This month I would like to bring the fabulous DUTCH test into focus. acronym for; Dry Urine Test For Comprehensive Hormones

If you think you have issues with chronic stress, that is affecting your hormones then this is the test for you to complete.  Like most private LAB tests it can be done in the privacy of your home, taking only minutes to complete.

MARKERS CONSIDERED IN THE DUTCH TEST

SAMPLE REPORT

Stress

The definition of STRESS is the down-regulation of the HPA axis. Down-regulating the para-sympathetic nervous system, creating a dominant sympathetic response.

What happens when we get stressed? We release cortisol, taking 10 minutes to release, but then between 1-2 hour to break down.  This can vary however depending on the health of the individual since the liver is involved within the process of breaking down cortisol when liver issues are present it can take 3-4 hours or even all day to break down.

Cortisol is then affected by the balance of all other hormones in your body. The Dutch test is a highly sensitive test, bringing all hormones into focus when considering your stress hormones.  See the sample report above.

Cortisol is bound up by cortisol binding globulin transcortin.  Transcortin is very sensitive to estrogen.  Actually, all binding globulins are sensitive to estrogen.  Therefore, when a woman is on the contraceptive Pill, or has been on the Pill for some time, there is a very good chance she is low in FREE cortisol, simply because it is all bound up to the binding globulins.

Free cortisol is less than 5% circulating but in its active form.


SEX HORMONES

DHEA

  • DHEA, 80% is made in the adrenal glands 20% in the ovaries.
  • DHEAs is what is measured, however, this is not the active form.  DHEA needs to un-S taking the S off to become the active form. This conversation is dependent on the SULT1A1 gene, therefore sulphonation plays a role.
  • DHEA is your master hormone, breaking down to the three estrogens.
  • If you’ve had your 23&Me interpreted, you can check to see the status of your SULT genes.
  • DHEA made in the brain protects the hippocampus from cortisol, therefore DHEA in the brain is a good thing.
  • Stress damages our hippocampus, affecting our short term memory, not good!

Cortisol

When we get too much free cortisol roaming the system, our receptor sensitivity stopping being so active. Adrenaline and cortisol end up circulating.  In this way, chronic stress leads us into a rut, in which the wiring of our neural networks keeps us repeating the same dysfunctional behaviour.  Yet hoping for a different outcome! This by definition, is a form of insanity.


Adrenal Medulla

Other genes which are relevant to our stress response, mood and thinking are the COMT and MAOA. When these are running slow, you will not be breaking down catecholamines easily, and therefore do not break adrenaline down easily either. Check these genes if you are feeling stressed all day! Running slow means a high amount of neurotransmitters are stored since you are not going to break down adrenaline or nora-adrenaline.  Rather, it can carry on ALL day.  Stressy, buzzy, tense.

All there needs to be present to impact this system significantly is an infection, inflammation, food intolerance or a pile of housework building up to tip someone with slow genes to be tipped into overwhelm.

Cerebral cortex > CRH > anterior pituitary > ACTH > cortisol release > adrenaline and noradrenaline.

Our protective, survival mechanism is to shut down the parasympathetic nervous system and upregulate the sympathetic, now we are chronically in fight and flight! At this stage, we are likely to get receptor sensitivity. We can liken this to ‘annoying kid syndrome’ which I use to call being ‘mummed’.  Mum, mum, mum .. for hours.  We then get hyper-sensitive, and cortisol goes up even further because we are not tolerating it.

On the other hand, if you are a super laid back person your COMT and/or MAOA may be running too quickly.  Feed the furnace with additional protein plus Tyrosine.


How do we break the cycle? 

Change the biochemistry through food and nutrient therapy and then also rewire your habits.

Two analogies work for me here:  First, we need to dry up the riverbeds were ‘too much’ of a hormone/catecholamine/ transmitter has been allowed to flood the system. Secondly, it takes a while for a worn-down path to grow grass again, was ‘not enough’ of the right hormone/catecholamine/transmitter has been present.


Stress and Fasting

Clients like to bring in the option of fasting, believing that fasting will help to clear the system and take the stress of the system.  Whilst this is true in cases where adrenal fatigue is NOT present, it is not true for those who do not have a robust HPA axis. Primarily cortisol manages blood sugar levels. Do not stress the system out even more by Fasting when adrenal dysregulation is present.


Auto-immunity

Cortisol is higher in the morning with the sun. When cortisol is high it suppresses melatonin and growth hormone production.  Cortisol helps to fight infection via inflammation, think viruses, bacteria, etc.  The pro-inflammatory cytokines stimulate the stress system releasing cortisol.

There is real importance in this morning cortisol spike.  When auto-immune symptoms are presented then understanding your cortisol patterns is super important.  Low cortisol in the morning means that the auto-immune regulator does not happen.  Morning cortisol triggers those cells in the thymus who failed central tolerance to get destroyed.  What that means is, before immune cells get let out into the body, the thymus checks whether immune cells are auto-immune.  If cells are auto-immune, then the thymus pushes the cells off to the side and the thymes kill those cells.  Without the morning spike THIS DOES NOT HAPPEN!, and auto-immune cells get let out into the system.

Therefore, if we are consuming foods which create a cortisol spike at night, or we are fighting infection at night, this suppresses melatonin, which in turn stops us from sleeping.  Leads to a low cortisol spike in the morning with auto-immune flare-ups.  For this reason, gluten and HHV6 will play more than one roll in creating auto-immune flare-ups.


GET YOURSELF TESTED

When is it best time to test?

  • 5-7 days after ovulation on days 19, 20, 21
  • If your cycles are long, then shift up. If your cycles are short, then shift down.
  • First, track your ovulation through temperature gauging or other symptoms.  Then count forward by 5-7 days and collect your urine.

Look at your Estrogens

Dutch tests for Estrogens E1 E2 E3, which then go through the liver and get converted to Hydroxy 2, Hydroxy 4 or Hydroxy 16.

Each esterogen dominant pathway has key characteristics. Estrogen 4 hydroxy for instance goes down the quinone pathway, correcting to estrogen-related cancers.

16 Hydroxy, the 2/16 ratio 2:16 can implicate estrogen proliferative symptoms such as moody, PMS, tender breasts and weight gain.

2 Hydroxy is The Happy Healthy Way.

Estrogen in the right amount

Good for > bone health

Good for > brain cognition

Good for > temperature regulation

Good for > collagen, tissue skin

Good for > fertility

When it’s decreased, we can face menopausal symptoms, skipping of cycles, low cholesterol even anorexia!

Too much estrogen, pre-disposed from either being on the contraceptive pill, environmental estrogens such as cling wrap, tap water (re-cycling of the hormone pill within the water system:

We can experience being over-weight, diabetes, increased risk of Alzheimer, PCOS.

Reduced hormones, on the other hand, can be a direct result from cholesterol-reducing medication for instance. People seem to over-look that cholesterol makes up all our hormones.  When we lower cholesterol we also lower our testosterone, DHEA and Estrogens.


Other estrogen lowering activities

  • Extreme exercise, marathon running, cross fit.
  • Frequent flying
  • Under appropriate body weight.
  • Head injuries.
  • Surgery decreases the blood flow to the area as capillaries are damaged.
  • Sugar, gums up the works, diabetes, and smoking.
  • Birth control pill reduces estrogen in the long term.

Consider Progesterone

Progesterone helps with anxiety and insomnia as well as the lining of the uterus, as women losing progesterone report anxiety and insomnia.

Alpha-pregnanediol goes down, usually goes up to GABA, supporting the glymphatic system during sleep.

A-pregnanediol typically converts into neuro-steroid ALLO, that crosses BBB (blood brain barrier) and can activate GABA a-receptors.

Progesterone in the brain is calming, supporting neurons, and is even used after traumatic brain surgery or after Stroke.

Progesterone enhances serotonin receptors in the brain and reduces gall bladder activity. Conversely, higher estrogen increases the risk of gall bladder disease and stones.

Those on lots of NSAIDS will typically have low progesterone activity when used for more than 10 days.


Consider Androgens

DHEA: facial hair, acne


Consider FREE cortisol, verses stored cortisol

  • Consider infections
  • Consider allergies
  • Consider food intolerances
  • Consider weight gain

Marker 8-hydroxy-2-deoguanosine (8OHdG)

Marker correlating to chronic inflammation, high stress, high cortisol, insomnia, hypertension, kidney disease, IBD, depression.


What do we do now with this information?

Note where on the dials we are, which is dominant. Are we triple estrogen dominant?

Depending on where your markers are, we may wish to support Phase 1 liver with P450 enzymes and DIM. Or Phase 2 Liver with SamE precursor or SamE if you wish to order it in from the US.  P%P, Mg, Choline, Methionine, Methyl groups TMG are all useful here.

Foods can be influential, but ONLY if stomach acid is good.  This will not be the case where P5P and/or TMG is warranted. Kale, broccoli, Brussel Sprouts, Broccoli Sprouts, artichoke, onions, foods high in FOS and fiber.

Support Glymphatic system for catecholamine clearance at night.

Support MAOA with SamE donations and methyl donors.

Support COMT with Mg chloride.

Support the serotonin pathway.

Support the dopamine pathway.

Harness the benefits of apoptogenic herbs.

Combat infections.

Temper exercise according to the dominant hormone, verses hormone insufficiency.

Support HPA axis with key nutrients; C, B5, Zn, Fe, Mg, Sel

Weight management.

Given the results of your DUTCH test, there are plentiful options to improve your health.  So, if you are interested in ordering this test with result interpretation you can email Anna directly.

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5 Healthy Daily Habits

1.  Go to bed at 9pm

2.  Commit to NO BLUE LIGHT from computer screens or phones past sun-down. And when you do, wear amber glasses to block out the light.

3.  Have your last meal 3 hours before bedtime

4.  Break your fast more than 12 hours after your last meal, with a protein Break-Fast

5.  BREATH. Practice breathing OUT twice as long as you breathe IN. This way you positively engage the parasympathetic nervous system. Allowing your body to heal naturally.


GO TO BED AT 9PM

ALTHOUGH ACTION-ING THIS IS NEAR IMPOSSIBLE WHEN YOU HAVE KIDS, IT’S WORTH KNOWING THAT OUR BODIES HAVE THEIR OWN AGENDA AND CONDITIONS WHEN IT COMES TO HEALTH.  IF YOU ARE NOT ACTUALLY GETTING TO BED BY 9PM, BE SURE YOU DON’T STAY UP IN FRONT OF YOUR COMPUTER.

WHICH BRINGS US TO THE SECOND POINT.


BLUE LIGHT & SLEEP

LIGHT FROM THE THE BLUE END OF THE SPECTRUM IS NATURAL AND COMES FROM SUNSHINE. HOWEVER, COMPUTER SCREENS, IPADS, FLAT-SCREENS, LED LIGHTING AND SMARTPHONES ALSO ALL EMIT LARGE AMOUNTS OF BLUE LIGHT.  

RESEARCH HAS SHOWN THAT ALL LIGHT TOWARDS THE BLUE END OF THE SPECTRUM IS ESPECIALLY EFFECTIVE AT KEEPING YOU AWAKE BECAUSE IT SUPPRESSES THE PRODUCTION OF THE SLEEP-INDUCING HORMONE MELATONIN.

THEREFORE TIME SPENT WITH GADGETS BEFORE BEDTIME TRICKS THE PINEAL GLAND INTO STILL BELIEVING THAT IT IS STILL DAYTIME. 

IDEALLY, SWITCH GADGETS OFF AT LEAST 2 HOURS BEFORE BEDTIME.


PREPARE YOUR LAST MEAL EARLY, AND THEN EAT 3 HOURS PRIOR TO BEDTIME AT THE LATEST

THIS GIVES YOUR BODY THE RECOMMENDED 12 HOURS FASTING PERIOD REQUIRED. 

DURING THE NIGHTTIME HOURS YOUR BODY SHOULD IDEALLY BE EMPTY ENOUGH TO CARRY OUT A SEMI DETOX DURING THE HOURS WHEN YOU SLEEP.  BETWEEN THE HOURS OF 1-3 AM OUR LIVER (THE GRAND-PARENT ORGAN) COMES INTO ACTION AND WORKS VERY HARD CLEANING-HOUSE! WHEN WE HAVE EATEN CLOSE TO BEDTIME, WE ARE UNABLE TO CLEANSE OUR BODIES ADEQUATELY, AND CAN EVEN WAKE THE FOLLOWING MORNING FEELING DRUNK AND SQUEEZY FROM THE FERMENTATION IN OUR GUTS. 


BREAK-FAST 12 HOURS AFTER YOUR LAST MEAL WITH A PROTEIN BREAKFAST

AFTER 12 HOURS OUR BODIES WILL HAVE HAD THE TIME TO CLEANSE ADEQUATELY. THEN STARTING OUR DAY WITH A PROTEIN BREAKFAST PROVIDES THE BODY WITH THE BEST OPPORTUNITY TO STRENGTHEN THE LIVER AND AID LIVER PERFORMANCE. IT DOES NOT HAVE TO BE A LARGE BREAKFAST, EVEN NUT BUTTERS WITH PROTEIN POWDERS, BERRIES AND YOGHURT MAKE A GOOD, HIGH PROTEIN YET BALANCED BREAKFAST. 


BREATH 

BREATHING EXERCISES HAVE THE POWER TO RESTORE HEALTH ON THEIR OWN.

AT THE MORE EXTREME END OF THE SPECTRUM WE CAN TAKE ICE-MAN (FOR EXAMPLE), WHO HAS ACHIEVED BEYOND HUMAN POTENTIAL THOUGH BREATHING EXERCISES ALONE.

FOR US REGULAR FOLK, A REALLY GOOD BREATHING EXERCISE IS TO BREATH OUT TWICE AS LONG AS YOUR BREATH IN AND TO DO THIS FOR 7 MINUTES.  THIS ENGAGES THE PARASYMPATHETIC NERVOUS, WHILST SYSTEM REDUCING STRESS HORMONES AND SIGNALLING IN THE BODY PRESENT WHEN WE ARE SYMPATHETIC DOMINANT (FIGHT & FLIGHT) .

DIAPHRAGMATIC BREATHING ENGAGES THE DIAPHRAGM DURING THE BREATH.  YOU CAN PRACTICE DIAPHRAGMATIC BREATHING BY PLACING YOUR HAND ON THE STOMACH AREA, WHILST WATCHING THE STOMACH EXTEND AS THE BREATH IS DRAWN DOWN TO THE BASE YOUR LUNGS. WHEN YOU BREATH OUT, THE STOMACH GOES FLAT.

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Chronic Fatigue Syndrome is a notoriously tricky illness to pin-down.  Since CFS related health-issues tend to be serious to the degree that it can be life altering, but they are usually not so serious that they become a classified disease like heart disease.  This is not only confusing to the sufferer but immensely frustrating too since many of the symptoms are not taken seriously by mainstream medicine.


1.  The first condition to be common among CFS sufferers is Adrenal Fatigue

Unrecognised by most General Practitioners, Adrenal Fatigue affects our energy performance.  It influences how we regulate energy via our adrenal glands, but it is not Addison’s Disease – which is a recognised disease. Adrenal Fatigue is a serious life-altering condition – but it is not Adrenal Failure.

So what tends to happen is the adrenal glands are tested with a blood test.  But because a blood test is not a sensitive enough test to pick up on adrenal dysregulation, results come back suggesting they are functioning normally.

This presents false understanding and confusion when the sufferer is experiencing low energy due to sub-optimal adrenal function, but the tests being used are not sensitive enough to pick up on the true performance.

A four-point saliva test should be provided, obtainable by private labs through the UK and overseas.  The four-point saliva test picks up on steroid hormone excretions throughout the day, tracking adaptogenic responses.  And therefore provides a clear understanding of how the adrenal glands are ‘responding’ and adapting to daily stressors.


2.  The second condition is Left Ventricular Disease

Studies release that a shocking 35% of us is said to have this condition, however, the CFS / ME sufferer will experience the downstream effects of this condition as a chronic and debilitating element of the whole CFS picture.

They may be aware that their heart feels unstable but unable to identify this through medical means since it is not classic heart disease and easily missed.


3.  The third piece to the Chronic Fatigue conundrum is the role of Gut Dysbiosis

Often present in those with Chronic Fatigue.  Gut Dysbiosis fits into the picture of both Adrenal Fatigue and Chronic Fatigue Syndrome due to the role the adrenal glands play in providing an anti-inflammatory corticosteroid (cortisol) to the body to buffer inflammation in the gut.

  • Causative factors for inflammation in the gut 
  • Food Intolerances / Virus / Toxins such as methyl-mercury / Stress

Gut Dysbiosis has a number of potential causative factors with stress, food intolerances as well as toxins such as methyl mercury trumping possible causes for. Gut Dysbiosis is chronic low-grade inflammation, however, it is not inflammatory bowel disease (IBD) and therefore unrecognised by medical communities once again.


4.  The fourth mechanical issue to arise within CFS, and ties in with a performance of the heart, liver and adrenal glands are Mitochondrial dysfunction

This is not an inborn error of the mitochondria, however, it is an inherited epigenetic malfunction.  What that means is that due to the environment the mitochondria has been presented within, the functionality of mitochondria is reduced.  The trouble is, when there is poor mitochondrial function, then everything else in the body is affected.  But in particular, the function of the heart and liver since this is where mot mitochondria reside.

  • Nutrients which positively support Mitochondria Function / Krebs Cycle
  • D-Ribose / L-Carnitine / B3 (NAD) / Co-enzyme A / Co-enzyme Q10

What causes mitochondrial breakdown?

Crisps, rancid fats, hydrogenated oils, poor nutrient profile, toxic metals blocking biochemical pathways and oxidative stress.


5.  The fifth area of health which has more studies relating to CFS than any other area is Nitric Oxide and Oxidative Stress

Within the central nervous system and under normal conditions, Nitric Oxide (NO) is an important physiological signaling molecule, however when produced in large excess Nitric Oxide also displays neurotoxicity and is a risk to heart health.

Nitric Oxide has been found to be excessively high in Chronic Fatigue Sufferers and is seen in conjunction with risk factors for cardiovascular disease.


6.  The sixth element of Chronic Fatigue Syndrome is observable Inflammation

Inflammation is present but it is not a classifiable Auto-immune Disease.


7.  The seventh component of this complex condition is the presence of low-grade infections

Usual infections often present in CFS sufferers

Epstein Bar / HHV6 / Enteroviruses / Cytomegalo viruses / Parovirus B19 / Retrovirus

Co-infections often present in CFS sufferers

Mycoplasma / Chlamydia / Chronic Borrelia / Bucella / Rickettsia / Babesia 

All together we can view this complex condition as a disease of compromised milieu. Triggered by increased cellular stresses such as toxic heavy metals, infections, and emotional stressors.

Strengthening the milieu / biological terrain interior will help to de-activate the viruses present.


8.  Finally, the eighth piece in this Chronic Fatigue quandary is the emotional status of the CFS sufferer

It is interesting to note that Chronic Fatigue patients tend to fall in three main personality categories known as energy depleting psychology types.

  • The Achiever Perfectionis Type
  • Anxiety Type
  • The Helper Type

There can also be a genetic or epigenetic predisposition element to our stress responses to emotional trauma. Meaning that this can be either genetically inherited or genetically learned behaviour.  And then the condition/illness itself perpetuates further trauma in the sufferer as there is a constant fear of becoming ill.  Other behaviours feed into this cycle such as avoidance of certain foods and situations that they believe will make their condition worse.

Each category will be expanded upon within subsequent posts in the coming weeks.

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