Hormones 101, go DUTCH

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 are 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 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 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 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 infection, inflammation, food intolerance or a pile of house work building up to tip someone with slow genes to be tipped into over-whelm.

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 called 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 where ‘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, where ‘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 stress of the system.  Whilst this is true in cases where adrenal fatigue in 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 supresses 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 a 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 supresses 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 clingwrap, 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 as 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 boy 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.


Look at your Progesterone:

Progesterone helps with anxiety and insomnia as well as lining of the uterus, as women loosing 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.


Look at your Androgens:

DHEA: facial hair, acne.


Look at your 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 with the information?

Note where on the dials we are, which is the 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 serotonin pathway.

Support 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 

If you are interested in ordering this test with result interpretation you can email Anna directly.

If you like this post, or found it interesting please do help to get our message out there and share it.  

Top 5 can-do’s to positively influence your health NOW!

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 breath 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 SMART PHONES 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 BED TIME AT THE LATEST. 

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

DURING THE NIGHT TIME 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.

What is Chronic Fatigue? Part 6: Maladaptive stress responses and what this does to your life.

Once the body becomes chronically ill, stress is no longer JUST stress.  Rather, we become kindled to respond to all stressors with heightened responses.  Lowering our reception of dopamine, inflaming tissues throughout our body, disarming the immune system, weakening the gut, increasing the propensity to food allergies and allergies to all chemical triggers.

There is no wonder once we become this ill we then learn obsessive avoidance patterns to help prevent the condition from worsening.  This state or learned avoidance plagues the sufferer with fear of what may happen should they encounter triggers from one moment to the next. This avoidance tends to be very isolating, but it goes way beyond that because it is our reptilian brain that is engaged with a heightened sense of perspective on Life and Death.

From the non-CFS perspective, others can see that our avoidance behaviours to food, people, chemicals, situations, further trains the brain to have more of a reaction to these things, trains the brain to believe there is more than out there to be afraid of.

Spotting avoidance behaviour is not always enough to turning learned patterns around.  Because when we are threatened by our environment, leading us to experience states of severe lack of safety within our own body, then every potential trigger becomes a threat.

Common thoughts could be .. Am I dying? or ..What’s going to happen to me?  

States of mind which require midwifing through the trauma that has set in.

For this to occur there are many therapies which fall under the remit of brain re-training.  Neuro Linguistic Programming (NLP), Emotional Freedom Technique (EFT), CBT, EMDR, Meditation and others are designed to address subscripts which although not conscious, actually dominate 99% of choices, behaviours, patterns.

Therapies which compliment nutritional therapy in the reversal of Chronic Fatigue Syndrome:

  • Emotional Freedom Technique
  • The Lightning Process
  • Dynamic Neural Retraining
  • Family Constellations
  • Neuro Linguistic Programming
  • Breath-work

There are different entry points into psycho-emotional traumas, and so not all therapies work in all cases.

Traumas that have lasting effects in our cells and therefore health are Childhood Traumas – even from the experience of our mother’s womb, Trauma of Stigma and illness itself, Inter-generational Trauma which is passed down from one generation to the next.  If our grand-parents were in a concentration camp for-instance.  This is the power of the fear response and in particular where Family Constellations can be of great help.  Emotional trauma in general benefits from Breath-work.

We know that when deep trauma is present, inter-generational, then emotional trauma of this magnitude actually imprints on the microbiome of the mother, and then the microbiome is then passed on to the child.  Trauma becoming epigenetically inherited.

 

What is Chronic Fatigue? Part 5: The Nervous System, Re-Wired for Stress

There is a vicious cycle within Chronic Fatigue Syndrome, where-by long-term chronic stress can be the main determiner to our stress thresh-hold in the long-term.

This is neuro-plastisity, meaning changeable.  Simply put our nervous systems are capable of forming new pathways for better of for worse.  Neuro-plasticity means our brains respond to stimulation, which over time, literally changes the structure of the brain to grow new neuro pathways causing physiological changes and therefore new responses to dealing with new stressors. Through neuro imaging it is possibly to visibly see these changes, as an increase and a lengthening of neuro dentrites.  Literally building new neural pathways which are wired for stress!

LIMBIC KINDLING & MCS

This is model of neuro-plasticity is also known as ‘Limbic Kindling’, kindling of our nervous system and brain to respond to chemicals.  Chemicals are saturated into our homes and personal care regimes.  Everything from upholstory, hair dyes, cosmetics car fumes etc and other toxins such as heavy metals from our soil, water and therefore in our food.

Multiple stressors from multiple sources including environmental toxicity have the power to kindle our brain to act on its own as if it were experiencing the stress when it is not!  Acute infections can also kindle the brain to the same effect.

This over-stimulation is of the Hypothalamus-Pituitary-Adrenal (HPA) axis, and ultimately lowers our threshold to environmental pollutants so that less chemical or other trigger stimulants are required to activate a chronic stress response.  An assembly for hyper-sensitivity and reactivity has then occurred.


LOW DOPAMINE

As the brain becomes affected we can observe changes that affect the physiology of the body.  For instance we frequently observe the correlation of lowered dopamine typical of CFS sufferers.

Low dopamine reduces Basal Ganglia typically responsible for;

  • Movement changes, such as involuntary or slowed movements
  • Muscle tone
  • Problems finding words

REST, DIGEST, DETOXIFY

Where there is a chronic over stimulation of the Sympathetic Nervous System, this is also known to down-regulate the Parasympathetic Nervous System which other-wise engages the rest, digest and detoxify states of well-being.

The Vagus Nerve (otherwise known as the nerve of compassion) is governed by the Parasympathetic Nervous System, which induces states of resting, gratitude, happiness, stillness, peace.  This is a profoundly anti-inflammatory state of being.  Good Vagus nerve activity can be induced by deep breathing, where the out-breath is twice as long as the in-breath.  

Benefits of good Vagus Nerve activity;

Regeneration of the organs and cells by activating stem cells.

Thickens the brain, which normally shrinks with age.

Boosts the immune function. Modulates the nervous system.

Reduces depression

And lastly Improves the quality of life! 


LYMPHATIC DRAINAGE

Kindling’s affect on the Sympathetic nervous system also affects lymphatic drainage as lymphatic circulation is rhythmically pumper by the SNS.  Lymphatics cannot rely upon the heart to pump fluids around the body, only a series of valves and SNS regulate this important clearance pathway.

Changes to the lymphatic system can also lead to oxidative stress and cardiomyopathy.  


FURTHER DAMAGE

Intestinal Permeability; Chronic nervous system stress, kindled is known to increase intestinal permeability and therefore opportunistic infections to trans-locate across the intestinal mucosal lining.

Pyrroluria and Porphyria; Stress causes Pyrols in the urine.  Pyrols leach B6, Mangenese and Zinc from our system. Heam is made from Pyrols, so are P450 enzymes (phase 1 detoxification). Therefore where there are high Pyrols there may also correlate low P450 enzymes.  Reduced P450 enzymes means reduced liver detoxification, leading to Multiple Chemical Sensitivity and toxicity.  

 

 

What is Chronic Fatigue? Part 3: The Role of Mitochondria and ATP


Mitochondria2Within the Chronic Fatigue Picture it helps to know WHERE and HOW we create energy.

Mitochondria are rod-shaped organelles that can be considered the power generators of the cell, converting oxygen and nutrients into a substance known as Adenosine Tri-Phosphate (ATP).

ATP is the chemical energy “currency” of the cell that powers the cell’s metabolic activities. This process is called aerobic respiration and is the reason we breathe oxygen.

Without mitochondria humans and  animals would likely not exist because we need large amounts of energy in order to survive. In fact, mitochondria enable cells to produce 15 times more ATP (energy currency) than they could otherwise.

Chronic Fatigue Syndrome as we have discussed is a multi-factorial health condition, with a number of imbalances contributing to the over-all experience of CFS.  However mitochondrial imbalance can explain more than any other contributory factor Post Exertional Fatigue, which is a key player within differential diagnosis.

Mitochondria’s key function is the Recycling of ATP to ADP and back to ATP.

This cycle relies upon various nutrient substrates such as D Ribose, Carnitine, B3, Co-enzyme A, Co-enzyme Q10.  The role of these substrates is to move into the cell in the process of completing the important recycling metabolic process.

As the nutrients are harnessed, Adenosine Tri-Phosphate becomes Adenosine Di-Phosphate (ATP > ADP). This process actually releases energy, whilst becoming carbon dioxide and water.

Rate Limiting Factors:

Firstly a deficiency in any of the substrates mentioned above create a BLOCK within the cycle.  Therefore nutrient deficiency plays into mitochondrial insufficiency.

And because Carnitine, Co-enzyme Q10 and other substrates result from a process called methylation (a biological process that will be expanded on in subsequent Blog posts), when a person under-methylates there is automatically a material deficiency regarding these substrates.

However others things also BLOCK this cycle, like heavy metals, hair dyes and excessive oxidative stress. Excessive oxidative stress destroys both the fatty membrane of the cells and the mitochondria itself.

Further to, there is a protein called trans locator protein responsible for moving ATP and ADP from the mitochondria cell to the cytosol of the cell.  When mitochondria senses that ADP/ATP have been depleted, used up for cells function etc, then this triggers mitochondria to produce more ATP. So this constant re-cycling occurs.

The key thing about those individuals who struggle with a rate limiting factor is when they push through, meaning that they carry on doing exercise when or even in some cases just daily chores and tasks throughout their day, and they are not capable recycling the ADP to ATP then the body goes into emergency mode.  What this means is that the body then targets ADP to be broken down instead because there is not ample ATP because boundaries have been crossed.

ADP is then broken down to AMP, which is a purine, and is lost to the system since it is then urinated out of the body.  Understood by leaders in the field of CFS to be a metabolic disaster.  This is where Post Exertional Fatigue comes from.  Usually the person pushes through and can feel fine, and even feel fine the following day. But the day after that could be when they crash!!!

AMP cannot be recycled.  ADP then has to be built from scratch before it is then recycled to ATP.

However Mitochondrial function is not enough to create CFS on it’s own.  Rather understood a down-steam consequence of other factors. 

A key factor in how the disease is managed as well as forged is the personality type of the person.  If you are a perfectionist for instance who finds it hard to pace, then typically as soon as the person has some energy they use it up again.