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Mind Pump: Raw Fitness Truth
2570: Test Your Sex Hormones & Cortisol at Home With Dr. Stephen Cabral
01:00:15
Dr. Stephen Cabral How your hormones are connected to your circadian rhythm and sleep. (2:15) The differences between a cortisol and blood test. (3:24) The function of cortisol. (5:32) The most common lab results from this test. (8:12) Can...
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- [00:00]
Dr. Cabral
Hey prime members, are you tired of ads interfering with your favorite podcasts? Good news.
- [00:06]
Sal Destefano
With Amazon Music, you have access to.
- [00:08]
Dr. Cabral
The largest catalog of ad free top podcasts included with your prime membership. To start listening, download the Amazon Music app for free or go to Amazon.com ADFreePodcasts that's Amazon.com ADFreeP Podcasts to catch up on the latest episodes without the ads. If you want to pump your body and expand your mind, there's only one place to go. Mind Pump.
- [00:33]
Sal Destefano
Mind Pump.
- [00:34]
Dr. Cabral
With your hosts Sal Destefano, Adam Schaefer and Justin Andrews, you just found the.
- [00:40]
Sal Destefano
Most downloaded fitness, health and entertainment podcast. This is Mind pump. We had Dr. Cabral come on the show today and talk about why people sometimes are just gaining weight. Water retention, bloating, low libido, low ambition, low mood. He took us through some sex hormone and adrenals tests to look at us and then he talks about the value of doing this. By the way, if you go to stephencabral.com hormonestest Stephen is spelled S T E P H E N. So stephencabral.com hormones test you can get a discount on their hormones test that tests all these things. He looks at your hormones and cortisol in the morning, afternoon, early afternoon before you go to bed. It's 50% off. By the way, if you go on that link, half off. So it's stephencabral.com hormones test. By the way, this comes with a 30 minute health coaching call, which is awesome. Now this episode is brought to you by a sponsor. Eight Sleep. This is the most advanced sleep system that you'll find. Anywhere goes on your bed, cools or warms your bed and it uses AI technology to optimize your individual sleep. So it monitors your sleep and it adjusts on the fly to keep you asleep and give you really recuperative sleep. Anyway, go to 8sleep.com mindpump Use the code mindpump and you can get $350 off the Pod 4 Ultra. We also have a sale this month. Maps hit is 50% off and the extreme fitness bundle of programs also 50% off. If you're interested, go to mapsfitnessproducts.com and then use the code APRIL50 for the discount. All right, here comes the show. Dr. Grohl, welcome back to the show.
- [02:20]
Dr. Cabral
Great to be here as always. Thanks for having me.
- [02:22]
Justin Andrews
Always fun, always revealing, always excited and nervous at the same time.
- [02:26]
Dr. Cabral
Yeah, putting out all our laundry whenever you're waiting for lab results. That's always the way that is, you hope that they're going to be good. You anticipate they will be, but there's always the chance. Yeah.
- [02:35]
Justin Andrews
You also provide great shit talking between the three of us for the next couple months till we see you again. Yeah, that's always a good time.
- [02:41]
Sal Destefano
So today we're going to talk about hormones. Essentially. Yes, hormone optimization. That's the test we all did, but I wanted to kind of connect it to your circadian rhythm, your sleep, and what's the connection between those?
- [02:55]
Dr. Cabral
Yeah, so the biggest thing that I always look for in terms of people's hormones is not one single number, but what does it look like in terms of balance? So we as humans, and I've kind of shared this before, but this is really important, we are diphasic beings, so we're really meant to be on the go for from 6 to 8am in the morning and then that starts to really decline mid afternoon to evening when we want to start to go into cool down mode. That cool down mode is some of the hormones that we're gonna be talking about. So today I wanna talk about what are the hormones in the morning to optimize and then what are ones at evening? Because how this works is that ultimately the health of you, take through your 30s, 40s, 50s and beyond, is what allows you also to live to 80, 90 plus with, with the ability to actually still be able to use your body and enjoy quality of life. So it's a balance between cortisol, the catabolic hormone, as well as the sex hormones like testosterone and even estrogen, progesterone, dhea that we'll talk about today.
- [03:50]
Sal Destefano
Okay, and now is that, now is that why the test we did required us to test ourselves throughout the day versus the standard blood test? It's once a day, you know, type of deal.
- [04:00]
Dr. Cabral
Exactly.
- [04:01]
Sal Destefano
Because I could see how that was kind of a snapshot. Whereas what you're trying to do is look at the whole day, and you mentioned cortisol, I'm familiar with, that's supposed to be high in the morning, low in the evening when it's flipped, people have terrible sleep and they don't feel so good.
- [04:15]
Dr. Cabral
That is, it's probably the fastest way that you will begin to age is high elevated evening cortisol. So that's one of the most important numbers you could run. We do a test that's just bedtime cortisol. It's that important to understand that one number. But here's the issue. When you run your blood work with your doctor or you Run it on your own that you should do. Like, I'm a big believer in annual blood work and for myself I do it semiannually. But you're only getting one snapshot in time then as well. And you want it to be between 8 and 10 in the morning so that you get proper lipid profiles and proper thyroid levels. So your blood work should always be done first thing in the morning. I think it is the best time to do it. Overall, you get the best numbers that you want to look at and it should be fasted as well. However, you don't get your best cortisol because almost everyone's cortisol between 8 and 10 in the morning is totally normal, like almost less than 1 out of 10. But the problem is, is it normal the rest of the day? Does it actually start to decline at night? And then what does that look like the next day for testosterone and dhea, et cetera? Because in the labs that we look at, we also look at the symptomatology, like what you're actually feeling. And so as people begin to get older, they're their strong levels of testosterone or DHEA can no longer compensate for their elevated levels of cortisol. So when you're young, you can have high cortisol all day long because you're also high dhea, which is great for the immune system, and high testosterone, which is amazing for your libido, your ambition, your drive, your strength and your recovery. So you can do that when you're younger, but as you start to get to mid to later 30s, depends on how much stress you've dealt with over your life. Also, genetics matter as well. You start to see that decline. That's why when people talk about 40 to 50 years old, there's a window within that that people, if they haven't been doing the work or they don't start to do the work, will start to accelerate the aging based process.
- [05:58]
Sal Destefano
Let's talk about what does cortisol do then? So it's catabolic, releases energy. How does it make you feel? What is the function of cortisol? Because you need it. Yes, we always hear it as this bad thing, lower cortisol. It's bad for you. It's, you know, too much cortisol causes visceral body fat, et cetera, et cetera. But it's an essential hormone. We need it. Because having no cortisol would be terrible as well, right?
- [06:16]
Dr. Cabral
100%. So Hans Sele did some amazing research on this. When we look at the different stages of dysfunctional cortisol. Well one of the first stages is called the alarm stage and it's actually elevated cortisol throughout the entire day. So you run someone's lab that we're gonna look at here today, simple saliva samples. Why run saliva? Saliva is showing you free what's available in the body. So free hormone free testosterone free dhea or we use DHEA sulfate, which is a really good like proxy for dhea. Over the course of the whole day it's the average when you use the dhes and then cortisol. So if we do a upon waking when it should be added but it should be elevated but not high, meaning it should be between six and nine for a number. And then we look at lunch, we look at right before bed and we look atsorry, we look at before dinner and then right before bed. So you look at a total cortisol picture and your total unit should be between a 9 and a 13 for the whole day. You might see someone at a 26, 30, they're producing massive amounts of cortisol throughout the entire day. Now in the beginning they feel fantastic. It works as an anti inflammatory, it gives you energy, increases heart rate, you start to lose weight. Like it's all of those things. Well, what happens when it becomes chronic, when you become chronically stressed, okay, the morning levels can no longer keep up because your sleep becomes really poor at night. If you were to track your sleep with a whoop or aura or apple watch, whatever it might be, you'll see lower levels of deep sleep and then typically later lower levels of rem. Deep repairs the body, REM essentially repairs the mind. And when those levels start to, when your restorative sleep isn't there, cortisol doesn't rise in the same way. Neither does thyroid in the morning. So thyroid starts to get going around 3am, cortisol around 6am to 7am somewhere right around there. Those levels stay a little lower however, as you then start to move caffeine or other stimulants into your day. What happens is cortisol levels then rise later in the day, still affecting sleep, but now you're more tired and wired. And I'm sure you guys have heard that before where you can't fall asleep, you can't turn off your mind at night, so you start to use different things to turn off the mind at night, but you never get going first thing in the morning. So cortisol is amazing. As an anti inflammatory it is great to get the energy going in the body, but too much of it begins to burn the body out and you become more catabolic rather than anabolic. So really difficult to start to put on muscle or recover from workouts. It's, you know, extremely important to have that. Your libido goes down, your ambition goes down, your drive goes down and you just feel overwhelmed, you feel irritable.
- [08:39]
Justin Andrews
Now I always love talking to you because you do thousands and thousands of labs on people. So you have this great, you know, test group basically to look at. What are some of the things that are most common that you see when you take these, this specific lab? What do you see that are most common? What happens?
- [08:54]
Dr. Cabral
So in women we see a lot of estrogen dominance. So that means that women have a, A, a menstrual cycle, that the first part of their cycle is typically denoted by higher levels of estrogen. And then once you get to around day 17, 18, 19, progesterone is going to start to increase and then that's called the luteal phase. So follicular phase, luteal phase. What happens is when women have exposed to a lot of levels or higher levels of cortisol, their progesterone levels start to decline. It can lead to infertility, it can lead to lower mood, lower energy, bloating, water retention, a lot of estrogen based symptoms. But we run their labs, estrogen looks totally normal. The problem is progesterone is low, it's too low. So they feel like they have high levels of estrogen, but estrogen is totally normal.
- [09:40]
Sal Destefano
Anxiety too, right? It's a common one though.
- [09:42]
Dr. Cabral
Absolutely, yeah. And so you'll know if this is affecting you even without running a lab. If it's happening about five to seven days before a woman gets her cycle. For men, what do we see? We see a decline in DHEA and testosterone. So we have normal levels, like levels for free testosterone. When you're below 22 years old, you want that 140 to 160 for free testosterone. Once you start to get into your 30s, 120 to 140. I mean we like to keep people on the higher end of optimal. Once you get to about 40, I like it around 100 to 110 minimum. You can still, it can still be higher. Yeah, absolutely. And then we go down about 10 points per decade. So we never get that low. If you're just looking at like what's normal, healthy. But then we can make the argument, and I don't know if you want to get into this now, but like is that optimal or is that just acceptable? Right. Because there's going to be a point in your life and it's usually between 55 and 65. And it depends on the individual. Depends if they're weight training, it depends if they're eating well, like if they're keeping themselves in shape, if they're doing all the things they can maybe push it off till 65. I've seen, because before I really got into integrative health and functional medicine, all these lab testing like you guys, I was personal trainer from 1996, you know, on and nutrition. Like I got to see this with my clients. No matter who the guy was, once he got to his mid-60s, it was difficult for them to be able to put on muscle and even maintain that muscle and not put on belly fat. Like it was just more challenging for them and obviously with recovery as well. So what I say to guys is that we can push this as long as we can, but around mid-50s to mid-60s, you're probably going to start to become more catabolic than anabolic and you're going to start to feel the effects of the lower anabolic hormones, the androgens, like testosterone, namely ndhea, which gets overlooked. It's really important for the immune system and overall anti aging, cancer, tumor suppression, a lot of that. And we start to see cortisol though, stay normal. So if cortisol stays normal and testosterone drops well, we've got a more catabolic situation.
- [11:41]
Sal Destefano
So you talk about the balance you mentioned, estrogen, progesterone, testosterone to cortisol.
- [11:46]
Dr. Cabral
Yes.
- [11:46]
Sal Destefano
There's a, there's a ratio or a balance of them that is as important as just the levels themselves.
- [11:52]
Dr. Cabral
Absolutely correct. Because as you know, there's genetic variability. Right. Some men have higher levels of testosterone than others, but the cortisol levels then should match that. So if you have a little bit elevated levels of cortisol, you need higher levels of testosterone and dhea. So let me go back to DHEA just for a second. DHEA is the signal if it's chronic stress or not. So if your DHEA drops below, we typically say at 10, but 6 is our lowest number. We know that it's been, you've been chronically stressed for some time, so that's our first proxy there. And then if we catch it, just like when you're at 9 or 8, testosterone still normal, we test you a year later, but you haven't done anything different. And, and now DHEA is a five and we see your testosterone start to fall, then we know what's coming next. Over the next year or two, your testosterone's gonna plummet.
- [12:40]
Sal Destefano
Right, and dhea. So what's the role of that? Because I know it gets converted into other hormones. I've heard it being referred to as like a parent hormone or something like that, right? Yeah, it can get turned into. Was it androgenidone, testosterone, even into estrogen. Is that all it does? Obviously not. Right. It's got its own functions.
- [12:57]
Dr. Cabral
Yeah, it's. No, you're right. So the steroidal hormone pathway, you're basically moving from cholesterol to pregnenolone and then you move right to dihydroepianosterone, which is dhea. So DHEA then can flow to any other part of the hormone pathway. So it can move actually from DHEA to fulfill progesterone cortisol pathway, or it can move down to, as you were saying, androstenedion, androstenediol, testosterone, which can then flow to estradiol, estrone and estriol. So it is that parent hormone. I mean, I would say that it's, it's a pro hormone, it's a precursor to the other sex hormones, but it balances both sides. Okay, so it balances the sex hormones, but it also, if cortisol needs to be made, it will steal from testosterone, it will steal from progesterone, it will take from dhea. And so DHEA is the balancer.
- [13:50]
Justin Andrews
So that is the reason why testosterone go lower. In somebody who's really stressed out then.
- [13:54]
Dr. Cabral
Is that what's happening of 10 times? Oh, interesting.
- [13:56]
Justin Andrews
I never knew that's why.
- [13:57]
Dr. Cabral
So chronic stress, now you can say, well, it's more complicated than that. It has to do with poor sleep and nutrition. All of that is true. It's chronic stress on the body, it's oxidative stress and chronic stress that ultimately wears. Now, could be gut health issues, could be heavy metals, could be viral based. If you look at the data, during COVID and other viruses, it crushes testosterone and sex hormones destroys it. And the reason is, is that your body is so inflamed and inflammation in general is going to lower sex hormones.
- [14:26]
Sal Destefano
Ye. If, if DHEA gets turned into these hormones and somebody goes and gets hormone replacement therapy, because I've seen oftentimes people will get on hormone replacement therapy looking for the end stage hormones, testosterone, estrogen, progesterone. Yes, but they'll still get recommended dhea. Why is that? Is it because it has its own function? Like you need that as well, just not just because it gets turned into other hormones.
- [14:51]
Dr. Cabral
Yeah, I'm actually a supporter of that. So men who are using TRT or even women that are using maybe estrogen or anything else, I do recommend supplementing with dhea. And the reason is DHEA may not be being made like it should be if you're satisfying all of the hormones that come after it. Okay, so your body's not like, well, how much more hormone do you really need when it's being satisfied? Like, you don't need to make your own testosterone. If the exogenous hormone that you're putting in is greater than the endogenous production, you'll stop making it in most cases. Now you can use certain pharmaceuticals as well to try to keep your testosterone going, but ultimately, after a long enough period of time, it's probably going to start to go down.
- [15:29]
Sal Destefano
Do you see resistance to cortisol like you might? Because I know you could see, you know, receptors downregulate for some hormones. Of course there's insulin resistance. Can somebody develop cortisol resistance where the cortisol stays elevated. Elevated, elevated. It's not affecting them. So it has to keep going up until it crashes.
- [15:48]
Dr. Cabral
Yeah, yeah, that's actually. So it's rare, but it is possible.
- [15:52]
Sal Destefano
Wow.
- [15:53]
Dr. Cabral
So we have concussions. Is it CTs? Yeah, CTE. Okay. I'm not. Couldn't recall that right now.
- [16:06]
Justin Andrews
Ironically, the guy.
- [16:07]
Dr. Cabral
Superchismatic limbic part of the brain. So basically inside of the hypothesis, hypothalamus regulates day and night. And a lot of people who have had brain based trauma or emotional based trauma stay stuck in. It's called the HPA axis, the hypothalamus pituitary adrenal axis that we've spoken about before. But it is what regulates with ACH and acth, the amount of cortisol you produce, as well as epinephrine. So if your body thinks it is permanently stuck in a state of fight or flight from a concussion, from sports. And so a lot of people just say, well, it's from football. Soccer is one of the highest sports with concussions in ct. It's unbelievable. Also jet skiing, I've heard too. Is that because of the bouncing up and down or. Yeah, yeah, that's crazy. But. But true. I mean, like these things really happen. Our brain sits there and floats a little bit in space with only millimeters of space against your cranium. And so, you know, it's important that we take care of that. But this does happen. So we've got Cushing's disease on one side where cortisol stays chronically elevated. What is that? I mean that is like the catabolic wasting disease. You lose massive amounts of muscle where you could actually be. And again, like, no, not trying to be disrespectful. You become skinny fat.
- [17:15]
Sal Destefano
Yes.
- [17:15]
Dr. Cabral
Like very thin. But your body fat is very healthy, right? Absolutely. Just like as if you were in progesterone. Not progesterone, but prednisone.
- [17:23]
Sal Destefano
Yes, yes.
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Dr. Cabral
So that basically a catabolic hormone that they're put in your body as a powerful anti inflammatory. That's what prednisone does. So we have to be really careful being put on prednisone. I know it can help with inflammation based issues and rheumatoid, but only symptomatically and temporarily when leading to much bigger issues. And also it puts you more susceptible for brain based issues. So you have to be really careful.
- [17:44]
Sal Destefano
And by the way, people, prednisone feels good. So does cortisol. Like you put someone on pregnant, they're like, oh my God, I'm on top of the world. I have all this energy. We refer to, we have a term we use, cortisol junkies, which. These were clients that we trained where they were chronically stressed and they gravitated towards the most intense workouts. And they would say, I feel good doing them though. And it's like, yeah, you just pushed your cortisol a little harder.
- [18:07]
Justin Andrews
Always hard. Convincing that client they're doing the wrong thing because they have that, the feedback. I feel better. How could you tell me this is.
- [18:13]
Dr. Cabral
The alarm stage of stress? You feel amazing.
- [18:15]
Sal Destefano
Yes.
- [18:16]
Dr. Cabral
So it's very rare that I see someone in my practice in the alarm stage of stress.
- [18:19]
Sal Destefano
It's after.
- [18:20]
Dr. Cabral
It's only after.
- [18:21]
Sal Destefano
It's when they feel great.
- [18:23]
Dr. Cabral
Yeah. And so the only people I see during it are those people that are staying ahead on their health. Like, yeah, I feel great. But my friend was doing this, they recommended it. Maybe I should try it as well. And so if you can get there, even when you feel great, you want to get a baseline no matter what. Like you want a baseline on your health. Plus, if your cortisol levels are elevated in the morning, you actually want to stay away from the high intensity interval training, the cold plunge, the etc. Now those could be beneficial, but not if you have elevated cortisol.
- [18:49]
Justin Andrews
This is why you told Doug not to do that. Right? I remember when we all did that test, you were told, out of all of us, Doug is the one that's not supposed to do the cold plunge. Right.
- [18:56]
Dr. Cabral
For that reason, he had the elevated cortisol and the elevated evening cortisol multiple times. So we'll talk about that here today. And you have to actually then give someone a more personalized plan for that. They need to start hours before bed to start to decline and lower that cortisol. Any light will upregulate cortisol and downregulate melatonin. So much more challenging to. They call it sleep latency. How quickly you fall asleep, how often.
- [19:25]
Sal Destefano
Do you see bandaids where people are like elevated cortisol? You mentioned melatonin, which kind of, for lack of a better term, balances it out. But how many times you see people in this alarm stage? Oh, Yeah, I take 5 milligrams of melatonin every night and it helps. And it's like a band aid, right?
- [19:42]
Dr. Cabral
Yes. Well, so melatonin, we can look at it as like, that's a natural hormone in the body, powerful antioxidant, powerful anti cancer, powerful antiviral. So it has benefits on its own. But I don't disagree. Meaning, like, so if you have a cup of coffee in the morning, you should have a cup of coffee with some caffeine in it because you enjoy it, not that you need it. If you can't get through the morning without caffeine, then it's a dependence. If you're taking some melatonin at night because you like the benefits you get from it and it gives you a little extra deep sleep. Phenomenal. But yes, if you can't fall asleep, that is an issue. Yeah, but like you said, Ambien, Lunesta, you know, over the count, all sorts of things people are taking. And even in the morning, like uppers, they're taking allergy medications that push epinephrine. Like, seriously. And they're like, well, I take it because I don't have allergies anymore, but I feel better when I take it. Yeah, you feel better when you take it because you're pushing something we didn't even talk about yet, which is excitatory neurotransmitters. Like you're spiking your epinephrine and dopamine, just like again, a cold plunge would do. Now what if someone, we run a neurotransmitter test and they have low levels of dopamine and norepinephrine and they don'tthis is important. And they don't have chronic fatigue based issues. Right. Because you don't wanna push someone's dopamine and norepinephrine and cortisol in the morning if they're still in a recovery phase of healing, because we actually don't wanna push that, they're still healing, which is why they're not producing as much. But if you were just more of like thethe larger kapha body type, like the endomorph and you're just not producing a lot of cortisol or epinephrine or dopamine, nothing wrong with stimulating that body in the morning. I wanted to ask you because we.
- [21:14]
Sal Destefano
Get a lot of calls for this.
- [21:16]
Dr. Cabral
Specifically and it's always a difficult question to answer for us in terms of, you know, advice, like, what's your best advice for somebody that works like a graveyard or like a night shift? And like, what are the methods that they can apply to, to kind of.
- [21:30]
Justin Andrews
Balance things in that situation?
- [21:32]
Dr. Cabral
It is challenging and I've gotten the same questions. So, I mean, I've worked with firefighters. I work with so many individuals. Firefighters is the most difficult because if flips their schedule. Flips exactly. Their schedule isn't the same. Their schedule is essentially like two or three 24 hour shifts. And so. And then there's also the trauma. There's the. It's like being not the same as being in war, but like you're stimulated like, oh, am I going to wake up tonight? Am I going to get the call tonight? Yes, I am. It's like, how many times am I going to get the call? Is this gonna be a, you know, four alarm fire that this is gonna be the day, or is it just a regular day? So that's a difficult group. Obviously we help them with getting to sleep as best they can, but you can't give them, you know, a high dose of liquid melatonin or anything like that because they need to be able to wake up, you know, that night. So that one's a challenge one. Now the shift worker, like the nurses we work with or others, what we need to do is create a separate, which is not ideal diurnal rhythm or diphasic rhythm. So let's say that they get off at 7 in the morning, okay. They're probably gonna have some food because it's difficult for them to even eat and drink while on shift. So let's say they then go to bed around 9am or 10am we need then the same preparation we would do for the evening as we would do in that morning. That has to become their night. Again, not ideal, but that the pineal gland and the part of the hypothalamus is regulated by light. So we need to do the blackout shades, just the salt lamps, the blue light blockers, the calming based protocol. And then still not eating a couple hours before they go to sleep, which is really difficult for shift workers in the morning. And then we need to wake up at the same time each day. So we just try to create that eight hours there. And then when they wake up, that begins their morning, which is again, kind of strange. But. But that's when they do their errands and their routine before going off to work. All right. So you just flip it. And usually it's when you're first starting out as a nurse or other jobs, police, et cetera. Once you get some seniority, you typically get normal hours. Yeah.
- [23:33]
Justin Andrews
For that.
- [23:34]
Dr. Cabral
Yeah. You're hopefully best able to deal with that also in your 20s and early 30s. Much more challenging if you're doing that for 20, 30 years. Yeah.
- [23:42]
Sal Destefano
What are some of the signs that your catabolic hormones are just taking over?
- [23:46]
Dr. Cabral
If you're starting to feel poor recovery from workouts, or you're not getting the gains or the adaptations that you think that you should, or you're starting to put on a little bit more belly fat even though you're working out as hard or even a little bit better, you're sore for longer decrease in energy libido. Now, you could just take like, maybe I am overtraining, but doing this for a little bit too long. Okay. You might take three days off or a week off with an unloading week. If you still don't feel better after that, that's a real sign that you're moving more to a catabolic stage. So lower mood, lower energy, lower libido, lower endurance, lower adaptations to exercise, what's.
- [24:24]
Sal Destefano
The connection between that and visceral or belly body fat? Because I've heard that higher levels of cortisol or inappropriate levels of cortisol, I should say, can promote visceral body fat in particular is connected to visceral body fat and belly fat. So in other words, it could change your fat disposition or where you store body fat. So you tend to store it on your hips. And now suddenly. And you heard this from women because men are used to storing body fat in our bellies, but you hear this from women, like, I didn't store body fat in my belly ever, and all of a sudden I'm getting belly fat.
- [24:56]
Dr. Cabral
Yeah. And it's a good point. And you probably will hear it more from women. And a lot of it has to do with levels of estrogen.
- [25:02]
Sal Destefano
Okay.
- [25:03]
Dr. Cabral
So if our cortisol levels Go up oftentimes. And typically, cortisol is a glucocorticoid. Right. So it raises blood sugar levels. So if you have chronic levels of. You can raise blood sugar levels without even needing any carbohydrates. Oh, yeah. That's what a lot of people don't know is like, oh, I don't even eat carbs, or I'm below 50 grams a day, or I don't have any carbs in the morning, but my blood sugar's still 120. It's like, okay, well, you know, if you're that stressed, your body's gonna look to the liver and if not, the muscles. Now you're breaking down muscle tissue. You're raising blood sugar levels. You start to increase fat stores. The higher the fat stores of adipose tissue, the elevated levels of estrogen. More elevated levels of estrogen. That elevated level of estrogen is gonna then cause you to store more body fat as well. So then it's a vicious cycle, because now as you store more body fat, you produce more estrogen. You're chronically stressed, and the cycle just repeats.
- [25:50]
Sal Destefano
Is it that you produce more estrogen or is that you're more sensitive to.
- [25:52]
Dr. Cabral
Estrogen or both your estrogen receptors are more sensitive. However, no, you don't necessarily produce more estrogen unless you're being exposed to environmental exogenous forms of estrogen. But your estrogen receptors are. They do go up.
- [26:06]
Sal Destefano
So it's like you just made it much. You made whatever estrogen you have. Like, you have more estrogen because you have more receptors.
- [26:11]
Dr. Cabral
Yeah, 100%.
- [26:12]
Sal Destefano
Wow. Now, what you said about blood sugar is very interesting. I remember years ago, I had a client who would monitor his blood sugar carefully. He was pre diabetic. And I remember we did a workout and we trained really, really hard. Too hard. And he tested his blood sugar, and it was high. And he's like, this doesn't make any sense. I didn't eat anything. And at the time, I had. I didn't understand it either. I said, I don't. I don't get what's going on. And I talked to a friend of mine who luckily was in the functional medicine space, which years ago was quite rare. She said, oh, it was too much stress. His liver dumped a bunch of glycogen. That was the first time I'd ever heard of that. So you could literally. He could have a nightmare in the middle of the night and get a spike in blood sugar even though you ate nothing?
- [26:53]
Dr. Cabral
Yeah. And if you're wearing continuous Glucose monitors, if you try it out, you might actually see that. Yeah.
- [26:58]
Sal Destefano
Argument. You'll see your blood sugar go up or something.
- [27:00]
Dr. Cabral
Really, you will. And so it's funny and I've shared this story, I think here before, but it's worth repeating. I've read that in the literature, but I had never seen it. I'd literally never seen it. And then I was working with a type 1 diabetic client and we were trying to get their blood sugar under control in every way, shape or form. Because having dysregulated blood sugar is one of the fastest way to age and end up with chronic based disease. And you end up with advanced glycation, end products, all sorts of different things. So we found, because he only had time to do his workout after work, which if that's all you have, that's all you have, no big deal. And so every time he did a boot camp, every time he did high intensity interval training, every time he did his boxing, his blood sugar went up, stayed elevated. The next morning, the only thing that brought it down was low intensity cardio. The craziest thing, and he hated low intensity cardio and didn't want to do that. So we had to play with it and move it around a little bit to try to get it earlier in the day. And that's a big one too is mismatch workout timing. So when you look at this great, great studies on this, that now again, not everybody can do this, but I like to do my strength training mid afternoon. I'm someone, I had Addison's disease, believe it or not, many, many years ago. That's kind of how I got into this industry in the first place. Rheumatoid arthritis, addison's disease, type 2 diabetes, a whole lot of issues took me 10 years to recover. But I learned a lot in that process and that's why I'm here today. But what I found was that now that I'm healthy, I produce a lot of dopamine, I produce a lot of norepinephrine, I produce a lot of cortisol, just naturally. And so for me, doing a morning workout is too stimulating, actually I feel terrible about two, three hours later after, feel great while I'm doing it. If I do a mid afternoon, what they found is that you get the most benefit from testosterone to cortisol ratio. So by the time you get to mid afternoon, your cortisol has dropped, you know, precipitously. It gets really come down if you start the day, let's say at a nine, before Lunch you're at a three, by dinner you're at about a one, one and a half normally. And so it really comes down the before bed of 0.5. And so one of the biggest issues with your workout is it's spiking cortisol and cortisol being almost in exact opposition of testosterone. So you can now testosterone is normally at its highest in the morning, but you can actually give it a boost mid afternoon through a strength training workout when cortisol's low. When cortisol's low with a smart workout that's so great.
- [29:20]
Sal Destefano
I was going to say it also helps with that afternoon kind of energy slump that some people get.
- [29:24]
Dr. Cabral
Yes. And plus it's a great de stressor if you're able to do that. I mean it'll sometimes be when I used to be in a gym and different places like that, my clinic, it could be 1:00 or so. I don't usually get that opportunity now. Usually it's now end of the day, but still four or five hours from bed. And it does give me that extra little wave of energy, but not that excitability, manic energy where your heart rate can't calm down. It's just enough to move through that afternoon lull where a lot of people, they'll reach for another coffee, an energy drink or you know, maybe, you know, something more stimulating.
- [29:57]
Sal Destefano
What do you now when you're doing these tests throughout the day? Because we did a hormone test with you and we did. It was four saliva tests, I believe. I think you mentioned it was like morning, like first thing when you wake up. Yes, lunch, before lunch, before dinner and then before bed. Testosterone is supposed to be the highest quarter in the morning, so it's cortisol. Those start to drop throughout the day. What about the other hormones? What do those look like throughout the day?
- [30:21]
Dr. Cabral
Typically for men, they're basically gonothey're going to all be at their peak. So that's the nice thing in the morning. So that's why in the morning you have four tubes of saliva, but the first one is the largest one. And that's because we're collecting all the sex hormones, not just cortisol. Then you get a smaller tube before lunch, you fill it up halfway just with saliva and then one before dinner and then one before bed. Any 30 minutes or so before bed. So we can actually look at cortisol. That's, that's to me, if you could only run two, it'd be first morning and then it'd be before bed.
- [30:50]
Sal Destefano
Okay.
- [30:50]
Dr. Cabral
Now, it's great to see your rhythm because all of you, we can actually see your total cortisol output, which is impossible to do any other way.
- [30:57]
Sal Destefano
Yeah, you can't.
- [30:57]
Dr. Cabral
Except through these saliva tubes.
- [30:59]
Sal Destefano
Yeah, yeah, yeah. And now when people are on, because, you know, when people on hormone replacement therapy or hormone optimization through exogenous means, are you. Obviously it's going to look different. Is it going to look different?
- [31:10]
Dr. Cabral
Yeah, we should, we should chat about that because I know you three are using testosterone replacement therapy and some great research on this as well. It's fascinating and I think it is now changing the industry and you all see a great practitioner. So they're doing it now twice a week. Are you doing it or are you doing it once a week?
- [31:29]
Sal Destefano
I do. Twice.
- [31:29]
Dr. Cabral
Twice. Okay. So what they found was the actual mean. So the elevation of Testosterone on day one for TRT. So you inject yourself, within 24 to 48 hours, it's going to peak. And so the mean on that, they only do it by. So conventional medicine just looks at total testosterone. They don't really look at free testosterone too much. A good doctor will look at the free testosterone because that's ultimately what really matters. But it was 1112, so 1112, I should say 1112 was the mean peak in terms of testosterone. Now by day six or seven, it was 400 with a plus minus of 297. So it's a huge range, right? Some guys were up to 1400, 1500, some were at what, 100 to 700. So it's just this huge range, which is why my recommendation actually last time, it was a bunch of years ago, but I said, if you can do twice a week, lower dosage and it will allow you to feel that same benefit all the way through. Now, since then, I've worked with a lot of guys on trt. It's obviously a lot more popular now, much more prevalent. And what I'll say is this. Most guys know right away when their level falls below a certain number. Like without even testing it, they're like, oh, yeah, I feel it. Mood, strength. I was just talking to a guy, he's 71 years old, he uses TRT. He's like, this is what I use. This is what I've always used. I can tell that every time I go down just by. I think he dropped it by like 30 milligrams his dosage. You know, I think he went from like 100 to like 75 or 70 somewhere right around there. He's like, yeah, it wasn't right. He's like, it didn't give me what I was looking for. Yeah. He's like, when I'm at this number, he's like, that's the perfect amount for me.
- [33:07]
Sal Destefano
I hear some people do now sub Q injections on a daily basis to keep it as long as possible. I don't know how you would do that with the oil, but that's what some people do.
- [33:14]
Dr. Cabral
Yeah. I think. I think in the future it's every two to three days now. It's a lot more of a pain. Right. Literally to do that. Yeah.
- [33:21]
Justin Andrews
That's the only reason why I don't like doing the two times a week is because of just having to inject twice a week.
- [33:27]
Dr. Cabral
Yeah.
- [33:27]
Justin Andrews
You know, forever like that. But I know that my levels are like that. They took a while before they could figure out the optimal dose for me because I was crashing hard by day seven.
- [33:35]
Dr. Cabral
I remember you saying that. Yeah, yeah, yeah. And it's. And you don't want that. I mean, it's. I don't know that it's worse, but it is worse in terms of mood and in terms of, you know, getting the gym and exercise and sticking with the routine.
- [33:47]
Justin Andrews
Yeah.
- [33:48]
Dr. Cabral
So I don't think it is. I think that if you can you take the dosage down based on what your levels say, but also based on feel. Right. Because part of it is how you feel, part of it is what your numbers look like. That goes for every functional medicine test in the world. It's not just the numbers. It's the. The symptomatology. And then one thing we need to look at is if you can remember, was this done this lab test, the day or two after an injection, because you're gonna be at high levels and some of you are at really high levels. But now we can talk about that and we can say. Okay, based on that, I would say based on that, safely, you're going to be around 40 to 50% in six or seven days. Like, however you want to look at it of that. And that might be perfect.
- [34:30]
Justin Andrews
Yeah.
- [34:30]
Dr. Cabral
Right. For. For each person.
- [34:31]
Sal Destefano
All right, so let's look at our test. Let's dive. Right.
- [34:34]
Dr. Cabral
All right, so we're going to start with Sal. Sal, yours is the only one we didn't have.
- [34:40]
Sal Destefano
You don't have a point of reference.
- [34:41]
Dr. Cabral
No point of reference. So that's why I do always love baseline. But that's okay. We're going to dive right into it. So I'm gonna. Oh, I'm gonna start with dhea and then I'll kind of work down to.
- [34:51]
Sal Destefano
Estrogen, so I supplement with that as well. So dhea, I was gonna ask you.
- [34:53]
Dr. Cabral
Because your DHEA is. Is. It's high, but it's excellent. Yes, it's a 49.
- [34:58]
Sal Destefano
Okay, good.
- [34:58]
Dr. Cabral
So how much do you supplement with DHEA?
- [34:59]
Sal Destefano
100 milligrams.
- [35:00]
Dr. Cabral
Oh, you do? Okay, so that's a high dosage as well. 50 to 100 milligrams is typically the dosage we would give 55, 60 plus.
- [35:08]
Sal Destefano
Yeah.
- [35:08]
Dr. Cabral
Usually divided dosage, if not all in the morning. Are you taking the morning. Okay, all the morning. So that's. That would mimic, you know, more of nature. So that's what we want. So your DHEA is great. You're a 49.4. If you ever wanted to, you could try doing 50. I always like to tell people I want. You want the lowest possible dose to get the best clinical effect.
- [35:25]
Sal Destefano
I started with 50 and I went up to 100 because I felt better on 100.
- [35:28]
Dr. Cabral
What did you feel? I'm interested.
- [35:30]
Sal Destefano
More energy and better sleep, actually. Better sleep, Yeah, I noticed.
- [35:33]
Dr. Cabral
Okay, that's great. Great to hear. Your testosterone was 1513. So it was higher than you. You were the high number in the group.
- [35:40]
Sal Destefano
Yeah.
- [35:41]
Dr. Cabral
I don't know.
- [35:41]
Sal Destefano
Obviously not surprised.
- [35:43]
Dr. Cabral
Yeah, I don't know what it was baseline, like I said before, but your levels could be. If it's 1513 may also be 700, 800.
- [35:53]
Sal Destefano
By the end of the week.
- [35:53]
Dr. Cabral
By the end of the week, yeah. But we're talking about. This is free testosterone. Okay. So could be accidentally drawing a little.
- [35:59]
Justin Andrews
A little bit more than what.
- [35:59]
Dr. Cabral
So what I'm saying is you probably feel phenomenal. We'll put it that way. Your progesterone was pretty normal, is158. Like. And your estrogen is only 2.8 now, is it higher than the 1.6 we like to see? Yes, but at this number for testosterone.
- [36:15]
Sal Destefano
It should be higher.
- [36:15]
Dr. Cabral
Oh, it should be an eight or nine.
- [36:17]
Sal Destefano
Okay.
- [36:17]
Dr. Cabral
Yeah, it should be like three times. So you are. Unless you're taking something you are not converting testosterone to. Interesting.
- [36:24]
Sal Destefano
Okay.
- [36:24]
Dr. Cabral
Yeah, yeah. So two.
- [36:26]
Sal Destefano
Masculine.
- [36:27]
Dr. Cabral
Well, it's, It's. It's a good thing you do want estrogen. It's actually, it's preservative for anti aging, but you just don't want a lot because it can cause obviously, gynecomastia and all sorts of other. Other issues. All right, so let's check out your cortisol levels now, unless you have any questions on the other. Okay, so what do we want. In the morning? We said six to nine, basically, is our number. You were a 7.8 nanograms per milliliter at noon. You were right on the cusp. We want 2 to 3 or 3.1. Technically, you were 3.2, so that's great. Nothing to change there. Evening, you were higher than we want. We want up to a 2. Again, only 2.1, but we want to start to come down and then before bed, not out of range, which is above a 0.9, but we wanted a 0.6 or less, and you were a 0.8.
- [37:09]
Sal Destefano
Okay, so just a little high in the evening.
- [37:11]
Dr. Cabral
Yeah. But really, like, great levels. I mean, there's really no issue there. And then total cortisol we talked about before, we want that between 9 and 13 units for the day, and you were a 13.9, so just out of the zone.
- [37:24]
Sal Destefano
Okay.
- [37:24]
Dr. Cabral
And so what I would say is this is, like, this is pretty balanced.
- [37:28]
Sal Destefano
Okay.
- [37:28]
Dr. Cabral
You know, the testosterone. You know, if I'm your. If I was your doctor, I would say, let's see if we can go a little lower.
- [37:35]
Justin Andrews
Back off a little bit for only.
- [37:37]
Dr. Cabral
Four, because I want you to stay on this and the right dosage for you for the rest of your life. Right. And so it's like, okay, well, what's the right dosage? You're gonna have to just play with that and find out what's right for you. But this is great. These are good levels, and so work a little bit more if you're. What's your deep sleep and REM sleep look like?
- [37:52]
Sal Destefano
I don't know. Okay. I don't track it now.
- [37:54]
Dr. Cabral
I would track that. Like, that's that next evolution of, like, what I would say to a client. Like, what do you want to do now?
- [38:00]
Sal Destefano
All right.
- [38:00]
Dr. Cabral
If you're optimizing nutrition and exercise and, like, healthy biohacking and all of those things, let's start to look at your sleep.
- [38:06]
Sal Destefano
Okay.
- [38:06]
Dr. Cabral
It's probably the number one thing for aging as we start.
- [38:09]
Sal Destefano
I mean, I sleep okay. It's not bad. I can have bad sleep sometimes, but usually I'm okay.
- [38:13]
Justin Andrews
Are you using your.
- [38:14]
Sal Destefano
I use a CPAP now you do a difference.
- [38:16]
Dr. Cabral
Okay.
- [38:16]
Sal Destefano
Yeah.
- [38:17]
Dr. Cabral
How long have you had to use a cpap?
- [38:19]
Sal Destefano
Well, I mean, I probably have had to have used it longer than I have, but it's been. It's been maybe at least three, four months now that I've had it.
- [38:26]
Dr. Cabral
Okay. And that's probably giving you a lot of benefit in terms of.
- [38:28]
Sal Destefano
Yeah, definitely. Definitely.
- [38:30]
Dr. Cabral
Good. So we'll look at that. Or a whoop. You know, I don't know if you guys work with any companies as well, but we don't.
- [38:36]
Justin Andrews
We use Aura, though.
- [38:37]
Dr. Cabral
Yeah, I would definitely check that out. Or is the best for sleeping?
- [38:40]
Justin Andrews
Normally I have mine. I didn't wear mine this time around, so it'll be interesting. But I will after this.
- [38:44]
Dr. Cabral
And then don't go by any one night look at, you know, month, you know, of aggregated data. Like, what's my typical deep. My typical REM. You want to shoot for 90 minutes or more of deep and then two hours or more of REM and just like, on a consistent basis, trying to get in bed, stay in bed. If you're training, stay in. If you can be in bed for eight and a half hours and get eight hours of sleep, that's ideal.
- [39:04]
Sal Destefano
Yeah.
- [39:04]
Dr. Cabral
If you find yourself waking a lot between 1 and 3 in the morning or 2 and 4 in the morning, it can be dysregulated cortisol as well. Yeah.
- [39:12]
Sal Destefano
Okay, so that'll happen sometimes.
- [39:13]
Dr. Cabral
All right, good. Good results. Justin's up next. All right, so, Justin, Previous DHEA was 12.4. Previous testosterone was 163, previous progesterone, 24, previous estradiol, 1.9. All of those were, you know, perfect. They were great numbers. You had just started TRT when we did this lab, and. And so those were, like, ideal numbers. Testosterone, or DHEA, now is an 8.1. No issues with that. So optimals between 6 and 18. Do you take any DHA or anything?
- [39:46]
Sal Destefano
I don't.
- [39:46]
Dr. Cabral
I don't supplement with that. Yeah. At 8.1, you could start to think. Think about it. You wouldn't. So we actually start out with just 5 milligrams twice a day. You can start with 10. You can start with a little bit more if you wanted to, but we don't really need to get you above a 20, 25, so not a lot more that would move the needle. Now, your testosterone this time was a lot higher. It was 826. And I don't think you said you've changed your dosage, right? No, I haven't. So I'm assuming that what we got was your day or two after your injection, closer probably to the injection, and then it will fall to maybe 200, you know, by the end of the week. Yeah, maybe not that low. That. That's. That would be a big drop. So I wonder if as well. Because these tests are really accurate. I mean, they're. These are very accurate tests, especially when you're looking at free testosterone is that if your body is utilizing this testosterone, the receptors are stronger for testosterone now than they were before. Maybe before you were converting more to dht, which this test isn't measuring or something like that as possible. Okay, yeah, Interesting. And DHT is. It's an anabolic hormone. It's not that it's not good in terms of exercise and gains and all of that, but it can have some detrimental side effects for prostate inflammation, hair loss, et cetera.
- [41:00]
Sal Destefano
Isn't. Doesn't DHT also lower estrogen?
- [41:05]
Dr. Cabral
Only if testosterone is moving to DHT instead of converted estrogen. Got it. Yeah.
- [41:09]
Sal Destefano
Okay.
- [41:09]
Dr. Cabral
Because it can go one of two pathways.
- [41:11]
Sal Destefano
Okay, okay.
- [41:11]
Dr. Cabral
Okay. So that. Those are the main ones. And by the way, now that I'm kind of like running my mind around it, I actually, I don't have to look back on the research on this. So you get me thinking. I do actually believe that your body can endogenously produce higher levels of estrogen from adipose tissue. So I want to go back and look at that. Oh, yeah, because for men, you're looking at a conversion from hormone production, estrogen, but for women, they're looking for estrogen production from the ovaries. So I actually want to look at. To see if the adipose tissue does that. I was fatter back then, so.
- [41:37]
Sal Destefano
Well, you're your.
- [41:39]
Dr. Cabral
Your estrogen. Your estrogen is at 3.6 now. That sounds high. It's high. So I would actually start to use Indole 3 Carbinol and Dim. So Di. Di. Indolmethane. So those two, which are in cruciferous vegetables, help to block that and get it out of your body faster.
- [41:59]
Justin Andrews
Okay.
- [41:59]
Dr. Cabral
Yeah, So I use that. Yeah.
- [42:01]
Sal Destefano
So don't touch me.
- [42:02]
Dr. Cabral
Estrogen balance that. That'll be. That'll be helpful. But if you look at the ratio. So you didn't even double your estrogen, but you quadrupled your testosterone number. So meaning, like it's not that the estrogen's.
- [42:13]
Justin Andrews
Yeah, that'd be pretty good. That sounds good to me.
- [42:15]
Dr. Cabral
Yes. All right, let's look at those cortisol numbers. So from before, cortisol was 7.6 in the morning. Excellent. High at noon at 3.8, high in the evening at 3.4 and then back down to 0.8 at night. So not bad at night again, would like it.
- [42:30]
Justin Andrews
Someone who's down at night.
- [42:32]
Dr. Cabral
Yeah, Just in the average hour.
- [42:34]
Justin Andrews
Stress them the out.
- [42:36]
Sal Destefano
Only ways around us.
- [42:38]
Dr. Cabral
Do you take. Do you drink a fair amount of caffeine?
- [42:41]
Sal Destefano
I Do.
- [42:41]
Dr. Cabral
Yeah. So that's probably the caffeine. And then the caffeine wears off, which is six hour half life of that.
- [42:46]
Justin Andrews
Going to be similar to bed on that.
- [42:48]
Dr. Cabral
Then that explains it. But your cortisol now, I believe. Let me just make sure.
- [42:53]
Justin Andrews
Oh, that was before.
- [42:54]
Dr. Cabral
That was previous.
- [42:55]
Justin Andrews
Okay.
- [42:55]
Dr. Cabral
Yep. So now it is a seven in the morning, so optimal still high around noon. It's at 6, so that's a big one. So that's gonna be the caffeine. Yep. And then in the evening, it drops down to low, believe it or not, at 0.4. And then optimal before bed. So.
- [43:11]
Justin Andrews
Wow.
- [43:11]
Dr. Cabral
Yeah, those look good, whatever you're doing. Yeah, that's good.
- [43:14]
Justin Andrews
I'm not yoga caffeine. Is that yoga classes? You can take it or what?
- [43:20]
Dr. Cabral
Yeah, just trying to be chill, you know, That's a good thing. All right, Adam's up next. Let's see.
- [43:25]
Justin Andrews
Did you save Doug for last because he won. Is that why this.
- [43:28]
Dr. Cabral
There's no winner in this. Everybody's a winner. I was gonna say the goal was.
- [43:37]
Justin Andrews
The highest testosterone then.
- [43:39]
Dr. Cabral
Yeah. Killing it then Sal's. That's right. All right, so let's talk to you. Where we at your testosterone last time was a 233.
- [43:47]
Justin Andrews
Okay.
- [43:48]
Dr. Cabral
And. And that was actually pretty good. We. We. I think that was actually before you moved to the twice a week, but I'm not sure you. It might have already moved to twice a week.
- [43:55]
Justin Andrews
I don't remember. I know I played with that for a little bit and I'm not there. I'm once right now because I've been. And it's harder for me to consistently remember to go twice a week. I just. I don't like doing it, so.
- [44:05]
Dr. Cabral
Oh, so you don't take it home?
- [44:06]
Justin Andrews
Yeah, no, no, I do it.
- [44:08]
Dr. Cabral
Take it at home.
- [44:08]
Justin Andrews
But I mean, I'm just. I'm not really. I'm not consistent. When I have to go twice, I'm good. If it's once a week. Once a week, it's easy. I start the week out. Every week I do it, It's. But if I have to remember to do it again, I always just stick it here.
- [44:18]
Sal Destefano
Let us see what you will remember.
- [44:21]
Dr. Cabral
But that's good.
- [44:21]
Justin Andrews
That's good.
- [44:22]
Dr. Cabral
But then the number's pretty good.
- [44:24]
Justin Andrews
Yeah, I felt like I've. It's been about, I want to say a good two years now where I felt like I've really honed in on where. I mean, I was telling. I don't know if you were in here or not. When I this is the best I've ever been too of not even having to take Arimidex, which was what I used to have to do to keep the estrogen at bay. I typically my estrogen would, would shoot up. But I haven't had to mess with Arimidex in a long time, which has made me really happy that I found that kind of balance.
- [44:49]
Dr. Cabral
How would it affect you? Because your lab doesn't show that. That's why obviously gynecomastia.
- [44:54]
Justin Andrews
So yeah, very sensitive if I ever.
- [44:57]
Sal Destefano
Could it be progesterone related because can't gynecomastia be related to progesterone as well?
- [45:01]
Dr. Cabral
Mainly estrogen.
- [45:02]
Justin Andrews
Anytime, any so two ways I would notice anytime I would kind of slightly up my dose, even the slightest bit I would notice or if I'm actually not training. So if I would keep my what my normal TRT dose and then not be lifting weights, I could notice it sort of kick up if I kept my TRT dose where it's supposed to be and I'm strength training at least two to three times a week. I'm. I've been perfect.
- [45:24]
Dr. Cabral
So it is good. I'm telling you, like there is some genetic variability with all this and to start to dial in what works for you is just of the utmost importance, without a doubt. Well I can tell you that we can just kind of jump back and forth for yours. Your testosterone is 224 this time. So it's exactly the same.
- [45:39]
Justin Andrews
Okay. I mean I've been very consistent with my dosage.
- [45:42]
Dr. Cabral
Estrogen before was 1.4, so it was higher but. But normal range.
- [45:46]
Justin Andrews
Okay.
- [45:47]
Dr. Cabral
And now is 0.7. So it's great. Yeah. Like there's not. You don't even need to take an estrogen support or the you're taking now. But if you find, if you feel you're prone to it, there's nothing wrong with taking that to just keep it at bay if you feel like you're someone.
- [45:59]
Justin Andrews
So I typically what I do and I haven't really had to do this in a long time but if I start to feel this sensitivity come up, I'll take it and then it'll go away and then I don't worry about it until then. I don't ever let it completely start to form like I would in the past not knowing how to control it where now I wait to feel that if only take it if I sort of feel it coming on. I haven't in a long time.
- [46:19]
Dr. Cabral
It's been good, very good DHEA has come down a bit. It was 39 before and it is 4.6 now.
- [46:26]
Justin Andrews
So I don't supplement at all. What would you recommend? I. I take.
- [46:29]
Dr. Cabral
I would probably do 10 milligrams twice a day.
- [46:31]
Justin Andrews
Okay.
- [46:31]
Dr. Cabral
Yeah.
- [46:31]
Justin Andrews
Okay.
- [46:32]
Dr. Cabral
And then just start at just 10 milligrams in the morning.
- [46:34]
Justin Andrews
Okay.
- [46:35]
Dr. Cabral
Make sure there's no aromata. Aromatase where it's starting to cause maybe some tingling or. Is that what you typically feel?
- [46:41]
Justin Andrews
Yep, yep. Starts with that before it starts to do anything.
- [46:43]
Dr. Cabral
Yeah. Around the nipple area. And then if you don't have that, then you can add the other 10. Now it shouldn't. Because remember, DHEA can move to wherever it wants in the steroidal hormone pathway. Can help to balance cortisol. Can end up with testosterone, then testosterone converted to estrogen or dht. Okay. And you might want to just use again the. It's just I3C and DIM2 extracts from broccoli. Great product. And it will block some of the estrogen.
- [47:08]
Justin Andrews
Okay.
- [47:08]
Dr. Cabral
It's not a bad product.
- [47:08]
Justin Andrews
You guys create that. You guys have that?
- [47:10]
Dr. Cabral
Yeah. It's called estrogen support.
- [47:11]
Justin Andrews
Got it. Got it.
- [47:12]
Dr. Cabral
All right, let's take a look at your cortisol levels. Progesterone was totally normal. It was a 55 before. Now it's 21. Now. Both are totally normal for guys. Cortisol before was high. It was 17.4 in the morning, so it should be above a 9. It was borderline. It was 3 in at lunch, 3.3 in the evening. So it's a point and a half too high. And then 0.8 at night. So it did come down a little bit before bed, which was Good. Now, perfect. 6.3 in the morning, 1.7 at noon, 0.8 in the evening, and then 0.5 at night. Yeah. So that's excellent. Really?
- [47:44]
Sal Destefano
What are we so stressed out about?
- [47:45]
Dr. Cabral
Before, there was something going on there. Yeah. That's slacking off.
- [47:49]
Justin Andrews
A while back, that's what it was.
- [47:51]
Dr. Cabral
Because that's not what it's gonna be higher.
- [47:52]
Justin Andrews
Right.
- [47:52]
Dr. Cabral
It's not caffeine. Yeah. That is.
- [47:54]
Sal Destefano
We're all good.
- [47:55]
Justin Andrews
What are you talking about?
- [47:56]
Dr. Cabral
That's the cortisol awakening response. I do.
- [47:59]
Justin Andrews
I'm with like just now. I'm pretty high on caffeine in the. In the morning time, so.
- [48:02]
Dr. Cabral
But that's before you even had caffeine. That was upon waking.
- [48:05]
Justin Andrews
Oh.
- [48:05]
Dr. Cabral
So when you. When you look at that. The previous one is what I'm saying. It's great now.
- [48:08]
Justin Andrews
Yeah.
- [48:09]
Dr. Cabral
And some people are slow and fast metabolizer of caffeine as well, so. But it also depends on the dosage. There's 200 milligrams and there's 600 milligrams, and there's, you know.
- [48:17]
Justin Andrews
Yeah, there's a five. There's one. Once I started into 600, so 400 seems to be very good for me. Like 400 and early in the day. Yeah, I feel great. I start flirting with 600 and start pushing it closer to noon, it starts to disrupt sleep. Definitely have connected that if you check.
- [48:31]
Dr. Cabral
Your heart rate too, you really don't want it to rise more than like, three beats to maybe five at rest. So if you have a caffeinated beverage, this goes for food sensitivities, which I know we're gonna talk about in the future. If your heart rate goes up, you are having a reaction to that, and you're definitely sympathetic nervous system tone. So just. It's a good. It's a good thing just to look at. Yeah. All right. Doug is up last but not least. Previous testosterone was a 42. Previous DHEA was 77.9. DHEA, borderline testosterone, obviously, too, too low. Right. What is it now? 121 for testosterone. Perfect.
- [49:08]
Sal Destefano
Okay.
- [49:09]
Dr. Cabral
Yeah. What are you doing, boy?
- [49:11]
Sal Destefano
All kinds of things.
- [49:12]
Dr. Cabral
Yeah, yeah. So you're. Well, I'll get to your cortisol. But like you've done, you had a big turnaround from your cortisol numbers and your testosterone, so I'll just go through them. Your testosterone was 42, which, you know, even at 70 plus, we don't want it at 42. So it means there's just a great stressor. And then, Doug, previously cortisol was 9.4, 6.4, 1.9, and 1.5 at night. So it was essentially double the amount of cortisol that you would want to produce for the day. I can just do quick math on this. 10, 16, 18, 19 and a half. Call it 20. Yeah, just. Just about double at the max. What you would want to produce now. Testosterone is 121, which is great, honestly, for any age. For Testosterone, progesterone was 31. Estradiol only 0.8. DHEA6. So, I mean, we can play with that DHEA a little bit, but it's not bad. It's just borderline Cortisol, though, had the biggest change. It went from 9.4, 6.4 to 6.8 2.6 1.1 and 0.6 at night. Total cortisol 11. So you get your cortisol based. Beautiful.
- [50:18]
Sal Destefano
Good for you.
- [50:18]
Dr. Cabral
It's great.
- [50:19]
Sal Destefano
He just cares.
- [50:20]
Justin Andrews
I know that's, I know that's been, that's been an area. I know you been really trying to.
- [50:24]
Dr. Cabral
I've been working on my sleep a lot. I track it and I've done a lot better. Yeah, that will change. We didn't actually talk about that. But sleep will change your testosterone faster than almost anything. If you're not getting good sleep and it's disrupted and it's not restorative, it's going to affect your progesterone levels, it's going to lower them, and it's going to lower your testosterone and DHA as well. So that's why really dialing in the sleep, making sure that you're getting not just enough hours, but restorative sleep of deep sleep and REM sleep really do matter.
- [50:54]
Justin Andrews
I know it was in competition, but I do kind of feel like Doug and I kind of won this one. Don't you?
- [50:57]
Sal Destefano
I think so.
- [50:58]
Justin Andrews
I feel like that, I feel like that.
- [51:00]
Dr. Cabral
Like I said, I mean, everybody's here. Winner. That's for sure. Great testosterone.
- [51:04]
Justin Andrews
That's good. That was good though, huh? That was a good one.
- [51:07]
Sal Destefano
Not bad.
- [51:08]
Justin Andrews
Probably one of our better, better balances, I'd say.
- [51:10]
Dr. Cabral
No, I, I actually, I think most of your numbers, especially cortisol, have improved over the last couple years. I know you've been using, you know, magnesium and different things like that to, to help to turn off that sympathetic nervous system at night. All of that comes kind of with just dialing in the lifestyle that you guys have been talking about and finding out what really works for your.
- [51:27]
Sal Destefano
Now, typically when you do these and you have a client who did a test like this, when you look at these numbers and there's some that are off, you have protocols.
- [51:35]
Dr. Cabral
Yes.
- [51:36]
Sal Destefano
You see, like, okay, this is out of whack here. This is out of balance there. It's a, it's a really, it's like a window into the, the right protocol for that individual to help. And it's through measuring the hormones now. How long do you, how often I should say, do you test the hormones after you start implementing certain protocols?
- [51:54]
Dr. Cabral
Yeah. So let's say a female has estrogen dominance, so lower progesterone levels. They might even show higher testosterone because of stress or males showing lower testosterone, lower dhea, higher elevated cortisol at night. That's the most typical profiles that we see. We are going to put someone on a 12 week protocol to maybe 16 weeks and then we're gonna lab test at that 12 to 16 weeks. Now, we're gonna use things like magnesium that we talked about before. Especially in the evening, we'll use B complex or activated Bs. During the day, we'll use Omega 3s which help to balance the hormones and inflammation. We'll use a product called Adrenal Soothe, which has Ashwagandha L theanine phosphloserine that starts to quiet cortisol in the evening. And maybe we'll use some liquid melatonin at night, which is a little bit different. Cause it's in and out of your system faster so you're not groggy the next day. For women or for guys with higher estrogen, we'll use estrogen support, which is that I3C and DIM. Again, these are all natural supplements and ingredients. And then what we'll want to do, though, this is really important. And we can use DHEA if we need to, but don't always need to in younger clients. What we want to do is we want to test these levels while still on the supplements. And that's what a lot of people don't do. They stop them and then they're getting not their baseline. Now, you've been on these for 12 weeks to 16 weeks. Test where you're at. If everything is balanced, amazing, then we're going to use a specific protocol as well to titrate you down. So we're very going to slowly to figure out maybe using sick products. All right, we're going to start with what first. Maybe we start to remove the liquid melatonin first. We're just using the magnesium, the adrenal sooth. Right. So then what do we do? Well, instead of taking 2.5 milligrams a night, not a big dosage, we'll take it to one and a half or one and a quarter. And we'll do that for a week. Did it change your sleep? No. Great. Let's go to a half a milligram. Change your sleep? No. And then after half a milligram, we can just remove it the next week. So it's typically over two to three weeks that you slowly come off a supplement. And it allows you to see if there's a rebound effect. And if there's a rebound effect, means your body just needs that for a little bit longer. But it's not just supplementation. It's also lifestyle.
- [53:57]
Sal Destefano
Lifestyle.
- [53:58]
Dr. Cabral
I mean, it's like people, if you're gonna do a workout and it's within an hour or two of bed, it might just Be too stimulated. Some people can do a sauna an hour before bed and it actually helps their sleep. Other people, it's detrimental to those certainly a lot of people like red light 60 minutes before bed because it's longer wavelengths, less energy like then blue light. So it can actually help to reset that circadian rhythm as well. So that could be a nice thing to do. So you add these things in and it's the whole de stress protocol and each. So every time someone runs this lab you get that whole protocol personalized for you. That's really, that's what I believe the future really of health and medicine is being able to run these labs.
- [54:36]
Sal Destefano
Totally awesome. So that's great. I feel like this is one of the more fundamental tests that people should do.
- [54:42]
Dr. Cabral
This is one that is probably our maybe like second or third most popular lab. We run tens of thousands of just this lab a year and it's with people literally all over the world. And it can be game changing because the goal is to find something before it goes wrong. But if not at least okay. Now you see what's going on between your hormones and you're able to fix that. So yeah, I appreciate you little, little.
- [55:05]
Justin Andrews
Off topic and we can cut this if you don't want to talk about it on here. But I'm just curious because what's so cool you have thousands and thousands of people. You got to have so much great data on all this. Are you using AI at all to support what you guys are doing as far as protocols? And I would think having that now you could really quickly solve a lot of problems and get right to a protocol. Are you using it at all? Are you messing with that at all?
- [55:30]
Dr. Cabral
Yes. We built this about 18 months ago. Like you said. We've have over half a million labs, over 500,000 labs. Over a million to a million and a half data points. Well it's actually well over that. It's probably around 10 million data points. And then we have all the people and their healing based process. So what you're able to do because a lot of people worried about their data and this is the nice thing about these labs, it's not shared with anybody. So we use all third party lab testing, which you should always do as a practitioner. If you own the lab company. It's a little sketchy of course. Right. So you always keep that separate supplement fixed.
- [56:04]
Sal Destefano
Everything.
- [56:04]
Dr. Cabral
Exactly, exactly. So you want independent research and data clia certified labs and then you have your practitioner and then there's you. If you want to share this with your PCP or insurance or whatever, feel free, but people like it private. Now what we can do is on a HIPAA compliant level, you can anonymize all this data.
- [56:21]
Justin Andrews
Sure.
- [56:21]
Dr. Cabral
Yeah. And that's the amazing thing. So all you see is numbers and then what we now do and you'll see our labs actually look different than they have before. So we've created our own API. We have all new structured data. I like to geek out on this stuff all the time and I've got a couple scientists on my team that love to do this as well. We've now made it super easy to read for a client. It summarizes exactly what your data points mean just based on your numbers. So no humans doing that. And then it gives you a protocol based on how others got well based on your numbers. So it's unbelievable. Now the nice thing is you then again doesn't take into account though the symptoms really. So I still believe there should be a human. So a human then goes through this and says oh yeah, but based on Sal or Justin or Adam or Doug this, that we need to take out this one and add this instead. So that's how I believe that human and AI will work best in the future is our practitioners can't forget anything because it's already there. It's based on all of the teachings that I've done before and so it's pretty remarkable. I mean, I love this stuff.
- [57:25]
Justin Andrews
That's so cool. I mean, I feel like there's a future in the business to where people can almost do it themselves. But then only if I am running into problems or I notice other symptoms, maybe I call your team and I'm like, okay, I'm following the protocol as it's laid out. But I noticed this and fill this and then that's where the real person comes in. But I bet I would be able to help a good percentage of people just because you have so many data points.
- [57:47]
Dr. Cabral
So and we do use that now and people are able to get their labs if they need to on their own. But do a 30 minute call with a practitioner, that's like our, our team, their average industry experience is over a decade. So I mean they just have so many hours, they've got that 10,000 hours and you really want that. Unfortunate story the other day someone wrote in on the minerals and metals test and they looked at their heavy metals and they were a practitioner. They weren't trained through ihp, which, you know, we try to train people to be able to read all of these labs. But they're a doctor. And so we give them access to all of these labs. We sign off on it. We have a medical director and a medical doctor in every single state. And here's the problem. They look at just the graph and they saw that mercury was elevated and aluminum was elevated. That's not uncommon. You know, we're exposed to all of these things in the environment. The problem is they looked at five different to test and the graphs looks very similar. Well, the problem is there's no upper limit on heavy metals. So the graph goes from like we'll call it a one is high for aluminum to infinity. And so where do you graph it? Well, you have to graph it like halfway, somewhere between one and infinity. Now we're going to change this in the future. But they didn't interpret it correctly because they didn't look at the numbers on the bottom. All the numbers for all their clients were different. All they looked at was the graph. So that's why having a qualified person read this lab, it's worth it. Plus it comes with all of these labs. So that's the nice thing is you might as well just take advantage of it. We already include that with all the lab testing.
- [59:12]
Sal Destefano
Very cool.
- [59:12]
Justin Andrews
Thank you.
- [59:13]
Dr. Cabral
Thank you. So my team, we've done this before, but it's half off for your community. So that is something that we'd love to be able to bring you. So it's literally 50% off. That still includes the consultation and that's@stevencrabal.com hormonestest if people want to pick up their own lab, definitely recommend they do so. Thank you. Appreciate it.
- [59:33]
Sal Destefano
Do it. Thank you for listening to Mind Pump.
- [59:35]
Dr. Cabral
If your goal is to build and shape your body, dramatically improve your health and energy and maximize your overall performance, check out our discounted RGB super bundle@mindpumpmedia.com the RGB Super Bundle includes maps, Anabolic.
- [59:50]
Sal Destefano
Maps, performance and maps aesthetic.
- [59:53]
Dr. Cabral
Nine months of phased expert exercise programming designed by Sal, Adam and Justin to systematically transform the way your body looks, feels and performs. With detailed workout blueprints and over 200 videos, the RGB Super Bundle is like having Sal, Adam and Justin as your own personal trainers, but at a fraction of the price. The RGB Super Bundle has a full 30 day money back guarantee and you can get it now. Plus other valuable free resources@mindpumpmedia.com if you enjoy this show, please share the love by leaving us a five star rating and review on itunes and by introducing Mind Pump to your friends and family. We thank you for your support. And until next time, this is Mind Pump.