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Home , Cortisol, Estrogen, Progesterone

PATIENT HANDOUT Understanding Highs and Lows

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Copyright © 2014 ZRT Laboratory, LLC. All rights reserved. Revised 02.11.14 range and postmenopausal levels at low-normal range. In men LOW CORTISOL, particularly if low throughout the day indicates testosterone levels peak in the teens and then fall throughout adrenal exhaustion, caused by some form of , e.g. emo- adulthood. tional , sleep deprivation, poor diet, nutrient deficiencies LOW TESTOSTERONE is most commonly caused by aging, (particularly low vitamins C and B5), physical or chemical insults removal of the ovaries or testes, suppression of ovarian and (chemo, radiation) or synthetic that testicular production by stress hormones (cortisol), use of con- suppress cortisol production. Chronic stress depletes cortisol traceptives and synthetic HRT, and/or damage to the ovaries, and is associated with symptoms of fatigue, (immune testes and adrenal glands by trauma, medications, or radiation dysfunction), chemical sensitivity, cold body temp, and therapies. Chronically low testosterone can cause loss of bone craving. Symptoms of thyroid deficiency can also stem from low and/or muscle mass, erectile dysfunction, thinning skin, vaginal cortisol. Adequate sleep, gentle , meditation, proper dryness, low , incontinence, fatigue, aches and pains, de- diet (adequate ), ‘bioidentical’ progesterone, adrenal ex- pression, and memory lapses. tracts, herbal, and nutritional supplements are often helpful in correcting low cortisol (hypoadrenia). HIGH TESTOSTERONE is usually the result of excessive pro- duction by the ovaries, testes and adrenal glands or supplemen- HIGH CORTISOL suggests some form of adrenal stress (see tation with androgens (testosterone, DHEA). Slightly elevated above), supplementation with topical or use of testosterone (range 50-60 pg/ml) is often seen in postmeno- corticosteriod . Heightened cortisol production by pausal women as they transition into . High testos- the adrenal glands is a normal response to routine stress and terone in premenopausal women is associated with polycystic essential for health; when stress is chronic and cortisol output ovarian syndrome (PCOS), which in turn is caused by re- remains high over a prolonged period (months/years), break- sistance/. Symptoms include loss of scalp down of normal tissues (muscle wasting, thinning of skin, bone hair, increased body and facial hair, , and oily skin. Supple- loss) and immune suppression can result. Common symptoms mentation with topical testosterone at doses in excess of levels of chronic high cortisol include sleep disturbances, fatigue, de- produced by the ovaries (0.3-1 mg) or testes (5-10 mg) can raise pression, weight gain in the waist, anxiety. testosterone to levels beyond physiological range.

DHEA is a testosterone precursor shown to have direct effects For more information and recommended reading please visit on the immune system independent of testosterone. DHEA and www.zrtlab.com. its sulfated form, DHEAS, are produced predominately by the adrenal glands. Youthful levels are at the high end of the range; levels decrease with age and are usually at the lower end of normal in healthy middle-aged individuals. Athletes tend to have higher than normal DHEAS levels. Low DHEAS can be caused by adrenal exhaustion and is commonly seen in accelerated aging and diseases such as . High DHEAS is associ- ated with /PCOS (polycystic ovaries) or DHEA supplementation. CORTISOL is produced by the adrenal glands in response to , both daily (e.g. waking up, low blood sugar) and unusual (e.g. emotional upset, infections, injury, surgery). Cor- tisol levels are highest in the morning, and then drop steadily throughout the day to their lowest point during sleep. Corti- sol is essential in regulating and mobilizing the immune system against infections, and reducing . It helps to mobi- lize , the primary energy source for the brain and main- tain normal blood sugar levels. While normal levels of cortisol are essential for life and optimal functioning of other hormones, particularly thyroid hormone, chronically elevated levels can be detrimental to health. Stress and persistently elevated cortisol levels can contribute to premature aging and chronic illness.

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