Cortisol and Hormones, a Signal Not the Problem

So I know a lot of you have probably checked out your patient's labs in terms of things like testosterone and estradiol and progesterone.

And I think what a lot of providers feel really confused about is cortisol in terms of, is this something we measure objectively? Should we objectively measure it or should we just go based on symptoms, right? At what point is it important to check these sorts of labs and at what point is it kind of futile? So let's break down all the stuff about cortisol.

We all have those patients who, you know, from a guy's side, maybe they feel kind of flat, low energy.

Maybe they're not sleeping very well.

Maybe the libido is just kaput.

Maybe you've got the classic young to even elderly female who's Progesterone is just absolutely destroyed essentially.

They're feeling really anxious and they start having those frequent wake up periods between say like two and four in the morning.

You feel me there? So these are really common complaints that we hear again and again and again.

in our HRT and wellness clinics.

And sometimes we can adjust the doses.

Say they're taking progesterone, we adjust the progesterone dose or testosterone dose.

Sometimes that does help.

Other times it doesn't so much.

And so again, I want to kind of try to be nuanced here and educate in this gap where we need to consider not just the one hormone like progesterone, testosterone or progesterone that we should be optimizing, but also how can we address cortisol and look at cortisol as that variable that affects so much of this other stuff? Because again, we're not forgetting to do these things.

It's just that probably nobody taught us how to do that, right? So again, most providers, if we think about it, we were all trained to think about hormones and practically everything when it comes to the human body in isolation.

And that's not a groundbreaking thing to consider.

We were taught to look at the heart as kind of this isolated thing, and then the lungs and the brain.

And so then when it comes down to hormones and neurotransmitters, we always think of them in this very isolated way rather than as a system, as kind of an orchestra.

And I feel like that, again, disconnects, of course, the one thing that we all suffer from, whether we like it or not, which is stress, right? The stress system is so acutely attuned to all of our endocrinology and therefore both, again, acutely and chronically.