#225: Carrie Jones, ND, MPh-Adrenal Fatigue Updates & the Cortisol Awakening Response

by Deanna Mutzel, DC

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About Carrie Jones, ND, MPH

Dr. Jones earned her ND from National College of Natural Medicine, where she is Adjunct Faculty and now serves as the Medical Director at Precision Analytical, Inc.

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Episode #122: Carrie Jones, ND- Adrenal Fatigue, Does it Exist? Advanced Discussion



Interview Transcript



05:41 Adrenal fatigue is a brain issue, rather than our adrenal glands giving out, though the symptoms called Adrenal Fatigue are real. Your brain signals your adrenals to produce more cortisol to deal with insults like pain, inflammation, blood sugar issues, stress, and environmental toxin exposures.

09:22 Are your adrenals at issue or is it a misaligned circadian rhythm? Perhaps you are making enough cortisol, but making it at the wrong time.

10:58 Testosterone testing for men should be done in the morning. On the DUTCH test a weighted average is given to women, whose testosterone does not vary much through the day. Other hormones, cortisol, dopamine, norepinephrine, oxytocin and more, contribute to a woman’s sex drive, but testosterone gets all the press.

14:30 You can tell that T3 is getting into your cells with a T3 to reverse T3 ratio. Your body will make T4. If it does not make T3, it will create reverse T3. Reverse T3 is inactive. You will feel more hypothyroid, but your TSH in your brain will be normal. Reverse T3 sits in the receptor and blocks T3 from doing its job. Supplemental synthetic T4 can make symptoms worse. Traditional doctors do not look at reverse T3.

16:48 Stress and sleep have a huge impact upon thyroid health, conversion health, weight loss, detoxification, repair and maintenance. Norepinephrine, one of your adrenal hormones, becomes damaging when it is high for prolonged periods. It diverts your body away from repair, regeneration, maintenance and reproduction and pushes you toward fight/flight. Chronic stress triggers and maintains high levels of norepinephrine. Norepinephrine is needed to burn fat.

18:56 Leptin affects TSH and T3 conversion. Leptin resides in fat tissue. The leptin from your fat tissue goes to your brain. If your brain is not listening, you are leptin resistant. Then your body does not let go of fat. Leptin levels above 10 in the US range, cause your cells to make reverse T3. You will have less T3 and it cannot bind. You are tired and gain more weight, have more hair loss, more constipation and more inflammation. The more body fat you have, the higher your leptin levels. Leptin is mostly made from body fat, though a little is made by your stomach. People with sleep apnea tend to have higher levels of leptin.

27:00 Your thyroid reacts to what you are doing or not doing. Start with the basics. You can give supplemental T3 or supplements, like selenium, zinc, and iodine to support T4 to T3 conversion. You must, however, address the cause.

28:30 The thyroid affects all metabolism.  When the thyroid slows down, everything slows down. When cortisol goes through the liver for processing, it will slow, showing as low cortisol on a DUTCH test.

32:34 Natural sunlight helps align your circadian rhythm. Within the first hour of waking, use full spectrum lightbulbs, use a light alarm clock and open the blinds.

35:42 The mitochondria in your brown fat convert T4 to T3. If you have chronic or high stress and poor sleep and you don’t have enough norepinephrine, you will not be able to utilize your brown fat for heat or fat thermogenesis.

38:56 Mitochondria are king for adrenal purinergic signaling. ATP in your mitochondria and ATP broken down to adenosine can both locally effect glands. You can have cortisol production because your brain signaled or because your mitochondria signaled within the adrenal gland. Purinergic signaling affects your thyroid. It is in the thyroid gland and it affects your testosterone production. It is in the testes. It is in the ovaries and affects ovulation, progesterone and estrogen levels.

46:28 DUTCH test stands for Dried Urine Test for Comprehensive Hormones. It tracks your circadian rhythm and your hormones. You can also do the cortisol awakening response. The urine test allows you to get more detail: estrogen phase 1 and phase 2 detox, testosterone breakdown, night melatonin and cortisol, and cortisol metabolism. Serum bloodwork for hormones gives you a momentary snapshot.

48:30 Your morning cortisol spike is important for blood sugar, inflammatory response, and it helps tell your thymus gland to kill cells tagged as autoimmune before it can sneak out into circulation.   Your cortisol awakening response is the ability of your brain to tell your adrenals to make cortisol first thing in the morning. Morning cortisol spikes and slowly falls through the day.

51:17 To boost morning cortisol, get 5 or 10 minutes sunlight/full spectrum light first thing in the morning. Do a little early morning HIIT training (5 or 10 minutes) to improve the communication from your brain to your adrenals.

56:16 When estrogen breaks down, it goes through phase 1. If it does not go through phase 2, a neutralizer, it can instead go down the quinone pathway, forming an adduct. Adducts will bind to and break off of DNA. Your DNA repair system kicks in and makes repairs. If you have too many adducts causing too many holes and not enough repairs are being made or they are being made in a rush and mistakes are made, mutation is possible. This may cause estrogen sensitive cancer.

59:19 Get your estrogen through phase 2, which is regulated by the COMT enzyme, made by the COMPT SNP. Problems on the methionine pathway will impact estrogen detox. Diet and exposure to endocrine disruptors impact hormones.

01:03:18 Opioids suppress the entire endocrine system.

01:04:28 THC drives up cortisol at first, though over time it seems to have a suppressive effect. Impacts upon sex hormones depend upon dose, length of usage and percent of THC.

01:08:00 CBD appears to be good for the body. The endocannabinoid system benefits, which benefits the sex hormones and cortisol, especially high cortisol.

01:08:20 Organic acids testing along with the DUTCH test including a dopamine metabolite, norepinephrine/epinephrine metabolite, serotonin metabolite (5-HIAA) and B12, B6 and one glutathione marker (pyroglutamic acid).  90% of your serotonin is made in your gut.

01:09:47 Problems with serotonin may not have origins in the brain. To make serotonin, you need tryptophan, found in protein. If you are estrogen dominant, you will not make much serotonin. If you are low estrogen (menopausal women and women who do not get a menstrual cycle) you cannot make 5-HTP, which makes serotonin.

01:11:09 The methylation cycle uses B12. If B12 is a problem for you, you may have estrogen detox problems, among other issues like memory and energy.

01:12:33 When DNA is being damaged, it releases 8-OHdG (8-Hydroxy-2-deoxyguanosine) into the urine. It is a marker for oxidative stress and DNA damage. DNA damage can come from cancer or chronic insomnia.

01:13:04 If you cannot sleep, you don’t get melatonin an important antioxidant, you don’t make growth hormone and you miss out on key repair, antioxidant and regeneration pathways. This makes you prone to a higher 8-OHdG. Higher 8-OHdG can also be from degenerative disease and high stress. High 8-OHdG also correlates with metal and environmental exposure.

01:14:34 Mycotoxin from mold raises 8-OHdG and slows your conversion of T4 to T3, so you have less T3. It affects your cortisol, initially raised and eventually downregulated.

01:17:01 Dr. Jones’ morning routine starts with gratitude. She write 5 things for which she anticipates she will be grateful for that day. At night, she write 5 things for which she is grateful that happened that day. She often works out in the morning, has her green tea and spends about 20 minutes journaling and meditating, using the Headspace app.

01:22:29 Dr. Jones’ desert island nutrient is broccoli sprout powder (sulforaphane).

01:23:33 Dr. Jones’ Elevator Speech: We need to find many healthy ways to negate stress. This includes having a diet that does not stress your body. Dehydration is a stress. Commercial feedlot animals, Dr. Jones believes, bring their stress to us when we consume them.

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