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Kris: So hi everybody, it's Kris from KrisCarr.com and I have a very special guest today - my
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new friend, Dr Sara Gottfried. Welcome, Sara! Sara: Hey Kris! Hi everybody!
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Kris: It is so great to have you here. And I'm such a big fan of yours. I have to say
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that your book, The Hormone Cure, has become ... there it is! Your book! And there's a
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paperback now - I still have the hardcover. It has become one of my new recommendations
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and bibles and I have brought it into my Functional Medicine practitioners. And I will say that
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I busted one of my own myths, thanks to you. I thought that I was high in cortisol but
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it turns out I'm low in cortisol. So thank you for that, Dr Sara!
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Sara: You know, I'm always happy to be of service. So thank you for that, Kris. I'm
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a huge fan, let me just get that out of the way. I've been a huge fan for years.
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Kris: Mwah, mwah! So for you guys out there who might not know about Dr Sara, I think
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that's probably hard at this point because you're such a superstar, but sometimes I'm
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certainly last to the party. Let me just tell y'all a little bit about her before we dive
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into this interview. She is a Harvard-educated physician, a board-certified gynaecologist,
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a speaker, a yoga teacher ... isn't that nice when it all comes together? I say those really
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big educational words and then I say she's a yoga teacher! What? She's a mom of two daughters
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and the author of this unbelievable book, The Hormone Cure, as I said. So, Sara, I want
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to talk about something that I know is going on for a lot of women in my life right now.
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That is an increased amount of stress. Sara: Mmm.
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Kris: I know you are just the master at solving these problems for folks. So tell me what
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you mean by 'runaway stress' and what happens to our bodies when we have runaway stress.
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Sara: This is such a great question. I think that most of us don't realize that we have
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runaway stress. You know, there's sort of tricky ways that it shows up. One way is that
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you just feel ungrounded, or you feel anxious, or depressed - 50% of people who have depression
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actually have high cortisol. It's a suicide marker.
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Kris: Wow. Sara: Cortisol is the main stress hormone
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and the problem with runaway stress is that it changes the entire hormonal makeup of your
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body. So this is really important. It can age you prematurely ... why don't we get the vain
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things out of the way first, Kris, does that sound good?
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Kris: That sounds awesome! Sara: And then we can talk about the inner
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ecosystem. So, you know, on the surface I really think that your skin is a mirror of
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your life and if you have runaway stress, if you have bad stress and cortisol is either
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too high or too low or, you know, maybe both within the same day, it causes you to wrinkle
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prematurely, it shrinks - on the inside - it shrinks your telemeters, those are the cute
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little caps on your chromosomes that are a marker of your biological, as opposed to your
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chronological, age. And it robs you of the mood and metabolism that you most deserve.
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So, if you don't want to be fat and cranky, you've got to make sure that you don't have
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runaway stress! Kris: [Laughs] I like that. Nobody wants to
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be fat and cranky. But, you know, we just don't, but I think that it's great in theory
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but how do we in our daily lives really practise that? Because, when we get that email, when
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we feel up against the ropes with a deadline, or when something's going on with our kids,
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you know, from your perspective, how do we walk out of that stress cyclone?
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Sara: Yeah, the stress cyclone! You know, the key thing with the cyclone ... actually I
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don't know cyclones very well but I know hurricanes!
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Kris: Hurricanes, OK! Sara: The stress hurricane, you want to find
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the eye. Like, we all have the stress hurricane happening all the time and it's not the amount
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of stress that you have, it's actually your reaction to it. It's your perception of the
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stress, especially if you think it's harmful for you. So I think the key part, when you're
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up against the wall and you have stress coming from multiple different places, is to really
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understand your response to it. And there's a lot of ways to do that but I think it really
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starts with measuring - and you can measure it with questionnaires, you can look at symptoms,
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blood tests, you can measure those cute little telemeters, it's not expensive to do that.
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So there's lots of different ways to measure it, but I think that's where it first starts.
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And, once you have that measurement, and you have the awareness, then you can step into
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the grace of developing your solutions - the solutions that are really tailor-made for
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you, because not everybody ... Kris, sometimes I have folks come to me in my practise and
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they'll say "Dr Sara, I know you're a yoga teacher and I just want to tell you right
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now I'm not going to yoga." Kris: [Laughs]
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Sara: "So can we talk about something else? Because that's not going to work for me and
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I'm not going to sit on a cushion and meditate either." So we've got to come up with the
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solutions that really work for folks. Kris: Yeah, I love that. And I think that,
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once we find those solutions, we actually have to practise them, because sometimes it's
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very easy to stay stuck in our habits - including the habits that support stress - when we know
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right around the corner there's something better waiting for us. I know, for me, dancing,
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hiking in the woods, really unstructured time and really awesome, fun movies are my go-to
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stress reducers. And, if I'm choosing not to do them, or I'm saying that I'm not making
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time to do those, then I'm actually choosing more stress in my life than more joy. And
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it's taken me a long time to actually own up to that!
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Sara: Yeah, that's such a good point and I think, once you have your a la carte menu - I like
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your menu, you've got the dancing, the hiking ... what was the third thing?
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Kris: I love movies and I love unstructured time.
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Sara: Yeah! Kris: Yeah.
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Sara: Unstructured time and movies! So, you know, all of those, I think, suspend time
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Kris: Mmm. Sara: And I think, for all of us, we need to get out of that hamster wheel of time. You know,
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running from one task to the next and the To Do list that is at the front of our consciousness
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instead of the mission that we want to rock while we're here. When you are able to hit
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the pause button it really makes such a difference in your physiology. And it's ... you know,
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I want to make sure that people understand that ... I'm not saying what I was told when
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I was in my mid-30s, when I was crazy stresspants and I went to my doctor and I was, like, "Waaaaah!
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I'm a working mother and I can't do this and I'm fat and I'm cranky and irritable and I
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don't want to have sex with my husband." And my doctor was like, "OK, you need to reduce
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stress." Kris: Right.
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Sara: That's not my message at all. My message is let's hike with it a bit differently, let's
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dance with it differently, let's take it out for a walk in nature. Because stress hates
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going for a walk in nature. That just doesn't work at all. So we've gotta find these ways
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to have a different relationship with stress. Kris: I love that you say that because none of us ...
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I mean, very few of us live in the luxurious life where we can protect ourselves 100% and
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live in a bubble from stress. I think it's very easy to kind of paint this either/or
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reality and then the vast majority of folks out there, especially the vast majority are
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women, feel like their problem isn't really being solved and they're still left scratching
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their head. So, for you personally, how do you, as you say, dance with stress, meet stress
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half-way? Sara: Yeah, oh this is such a good one. I'm
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a yoga teacher so, you know, I had to become a yoga teacher because Iwas so stress-crazed
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in my 30s. So I like to disrupt it with yoga. And sometimes it's as simple as sacral release.
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You know, like one yoga pose that I'll do in the morning and the days where I could
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go to those lovely 90-minute classes, like those days are pretty much over! So I don't do that anymore.
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I also use my iPhone, I'll be at the grocery store and I'll pop on Inner Balance by Heart Math and
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I'll do some coherance training, where you take the sympathetic nervous system, that half
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of your nervous system that's in charge of fight or flight, and I'll get it into sync
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with my parasympathetic nervous system, that half of your nervous system that does rest
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and digest. When you connect the two ... ah, it's like biological yumminess. It's so good
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for you. Orgasm does it too! So those are, you know, some of the things that work really
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well for me. Kris: Let's go to my favorite subject: the
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link between cortisol and all the bad crap that could go on in your life!
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Sara: [Laughs] Oh yes! Well, this list is long. I'll give you a few headlines and you
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can tell me where you want to dive deeper. Kris: You got it.
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Sara: I mentioned, you know, that, when cortisol's like a runaway train, you can get fat and
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cranky. So why don't we start first with fat? Kris: [Laughs]
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Sara: So, when you're stressed out, and I get ... I used to get stressed out over the
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most minor things. But, what I found when I was in that place of being thin-skinned
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and highly sensitive, was that I would get fat so easily. I would go into survival mode
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and, when you're in survival mode and cortisol is either really high or you're at more the
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burnout phase, where it's low, then what happens is you're storing fat. So your body is kind
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of like, if you imagine an Irish potato farmer who has a famine upon them, they don't know
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where their next meal is going to come from. So you store fat like crazy and especially
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where you can pick it up fast - which is right here at your belly. And that's not such a good thing. It's fat that is not just at
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your waistline, it's also around your liver and in your liver. It's around your organs
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and it's a special kind of bad fat that is metabolically active and working against you.
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Kris: Right. Sara: Including shrinking the telemeters.
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Kris: That's not good. Sara: None of us want to be fat. We want to
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be lean. In fact, we know that longevity, Imentioned that telemeters can track your
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longevity, when it comes to longevity you want to be either maintaining your lean body
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mass or making it better as you get older. That happens to be one of my goals. I want
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to look totally hot when I'm in my late 90s! What do you think Kris?
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Kris: I think that's a good idea. I like that plan.
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Sara: Yeah, green juice, keep the cortisol in check.
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Kris: Exactly. Sara: Right? So, yeah, what else. #1 you're
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going to get fat. #2 it robs you of those happy brain chemicals. I was making the joke
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about dopamine, which is responsible for pleasure and satisfaction, and addict brains tend to
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be really focused on dopamine and I happen to be one of those addict brains. If something
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is worth doing it's worth overdoing! And also serotonin. So serotonin is ... I like to call
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it Dr Serotonin, that's what my assistant calls it.
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Kris: [Laughs] Sara: Serotonin's in charge of your mood and
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your sleep and your appetite and it's not like all these brain chemicals are created
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equal. Like serotonin is the gatekeeper. You really want to love up your serotonin, it's
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very important when you have runaway stress, when you have high cortisol or low cortisol,
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it effects the levels of these happy brain chemicals. So that affects your mood, anxiety,
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depression, ADD, memory issues, those are some of the things that happen. In fact, we
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know, for people who have high cortisol, it can shrink your hippocampus.
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Kris: Oh. Sara: I just wanted to say hippocampus for
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you, Kris. Kris: It's a sexy word, hippocampus! It's
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such a sexy word. It's really for after-hours but, since you went there, here we are!
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Sara: [Laughs] It's cocktail hour somewhere, I thought I could bring in hippocampus! So
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your hippocampus is in charge of your emotional regulation and memory consolidation and, if
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you are shrinking that puppy in your brain with high cortisol, you are going to walk
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into a room and just be like, why did I come in here again? I can't remember. And you're
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not going to be able to emotionally regulate. And, oh my gosh, aren't relationships the
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most important thing on the planet? Kris: Yeah.
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Sara: We need our hippocampus to have strong, supportive relationships. So those are a few
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of the things. I could go on and on about what happens with the ...
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Kris: Cortisol, yes. Sara: When cortisol goes bad.
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Kris: So let me ask you a question, because I bet a lot of people out there listening
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to this will probably wonder how do I know if mine is high or low or where I stand? What
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would you suggest? Sara: Well, I ... I want to give a range of
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options here, ranging from absolutely free to ...
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Kris: Very expensive! Sara: Very expensive! Some of the tests that you can
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do ... free would be that you do a symptom questionnaire. And I have a free one on my
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website. I'm happy to give the URL for that. You can also, if you get my book, on page
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24 through 31 you can take my questionnaire that I've been using in my practice for 20
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years to identify problems with high cortisol, low cortisol, and anything in between. So
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those are some of the suggestions in terms of measuring. You can also do a blood test.
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And I'm a big fan. I practise functional medicine, as you know Kris, and I like to do blood work
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first, because it's the universal language of mainstream medicine. Now, that's a separate
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conversation, how I want to completely change mainstream medicine and bring them our way!
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But I like to start with blood tests, because most mainstream doctors don't really buy the
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whole cortisol issue and adrenal disregulation, even though there's thousands and thousands
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of studies showing that there's a link to cancer and to diabetes and metabolic syndrome
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and all these other issues. Kris: Now what about saliva or urine or anything
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like that? Sara: Yeah, so I say by any means necessary.
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I like to start with the blood test, because I think it's a good screening test and it's
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got this universality with other doctors that I like and then, if you haven't detected a
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problem or if you want to go further, I'm a big fan of saliva testing. And the most
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common is to do what's called a four-point test. The fancy word is 'diurnal'.
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Kris: Yes, yes. Sara: Diurnal. And that's where you check, when you
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first get up in the morning, your saliva for cortisol, before lunch, before dinner, and
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before you go to bed. You know, what happens with cortisol is you want to be high in the
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morning, not too high, not too low, you want to be at a certain level and you have this
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lovely downhill ski-slope that you run over the course of the day. And, if you don't have
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that slope, if you're flat, for instance, which is one of the things we see in folks
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who suffer with cancer. If you don't have that slope, it can be worse than smoking for
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your health. Kris: Wow.
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Sara: So you really want to pay attention to this. Another thing you can do is you can
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measure cortisol in your hair. How about that? Kris: Hmm.
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Sara: It's a bit of an average, so it's harder to kind of see the slope.
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Kris: Yes. Sara: And then you can also measure it in
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your urine. Kris: The reason why I brought that up is
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because I think that the ... I was calling them quizzes but I think that the forms in
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your book that you can go through to really figure out what's going on with you as so,
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so useful. And I've been a [laughs] a patient in functional medicine for a long time. And
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sometimes I feel like I know as much as some of the doctors that I've worked with - just
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because, when you're up against the ropes, you tend to get very passionate and learn
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everything you want to know or need to know about your particular situation. It wasn't
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until I took one of your ... I filled out one of your questionnaires that I was like,
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wait a minute, this is all off, because my blood test - and I share this with everybody
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because I think it might be common and Sara will tell us in a moment - my blood test was
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fine. So then I did the four-point test and that's when I learned that my cortisol was
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way too low in the morning. And, just taking some licorice first thing in the morning,
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with a really large glass of water before I go on to my warm water with lemon, I could
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see such a difference in my overall day. And it was that simple.
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Sara: Yeah. Kris: And, until then, I had licorice but
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I was taking other things and I thought this probably isn't the most important thing on
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my list. Sara: [Laughs]
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Kris: And I just relegated it off to the side because sometimes I take a lot of different
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supplements. Well it turned out to be the difference between being exhausted throughout
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the day or being like a regular human. So that's why I brought up the saliva test. And
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my question is, with, for example with the blood test, is it common that sometimes it
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can come back and everything looks fine but it really isn't still?
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Sara: Absolutely. There's so much, there are so many nuggets in what you just described
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and I want to unravel a couple of them. I'm going to come back to thsi point about the
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blood test and how it's not the best screening test, especially if you really think that
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there's an issue. So I wanted to say first that I totally believe that you are your best
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doctor. Kris: Mmm.
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Sara: You know, especially when you've had a wakeup call, as you have had, Kris. I think
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it just allows you to step into that place of kind of divine investigation that is very
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hard to find in a clinician. And if you find it, oh my gosh, hang on to that person!
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Kris: Exactly! Sara: You want to create a partnership, I
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think that is so crucial. #2 I want to say that the blood test, you know, even though
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it's part of this universal language that mainstream medicine speaks, it's a snapshot
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of the 10 seconds that a needle is in your vein, right?