Cortisol: the emergency responder hormone that when chronically elevated, makes you fat, stupid and unsexy. Nobody wants an excess of cortisol, but like all things in physiology there’s a sweet spot; low cortisol doesn’t feel right either. Which you have? Symptoms of high cortisol Symptoms of low cortisol Fatigue Extreme fatigue Muscle weakness Muscle or joint pains Depression, anxiety and irritability Depression, irritability Loss of emotional control Salt craving Cognitive difficulties Abdominal pain New or worsened high blood pressure Low blood pressure, even fainting Glucose intolerance that may lead to diabetes Low blood sugar (hypoglycaemia) Headache Nausea, diarrhea or vomiting Bone loss, leading to fractures over time Weight loss and decreased appetite Source: Mayo Clinic Both sets of symptoms are very similar, in fact, all of these symptoms could be attributable to half the diseases known to man. The only way to know for sure what’s going on with your cortisol is to do the test. I tested over 500 endurance athletes And all but a handful had low free cortisol. Free cortisol is the active fraction of the hormone, but it only accounts for 1% of the total cortisol production and so forms just part of the puzzle. I can’t give you any more information than this because free cortisol is all a saliva test measures. Luckily the testing has gotten more sophisticated Mark Newman is an analytical chemist and the founder of Precision Analytical, a lab using GC and LC-tandem mass spectrometry to measure not just free cortisol, but also the metabolites tetrahydrocortisol and tetrahydrocortisone. Their DUTCH test is a game changer. The extra information in this test enables me to be a better detective. Now I can differentiate between problems with cortisol production and cortisol clearance. The two have very different implications. Not just cortisol The DUTCH also measures no less than eight androgens, eight oestrogens and two metabolites of progesterone. The results can be overwhelming at first, but as you begin to appreciate the pathways that these hormones take, the picture becomes clear. Testosterone Testosterone can metabolise down one of two pathways: the more androgenic alpha pathway that leads to the hormone DHT, thinning scalp hair and prostate problems for older men or a potentially more desirable and less androgenic beta pathway. The good news is that once you understand your metabolism, there are nutritional supplements that you can take to inhibit the alpha pathway. Oestrogen Saliva isn’t a very accurate way to measure oestrogen. Not only is urine more precise, but it also enables us to test the metabolites that tell us all about both phase 1 and phase 2 metabolism. Oestradiol is the most abundant oestrogen, and its friend oestrone breaks down in one of two different directions. This can produce two very different, and not always desirable outcomes. The only way to know what’s happening to you is to do the test Establishing a baseline During this interview, Mark makes an important point. Let’s say you feel good right now. Wouldn’t it be nice to have the complete picture of your hormone metabolism for future reference? Or perhaps you suspect a problem. Either way, you can order a DUTCH though me and then together we figure out a plan to optimise your hormones. Don’t be that guy guessing using the list of symptoms you found on the Mayo Clinic website. Here’s the outline of this interview with Mark Newman: 0:00:50    Mark Newman is an analytical chemist with a master's degree in forensic science. 0:01:07    Mark started with urine testing then moved onto saliva testing. 0:01:41    DUTCH stands for Dried Urine Test for Comprehensive Hormones. 0:02:11    The DUTCH combines the best of saliva and urine. 0:02:51    Educational videos. 0:03:32    The DUTCH is the culmination of Mark's life work. 0:05:01    My first saliva test showed high cortisol at night, and low cortisol during the day. 0:05:51    We've run over 546 saliva