4 Crucial Things Your Saliva Can Tell You About Your Hormones.

In this episode of the Ben Greenfield Fitness Podcast.

Well, the blood hormones are what's flowing freely through the blood, whereas the saliva hormones is what's actually getting into the cell. It's what your body can use. I find the hormone replacement creams, they're more of a band aid approach. They're not addressing the cause of why it's happening. If there's high levels of obese glucuronidase in the bowel, that's going to lead to reabsorption of estrogen from the gut. And unless you're a professional athlete, you're also probably looking after a family, working, so you don't get as much time to rest and sleep. So you've got to do everything you can to keep your body functioning well. High testosterone in women will lead to high levels of prostaglandins in the blood, which will then lead to insulin resistance and becomes like a vicious circle.

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Hey, folks, it's Ben Greenfield. And I gotta tell you, if you want to know if you have a hormone imbalance or you've always wanted to test your hormones or figure out how to do that, or you want to know how to fix your hormones and you're just a complete hormonal mess, you definitely want to tune into this episode. And I actually want to start here because this is why I got today's guest on is. I get tons of questions from listeners who are, pardon my accent, down under, and they want to know about how to get things like blood and gut and hormone testing done. And a lot of them are having trouble kind of finding out how to do that in the great land of Oz. So I did some research and I talked to some of my trusted Australian friends and coaches and was eventually referred to and discovered this guy named Dr. Michael Smith. And Michael runs the website in Oz called planet naturopath@planetnaturopath.com and Michael is not only a naturopath, as you probably would have guessed from the name of his website, but he's also what's called a Kalish method functional medicine practitioner. And he specializes in hormone disorders, adrenal, thyroid and digestive function. Also, as we like to call it on this show, your poop so he does blood, he does saliva, he does poop. He works with clients from the chronically ill to athletes who want to improve performance. And most of the work that he does is in Australia. So if you do live in Australia and you're listening in, you'll definitely want to look this guy up. But he's also chock full of information that's going to help all of us out all over the world, no matter where we are. And specifically today, we're going to be talking a lot about hormones. So first of all, Michael, thanks for coming on the show.

Yeah, no worries. Ben, how are you doing?

I'm doing well. Did you like my Australian accent?

Yeah, a little bit to work on. My wife's actually Canadian, so, yeah, she's still trying to get an Australian accent After 12 years here.

Well, I don't know if you have children, but they're going to be extremely messed up, I'm sure based on the Canadian Australian accent combo. That can't be good anyways, though I jest. I'm sure they'll sound just fine. You're a naturopath. And before we start to talk about hormones and stuff here, like I mentioned and like you have written on your website, you're also this Kalish method practitioner for people who aren't familiar with what the Kalish method is, because a lot of folks know what a naturopath is, but the Kalish method is something that people might not be quite as familiar with. Can you explain what that is, what the Kalish method means?

So the Kalish method is looking at a lot more functional pathology testing. So getting to the cause of the problem with saliva testing for the hormones, looking at gut dysfunction through parasite testing, thyroid testing, just getting to the cause of the problem through extensive testing rather than just relying on signs and symptoms, which can be a little bit misleading.

Okay, gotcha.

So why do you need an entire, I guess like practitioner certification for something like that? Is it like a special series of tests that you learn when you become a Kalish method practitioner? I mean, are these tests unique to that method or what kind of tests are we talking here?

The tests, they're not unique to the Kalish method. They're saliva hormone testing for the adrenal function for estrogen, progesterone, testosterone. Dr. Daniel Kalisch has a unique method of interpreting these tests and getting great results. So he teaches a six month course on how to go through step by step, getting to the cause, working out a systematic treatment, and the bottom line is getting great results.

Can anybody Become a Kalish method practitioner. Is that something that you need to have like a medical degree to get a certification in, or is that something like, for example, myself as a lowly podcaster could go and look into?

I don't think you need a medical degree, but you definitely need some sort of qualifications. You want them to have a really good base of knowing what you're doing before you would step into it. Have to talk to Dr. Kalish about that.

Gotcha. Gotcha.

Yeah, That's Kalish, is it? Kalishinstitute.com is where you go to look into that.

That's it, yeah.

Okay. All right, cool.

Yeah, it's something I've been meaning to look into a little bit more myself because I've heard a couple of interviews with Dr. Kalish and he sound really intelligent when it comes to this process of kind of basing medical treatments and procedures on really adequate testing and the type of testing that I know you and I are going to talk about here in just a second, so. Okay, cool. Well, that clears up the whole Kalish thing then. It's not some strange Australian, I don't know, farming certification or something like that. It's an actual medical deal from. And I think Dr. Kalish is in California, right?

Yeah, San Francisco.

Yeah. Okay, cool.

So, you know, like I mentioned, I wanted to talk to you, Dr. Smith, about hormones because I know that's something that you specialize in. And you know, there. There are things like low testosterone, right? Like that's a horse that gets kicked to death and that you hear a lot about. But are there things that you would say like hormone imbalances in seemingly healthy people? We have a lot of people who listen to this who are already working out, who are already out of couch potato mode, who are out doing triathlons or competing in CrossFit or something like that. What kind of hormone imbalances do you tend to find in seemingly otherwise healthy people?

Hormone problems come in four different categories. Probably the most common one is a decrease in progesterone, which can lead to mood problems, pain, breast tenderness, and that can be quite common in athletes because of the high training, the high stress, sometimes not getting enough calories in their diet.

Now, is that mostly women or.

Yeah, that would be women. The hormonal imbalances for the progesterone estrogen would mainly come down to women. So for men, that would be more low testosterone they would experience, and that can be from over training. Once again, stress. Stress is the big kind of driver behind hormonal problems. So the first thing you want to look at is what stresses they're under, whether it's from diet, digestion, over training. It could even be just lack of sleep can lead to this stress, which will lead to excess estrogen in men and low testosterone through the adrenal stress.

But it's low progesterone. You know, when we're talking about hormone issues in healthy people or in athletes, the first one that you come up with is low progesterone. And specifically that would be something that you'd see in like athletic women.

Yeah, it's always an imbalance between progesterone and estrogen. So they kind of work hand in hand. You need them in the right balance. And for some women it's excess estrogen. And that can be probably not always, but probably more women who are possibly overweight or having liver digestion issues. Whereas the low progesterone, that can probably from athletes. And once again, the stress on the body is the main cause. And the stress, as you know, can come from many different angles. It can be from the diet. Just having a low calorie diet especially, you know, a lot of athletes are still on the low fat, you know, bandwagon. So they still get. They just don't get enough calories into their diet. And that's where some of the symptoms might be. You start skipping periods or getting more moody, getting breast tenderness, things like that.

Okay, so how would you test for something like low progesterone?

So you can get a blood test for progesterone or a saliva test? I use the saliva test because that measures the bioavailable hormones. So sometimes you might have normal progesterone levels in the blood, but in the saliva sample they're low. Sometimes you can have low progesterone symptoms, but the progesterone levels are normal as well. Yeah.

Can you explain that distinction between blood measures of hormones and salivary levels of hormones a little bit more thoroughly? Because I'm kind of curious about the real reason that you say maybe wouldn't want to rely on, say, just blood cortisol or just a blood progesterone or just a blood testosterone versus the salivary. What's the distinction there in a little bit more detail?

Well, the blood hormones are what's flowing freely through the blood and they're unbound hormones, whereas the saliva hormones is what's actually getting into the cell. It's what your body can use. So you can also, with the bloods, bloods can be okay if you're checking also sex hormone Binding globulin. And there's an equation you can work out to work out the unbound hormone that you have. And they're free, but the saliva one is. It's more convenient also for clients because they can do that at home. They don't have to go and get blood taken at a lab. They can just do a sample in the morning and send it off to the lab. So it's convenience, a little bit cheaper, and you get what's available to the.

Body now in the blood. Couldn't you get, like. I know with testosterone, for example, you can get a total testosterone reading and a free testosterone reading. And I know that's not progesterone, which we were kind of talking about just a second ago, but in a situation like that where when you get a blood test, you can get both a total and a free, would that mean that it wouldn't necessarily be necessary to also do a salivary test? Like, would the free levels in the blood be indicative of the same type of information you'd get from the levels in the saliva?

Yeah, if you had a free testosterone in the blood, that would be a good measurement as well. So, yeah, that's fine.

Gotcha. So returning to the progesterone issue, in women who suspect that they may have low progesterone due to low amounts of energy or moodiness or low sex drive or something like that, they can get what's called a salivary progesterone. Is that what it would be termed?

That's right. And I always do that with an adrenal test as well, because you can have normal progesterone, but if you've got high cortisol, that's actually blocking the action of the progesterone. So you might have normal progesterone levels in your test, but you're actually. The progesterone is not being able to be used by the body.

Interesting. So you could have, for example, high progesterone or normal levels of progesterone if you were to measure just salivary progesterone. But if you don't measure your levels of cortisol, that doesn't necessarily mean that you're able to use that progesterone.

That's right. You've got to take into signs and symptoms. So sometimes a client might go to a doctor and get their hormones tested and be told everything's fine. But they have high cortisol, which is blocking the body being able to use the progesterone. The inflammation that causes will block the progesterone receptors.

Okay.

See, I was always under the impression that if you weren't making enough progesterone, that it was potentially because you were making a bunch of cortisol and that you couldn't necessarily have a state of both high cortisol and high progesterone. But it sounds to me like what you're saying is you could have high progesterone and also have high cortisol, and that cortisol would keep that progesterone from being bioactive. Is that what you're saying?

Yeah, you probably wouldn't have high progesterone. You'd have normal progesterone and high cortisol. And the longer that goes on, you're right there. If someone's been under stress for a long time, eventually you'll end up with maybe even normal cortisol, but low progesterone, and then eventually low cortisol, low progesterone, and the symptoms are a lot worse then and often leading to low dhea. That's another way to measure just how long. How long the stress has been occurring for.

Okay, gotcha. So one of these salivary stress tests would be measuring cortisol, dhea, progesterone. Anything else?

You always measure estrogen because you want to see that in the right balance between progesterone and estrogen, too. So sometimes you can have normal progesterone, but the estrogen is high, or you can have normal estrogen, but the progesterone's high. Low. Sorry. So the symptoms are often the same, but knowing which one's high or low helps target treatment a little bit better.

Okay, gotcha.

So, returning to the progesterone issue, let's say that you find out that you've got normal progesterone with, well, obviously normal progesterone with high cortisol. You'd want to go after the cortisol, I would imagine, from a stress standpoint or a training standpoint or a recovery standpoint. But if you find that you have a low progesterone, a lot of times you'll see recommendations for, like, these progesterone creams or, like, topical progesterone lotions, stuff like that. Are you a fan of those, or what exactly do you recommend for women who wind up having low progesterone? Because I frankly run into this all the time. It seems athletic women who either have low progesterone or low progesterone and low estrogen. And I'm curious what your thoughts are on some of these Hormone replacement creams or lotions or topicals or whatever.

I find the hormone replacement creams, they're more of a band aid approach. They're not addressing the cause of why it's happening. They can actually help in the short term, but long term, they lead to very high progesterone levels and it just leads to more progesterone resistance. So there's too much hormones and the body will sort of down regulate the receptors. So it's just not as effective as it can, could have been and should be.

Got it. So what do you do?

Well, in Australia, I use herbs. And Dr. Daniel Kaley, she uses the progesterone drops, which in very low doses, which are effective. It doesn't bypass that feedback loop that the creams do. There's different herbs you can use. So progesterone, if you've got low progesterone, that's the precursor to allopregnanolone in the brain. And so that leads to a lot of those mood problems that people get. So I'll be looking at using things like that stimulate GABA herbs like Zisyphus and magnolia, even herbs like Vitex can help to stimulate progesterone production by reducing prolactin levels. So there's some herbal and nutritional methods you can use to get around it.

What would you say would be for people listening in if they wanted to look into, like, there's all sorts of ways that you can get organic herbs out there. Like my wife and I shop at over here in the US we shop at Mountain Rose Herbs, which is one place you can get totally organic herbs. But if someone were to be looking for one of your top recommendations for a good progesterone increasing herb, what would you say would be one of the better that you've found?

The better herbs or the better places to get them from?

The better herbs or herbs. Or herbs, as you say, herbs.

Vitex or Chaste Trees, sometimes called, is probably the better one for improving the progesterone in the brain.

Okay, gotcha.

And isn't that something that guys would want to be careful with? Because couldn't Vitex or Chaste Tree actually lower testosterone or lower libido in men?

Yeah, that's true. But it can actually be an effective treatment for, say, teenage boys or young men with a lot of acne. So Chaste Tree can be effective for lowering that inflammation that testosterone is causing.

So basically they won't have zits, but they won't like girls anymore either.

You just gotta get in the right balance.

Okay, gotcha.

All right, so we've got low progesterone as one of the four common hormonal imbalances that you tend to see on what is the second.

The next one would be excess estrogen. So estrogen's a growth hormone, so when it's in excess it leads to inflammation, which can lead to like heavy periods, clotting, a lot of painful periods. Some of the, you know, can lead to things like endometriosis, fibroids, and especially if the estrogen is not getting detoxified correctly, it can be a cause of breast cancer.

Now, do you tend to see the excess estrogen in athletic females? It seems like a lot of times in a state of caloric cutting or deficits combined, especially with heavy training, a lot of times low progesterone and low estrogen seem to go hand in hand. Do you find that high estrogen is something that occurs in hard charging female, female athletes or exercisers? Do you find estrogen to be more of a problem in like women who don't exercise enough or who are fat? Or do you find higher estrogens to be an issue in men? Like what are the populations that you think tend to deal with this high estrogen issue or estrogen excess?

So estrogen excess? You're right. It's probably not as common in really tuned in high performing athletes. It can be though, due to genetic predisposition or they might have a lot of. They might be doing all the training and the exercise and have their diet down. But if they're in contact with a lot of environmental estrogens, that can lead to estrogen excess, Especially if they're having issues with liver detoxification. They might have genetical predisposition with the COMT enzyme or the MTHFR enzyme. So while it's common not to have estrogen excess for athletes, it definitely can happen.

So you don't have to be like the stereotypical, and I don't want to use this word to be offensive, but like the stereotypical fat woman to have like estrogen dominance or estrogen excess. You could, for example, be getting exposed to perfumes and fragrances at your gym or you could have. Which genetic defect did you say?

The mthfr.mthfr&comt.com t is an enzyme that metabolizes estrogen in the liver.

Are you saying COMT or pom Tea.

Com Tea.

Okay.

Catecholamine methyltransferase.

Okay, so how would a woman test. Let's say a woman has excess estrogen. How Would she know if it's because of the. Maybe like the fragrance or perfume that her co worker is wearing on a daily basis versus whether it's due to some kind of a liver that needs detoxing? Is that simply a test that you run or how do you differentiate?

Well, quizzing them about their lifestyle and what they're coming into contact with, how they're reheating their food and what containers they're drinking out of, what things they're putting, what creams they're putting on their body. You could do an organic acids test which measures, you can measure the environmental toxins in that and see and also measure the liver, how the liver's working to see if they're detoxifying those toxins or not. So sometimes people, they're not coming in, not getting a lot of toxins in the environment, but their liver's not detoxifying them or their liver's working fine. They're just overloading their body with all the xenoestrogens in the environment.

Now, what about men? Because, and I asked this question actually because I recently, I haven't even released the blog post about this yet, although it probably will be released by the time this interview with you comes out. I recently tested and I noticed that my estrogens have gone up a little bit. My estradiol has gone up a little bit since the last time that I tested. Now my testosterone has also gone up. And of course that means that potentially some of this extra testosterone that I'm making is getting converted into estrogens in men. What are some signs and symptoms of having excess estrogen and what do you do about it?

So excess estrogen in men, it's actually becoming more and more common. So the signs and symptoms would be possibly not losing weight as easily as they used to do, putting on a bit of breast tissue fatigue, muscle soreness. A lot of the same symptoms of low testosterone will come from the higher estrogen. So always finding out why they've got that high, high estrogen is the most important thing. Some men, they're supplementing with testosterone, which is an, once again, it's a band aid effect. So often I'll see men with testosterone supplementation, they'll end up converting a lot of that to estrogen. Yes, that can be from inflammation. So looking at their gut health, if you've got, there's an enzyme called beta glucuronidase which will convert the estrogen that your body's trying to detoxify into estro trial in the gut. So that can lead to high estrogen levels from just not detoxifying properly.

So elevated levels of this beta, how'd you pronounce it, the beta gluconiridase.

Yeah, glucuronidase.

Excess levels of that would cause potentially for estrogens getting metabolized in your liver to get converted into estradiol in men. And that's what would cause like a higher level of blood.

Yeah, yeah. So that's where the calcium glucarate supplement is quite good because that inhibits that enzyme from doing that and helps the estrogen detoxification through the gut.

Calcium D glucarase. That would be something that, for example, men with excess estrogen could look into as a way to keep that from occurring.

Yeah, men and women, actually, if you've got excess estrogen, it can work with women, especially if it's the gut function that's causing the problem. So looking at all the signs and symptoms of their digestion, what they're eating, how they're eliminating, what their poo's like, all those sort of things give you signs of what steps you need to do to reduce down the estrogen, whether you focus on the gut or focus on other things like detoxification.

Now, a lot of people at listen and use, for example, like glutathione, and I've talked to a lot of people who use N acetylcysteine as liver detoxification supplements, you know, in addition to eating like sulfurous vegetables like broccoli and cauliflower and garlic and onions and things of that nature. How do those type of strategies compare to something like calcium deglucarate? Are they acting via a similar mechanism or is calcium D glucarate different?

So herbs and nutrients like the N acetylcysteine glutathione, they work on phase one, phase two, liver detoxification. So once the estrogen is metabolized in the liver, it gets cleared out through the bowel. But if there's high levels of the beta glucuronidase in the bowel, that's going to lead to the conversion, that's going to lead to reabsorption of estrogen from the gut back into your system rather than getting eliminated. So it's a step down in the process.

Okay, so theoretically you could have like a 1, 2 combo of using glutathione and calcium D glucarate.

That's right. You always want to get the liver working well. And detoxifying.

For pill phobic people are there Are there dietary sources of calcium D glucarate, Kind of like whey protein is one good way to get glutathione.

Yeah, not really. Well, not that I know of. I always just use the supplement because it's really effective. Yeah. So that's, that's why, you see, I'm not too sure if there's another way of getting it into your supplement.

Gotcha.

Well, I'm, I'm certainly by the way, for people listening in, I'm taking notes as we go and you can find them all over@BenGreenfieldFitness.com Saliva just in case you have too many things from MTHFR to calcium D glucarate rolling around in your head right now. Don't worry, I'm taking notes. Interesting. Okay, so you like that for estrogen excess in men. One other question before we move on to the third hormone imbalance you wanted to talk about. When men or women have estrogen excess, can that affect mood? Like, you know, I've always wondered if, you know, I don't really experience this, but I'm wondering if my estradiol, for example, were to continue to go up, would I get moody, would I get teary, would I turn into my grandma? You know, like what, what happens when you get too much estrogen from a mood standpoint?

Yeah. So that can affect the excess estrogen will affect the conversion. It's an inhibitor of progesterone getting converted to allopregnanolone in the brain. So allopregnanolone is the final precursor to produce gaba. So GABA is like your calming neurotransmitter. So if that step's getting blocked, that can lead to less pain tolerance and more mood anxiety. So that's how estrogen would affect mood basically in the brain.

Gotcha. So you could, for example, if you had excess estrogen, it could lead to something like anxiety, lack of sleep, things along those lines. Like you wouldn't necessarily just have to get more teary eyed while watching a chick flick.

That's it. Yeah. So it could be the excess estrogen or the low progesterone. They both have that same symptom of mood and emotional or anger as well. So GABA is another solution, always getting down to the cause of working out why that's happening. So that comes down to stress cortisol levels. But in a short term solution would be to supplement with GABA for the, to help get things in balance. That's why you get the rest of the body back in order.

Right. GABA as an inhibitory neurotransmitter to help with anxiety. Yeah, I'm personally, I gotta tell you, a huge passion of things like passion flower extract or even valerian root as alternatives to just getting like straight up gaba. I've had a lot of people feel like both of those herbs help them to be very, very relaxed. Like especially like liquid passion flower or liquid valerian root have messed around with either of those. Much as an alternative to something like gamma aminobutyric acid as a supplement.

Yeah, passion flower and valerian are excellent. I also use Zisyphus, the Chinese herbs, Zisyphus and magnolia as well as even L Theanine as a precursor to GABA as well. So a lot of the Chinese herbs are great for the premenstruals.

The Thorne FX multivitamin that I recommend has an AM and a pm. They're actually rebranding now. They're going to be called the Exos multivitamin now. But they have magnolia and philodendron in their PM formula to help as an anti angiolytic for sleep. So those two components are definitely included in that one. Interesting. Okay, so let's jump into the third hormone imbalance in addition to low progesterone and excess estrogen. What's the third one?

Well, the third one would be low estrogen, which often affects women later in life. But especially for athletic women, that can lead to over training. Once again, high stress can lead to low estrogen and low progesterone. Once again, that can lead to a lot of mood problems. More the heat and hot flushes, dryness. Yeah, that's with athletes that would be a big problem.

So in terms of low estrogen, is that something that typically goes hand in hand with low progesterone or could you have normal progesterone levels and then have low estrogen levels in athletes?

It probably comes hand in hand with low progesterone because it would be due to that stress.

Now in men, wouldn't low estrogen be a good thing?

Low estrogen is the natural state in men. Men do need estrogen, but you. But the lower is generally the better. So I haven't seen or haven't noticed people with men with low estrogen symptoms. That's more of an excess.

Okay, gotcha.

So in women with low estrogen, what do they do? Just start to sniff more more paraben filled perfume and use nasty shampoos and conditioners to get their estrogen back up or eat a bunch of soy or what exactly do you do there?

Yeah, well, soy can be an option, especially if it's. I wouldn't recommend going and guzzling liters of soy milk. But having some of the natural fermented soy products can actually help with low estrogen symptoms.

What would be an example of a natural fermented soy product?

Things like tempeh, miso, some of those fermented. Even some of the fermented soybean Japanese dishes.

Okay, gotcha.

Once again, so if a woman were to do. And is this a salivary test, Low progesterone.

The low estrogen would come up in the.

Low estrogen rather.

Yeah, that would come up in the saliva test.

Okay, gotcha. So a woman would get a saliva test if she finds out she has low estrogens, then in addition to. Well, of course. And this is kind of the elephant in the room, right? Like overtraining and extreme caloric deficits and fasting too much and being fat phobic. I think most of our listeners probably know by this time that all of those things could cause you to have low estrogen, low progesterone, low hormones in general. But if folks were kind of getting those pieces into place, one of the things that can help is to actually start to increase the amount of fermented soy products that you're consuming. Huh?

Yeah, that would be a. Once again, that's addressing the symptoms. The first thing I would look at is what's the cause? I look at. The other thing in the test I'd look at is dhea. So DHEA is the final precursor for your body to make estrogen. So looking at the stress, whatever it's coming from, whether it's inflammation from injury or from the possibly an inflammatory diet. But looking at why that DHEA is low, so you support the nervous system, again with things like magnesium, once again, Magnolia withania. Also looking at blood sugar support and possibly even thyroid function would come into this too. So low thyroid function could be a contributing factor.

So with the dhea, I have actually, you know, because I work with Wellness FX and one of the performance panels that Wellness FX runs, and a lot of times for me on Thursdays, I do a lot of consults with folks who've had their Wellness FX blood work done here in the US I'll a lot of times see athletes who have decent levels of testosterone, for example, but who have low dhea. Is that something that you run into much like people who have adequate levels of, say, estrogen or progesterone or testosterone, but who have low dhea? And if that is something that you see what you tend to do about it.

So the low dhea, you can still have normal estrogen and low dhea, but often, especially later in life, that becomes more of a problem. That's when you might get more hot flushes. It becomes more of a problem with menopausal women, the low dhea. So to support dhea, we can't supplement with DHEA in Australia? Well, I can't.

Well, over here in the US it's banned if you're going to compete in anything sanctioned by USADA or the wada. So yes, similar situation over here in the US as far as just like buying DHEA from Walgreens or whatever. So what do you do?

So get to the cause of why it's happening. Addressing the stress, whether it's from the overtraining or blood sugar. Support inflammation. I might look at herbs like turmeric, rosemary and also the nervous system support. Again, phosphatidylserine is one of my favorites. In withania.

That last one you're saying withania. Maybe it's just the way that you're pronouncing it with your strange down under accent. But how do you spell this? Withania.

That's W I, T H A N I, A.

Okay.

You guys call it ashwagandha. I forgot about that.

Oh, ashwagandha. Okay. Yeah, I'm very familiar with ashwagandha.

Gotcha.

So you're a fan of things like turmeric, curcumin, ashwagandha, like natural anti inflammatory and natural. What we call over here. Who knows what the heck you call them in Australia. Adaptogenic herbs to assist with adrenal function. All of those things as legal and safe ways to increase dhea.

That's it. Yeah. It can take time to. You can be quick to sort of adjust the levels of progesterone and estrogen, but DHEA can take time to improve. That can. And you might be looking at like a 6 to 12 month sort of plan to get everything back in the ideal range.

Okay, gotcha.

So you're basically recommending, kind of. It sounds like. And this is something I recommend to a lot of the athletes that I work with to just like use adaptogens or use something like curcumin on a daily basis as almost like a preventive. As a preventive tonic.

Yeah, that's a great idea. And also magnesium would be another one I'd keep in there as a standard thing for people training hard.

Curcumin, magnesium, adaptogenic herbs. Yeah, all of those are things that I've found a lot of success with in hard charging athletes and in myself. So, you know, I personally use turmeric on almost every salad and dish that I use. I use a ton of turmeric and black pepper and sea salt. I smear transdermal like topical magnesium on my limbs after a tough workout. And then I'll typically do some type of adaptogen, whether it's cordyceps or ashwagandha or rhodiola. Or I have this stuff I use called Tian qi, which is like 40 different adaptogenic herbs. And I'll typically throw something like that in almost every day. And to people who are listening in, who are thinking that this sounds like, like, you know, we talk about the calcium deglucarate and progesterone drops and adaptogenic herbs and all this jazz, people who think that this might seem like a lot. I'm not sure what you tell folks, Michael, and I'd love to hear it. But you know, when you're training for an ironman, for example, a lot of times you need unnatural means to achieve an unnatural end if you want to maintain hormone balance. And then we also live in an environment that's incredibly toxic and polluted and we're surrounded by EMF and stress and heavy traffic and all these things that make life kind of a scenario where we almost need better living through science if we want to operate at full capacity.

Yeah, especially if you're training for an ironman. And unless you're a professional athlete, you're also probably looking after a family, working so you don't get as much time to rest and sleep. So you've got to do, you've got to do everything you can to keep your body functioning well. So often I'll see the people after they've been doing all the training and they've ended up with hormonal dysfunction or adrenal dysfunction. And so you're better off preventing than waiting for the problems to start.

Yeah, yeah. Interesting. Okay, so we've got low progesterone, high estrogen, low estrogen. And what is the fourth?

The fourth one is high testosterone, which is not such a big problem for men. But testosterone, women need it. But high testosterone can lead to all sorts of problems like amenorrhea or irregular periods, insulin resistance, weight gain, hair growth, acne, all those type of excess androgens symptoms.

Interesting. So you tend to see high testosterone as being an issue in women, huh?

Yeah, often women, especially if they're doing a lot of weight training, they might have natural Levels of high testosterone, and it may not be causing problems, but testosterone it will lead to. High testosterone in women, will lead to high levels of prostaglandins in the blood, which will then lead to insulin resistance. And it becomes like a vicious circle. Insulin resistance will drive the body to make more androgens. So that's where not every woman, but probably 80% of women with the PCOS type of picture, polycystic ovarian syndrome, will struggle with weight. Wow. You can be doing all the training but still struggle to lose those last three, four, five kilos.

Now, a lot of times what you'll hear people say, I hear this cement mixer analogy quite a bit, and that is that a woman would never bulk up or get huge muscles because women naturally just don't have enough cement mixer, AKA testosterone, on board to make that amount of cement. Unless they're using some type of performance enhancing drug or using like androgel or something like that, which when I was a bodybuilder, I used to to see a lot of women backstage using that type of thing. But in the average woman who's exercising, what you're saying is she could have high testosterone without necessarily using some type of performance enhancing drug. How would a woman get high testosterone? The same way they would get high estrogens.

Yeah, they have enough regulation of the androgen synthesizing enzymes. But women with high testosterone, it's not going to be like men. They're not going to get big and bulky and muscly. It's going to lead to insulin resistance. So you're actually going to get excess body fat.

Interesting. So what do you do about high testosterone?

Well, there's two things you can do. The first thing is address the insulin resistance. So for someone like that, more of a ketogenic diet could be really beneficial, especially in the short term, to get things back into a balance. So high fat, low carbohydrate diet. The other thing is herbs like peony and licorice. That's a classic Chinese combination for inhibiting that enzyme that leads to the increase in the androgens and another nutrient that I use.

What'd you call it again?

Peony.

How do you spell that?

P, A, E, O, N, Y. Could be my accent as well.

Okay, peony, got it.

Okay, cool.

I'm just taking lots of notes for folks over here. Okay, so peony is one thing for high testosterone. And what else were you saying?

Licorice. So that combination together works really well.

Okay, so it's peony, licorice and what inositol inositol. Got it, yeah.

So that can help prevent the conversion of the androgens to testosterone, which then leads to the high, you know, tumor necrosis factor, interleukin 6. Those inflammatory prostaglandins then lead to the insulin resistance. So just becomes that vicious circle. And that can be, you know, you often, you don't know you have pcos often to the teenage years, it's often undiagnosed and many women have it without even realizing until they try and start making a family or something like that. Especially athletes, they might just be getting irregular periods, but they might just put that down to over training.

Okay, gotcha.

So when you're testing each of these different functions, is there a name for the type of test that you do or are these just one off salivary measurements that you order a la carte when you're working with a client?

Generally, depending on what we're trying to look for, but generally I'll get a test between day 19 and 21 and just do a saliva hormone analysis. If someone's having a lot of menstrual cycle problems or infertility problems, I might run a whole month long panel, but that starts getting a little bit more expensive. But sometimes that's the best way to track the cycle every three days and see exactly what's happening with the hormones.

Now what about urinary testing? That's not something that's come up much, but I certainly do know some docs who will do like a 24 hour urine sex steroid test as an alternative to salivary hormone testing. What's your opinion on the efficacy of urinary testing versus the salivary index that you're talking about?

Well, I've never used urinary testing, but it can be valuable and it shows you how much of the hormone is getting secreted over a 24 hour period. But yeah, it's not something I'm really familiar with using, but it's not a total of a waste of a test because it sort of gives you an idea of what your body's doing in that day. Whereas blood testing and saliva testing is like a snapshot of what's happening at that moment.

Gotcha.

So the name of the actual test that you run is just, is this asi, this adrenal stress index?

Yeah, the adrenal stress index checks the cortisol four different times of the day and dhea. And then the extra one would be the sex hormone test, which does the estrogen progesterone. It does the three different Types of estrogen as well estradiol, estrotriol and estrone plus testosterone.

And you're simply dripping saliva into a tube. Do you have to do special things beforehand like do you refrain from eating certain foods or do you refrain from drinking water or caffeine or anything like that?

Yeah, especially doing the adrenal test. You want to have a caffeine free day. You want to do it before you eat breakfast, before you eat lunch, in the afternoon and evening. So you want to do it after you haven't been eating. Sometimes people struggle. They can't believe going a day without caffeine is possible. But they're often the people that really need the adrenal test if they can't get through a day without caffeine.

I've actually been going without caffeine for the past week because we ran out of coffee. And generally like, that's my sign, we run out of coffee. I'll switch to decaf or to tea for anywhere from a week to about a week and a half or ten days or so. And that's kind of like the way I tricked myself into cleaning out my system and staying sensitive to coffee so it can be done. I find that a big part of it is just the taste of coffee as much as the chemical effect. So what about that? What about drinking decaf coffee on a day that you do a salivary hormone panel?

Well, decaf is still going to contain some caffeine. I generally recommend trying to go no caffeine at all if it's the deal breaker. If it's the deal breaker between someone doing the test or not, I might get them to do their morning sample and then have their decaf coffee and the amount that's going to be out of their system by, say, the lunchtime sample.

Gotcha, gotcha.

Sounds like. Sounds like caffeine and coffee addiction is just as much of a problem down under as is here in North America. So, wow, this is a lot of really cool stuff. I've been jotting notes furiously and again, if people want to check out the notes, I've got them over@BenGreenfieldFitness.com Saliva Michael, like I mentioned in the introduction, one of the reasons that I looked you up in the first place was I've been looking for someone who I can refer my Australian listeners to as a practitioner who they can work with. They're in Oz. So can you tell me a little bit about your practice there for our Australian listeners or for people who are interested in working with you?

Yeah. I live in Queensland, which is in a little place called the town of 1770, which is in the middle of nowhere. So I do practice in clinic one day a week, but the rest of the time I practice with anyone throughout Australia via Skype or the phone. So it doesn't matter where anyone is in Australia. I can get test kits sent to them directly. And if it's saliva tests, they can do it at home. If it's blood tests for things like thyroid hormones, they can do them at their local pathology. All the results get sent back to me and then we just do a consult over the phone or over Skype.

Okay, gotcha.

And I know that you had graciously offered for any of the listeners who hear this podcast, if you mentioned that you heard about Michael on this show, you're giving some kind of a discount.

Yeah. If you just say that Ben sent you, send me an email to michaellanetnatropath.com say Ben sent you, and I'll give you $50 off the consultation. My Dogs Are Green consultation for adrenals and estrogen. So that test does the estrogen, adrenals and a one hour consultation to go through the results and work out a treatment plan.

Okay, gotcha.

Cool. Well, I'll put a link to Michael's website there so that if you are in Australia or you happen to be swinging through Queensland, you can meet with him and get your own saliva test done and walk around with a tube that you can drip saliva into. I know, and I'll give folks a clue. I've done this test before and I found that the clue to getting saliva to come out of your mouth in adequate amounts for this test was to sniff peanut butter. That worked for me. So there you go. By the way, down in Australia, what's the stuff that you smear on bread there? It's. I'm blanking on the name of it now. It's like a super salty.

Yeah, Vegemite.

Yeah, that's right. Just sniff a can or a tube of Vegemite.

Yeah, it's not to my liking, but.

All right, well, cool.

Well, again, all the resources for this show are at BenGreenfieldFitness.com Saliva and Michael, thanks for coming on and sharing this stuff with us. Really fascinating stuff about the four different hormone imbalances and what we can do about.

No worries, Ben. Thanks for having me.

All right, folks. Well, this is Ben Greenfield and Dr. Michael Smith signing out from BenGreenfieldFitness.com have a healthy week.

Visit BenGreenfieldFitness.com for even more cutting edge fitness, nutrition and performance advice.

Sam.