High Estrogens, High DHEAS, Low Cortisol

Joe C

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Hi, I was listening to the excellent GE podcast with @haidut and Danny Roddy, and a common theme is cortisol rising with estrogen, serotonin etc.

What I'd like to know is in what situations does cortisol stay low, even though DHEA-S, androgens and estrogens are all high?

I ask because I recently looked over Dutch test results for a friend after I pointed out some excess estrogen symptoms, such as water retention, painful periods, cellulite and cold body temperature, as well as a history of migraines. I thought it was just liver and gut problems not getting rid of the hormone load - but looking more closely we saw that cortisol is probably the feedback switch for ACTH, and without it DHEA isn't being switched off leading to high DHEA and higher hormones all through the cascade, eventually finishing with high estrogen metabolites. Her progesterone was in the middle.

Right now I'm thinking it could be reduced enzyme function in the CYP21A1 or CYP11B1 leading to abnormally low cortisol. Obviously beneficial to have cortisol low, but not so much if we have a surge of estrogens out the other side.

As a proof of concept, she had to take exogenous cortisol for a few weeks a while back and felt amazing with boundless energy all throughout the day. (a little too much!)

Liquorice helps a bit - but any other ideas on how to normalise cortisol without being excessive?

Thanks!
 

lampofred

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Caffeine is perfect for this situation. And NoFap too. My guess as to what causes this situation: If you are under chronic stress but mask the stress in the short term via things like alcohol, then cortisol will be low and DHEA will be high. The way to counter it is to resolve stress by increasing your energy levels via caffeine, thyroid, stimulants instead of numbing yourself with depressants.
 
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Joe C

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Thanks... yes, I guess that would be in line with the research for low cortisol / high DHEA pointing to PTSD. The problem is that it doesn't really fit with her situation: she drinks plenty of coffee and doesn't use alcohol often, and is pretty happy. It's also been like that her whole life - even as a child she would fall asleep at the drop of a hat in the evening. Always been more of an estrogen body type too - and always had a low body temperature like her mum, so that's why I was looking at potential polymorphisms in the cortisol creation enzymes - although research is almost non-existent, especially for people wanting to speed up those enzymes. Maybe she should test some of the intermediaries to see if there really is a slow enzyme at play. And maybe some adrenal cortex for a bit would be good. Boost the cortisol for a bit to turn down the ACTH and give the body a chance to clear out some estrogens...

But I will check out other signs and symptoms of chronic, unresolved stress. There is a tendency to bury things. Thanks again!
 

Ella

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Right now I'm thinking it could be reduced enzyme function in the CYP21A1 or CYP11B1 leading to abnormally low cortisol. Obviously beneficial to have cortisol low, but not so much if we have a surge of estrogens out the other side.

If cortisol metabolites are low on DUTCH, this means cortisol will be high as clearance is sluggish.

If estrogens are being conjugated and excreted via urine and feces efficiently, then you would expect to see higher estrogen metabolites in urine. This is good. More important is they are being excreted via beneficial pathways. More worrisome, if we see low estrogen metabolites in urine as they are being deconjugated by beta glucoronidases and unsulphated by sulfatases and making their way back to the liver.
 

lampofred

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Thanks... yes, I guess that would be in line with the research for low cortisol / high DHEA pointing to PTSD. The problem is that it doesn't really fit with her situation: she drinks plenty of coffee and doesn't use alcohol often, and is pretty happy. It's also been like that her whole life - even as a child she would fall asleep at the drop of a hat in the evening. Always been more of an estrogen body type too - and always had a low body temperature like her mum, so that's why I was looking at potential polymorphisms in the cortisol creation enzymes - although research is almost non-existent, especially for people wanting to speed up those enzymes. Maybe she should test some of the intermediaries to see if there really is a slow enzyme at play. And maybe some adrenal cortex for a bit would be good. Boost the cortisol for a bit to turn down the ACTH and give the body a chance to clear out some estrogens...

But I will check out other signs and symptoms of chronic, unresolved stress. There is a tendency to bury things. Thanks again!

Also sounds a lot like PCOS, which Peat says is caused by low thyroid, excess estrogen due to a chronic low nutrient, high PUFA diet. What did she typically eat while growing up?
 
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Joe C

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If cortisol metabolites are low on DUTCH, this means cortisol will be high as clearance is sluggish.

If estrogens are being conjugated and excreted via urine and feces efficiently, then you would expect to see higher estrogen metabolites in urine. This is good. More important is they are being excreted via beneficial pathways. More worrisome, if we see low estrogen metabolites in urine as they are being deconjugated by beta glucoronidases and unsulphated by sulfatases and making their way back to the liver.

Thanks - you made me take another look at the results. I was concentrating more upstream on the production, and not paying enough attention downstream. It's the free cortisol / cortisone that are low and the metabolites that are mid/high. At least, alpha-THF is above the range and beta-THF is in the middle. So maybe a 5 alpha reductase inhibitor would do the trick. There is also signs elsewhere that 5 alpha reductase is over expressed.

I know insulin resistance can change 5 alpha reductase expression - anything else come to mind?
 
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Joe C

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Also sounds a lot like PCOS, which Peat says is caused by low thyroid, excess estrogen due to a chronic low nutrient, high PUFA diet. What did she typically eat while growing up?

Yeah - I had discounted PCOS because it didn't seem to fit, but I am looking again now so thanks! I never realised that 5 alpha reductase was also involved in cortisol metabolism as well as the androgens. I see insulin resistance involved too, which I've suspected. Diet wise better than most - plenty of fruit and veggies...but like most these days some processed junk and PUFAs in abundance probably. Probably predisposed, but the pill surely got the ball rolling!
 

Jackrabbit

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If cortisol metabolites are low on DUTCH, this means cortisol will be high as clearance is sluggish.

If estrogens are being conjugated and excreted via urine and feces efficiently, then you would expect to see higher estrogen metabolites in urine. This is good. More important is they are being excreted via beneficial pathways. More worrisome, if we see low estrogen metabolites in urine as they are being deconjugated by beta glucoronidases and unsulphated by sulfatases and making their way back to the liver.
You seem really knowledgeable about this, what are your thoughts on calcium d glucarate? I have been using it for a couple of weeks and have really felt better in that my breasts aren’t hurting, etc. Before I started taking it I was testing high for blood estrogen and low morning cortisol. I know those are only the free forms so that doesn’t give a ton of information. Also, I have prolactin in the range that Peat recommends so I don’t think I have high tissue bound estrogen, and I’ve been taking progesterone for a while. I’ve also decided to start taking methylated folate.
 

Frankdee20

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You seem really knowledgeable about this, what are your thoughts on calcium d glucarate? I have been using it for a couple of weeks and have really felt better in that my breasts aren’t hurting, etc. Before I started taking it I was testing high for blood estrogen and low morning cortisol. I know those are only the free forms so that doesn’t give a ton of information. Also, I have prolactin in the range that Peat recommends so I don’t think I have high tissue bound estrogen, and I’ve been taking progesterone for a while. I’ve also decided to start taking methylated folate.

Isn’t Calcium D Glucorate an anti estrogen ? I don’t hear much about it on this forum, or haven’t seen anything much. It’s very expensive too
 

Jackrabbit

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Isn’t Calcium D Glucorate an anti estrogen ? I don’t hear much about it on this forum, or haven’t seen anything much. It’s very expensive too
It is anti estrogen or at least it helps you detoxify estrogen. Apparently it can also eliminate other good hormones like progesterone. I think if your estrogen is high enough the price is worth it, but I think you’d need to at least supplement progesterone as well.
 
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Joe C

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Isn’t Calcium D Glucorate an anti estrogen ? I don’t hear much about it on this forum, or haven’t seen anything much. It’s very expensive too

It provides calcium and glucuronic acid, so aids glucuronidation in the liver... So yes - helps get rid of estrogens and anything else that can be glucuronidated. If someone has a higher ratio if estrogens then I assume it'll preferentially reduce them - so probably worth testing first.

It's been suggested that certain intestinal bug overgrowths inhibit glucuronidation by producing beta glucuronidase in order to keep the estrogens circling round, so providing more glucoronic acid can get round that, although it doesn't solve the cause. It might also be useful if someone has impaired sulfation.

Rosemary also aids glucuronidation of estrogens...it's cheaper and is also one of the best herbs against nitric oxide side effects - ie peroxynitrite scavenging - which is also one of the main effects of emf exposure. It's also has some great effects on the brain by increasing blood flow, reducing inflammation and protecting fat from oxidation.

Dietary administration of an extract from rosemary leaves enhances the liver microsomal metabolism of endogenous estrogens and decreases their uter... - PubMed - NCBI
Peroxynitrite scavenging activity of herb extracts. - PubMed - NCBI
 

fradon

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Hi, I was listening to the excellent GE podcast with @haidut and Danny Roddy, and a common theme is cortisol rising with estrogen, serotonin etc.

What I'd like to know is in what situations does cortisol stay low, even though DHEA-S, androgens and estrogens are all high?

I ask because I recently looked over Dutch test results for a friend after I pointed out some excess estrogen symptoms, such as water retention, painful periods, cellulite and cold body temperature, as well as a history of migraines. I thought it was just liver and gut problems not getting rid of the hormone load - but looking more closely we saw that cortisol is probably the feedback switch for ACTH, and without it DHEA isn't being switched off leading to high DHEA and higher hormones all through the cascade, eventually finishing with high estrogen metabolites. Her progesterone was in the middle.

Right now I'm thinking it could be reduced enzyme function in the CYP21A1 or CYP11B1 leading to abnormally low cortisol. Obviously beneficial to have cortisol low, but not so much if we have a surge of estrogens out the other side.

As a proof of concept, she had to take exogenous cortisol for a few weeks a while back and felt amazing with boundless energy all throughout the day. (a little too much!)

Liquorice helps a bit - but any other ideas on how to normalise cortisol without being excessive?

Thanks!

cortisol competes with DHEA, TESTOSTERONE, ESTROGEN so that explains why it is low. her pregnenonlone is beinged used to make more sex hormones than stress hormones.

https://333oee3bik6e1t8q4y139009mcg...oads/2014/07/Pregnenolone-Cortisol-Steal-.jpg

i would look at her HPA axis. HYPOTHALAMUS, PITUATARY, ADRENAL axis. she could have some sort of adrenal insufficiency or something simlar to addisons where she is not making enough cortisol. which explains why the cortisol they gave her made her feel good.
 

Ella

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It's the free cortisol / cortisone that are low and the metabolites that are mid/high. At least, alpha-THF is above the range and beta-THF is in the middle.

She must be making decent amounts of cortisol if cortisol metabolites are mid/high, otherwise where are the metabolites coming from?

If progesterone is mid range and estrogen high, she may still be estrogen dominant.
 
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Joe C

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She must be making decent amounts of cortisol if cortisol metabolites are mid/high, otherwise where are the metabolites coming from?
Exactly. So it'll be interesting to see how some 5 alpha reductase inhibitors work. Maybe some zinc, saw palmetto, reishi, nettle root etc. PUFAs also inhibit 5 alpha reductase - which is strange because her diet is far from pufa free. Do you know any environmental reasons why 5 alpha reductase is over expressed?

The progesterone/estrogen levels are exactly that - mid progesterone/high estrogen.

I think if the cortisol rises a little, that'll lower ACTH which in turn should reduce the estrogens by reducing the DHEA.
 

alywest

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Exactly. So it'll be interesting to see how some 5 alpha reductase inhibitors work. Maybe some zinc, saw palmetto, reishi, nettle root etc. PUFAs also inhibit 5 alpha reductase - which is strange because her diet is far from pufa free. Do you know any environmental reasons why 5 alpha reductase is over expressed?

The progesterone/estrogen levels are exactly that - mid progesterone/high estrogen.

I think if the cortisol rises a little, that'll lower ACTH which in turn should reduce the estrogens by reducing the DHEA.

Would over-expression of 5ar imply that she is overly androgenic? I sound a bit like your friend, haha. Seriously, you could pretty much be talking about me except I haven't been on the pill for over a decade. These are all questions I am struggling with so I'm trying to think what could be the cause...
The reason I ask the original question I did is because I've been reading studies on autism and that 5ar inhibitors reduce the production of epiT, which is apparently a really important anti-androgen which regulates a lot of the other sex steroids, like T, DHT and E2. "epi-T deficiency disrupts the action of sex steroids and other hormones (ie. glucocorticoids) at their largest sites."
Epi-T is derived from the enzyme 17a-hydroxysteroid dehydrogenase and I don't understand how to increase that. I have read that taurine can, but I'm not totally sure. I'm really interested in figuring this out because I suspect that I and my son (who is autistic) would benefit from the addition of more epi-T. Perhaps your friend would, as well. Actually, I believe that the enzyme can be increase with corticosteroids. I am low on cortisol as well, I have been tested twice now and have low baseline cortisol and they still want me to take more tests, although I'm convinced I would benefit from the steroids. I also suffer with breathing problems that I never actually realized I had but now it is becoming full-fledged sleep apnea. I think my migraines have stemmed from breathing poorly at night and in general, and I actually think taking aspirin for the migraines made the breathing issues worse, which created a vicious cycle.
I've actually been experimenting with Myo-inositol, d chiro inositol and methylated folate to balance hormones. I don't have PCOS or hirsutism, but it seems that women get the balance that they need from this combo, whether they have higher estrogen or they don't get periods at all. It can take some time to see results. They are considered anti-androgenic. Anyway, considering that T can be so easily converted to estrogen as well, it might be worth considering lowering androgens, as popular as they are on this forum and elsewhere! Also adding some progesterone to the mix might be beneficial as it's debated whether progesterone is androgenic or not, however, many consider it an anti-androgen as I'm sure you know. I think it also kind of fulfills whatever is needed in the particular individual. For instance, I just read a study that showed a woman's serum progesterone would elevate from stressors at the same time as cortisol, although it's only supposed to lower cortisol. But since progesterone can be made by the adrenals as well, perhaps it's the body's way of balancing itself out since it knows that cortisol is damaging. I'm thinking that taking progesterone might be counterintuitive if cortisol is low, but I don't believe taking it actually lowers cortisol, I think it reverses or prevents the damage from cortisol, but the bloodwork will show that they counter each other in most studies. The study I read was also only talking about the woman's follicular phase. Or luteal phase. I can dredge up the study if you'd like!
 

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