 dominance, which this panel would theoretically show. If it were me, I’d be curious about the results of this panel.
  3. Neopterin – This is a huge stretch, but I personally love this marker. When neopterin is elevated, it suggests an Th1 response due to activated macrophages. If I had to bet money, I’d say this would come back normal for you but again, medicine attempts to rule out things first, and this would rule out any Th1 involvement.
  4. I don’t suspect any autoimmunity in you, but if you’re getting your blood drawn anyways, you could run something like ANA. This won’t identify all autoimmune conditions, but some. I’m on the fence about this marker.
  5. There’s one other marker you could run, but I would only run it for educational purposes for your listeners, and that is Glycomark, also known as 1,5 anhydroglucitol. This is one of my favorite markers of all time, because it measures postprandial glucose levels two weeks prior to the test, which is just awesome. I suspect that this marker, when abnormal, is the first of the glucose regulatory markers to show tendencies for glucose dysregulation, far before fasting glucose, c-peptide, or A1C.
  6. Cyrex panels – You mentioned this on the call. If you’re truly using yourself as an experiment for the benefit of listeners, you could run their antibody panel and/or their intestinal permeability panel. I know you’ve had some gut issues in the past, so the latter might be of interest. For the average patient, we usually use these when things aren’t resolving well, but for myself, if money weren’t an issue and I was truly doing an experiment, I’d run these panels to see what came up.
  7. If you’ve indeed had elevated cortisol for a few years now, and possibly elevated ACTH, it may be that you actually have enlarged adrenal glands capable of making more hormones. Here’s the thought process. ACTH is a “trophic” hormone, meaning it enlarges its target organ (adrenals). Not only that, the cells of the three layers of the adrenal glands can be repurposed for making different hormones than they were designed to. For example, cells in the outer-most layer of the cortex (glomerulosa) normally make aldosterone. But in the presence of sustained and elevated ACTH, the cells of the glomerulosa can morph into fasiculata cells, which normally make more cortisol. Thus, it may not only take less ACTH to stimulate cortisol release, but if the cells of the glomerulosa are repurposed, they will make less aldosterone, which is something you’re seeing on your lab as well. If you did want to ask a doc to humor you and get an ultrasound on your liver, you can see if they would be willing to do it on your adrenal glands as well. There are cash-based ultrasound clinics around and you wouldn’t even need a doctor’s recommendation.
Do you have questions, comments or feedback for Dr. Brady Hurst from TrueHealthLabs, Dr. Bryan Walsh or Ben Greenfield? Leave your thoughts at BenGreenfieldFitness.com and one of us will reply!