26. Dutch hormon testing (English)

Welcome to Biohacking Girls, the pod for those who want a real health boost. We keep you updated on the latest news in health research and test different diets, fitness trends and mental techniques. Yes, join us on an exciting journey where the goal is to learn how your body can be healed, how you can age in reverse, and how your intuition can be strengthened so that you dare to rely on your own health. This with hormones has been a big and complicated topic, and we have actually been a bit under this, right Talette? We have. Because when you go to the clinic, that's how it has been for me, then all my tests look very good every time, and then I get a little passive and unengaged. But I have to say that I am quite curious about stress hormones, and of course my own menstrual cycle. What about you? Totally agree. This is a big and exciting topic. We as female biohackers, we do not come without hacking hormones. No, we don't. Now we have finally taken this Dutch test, which we have heard so much about. All biohackers love it. It collects information about all hormones, our hormones through saliva and urine tests. You actually spend 24 hours taking a lot of tests and then you send them to the laboratory. It's quite extensive. There's a lot of saliva and a lot of urine and you just have to learn a whole lot about yourself. What triggers a lot is stress, and stress as a topic, and especially chronic stress. Where does this come from? Is it from our thoughts? Or is it something that is really inside of us? Or maybe something that is brought to us from the outside? Maybe a combination of all these things. But what we are concerned about is how it affects health. We might find out today. We will talk to a speaker for Nordic Laboratories and the Dutch test. He is the director of Nordic Laboratories. He is a clinical psychologist and a researcher in personal functional medicine. He works at the Karolinska Institute with research at IBS. He is a mentor for hundreds of people who have taken the Dutch test at Nordic Laboratories. We know so little about our hormones, but now we have finally gotten some answers from this Dutch test, and then it is possible to take some steps forward. Welcome to you, Graham Johnson. You are in Stockholm right now, aren't you? Yes, I am. And you work for the Nordic Laboratories and Nordic Group. Yeah, I do. I work for Nordic Clinic and Nordic Laboratories, which of course are two elements or parts of the Nordic group. That's wonderful. So we, Aletta and me, we have been doing this Dutch test. And just for our listeners to understand a little bit, we know that this is one of the biohackers' favorite tests. And would you just start by explaining what this test is showing us? Sure. So the Dutch test, as it's called, it's not a language test, it's an acronym. So it's basically, yeah, it's a dried urine test for total comprehensive hormones. So it basically... analyzes the different sex hormones so estrogen and progesterone for example and it also analyzes the different stress hormones so cortisol an indication of adrenaline And then it also looks at sleep as well. So it's a complete hormone overview with also the hormonal metabolites. So it's a very nice thorough review of what's going on in regards to hormonal balance in general, specifically to the sex and the stress hormones. Just a little question, because when you go and see the doctor, like here in Norway, we have our doctors and usually when we receive these hormone tests, they look so good. But when I looked at my Dutch test, it was, I mean, it was not comparable. Is that something you often see? I mean, it is something we can see. So Nordic Clinic is a combination of both medical and functional medicine practice. So we do have doctors that work in the standard system and those doctors, as well as other practitioners, use functional medicine testing alongside, if you like, the more standard hormone analysis. And I think really... Each test has a pro and con, if you like. So there are pros and cons with standard blood tests, and there are pros and cons even with the urine analysis test, in this case, the Dutch test. So we have to recognize where these tests are strong and where they're weak. and not necessarily totally rely on one test alone but usually utilizing a combination of tests to try and understand what's going on. But yes, we can see that because for example in the blood test there is a huge wide range that's included in that accepted reference range It might be that you fall within the normal parameters, but it's at the low end of normal and that might be too low for you in that case. So we're always trying to bring a more personalized element to the different analysis or analyses that we run. we've got to use your symptoms in accordance with the testing to really try and draw some kind of clinical conclusion like you are too low in this hormone or that hormone. So 24 hours, is that accurate enough? Well, it's, I mean... Of course it's only 24 hours and so any testing, I mean no test is perfect and with with hormonal testing. I mean, in this case, the Dutch test that you did, it was a 24-hour test. So it's much longer than going for a blood test where it's that, you know, your hormones in that specific moment in time. This is getting more data over a 24-hour period. But of course, you know, that's only a 24-hour period. And yeah, we can't, of course, gather data, like hormonal data, for months and weeks on end because it would just be too complicated to do the analysis. So this is a kind of happy medium between just running a spot blood check, whereas this is an actual 24-hour period to get a better indication of what's going on over the 24-hour cycle. Great. Great. Yeah. But we hear about hormonal problems all the time these days. Is it more today or is it just more testing? Do you have an opinion on that? Yeah. What a great question. I think it's, of course, it's very difficult to answer that question. really accurately because of course testing is developed all the time and we have new tests compared to what we did have even a few years ago. I mean the Dutch test itself has evolved over the years that that's been running so it's now a much bigger analysis than it was in its first launch and Of course, we've become much more aware with science and research over time what are hormonal symptoms and how can they be treated and how can they be tested. So it's, of course, it's very difficult to answer that. But I suspect that it's, of course, there maybe are also more hormonal issues and we're seeing that as well because of the kind of westernized lifestyle with high stress and higher levels of pollutants and toxins that are in the environment which are known to of course impact the hormones in different ways. So I think we do have more hormonal symptoms due to the environment but we also have more accurate and detailed testing which can also pick up these more subtle hormone imbalances. I was actually kind of pleased and happy when we looked at my results, when we saw the menstrual cycles, all the sex hormones looked really nice because I'm a grown-up woman. But do you think my lifestyle affects the tests or are these... I always try to find out if they're accurate. I still have my period and you know, it seems normal for me, but can I trust these tests? Yeah, I mean, of course you can trust the test. I mean, we wouldn't be recommending a test like this if we thought the test was not to be trusted. So, I mean, like I've already mentioned, I mean, no test is perfect. There's always pros and cons with each test. And, of course, we can see things change quite quickly, especially with female hormones and menopause, for example. Yes. In some women, that can – I mean, you could look – very strong at the moment in your, your sex hormones and be, be cycling, uh, having your menstrual cycles. And then suddenly, uh, menopause can come very quickly. Uh, So it's really what's difficult to say is, well, just because you had a very, if you like, normal premenopausal level of hormones right now, how long that is going to go on for. And yeah, we don't know. But of course, yeah, we saw on your test that your hormone levels were very strong. And if I hadn't have medicated have met you or could have seen your you know didn't see your your age on the test i would have assumed it was um uh yeah a much a much younger female just by looking at the sex hormone levels i i love this so so uh but also i did the test the blood test at my doctors and they looked probably the same because there was nothing to do but she also said you should test again in a few months because this can change very dramatically but But the other thing is like the stress hormones. I have more to work on there. And we have been rebuilding the house the last six months. Kids in my bed, like 10 workers in the house from seven in the morning to seven at night. So when I did this test, I was more stressed. But you mentioned something being a business owner and a mom that my... my stress hormones were kind of typical. Could you elaborate a little bit about that? I'm sure many other listeners here would feel the same. Yeah, absolutely. I mean, of course, at Nordic Clinic, we're heavily focused on and the environment. So we really like to, I mean, analyse that in each individual patient that comes to the clinic and see how much we can optimise that to improve results and improve symptoms. So, I mean, with... With you, we did see some interesting things. So we saw a low, what we call DHEA level. And DHEA is one of your main building block hormones. And it can be lowered where so we're measuring a version of that DHEA called DHEA sulfate and that can be low under higher inflammation states so when you have for example a lot of house renovation and your sleep is affected and of course you have family and work I mean one thing that can happen is under those type of circumstances your DHEA level can lower or your DHE sulfate and We want to then try and optimize things like your sleep and, of course, diet and exercise, stress management, all of those factors. But, I mean, the main things we saw in your test was that this DHEAS, as we call it, was low. And that can give you certain symptoms. And then also we saw that your total cortisol level, so cortisol is your main stress hormone level, that was low in the urine test. Now, that doesn't necessarily mean that you have some kind of disease process going on, but also we can see that low when there is either some kind of... thyroid dysfunction so hypo so hypothyroidism but um of course you don't have any signs of those symptoms um so then the other case is where things like if you've had a particularly stressful period in life whether that's due to work or let's say renovations and lack of sleep that we can see this this total amount of cortisol coming out in the urine reduced which we um which we link with the kind of period that you've been through and it seems like you know that that stressful period um somehow is affecting the um this metabolism of cortisol, this stress hormone through the liver and out into the urine. So you're getting a little bit of what we call functional hormone issue or dysfunction. So again, it's not that there's a medical issue, but it's more a functional problem. So things just aren't functioning as well as they could do. So stress, stress, stress. Everyone seems to have chronic stress these days. How can a Dutch test help us work with this? How do you interpret it? Yeah, so of course stress is, I mean, Certainly in the Western world, it's a big topic and it's a big issue and we can't avoid stress. So we're consistently trying to teach our patients how to become better at handling stress. I think that's where the Dutch test is particularly interesting because it gets some different measures on your stress hormone. It has your total stress hormone production and It then has what we call the bioactive level of your stress hormone. So the amount that is available to actually stimulate your cells. So if we can use an analogy here, we've got the amount of money you have in savings. So that's more like your total amount of money. And then we have the amount that's in your wallet, in cash that you can spend. So it measures these two different levels if you like, forms of stress hormone. And it also measures a metabolite of your adrenaline because adrenaline is hard to measure in blood because it has an extremely fast half-life. So even when the adrenal gland, which produces adrenaline, is pumping that into the blood, it's going to disappear very quickly. So we can measure a metabolite So a breakdown marker of adrenaline that we can find in the urine. So we can get an overview of different patterns of stress and we can see that different lifestyle factors and stress can affect people in different ways. So some have high adrenaline, some have, you know, they have They have low adrenaline because they're going more into a burnout type state, so to speak. And we can see similar with also the main stress hormone cortisol, where we can sometimes see high levels. We can sometimes see low levels. We can sometimes see high-level total production and low-level bioactive version. So it's like you've got a lot of savings in the bank, but no cash in the wallet to be able to spend. So it's a little bit... hard to explain over audio, but basically we see different presentations in the stress hormones that can make people feel different types of symptoms and that's where the Dutch test is a cool test because we can measure that, we can then implement changes whether that's medical or nutritional, lifestyle or supplements, supplemental, to try and change that scenario. And then we can track the progress so we can see, oh yes, the strategies we've recommended to you and you're implementing, they're working. so it's very empowering for people or patients to have or to use this test because you can actually see well the strategies that I'm doing it's helping so that's a good thing right and Yeah, it's a great thing for biohackers because we love to measure. So what would be like a typical advice you would give to somebody with elevated stress hormones? And how would you suggest coming back doing a retest or what would be the procedure for our listeners if they want to try the Dutch test? I mean, if they have elevated stress hormones, then a lot of it does come down to basics. So we want to make sure that you're getting good sleep, so you have good rest. We want to make sure there's breaks in the day. We want to make sure there's not excessive time sitting, you know, in a sedentary lifestyle, sleeping. we we may refer for psychological support different kinds of therapies depending on what we feel that patient will respond to um we we certainly you know use a lot of uh or recommend some different meditation techniques depending on what the patient is open to to try um so So we see things like meditation, which, you know, again, it's, it's free. Um, and again, you know, five minutes a day can make a huge difference. And if you'd have asked me eight years ago or so, I'd have, you know, 10 years ago, I'd have said meditations fluffy and, you know, there's no, you know, don't do that. It's just, there's no science behind it. But I mean, We've seen that change dramatically. And of course, these techniques that have been used for a long, long time in the more eastern part of the world, I mean, we see they have a huge effect on psychology and the resilience to stress. So we do a lot of basic things and common sense implementation like that with patients. There are some more complex patterns or there may be like hidden infections or other imbalances that may be contributing to high stress hormones. But fundamentally, we work quite a lot on lifestyle. And then we might use different kinds of supplements, whether it's things like phosphatidylserine or adaptogens, etc. to help lower or try and at least move the stress hormones in the right direction. And then of course we're tracking that progress to see, well, the intervention that we've recommended, is it actually working? So, yeah, I mean, they're the most common things. What would be a typical recommendation for using adaptogens? Like which one and how much per day and for how long, for example? I mean, it's a great, it's a really great question. And there are thoughts that maybe different adaptogens might be helpful under different circumstances, but there's no agreed, like... what's the word that I'm looking for or words that there's no like, yeah, set level of agreement or no agreement in the field that this amount needs to be used for this many days. And, you know, we see sometimes that maybe ashwagandha is very helpful for one person, but not from another. And some people respond really well to things like rhodiola and And then we use other things like L-theanine, maybe at night, or phosphatidylserine. So again, there's not a general consensus that, okay, this is the amount that should be used. we've also seen some patients don't react well to adaptogens it makes them feel more speeded or affects their sleep so it actually has the opposite effects and i think this is the the beauty in whether we're talking biohacking or you know functional medicine that there is an individualized response from patients and we're we're you know we don't have a a perfect algorithm to say this person should use this adaptogen. We have to fundamentally improve the lifestyle and the environment because that's what drives most of chronic disease in our opinion. And I think the data pretty much supports that. And then we use these supplements, again, where we feel they may be needed and supportive in cases. But again, you can't, if you're stressed, I mean, maybe a supplement may help to move you a little bit in the right direction. But fundamentally, we see that you can't out-supplement anything. you know, a very dysfunctional lifestyle and of highly high stress that goes on for years and years. Um, and, So I think that's where we're always the key message from our clinic perspective is that you, you know, those things may do a little bit of support and help you through tough times. But, you know, it's ultimately, it's nothing compared to getting good sleep or using exercise, breaks in the day, you know, things like that on the lifestyle side, which are far more important. Yeah. About sleep. We as biohackers, we're always eager to improve our sleep. We use the Oura Ring to track and we can also see how the stress is really important to work on with sleep. But how can the data from the Dutch test help us to work on better sleep quality? Well, it's looking at... the cortisol rhythm. So it's measuring something called the cortisol awakening response. And that's a key reaction. So when you open your eyes in the morning for the first time or you wake up, it takes around 30 minutes, but then you should have your highest cortisol level for the day. And that's really important for the circadian rhythm. And circadian rhythm, I mean, is hugely important for all aspects of health. So on On one level, in order to have good melatonin production at night, I mean, we need a solid cortisol awakening response in the morning because, again, this is signaling. This is to the different tissues of the body. Now we're at the start of the day. Now it's time to really get going, activate the sympathetic nervous system, cortisol pathway, and, yeah, get ready to hunt and gather, so to speak. So that's one way. Of course, then just total stress hormone production over the day because we know that will affect sleep and we can measure the stress hormone level at night. So we can then see, okay, is this person producing way more stress hormones than they should in the mid part of the day, early part of the day or at night time? So then we can implement different strategies during the right part of the day. So, of course, if there's high stress hormones at night, we need to look at, well, why is that? What's causing that? And then we can put in some strategies to help lower that. So it might be that we use more implementation during the evening than during the morning in that. in that case. So we're always asking the background questions, you know, why, why is that going on? What can we do to solve that? And then use temporary measures, whether that's like supplementation or sometimes medical intervention, we may be prescribing melatonin at night, for example. improve quality of sleep in the short term that buys us time to look on to improve the lifestyle dysfunction and things that are probably driving those issues. I can actually read on my aura ring and the weapon if I I have to work at night and I bring my laptop to bed or if I'm on the phone and go to sleep. I mean, it's horrible to read the numbers on the HRV. Yeah, it's terrible. Yeah. And that will affect probably the cortisol awakening hormone too. Well, we, I mean, yeah, we've been using a lot of different drugs. wearable tech, you know, Oura Ring, Wootbands, Fitbits. I mean, also I've been using an Oura Ring for years now and a lot of our patients will use them as well. So we've been tracking a lot of data like that, but in combination with lots of medical data from, you know, standard blood tests and other data from the functional tests, I mean, I think we see lots of different areas that potentially interact, of course, with sleep from anything like working too late to drinking alcohol. I mean, blue light exposure, just anticipatory stress of the next day. So we know that if you have a very stressful day coming up tomorrow that your quality of sleep will likely be not as good. I mean, we all know if you've got to catch a flight the next morning, you're probably going to wake up a couple of times in that night worried that you've missed your flight. So that's like an anticipatory response So, of course, a lot of it can be driven psychologically. Also, you know, a lot of it is driven just by our daily routines and habits. And, yeah, we're not designed to be activating our brain or activating ourselves physically too much once we get into that kind of later stage in the evening so we need to I mean that's where the aura ring is quite cool because it also sends us reminders like you should be winding down now of course and it will not lie it would not lie for us but we wonder also about the infections and inflammation what what hormones are connected to inflammation in the body when you read well there's an inflammation going on I mean, of course, cortisol is fundamentally it's an anti-inflammatory hormone. So corticosteroids are used for inflammation or autoimmunity. So, of course, there's ideas that if you have a poor cortisol awakening response, we believe that is also connected to worsening outcomes with autoimmunity for example. So I mean that's the main one that we're measuring on the Dutch test but also things like if there's oestrogen imbalances that it also thought can contribute in different ways to inflammation Like if very earlier on in life, if women are becoming very low in estrogen, for example, that can accelerate heart disease. So we know that estrogen can be protective against heart disease, for example. But of course, there's also where if there's high states of estrogen or imbalanced hormones, that that might also contribute to inflammation and And there's links with, of course, cancer and things like oestrogen imbalances. So it's balance. We need the right balance. And this is where the Dutch test is helpful because it measures way more hormones than just having the standard blood markers. We may run a standard blood marker test as well as doing a Dutch test. But the standard blood marker test is a bit more crude. It's just very new at that given point in time, whereas, of course, the Dutch, we get a 24-hour monitoring. We also get many, many more markers with how are you detoxifying your estrogen levels, for example, because if that detoxification of estrogen or biotransformation is not – putting the estrogen down the more favorable pathway, then it can also, or it's also linked with things like certain types of estrogen-dominant cancer. So we do things like look at genetic risk for estrogen-dominant cancers in females, and then we also might use the Dutch test to actively see how that is playing out Okay, but not everyone has the means to take the DIRTCH test. What is your best hacks or tips to improve hormonal health without testing? Yeah, of course. I mean, my best, I think the best hacks are ultimately... the most common sense factors. You want to have good routines, good sleep, good feeding and fasting patterns. So not eating all day, using things like time-restricted feeding. You want to be as fit as you can be. You don't want to have a sedentary lifestyle. You want to make sure you're managing your stress. So I would say they are by far, I think, I've seen while we're working with a number of biohackers and having a lot of patients that are like very serious biohackers I think sometimes the these like biohacking strategies which yeah can be very good but it's sometimes the basics are just overlooked so a lot of my advice to biohackers when I see them is you want to get the basics nailed down and then use you know the more like cooler technology like biohacks to help to add more on top that's wonderful yes uh we are soon uh off to holiday here now so we're gonna take off our rings and just uh de-stress and try to live the caveman life a cave girl life but that was really interesting and thank you so much for all your information and knowledge yes thank you so much yeah of course thanks for having me on and great great work with um spreading the word about all these cool things that people can do and just involving their lifestyle to help improve their health. It's... these things are not always easy to do so it's thanks for all your help in getting the word out there that's wonderful Graham and we'll talk to you again we're just going to dig more into the Dutch test and have a follow up be safe and have a super summer in Stockholm and thank you again for joining us thank you you're welcome thanks for having me on bye take care bye Yes, this was interesting. I got my answers very thoroughly, I think. But it's exactly what he said. Businesswoman, yes. Small business mom, or business owner. And then I also think about this with breastfeeding at home. So there were many factors that made me feel that the test was not 100%, but 100%. I'm getting to know myself in something. That's great. I also like what you've been talking about all the time, with these common things that we can all do. The things we try to promote and promote. Sleep and fast, eat and exercise. It's so easy, really. What I found most interesting was that I lack some DHEA. You know that, because I have... We have stripped all supplements and that was one of them. And then it swelled down. I actually need some support on DHEA. Yes, and you should take it. And it's 15 milligrams, it's very little. So I'll just take it. But have some work to do again. And then we can just continue with the exercise. We can just continue. Thank you at home. We'll put a link to the Dutch test if you're interested in it. and the name of Graham Johnson, where you can find Nordic Laboratories. So you can have a happy biohacking week. Lovely. Bye. Bye. We remind you that you must talk to your own doctor or diet or other questions related to medicines and supplements. Information we share cannot be used to diagnose, treat, prevent or cure any diseases or conditions.