A short educational video by Dr. Tabatha Barber explaining cortisol’s role as the primary stress hormone and its central influence on weight, thyroid, and sex hormones. The video emphasizes limitations of single blood cortisol measurements and illustrates how the DUTCH urine/saliva test captures 24‑hour cortisol patterns (including the cortisol awakening response) and DHEA metabolism to reveal chronic dysregulation.
Chapters
So we're going to talk about cortisol. That is our major stress hormone. It gets villainized, but it's actually necessary for life. It's also the number one hormone responsible for weight gain or weight loss. Okay, cortisol, number one hormone responsible. So when people say we need to manage stress, it sounds like, oh, whatever, Mentally I can handle it. What's the big deal? I'm going to show you the physiolog of why it's a big deal. So this is a report or a page of a long report from a Dutch test. A Dutch test is a functional medicine testing company that tests hormones through urine and saliva. There's great benefits to this. I'm going to show you what those are. Traditionally, doctors will check hormones through blood. This gives you an overall available level of a certain hormone, but it doesn't tell you what your body is doing with it. This test, the Dutch test, will show you how your body's using your hormones, how it's metabolizing it, whether it's removing it from the body or recirculating it. And when it comes to cortisol, cortisol has a distinct pattern over a 24 hour period. That is what's highlighted in this gray area right here. And this is showing samples taken as soon as someone wakes up, 30 minutes later, an hour later, late afternoon and evening. And so where a lot of practitioners get this wrong is they will check one morning waking cortisol and if it's quote unquote in the normal range, they'll tell you you're fine and there's nothing wrong with your adrenals, but you're missing the other 23 hours of what your cortisol is doing. So I often will see this blue line is the patient's results. I'll see a blue start here in the middle, like it's going to be normal when she wakes up. And then it goes straight up and it stays up all day long or then it drops and it stays low. So you get this false sense of reassurance that everything's fine when it's actually not fine. So I've had many patients come to me after they have been disregarded and told their adrenals are completely fine and they're like on the verge of adrenal fatigue. So that's why I love this test so much. You get the real picture of what's going on with your adrenals. And this also shows us your DHEA production. DHEA is your anti aging, keep you young and healthy hormone. It Keeps cortisol in check, just like I'm going to talk about progesterone keeps estrogen in check. DHEA keeps cortisol in check so that it's not too high, it's not too low. The two of them are working together to repair your cells at every moment and heal your body. Because cortisol is catabolic. It breaks cells down, it destroys. DHEA is anabolic. It builds stuff up. And so you need a nice balance of, between these two. And yes, this is the test that a functional doctor can order. It gets sent to your house, you collect it, send it in. It's super easy to do. This part right here from waking to 30 minutes later is a really important piece of the, of your cortisol pattern. It's called the cortisol awakening response. You want at least a 50% increase in that first half an hour from when you wake up. That's like your body's natural cup of coffee. It gives you the energy to get going for the day. And so if you have a flattened car, meaning it doesn't rise, you probably struggle to get out of bed, and you're hitting snooze 50 times and you have to have coffee literally the minute you step out of the bed or you can't function. That's usually a sign of a messed up car, as I like to say. So this pattern can be all different kinds of ways. But just know that cortisol isn't bad in and of itself. Like for an acute stressor, it's good. It helps you get over something. Like if you have surgery, you go in for a colonoscopy, you almost get in a car accident. All of those acute situations, you need cortisol to manage that, but then you need it to come right back down into the pattern that it belongs in. And if it doesn't come back down into that gray area, then you're dealing with chronic stress, chronic cortisol production. And that is when it can start to cause disease and illness and feel like anxiety. And then your thyroid gets involved and your sex hormones get involved because of that pathway.
