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How Do I Know If My Hormones and Adrenals Are Out of Whack?

Updated: Jun 26

Adrenal fatigue is a popular topic and often times we're quick to assume it's our hormones or adrenals that are causing fatigue and other symptoms.  It's actually usually other factors contributing more so than hormones and adrenals, however having balanced hormones and supporting your adrenals is definitely important. 

When looking at our sex hormones and adrenal levels, a DUTCH test is a must to run.  This is the best test there is, because it shows their metabolites (in other words how they're broken down).  Our levels could be good, but the hormone is going down a toxic pathway and causing issues.

If your hormones are out of balance, it can contribute to fatigue, depression, anxiety, hair loss, migraines, hot flashes, interstitial cystitis, vaginal yeast infections, weight gain, and bladder leakage.

For women, if estrogen is higher than progesterone (when testing at the correct time during the luteal phase) it indicates estrogen dominance which can cause breast tenderness, reduced sex drive, weight gain, irregular periods, mood changes, and more.  When progesterone is low it can lead to irregular periods, low sex drive, fibroids, endometriosis, ovarian cysts, fertility issues, and more. 

For men, if estrogen is higher than testosterone (estrogen dominant) it can lead to enlarged breasts, erectile dysfunction, infertility, and depression.

For both men and women, it's important to look at the estrogen metabolism, so you can see how your body is detoxifying estrogen.  This will show if estrogen is being absorbed in the gut and gut dysbiosis is present and/or if your body is having trouble metabolizing estrogen.


For women, if testosterone is high or if the metabolites that are going down the androgen pathway are high (it shows this on the DUTCH) often times the person has Polycystic ovary syndrome (PCOS). 

For men, if the testosterone metabolites are going down the alpha pathway it can lead to prostate issues, aggression, anger, and male cancers.

This is why it's so important to look at the metabolites.  Unfortunately, most tests don't show the metabolites and that's what's so great about the DUTCH test.  If a test only shows the hormone levels and not the metabolites, testosterone levels could be low and the person might think they need testosterone support, but in reality the testosterone is going down the toxic alpha pathway and they won't know that, and supporting testosterone in that case could lead to a lot more issues.

The DUTCH test is the best test for adrenals as well because it shows both free and metabolized cortisol as well as a cortisol curve.  Free cortisol is the cortisol that is circulating in the bloodstream not bound to proteins.  Free cortisol gives insights into circadian rhythm, which is what the cortisol curve shows.  Metabolized cortisol measures how much total cortisol is made and clearing through the liver.  It includes free cortisol and metabolites.  Metabolized cortisol shows the rate that it's processed and excreted. 

Just like with hormones, metabolized cortisol is important to test.  Other tests are a saliva test and are only testing free cortisol.  One might think they have an adrenal issue since their levels might be low and start doing things to support their adrenals, however their metabolized cortisol might be high and the issue is not output of their adrenals, it's either the body inactivating the free cortisol to cortisone which indicates inflammation or it's breaking free cortisol down quickly. 

If you have low free cortisol and high metabolized cortisol you're probably experiencing fatigue.  The body is stressed and inflamed.  It's important to rest and give the body what it needs. 

Those with high free cortisol and low metabolized cortisol may be experiencing anxiety.  With this presentation cortisol shouldn't be lowered with herbs since metabolized cortisol is low.  It's important to use lifestyle changes, meditation, mindset, and supporting your neurotransmitters to bring down the cortisol.

When both free and metabolized cortisol are high the body is experiencing the stress response (fight or flight mode). 

Low free and metabolized cortisol is true adrenal fatigue, which is actually pretty rare.  In this case overall hormones are usually low as well. 

The good news is there are herbs and support that we can do for all the different presentations you could be seeing on your results, whether it's estrogen dominance, gut dysbiosis, high androgen metabolites, high free or metabolized cortisol, or something else.

I'm sure you can see how important it is to run the DUTCH test.  It's one of the essential tests I run with my clients to get to the root causes of their health issues.  To read about the other essential tests, check out my blog post titled 6 Functional Labs That Get to the Root Causes. The DUTCH test shows even more information than what I included in this post.  Please be sure to work with a practitioner who knows how to analyze the results properly and is also familiar with when a cycling female should be testing to get accurate results.

Want more info about healing from health issues?  Click here to sign up for my free video series. If you're looking for a practitioner and want to contact me or sign up for a free 20-minute health assessment, click here to visit my website.

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