SS 130 – Your Hormones and Your Energy- Part 1

This is the first of this two-part episode as Grant and Heavey discuss a hormone test they’ve recently conducted to shed light on some energy issues. This episode specifically covers the sex hormone component of the test and the next episode will dig into the adrenal function component of the test.

 

 

[02:20] Running Increases Longevity

 

Grant reads a recent study featured in the article called Running May Give You More Time Than You Put In suggesting that “one hour of running could elongate your life by nearly seven hours, earning you more time than you spend on the activity.” This study was actually published in Study in Progress in Cardiovascular Disease, which is followup to a different study from the Cooper Institute a few years back. So running for an hour and getting seven hours in the end means you get a net benefit of six hours.

 

Heavey basically questions how they’re able to quantify this since there’s no way they had one person running and see how long they live. The article says that not only did consistent running seem to drop the risk of premature death by almost 40%, the activity seemed to statistically return more time to runner’s lives than it consumed.

 

Heavey’s guess is they probably looked at some measure of risk factors for atherosclerosis for instance to see how running may or may not affect them and backtrack that into lifespan. Grant further reads that compared to walking, cycling, and other cardio activities which also had life prolonging benefits, they suggest that running seemed to provide the best return of time investment. Grant and Heavey both agree this may not be a conclusive study.

 

 

[05:40] The DUTCH Test

 

Last year, Heavey gave Grant a present for his birthday, which was a little test kit called the DUTCH Test and they just recently got around to use it. Manufactured by Precision Analytical, The DUTCH test is a home urine test where you take a piss on four pieces of paper at different times of the day and you follow a set of rules with regard to your diet and intake of caffeine and other fluids. Then you shoot them off to the lab so they can analyze them. And then they give you this comprehensive report of your sex hormones and adrenal function.

 

The tough part for Grant was finding that time where he could schedule the collection of urine four times and in the manner they wanted while maintaining the rules. For example, you’re supposed to pee first thing in the morning upon waking up and that’s easy. The hard part, however, is you have to go two hours without having any water or caffeine before the second collection. (Although you’re actually allowed to have less than eight ounces.) Two hours without water, juice, tea, soda, coffee, or anything in the morning can be tough when you’re working and you need to do stuff especially if this has been part of your habit.

 

 

[08:26] The Purpose of Hormone Imbalance Test

 

The DUTCH test is used to help uncover what underlying causes of energy problems as well as issues like anxiety, depression, stubborn fat loss, difficulty in building muscle, PCOS in women, and more. Heavey believes this can actually help shed some light on that and so he finds it valuable and it’s something he frequently runs for a number of his clients.

 

Grant sure can grumble about how hard it was to do it but he admits this test is actually a lot easier than having to get blood tests for a week straight at different times. He further adds that the power is in the amount of information you get in it.

 

 

[10:00]  A Two-Part Episode and a Disclaimer

 

Today, Grant and Heavey are only covering the sex hormone component of the test and the follow up episode will cover the adrenal function component of the test.

 

Full disclosure: Heavey is not a doctor. This is not a medical advice. So follow everything at your own risk.

 

 

[10:48] First Component: The Sex Hormone Stage

 

This stage gives a comprehensive view of your sex hormone status and the metabolism of these hormones. Most of the time when people go to a doctor, they get their blood test checked once a year but they’re not usually looking at testosterone or estrogen unless you’re presenting to them certain symptoms that make them want to question that.

 

What’s interesting as Heavey puts it, is that all these hormones are interrelated. They’ve talked about this in the context of a low-fat diet but your body needs fats, specifically cholesterols, to create these hormones. They’re basically the raw material essential for producing downstream hormones like testosterone and estrogen.

 

 

[12:15] The Steroid Hormone Pathway

 

It starts with cholesterol that feeds into another hormone and which feeds into another hormone. Through this DUTCH test, you’re able to assess the entire pathway. As opposed to just looking at your blood test, you typically can’t see these metabolites showing up in the urine.

 

The steroid hormone pathway starts with cholesterol (coming from the stuff we eat) and then the master steroid hormone called Pregnenolone. It can then branch out and form different hormones.

 

[13:51] The Results Are In!

 

Looking at Grant’s lab results, there is Progesterone and two of its metabolites and it shows Grant has a healthy progesterone level. Progesterone is considered as more of a female hormone though it certainly plays a role in men. Lower levels in men are associated with with depression, fatigue, and low libido.

 

Heavey suggests there is a chance that a low progesterone level can be causing problems for men but oftentimes, it’s looked at in the context of a woman’s cycle and if she’s having some irregularities with that. Fortunately, Grant’s progesterone cycle looks pretty sound.

 

 

[14:55] First Branch: Progesterone Metabolism

 

Progesterone metabolizes into two different pathways, an alpha and a beta called Pregnanediol. This is what they’re measuring in the urine and they’re backing out an estimate for your total progesterone. The purpose of this test is to show any dominance between those two pathways. As with Grant’s results, the levels are pretty close so it’s not a big deal.

 

 

[15:27] Androgen Metabolism

 

Another big factor is looking at the Androgen metabolism where people favoring 5-alpha metabolism with androgens can actually experience a lot more side effects like higher than their normal testosterone levels. Heavey’s results are in as well and his levels are pretty much the same as Grant’s.

 

 

[16:20] Second Branch: DHEA

 

The second branch of the Pregnenolone metabolism is to go to DHEA. Although it serves many bodily functions, DHEA mostly serves as an intermediate for androgen and estrogen. It’s the raw material these hormones get created from and it’s largely produced in the adrenal glands.

 

Grant’s DHEA result is 47, which is below the reference range. Looking at the actual age-dependent range for males 20-40 years old, Grant should at least have 100. Heavey is the same.

 

 

[18:00] Sulfur Deficiency

 

The interesting thing to note is the test doesn’t directly measure DHEA.  It looks at the level of sulfation. In people that have a regular DHEA level compared to their sulfated level, if the sulfated level is lower, it usually means one of two things. One, you have sulfur deficiency. Second, inflammation is playing a significant role in inhibiting that sulfation process.

 

If you’re eating sulfur-containing food like vegetables, dairy, eggs, garlic, and legumes, you’re probably getting enough sulfur so you probably won’t have any sulfur deficiency. Comparing low sulfated level to your total DHEA, this may give you a clue whether inflammation is playing a role in inhibiting sulfation in your body. This may indicate that both Grant and Heavey are having some inflammation issues.

 

 

 

[19:35] Down the Path of DHEA: The Creation of Testosterone

 

If you don’t sulfate that DHEA, it can be used to create another intermediate hormone called Androstenedione. This can then feed into the creation of Testosterone. Now we’re getting into the exogenous area of people wanting to use performance-enhancing medications. By exogenous, you’re supplementing hormones from the outside. As opposed to endogenous hormones, which are created within your body, an example of exogenous hormones are hormone replacement therapies.

 

Androstenedione can be used to create Testosterone. Looking at Grant’s results, he is at the very low end for his age range. Testosterone is produced in the balls of men while in women, it’s made in the ovaries and synthesized directly from DHEA. Analyzing Grant’s results. He is turning 37 so he belongs within the 26-40 age range and testosterone range is 40-95. His number came out at 41.5, which close to the bottom. But looking at the age range of 41-60, the testosterone range would go from 30-80.

 

 

[22:15] Fixing Your Hormones

 

Heavey explains you can’t just focus on one specific hormone and say how do I fix that. That’s how the conventional model works for hormones. You can go to your doctor complaining about low testosterone symptom. They’ll measure your testosterone and if it’s low, they’ll give you exogenous testosterone through hormone replacement therapy to elevate your testosterone level that way.

 

Additionally, Grant’s blood test results have come back and his testosterone are on the lower end of the normal scale. Heavey says this test looks at the entire hormone metabolism before making a judgment. It might say your testosterone is low but you might still see something else there that helps you figure out why it’s low. Instead of just putting a band-aid on low testosterone with more testosterone, it helps you figure out the underlying cause, fix that, and it goes back naturally.

 

This is much better than supplementing yourself with exogenous hormones otherwise there’s a ripple effect. Your body has these built-in mechanisms that help maintain homeostasis like your body has this thermostat that is able to maintain your temperature at 98.6 degrees in the same manner that your body has these controls for hormone levels. If you’re just shoving in another hormone, this can ripple out into the processes in your body innately to manage that hormone level and maintain it. People going through testosterone replacement often have to take other medications to make sure they don’t cause more problems, especially aromatase inhibitors.

 

 

[24:44] 5-Alpha Dominance: Cause of Thinning Hair and Acne

 

 

Testosterone also gets metabolized into 5-alpha and 5-beta pathways (same as Pregnenolone), specifically into 5-beta androstenediol and 5-alpha androstenediol, the 5-alpha being the more potent.

 

The occurrence of thinning hair in men, acne, unwanted facial hair growth in women or women with PCOS or men with prostate issues, is associated with 5-alpha dominance. Then you can take a look at that and say, maybe it’s low testosterone but you’re still favoring that pathway so this leaves us with more clues as to what is going on and how we can actually fix the problem.

 

Looking at Grant’s test results, he doesn’t favor 5-alpha while Heavey favored it a little bit in his test. 5-alpha favoritism is usually caused by things like high-insulin or obesity. Although nutritional factors may also play a part.

 

 

[26:10] 5-Beta Dominance and Adrenal Issues

 

People with more 5-beta is not a problem but maybe they have trouble with putting on muscle or some of those lower testosterone symptoms. Grant admits having trouble with putting on muscle, losing fat, and having energy.

 

Grant’s total DHEA is on the lower side too. That means his raw materials for testosterone are inherently low. This may be due to some adrenal issues which will be discussed on the next episode.

 

 

[27:47] The Rise of Estrogens

 

Your body can shunt your testosterone into estrogen, which means estrogen is created out of testosterone and you can favor that pathway along with some fairly negative side effects for men. This comes back to the whole aromatase stuff discussed earlier.

 

Estrogen is a family of hormones consisting of Estrone, Estradiol, and Estriol, also referred to as E1, E2, and E3 respectively. Looking at Grant’s test results, his E1 is still within the range but it’s pretty high. Both Grant and Heavey’s estrogen levels are all high.

 

 

[29:22] The Aromatase Pathway and Moobs

 

The increase of estrogens are caused by the aromatase enzyme through the process of aromatization. So the testosterone can be aromatized and this is why we see men who have lower testosterone level but high estrogen level because they’re favoring this aromatase pathway to estrogens. Apparently, both Grant and Heavey seem to follow this pathway.

 

One of the things higher estrogen levels can lead to are moobs (short for “man boobs”). Moreover, aromatase can be upregulated with factors like inflammation, obesity, high insulin, or alcohol. Yes, too much scotch can lead to too much estrogen. Part of why Heavey wanted to run this test is to show that the results are consistent with inflammation.

 

This whole aromatase process is something that people who are taking external hormones, like exogenous testosterone, have to worry about. This the reason bodybuilders develop breasts is because they weren’t blocking that pathway and they were feeding the estrogens. So any smart person taking androgen supplements should also be taking something to inhibit that process. Nevertheless, Grant and Heavey, although not taking androgen supplements, are candidates for trying to slow that process down.

 

 

[32:15] Estrogen Metabolism and Methylation

 

Those estrogens get processed in the liver through Phase 1 Detoxification and after that, three metabolites get produced from Estrone, namely, 16-Hydroxyestrone, 4-Hydroxyestrone, and 2-Hydroxyestrone.

 

You’d like to see the body favoring the 2-Hydroxy pathway and roughly 70% or so of the estrone should be metabolized down that pathway. About 10% down the 4-Hydroxy pathway and about 20% down the 16-Hydroxy pathway.

 

What you need to be careful about is the 4-Hydroxy pathway otherwise if you favor this and it’s not properly methylated from there, that metabolite can bind to your DNA and damage it which can lead to cancer.

 

If you look at the distribution across the hormones, the 2-Hydroxy which is the best pathway to favor. Grant is largely safe here but because of the level he has going to his 4-Hydroxy, he has to make sure that he’s methylating well since he’s on the upper end of the spectrum which is way over the normal at 10% and Grant’s is at 14%.

 

Another peek into the methylation in this test is through the Phase 2 Detoxification in the liver. 2-Hydroxy-E1 gets methylated into 2-Methoxy-E1. Looking at Grant’s methylation between Phase 1 and Phase 2 of his Estrogen, he’s methylating pretty healthily though it would have been nice if his 4-Hydroxy-E1 were a little bit lower.

 

 

[35:20] Ways to Reduce Inflammation

 

As Heavey mentioned, things like inflammation and alcohol help favor transferring testosterone to estrogen. So in order to control these things, you can address your inflammation and reduce your alcohol consumption.

 

In addressing inflammation, you’ve got to get to the bottom of what the source of it is and this is another challenge. In Heavey’s case, he has the same indicators for inflammation. He has done a number of stool test and gut-testing to know that he has got some dysfunction in his gut which is more likely contributing to the inflammation in his body. Grant, on the other hand, has a thyroid issue and thyroid can affect a lot of other hormones. This could be an autoimmune thyroid issue and there is a high probability that Grant is going to have higher inflammation levels in the body.

 

Heavey says there are ways you can address inflammation in the short term with some supplementation but this may not be a long-term approach. You’ve got to figure out what the root cause is. Heavey suggests trying these anti-inflammatory supplements to see any noticeable difference in the way you feel and if you do, that tells you there’s a good chance inflammation is causing you to feel it. Then this may just force you to figure out what’s actually causing it.

 

One way of reducing inflammation is getting a lot of good sleep. But the biggest issue in Grant’s case is that he’s aromatizing his testosterone, which he needs to stop. This is either caused by inflammation or alcohol intake. Aromatase inhibitor supplements may also be taken, but then again, Heavey looks at this as a band-aid approach and not a long-term solution. Next is to decrease the total Estrogen level. Inflammation may contribute to this. Short-term supplementation can be done. Lastly, Grant has to make sure he’s methylating well.

 

 

[40:20] The Benefits of Hormone Testing

 

Heavey runs this test with a lot of his clients and sees its value primarily for baseline analysis because it shows you what things are out of balance and give you clues as to what may be causing them. Only 10-20% of Heavey’s clients only end up running lab work so it’s not a huge percentage of people he works with but only those who are having some problems, like energy problems manifested by stubborn fat loss, which is consistent with high estrogen levels. So there are a lot of things you can pick out from these results that you can try to address.

 

Heavey admits some of this stuff is walking the fine line between medicine and health coaching so some of the things may be out of his scope. But he is familiar with this test and he has had great results with people he has worked with on it in terms of improving energy and fat loss. As a result, people tend to feel a little bit better once they start addressing it.

 

 

[44:22] Accept It or Fix It

 

Grant explains he has always had low energy problems and pain issues since he was young. A doctor may say this is normal and just accept it and Heavey thinks it’s delusional or lazy to think that you just have to accept everything. You either accept that or try to fix it. Scientific research that things are out of whack for specific reasons so it’s not delusional to think you can impact it. It’s a matter of how much effort you want to put into that. Heavey has been spending all his spare money running lab work on himself but he wants to feel better and that’s what it takes.

 

Listen to next week’s episode because there’s a whole lot more to learn. Grant and Heavey will also talk more about prescription and how you can actually fix this.

 

Links:

Running May Give You More Time Than You Put In

Study in Progress in Cardiovascular Disease

DUTCH Test

Steroid Hormone Pathway