How Stress Affects Your Hormones, Metabolism and Mood

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Stephen: A hard day is way easier when you have lots of energy, because in both mind and body you can reframe things a lot faster and easier. Like, that's not great, I'm not happy that that happened, but I'm going to go and do this, this and this. But if you don't have that energy and those same obstacles present themselves, it's like you're a totally different person, because you don't have the energy to work around those obstacles or challenges.

Nikkiey: What is going on, everybody? Welcome to The WarriorBabe Show. Today I am super stoked to be joined once again by Dr. Stephen Cabral. He is an amazing naturopathic doctor, functional medicine practitioner and the host of the Cabral Concept Podcast. He's also one of our favorite doctors within the WarriorBabe community. With decades of experience and a passion for uncovering the root causes of health challenges, Dr. Cabral has helped tons and tons of individuals reclaim their health through a personalized and integrative approach. Dr. Cabral, welcome to the podcast once again.

Stephen: It's so great to be here. Thanks for having me back.

Nikkiey: In our last conversation we covered a lot of amazing information and important ground, from understanding the difference between functional and conventional medicine, to stress and how it can affect you. We also went over my Equi.Life stress, mood and metabolism test results. For you listeners, that is a test we use for all of our new WarriorBabes coming into our community. Right when you join, you get sent a stress, mood and metabolism test from Equi.Life's team, and then we're able to deep dive into your results and personalize your program a little bit more.

So today, having Dr. Cabral on the podcast, we're going to dive into this: I retested. We're going to go through the updated results from my stress, mood and metabolism test with Equi.Life and break down what those changes mean. I'm going to be an open book with you guys. I'm going to share some things that have been going on that may be showing up in these results, and why retesting is so important for understanding your hormones. It's crucial for staying on top of your health and making meaningful progress as you continue to live.

So, Dr. Cabral, with all that being said, we're going to chat first and then dive into the results. When it comes to health and wellness, many people are tempted to follow general advice, trendy programs. Especially with the new year coming up, everybody wants to dive into something quick that's going to get them quick results. But hormones and metabolism are influenced by so many individual factors, from genetics to lifestyle to stress levels to environmental responses. Can you explain why the one-size-fits-all or quick-fix approach often fails, and why it's so important to understand the personal aspects of your own body and bring those personalized factors into your day-to-day? I definitely just elongated that question.

Stephen: The best example is The Biggest Loser. I don't know if it's still on, but it was the reality TV show where they brought people onto the ranch. They had them exercise for six or eight or more hours per day. Then they would add sauna on top of that, and then a very low-calorie diet. So on a daily basis maybe they're burning 5,000 or 6,000 calories, because if people are 300-plus pounds, they could easily burn 800 to 1,000 calories per hour. And they're only taking in 1,200 calories or so for women and maybe 1,600 to 1,800 calories for men.

So they're at a massive deficit. Of course anybody is going to lose a lot of weight on that type of program. Now, is that sustainable? No, not at all. It's not sustainable for any human beyond a couple of months, or at the very best maybe a year. Eventually the body starts to break down, because the energy out is far surpassing the energy in, which is your calories. And that doesn't even take into account micronutrients, your vitamins, your minerals, all those great things.

So they did a follow-up study, and you may already know about this, with many of the Biggest Loser contestants. What they found is that many years later, their metabolism never recovered. On average, they could eat somewhere around 500 to 700 calories less per day. That means that individual now has to eat a meal's worth less food per day, because they destroyed their metabolism. So sure, you can go on these short-term caloric deficit diets. And again, I believe in a caloric deficit, so I'm not saying that I don't. But mass deprivation along with high exercise output is a recipe to crush your metabolism.

That's why WarriorBabe does it differently. You're able to look at proper macros and proper exercise, customized for the individual based on what the coach says, and now add on: what does your adrenal health look like? What do your sex hormones look like? What does your thyroid look like? What does your sleep look like? What do your vitamin D levels look like? What's your blood sugar? When you have that, you can create a much more well-rounded, individualized approach that will allow someone to lose weight on their body's timeline as it gets healthier. Then they can keep it off for life while boosting their metabolism. That's exactly why we partner with people like yourself who are experts in that phase. We just use the lab part of it to bring it one level higher.

Nikkiey: Beautiful. Love that. I don't even know if the listeners know this, but The Biggest Loser reached out to me to come on and be a trainer. I went through the whole interview process too, but never made it because I was hella nervous in the interview. But I'm happy I didn't.

Stephen: You would have been great on the show, no doubt about it. I don't know if you would have been believing in the work you were doing, but you would have been great on the show.

Nikkiey: Thanks. I definitely don't think I would have been believing in the work I was doing, especially with that explanation, because I totally agree with you.

So with that being said, physical attributes can be so affected by certain things, and metabolic health doesn't just affect our physical weight and our physical energy. It also plays such a crucial role in our mental well-being. When the metabolism is disrupted, it can lead to symptoms like brain fog, low mood, fatigue, all of those symptoms a lot of people experience. Could you shed some light on how metabolism and mental health are interconnected, and why addressing one often benefits the other?

Stephen: Yeah. If we think of the thyroid as the thermostat or the metabolic regulator for the body, it's very easy to see how it can be disrupted by stress. The human body experiences stress from outside the body, which we call exogenous, or inside the body, which we call endogenous. So maybe you have gut issues, inflammation or pain inside the body, or outside the body you're not getting a lot of sleep, or you have stressful relationships, or whatever might be going on.

All of those things typically cause more stress hormones to be produced, and that's norepinephrine, or adrenaline, and cortisol. We hear about cortisol a lot. When those stress hormones rise, if it's chronic, thyroid begins to go down over time. That's why the body typically does okay on a 21-day to 28-day crash course diet, but after that we see the body start to show a slower metabolic rate. If you run your labs, you'll start to see TSH go above a 2. T3, which is your most active thyroid hormone, starts to go lower and lower, below a 2. Now we realize this person's body is slowing its metabolic rate. They're not going to burn as many calories, not only with exercise but at rest. So now they need to exercise more just to maintain normal weight, and if they don't, they're going to start to gain weight on the same amount of food. That's how stress really does affect the body.

Now, for women: 70 to 75 percent of our clients are women, and about 100 percent of your clients are women. The HPA axis, which is the adrenals, when it's stressed, whether from inside or outside, affects not just the HPT axis, which is thyroid. It also affects the HPG axis, which for women is the ovaries. So with increased stress, we'll typically see a decrease in progesterone production. That can lead to the feeling of higher estrogen, because the ratio is off.

So you feel maybe oilier skin, or thinning of the hair from the low thyroid as well, drier skin, a little bit of bloating, water retention, weight gain, poor sleep, irritability, low mood. All those things matter, because stress doesn't only affect your metabolism, it affects your overall mood and quality of life. So really what we want to do is, sure, help people lose weight if that's their goal, but ultimately we do that by getting their body extremely healthy. Then their metabolism is elevated and they can lose weight far more naturally. It's not as much of a struggle on a daily basis.

Nikkiey: Ladies, are you feeling frustrated with body changes you're experiencing during menopause? It's time to take control. If you're between 45 and 65 years old and tired of struggling with body fat and muscle loss, WarriorBabe is here for you. At WarriorBabe, we've helped over 18,000 women just like you lose body fat, build toned muscle and understand their bodies better with personalized plans based on hormone and thyroid testing and more. Imagine knowing exactly what your body needs to see real results, and results that last. Don't wait anymore. Take charge of your health and join our community of strong, empowered women. Visit warriorbabe.com/apply today to start your transformation. That's warriorbabe.com/apply. All right, let's get back to the show.

I just love listening to you. I love learning from you, and I love our partnership too. This is why we wanted to work with you guys, because having all the lab results and the education behind what they're showing gives us better insight to help people. Not just to get the physical results, but to have the right processes and alignment internally. Like you're saying, a person may have all of these disruptions happening, like brain fog, fatigue and low mood, but without being able to see what's actually going on, which your lab results help us do, we can't address it and fix it. That's why I love our partnership.

One last question before we dive into the results. When you improve hormonal health, that leads to better mood regulation and more stable energy levels. For those who struggle with mood swings or metabolic issues, making adjustments in their day-to-day can feel very overwhelming. For example, inside of WarriorBabe, when women are struggling with this and we ask them to make some adjustments, it can feel like a lot. So what are some small takeaways, some practical steps or lifestyle changes you would recommend to help optimize hormones and in turn improve both mood and metabolism?

Stephen: The biggest one is energy. It really is. If you think about it, a hard day is way easier when you have lots of energy, because in both mind and body you can reframe things a lot faster and easier. Like, that's not great, I'm not happy that that happened, but I'm going to go and do this, this and this. But if you don't have that energy and those same obstacles present themselves, it's like you're a totally different person, because you don't have the energy to work around those obstacles or challenges. And that is in both mind and body.

So one of the first things we do is look at what the energy drains are, as well as what can replenish this individual with more energy. That's why it's challenging, because if you drop your calories too low, you're not giving your body as much pure energy, in terms of calories, as it needs. You don't need more calories than your body requires on a daily basis, but those should be met, or a slight deficit, if your sleep requirements are being met, and we can talk about that, and your micronutrients are being met.

So there are macros, which are carbs, proteins and fats. But then there are also your micros, which include all of your B vitamins, which we need for energy. A lot of people talk about B12, but it's not just B12. It's B1 for the thyroid, B2 and B3 for the mitochondria and energy, B6 for the nervous system. You need all your B vitamins. That's really important, and they also help you metabolize carbohydrates. We also need vitamin C, zinc, all these great things, and omega-3s, which help balance female hormones. So the goal is to get in the right amount of macros, but get in 100-plus percent of all the micros you need. That gives you energy.

And then balancing blood sugar throughout the day. If you're constantly on the blood sugar roller coaster, not getting enough protein, not getting enough fiber, your blood sugar might spike to 180, and then you crash three or four hours later and feel lightheaded, low mood, low energy. It also causes you to reach for the foods that bring your blood sugar back up, but those cause you to crash again three or four hours later.

Ultimately, it's not one thing that solves this. But the great thing is you don't need to be perfect in any of them. I always say you need to get about 80 percent. We have something called the DESTRESS protocol that I wrote about in my book. It's diet, exercise, stress reduction, toxin removal, rest, emotional balance, scientifically backed supplements and a success mindset. Diet and exercise are obviously your cornerstones, but so is stress reduction, because stress is a drain on the body. So what we say is, I don't want you to get an A in any of them. You can if you want, that's great, but be 80 percent in those, and that's enough to reach your goals.

So if you miss a night's sleep, be better on your nutrition the next day. If you get a great night's sleep and you're getting your exercise in, and I don't know what your program entails in terms of flex meals, you're probably going to be able to do a flex meal once a week once you've stabilized that body. That's how I look at things. Get energy back into the body and everything becomes so much easier.

Nikkiey: Love that. We're definitely in alignment with what you'd do for the DESTRESS protocol. Being 80 percent right, we do that with the food and macros. We don't want you to be 100 percent all of the time, because it's going to make people feel overwhelmed and they're not going to be able to stick to it. So let's just focus on being at least 80 percent, which is hitting your macros the majority of the week and getting your exercise in. And flex meals, all of the things. It doesn't have to be perfect. I think perfect gets a lot of people overwhelmed.

Stephen: For my own diet, I do 90-10. So 90 percent of the time, 9 out of 10 meals are exactly what they're supposed to be. Super boring. I eat basically the same thing.

Nikkiey: Same.

Stephen: And then twice a week I have a flex meal of whatever I choose to eat. And since, again, you're healthy, my body responds fine. There's no fluctuation. Sure, maybe I gain a pound or two overnight. I'm holding water weight. I'm inflamed a little bit for maybe the next 12 hours or so. That dissipates. You don't need to weigh yourself. You go back to your normal life. You'll find what works for your body. That seems to work really well for me.

Nikkiey: I love that you just said that. I'm actually going to have a little flex meal tonight. I'm going to have Five Guys. I don't know if it's the best one, but my body is able to bounce back. Like you said, sure, I'm going to gain a little bit. I don't really weigh myself anymore, but I know in about five days it'll be back to normal. I think that's such an important concept. I try to talk to my clients about that, ones who have worked with me for four years, and they still get stuck on this concept. And I'm like, just don't step on the scale. Just put the thing away. If you're going to have a cheat meal, flex meal, whatever you want to call it, you're going to gain a little bit. But it's not fat. It's just bloat. It's water retention. So don't stress.

Stephen: Yeah, exactly.

Nikkiey: Okay, let's dive into the stress, mood and metabolism test. Everyone listening, I had Dr. Cabral pop on for a couple of minutes prior to this episode because I have the results. I'm really excited for Dr. Cabral to go through them, because there are some things we didn't get to talk about in the last episode. There were also some things I needed to bring to his attention, because a few things are skewed, and he's going to talk about this.

Last time Dr. Cabral was on, he said I was the best of the best. I forget what number you said, but you said my results were up there, so good. You all know that I recently went through the egg freezing journey. This is the second time, and it called for totally different strategies. My estradiol was at 6,000 at the end of it, and I was so uncomfortable, Dr. Cabral. It was wild. So the sex hormones Dr. Cabral is going to go through are a little bit skewed, and he's going to explain why. We can dive in a little more if there are any questions around that.

But for listeners who may not be familiar, can you give us a quick overview of the stress, mood and metabolism test? What does it measure? What insights can it provide? Obviously we're going to dive into all that, but at a high level, what does it do?

Stephen: The nice thing is these are called functional medicine at-home lab tests. Just like they say, you complete them at home. They are still signed off on by a doctor. We sign off on them with our company, and we ship them internationally all around the world. The nice thing is that everything is kept private. You may not want your numbers shared with your PCP, although of course you're welcome to, and you might not want them shared with your insurance and others. So they're kept private. Also, you don't need to do a blood draw, which a lot of people appreciate.

It depends on the test. For gut health, you might do a stool sample, or for heavy metals, a urine sample. But for this lab, the best way to measure your hormones is with saliva and blood. We do a small finger prick. That's how you get your vitamin D levels, your hemoglobin A1C and insulin, and your thyroid numbers. But to look at free hormones, you really want to use saliva, and this has been done for over three decades.

For women especially, we look at estrogen, progesterone and the estrogen-to-progesterone ratio, which is what we talked about last show, and yours was perfect. Then we look at cortisol four times throughout the day, which you can't run on blood work, because you'd have to have your blood drawn four times during the day, which is impossible. Nobody does a blood draw before bed, which is why so many people miss abnormal cortisol. We're going to talk about that today.

And then, of course, thyroid. You don't want just TSH. TSH is a great number. If it's above a 2, you know it's off. But many people might have a borderline 1.8 or 2.2 TSH and still have low free T3. So you need to measure free T3 as well, and we measure that.

We can walk through it right now. But again, it's a simple saliva sample and a finger prick, just like you would take your blood sugar at home. You mail it to the lab and get results back in two to three weeks, and then you get a personalized plan based on that. We provide the plan based on your results, and then the WarriorBabe coach integrates that into the greater program. So it's not the only thing. It's one part of your holistic plan, which is exactly how it should be done.

Nikkiey: It's great. Okay, I'm going to share. Should I share the old one first?

Stephen: Yeah, I think that would be great to go through. This is the one that looks at your estrogen, progesterone, the ratio, testosterone, DHEA, for both men and women, and then cortisol throughout the day.

We work with women of literally all ages, so this would be appropriate from a teenager all the way through our oldest female client, who is 105 years old. When you run this lab, if you have a menstrual cycle, you want to run it on day 19, 20 or 21 if you have an average cycle of about 28 days. If it's a 30-day cycle, you run it more like day 21 or 22, just one of those days.

Let's say you're not in menopause and you don't get your cycle, but you have symptoms for three, four or five days a month of lower mood, poor sleep, water retention, bloating. You're going to run it during that time, because we help a lot of women get their cycle back. And there are many women in menopause or perimenopause, and they can run it any time they decide during the month. Those values will obviously be unique to you.

If you have a normal cycle, we run it around day 19, 20 or 21 because that's peak progesterone. The issue is, as I talked about earlier, the more stress a woman has, oftentimes the more her progesterone levels drop, and we end up with a very low estrogen-to-progesterone ratio. We've run over half a million at-home lab tests, so we are one of the largest providers of these labs, and I can tell you that most women have normal estrogen levels but low progesterone. They feel like they have higher levels of estrogen, even though it's normal, because of the ratio between the two hormones. The lower your progesterone, the higher your estrogen is going to feel. That shows up as low mood, irritability, poor sleep, water retention and bloating, especially in the seven days or so before your period. So that's why we look at that.

As we saw before, yours was a 0.9 for estrogen, which is great, for those not watching on video. I think it says 179 for progesterone, and it's well above 100 for your ratio. So that's picture perfect. That's what we want for every client. You're in your early 30s, and this is exactly what we want to see.

Nikkiey: Yep.

Stephen: Then we move over to testosterone. I would expect many women in WarriorBabe to be between 30 and 40 for their testosterone. I think that's totally normal, lifting weights three days a week, maybe even more. You're right around that mark at a 29, so it's perfect. We feel anything above a 16 is acceptable, so your testosterone is excellent.

Your DHEA, though, we want to see at least a 6. So it does show there is a little bit of chronic stress on the body. Now, can DHEA tell you what the chronic stress is? No. If all your other hormones are normal, is it okay to have DHEA a little on the lower side? Yes, because DHEA is basically a precursor to your other hormones. DHEA stands for dehydroepiandrosterone, and oftentimes people take DHEA to make more sex hormones. I always compare it to a champagne flute tower at a wedding. You pour at the top, and that's DHEA, and then it funnels down to estrogen, progesterone, cortisol, testosterone. It makes more of everything else if you have more DHEA.

Nikkiey: It's a great analogy.

Stephen: It's also great for inflammation levels and the immune system. If I see DHEA low over the course of a year, which we'll talk about with your new lab, let's say you test every six months, I will give a small amount of DHEA to give the body a little boost while working on whatever those stresses are.

Nikkiey: Okay, interesting.

Stephen: And for women in menopause, I'll give a small dose on a daily basis instead of using hormone replacement therapy right out of the gates.

Nikkiey: Interesting. I'm excited to see that.

Stephen: We'll look at the new results too. Now if we look at cortisol, your AM cortisol is perfect. Your noon cortisol is perfect, right in the middle. On most labs, green is good, yellow is the start of the danger zone, low or high, and red is out of range. You're right in the middle for breakfast cortisol, basically upon waking, before lunch and before dinner. But your evening cortisol is creeping in on the high side.

Evening cortisol is elevated in many people for many reasons. One, sometimes it's hard to turn your brain off at night. You think about everything you did that day and everything you need to do the next day. Or you might be checking emails. You own your own businesses, so there's a lot to think about. And then there's blue light. Keep in mind, blue light is at its highest in the first half of the day, earlier in the morning. So if we're getting blue light from the overhead lights in our home at night, our body still thinks it's daytime. So we really want to either put on blue-light-blocking glasses, definitely turn our phones and computers to night mode, and ideally, in an ideal world, switch over to amber lights to take out that blue light for at least one hour before bed.

Nikkiey: I have the Philips Hue lights in here, so I'm doing something right there. I turn them all to warm right at nighttime.

Quick break. If you're finding this episode helpful so far, it would mean a lot if you could hit pause for just a second, leave a quick rating or review, or share it with someone who could benefit from it. Your support helps more women discover these tools to build muscle, lose fat and feel confident. Thank you so much for being a part of this journey with me.

Stephen: So that was last year's results, and it shows you the graphs of the cortisol wave. Now when we flip over to this year's, again, you're only a year older, so I would not expect to see any great changes in the sex hormones, meaning estrogen, progesterone, testosterone and DHEA. Whenever there is a change, keep in mind that hormones are very delicate. They will be affected the most by stress, just the way it is. That's because the reproductive system, especially in women, is very intelligent. If you're in a very stressful environment, your body's not going to allow you to get pregnant, and it won't allow you to get pregnant by basically turning off your menstrual cycle.

So if you want to give a little commentary on why we see very low estrogen and very low progesterone when you had picture-perfect results a year before, I think that would be helpful, as to the stress on the body the month before and so on.

Nikkiey: Yeah. So, as I shared a little before we opened up these tests, there was the egg freezing process. I took it on in July, and for about a month straight you undergo injections on a daily basis, sometimes twice a day, in the morning and in the afternoon. You're injecting yourself with hormones. My estradiol got up to around 6,000 by the end of it, because I was trying to build more follicles in my ovaries. They told me each follicle holds about 250 points of estrogen, or something like that. So that just continues to build up as the follicles get bigger and bigger. I had around 25 or 28 follicles. Then I Googled what it looked like, and they're the size of dimes. And I'm like, oh my God, I'm carrying around all these things in my ovaries. I got so bloated. I was so uncomfortable. I was so irritable. Talk about feeling all your emotions, because you totally feel them all.

At the end of it, I had the retrieval on August 5th, and they were able to freeze nine this round. I took this test a month and about six days after. Then the whole month of October, I didn't get my period, and this is what I noticed with my first round of egg freezing too. I believe it's just my body's way of trying to rebalance. So with this test, which Dr. Cabral is going to talk about, I didn't test on exactly the right day I was supposed to, because my period was all over the place in October.

Stephen: Yes. For those not watching on video, estrogen levels are not even readable. They're below 0.5, and progesterone is at a 25. These are very low numbers. For many women in our practice, let's say in their mid-60s, these would be totally normal numbers. These are basically menopause-based numbers, and we would help those individuals, only if there are symptoms, with a little bit of a boost naturally, because they're no longer producing estrogen and progesterone.

So why wouldn't you really be producing estrogen or progesterone? Think of it like a male taking testosterone, taking anabolic steroids. It shuts down his own natural production. A male produces, let's say, up to 140 or 150 units of testosterone, nanograms per milliliter, on this lab. Taking testosterone shuts down his natural production, because he doesn't need to produce any more. The body already has enough. In your case, your body doesn't need to produce as much estrogen and progesterone, in picograms per milliliter, because you're already taking them supplementally.

So you didn't get a menstrual cycle that next month, and your body needs to build back its own normal cycle. We see this all the time in women who have amenorrhea, or a missing cycle. What we do is put their body back in that safe, balanced position and rebuild the health of their body, not just the ovaries, so it produces normal levels again. You're not going to have a period when your levels are this low. It's very, very unlikely. And then you'll see the body begin to rebound in healthy individuals like yourself.

Nikkiey: To piggyback off that with a question: I got my period in September, on about the 26th. Then I didn't get anything in October. I didn't get it on the 26th. I was eight days late, which brought me to the beginning of November. Is this something that's going to continue? How long do you typically see it take? I don't know if egg freezing is something you've even seen this in, but how long do people normally take to balance out afterwards?

Stephen: It's not exactly the same, so I'm not going to say that it is, but we work with many women coming off birth control, and it can take three to four months to get their cycle normalized. But it does normalize. You add hormones into your body, then they're not there anymore, and the body has to adapt by building back its own natural levels, which it will only do if you're healthy. Then you'll start to have that normal menstrual cycle again within three to four months. So coming into November, it could be normal, or it could still be a little off, maybe 33 days instead of 28, or maybe a little early. And then you'll see it normalize by the new year for sure.

Nikkiey: Okay, beautiful. Like I told the listeners, I had you on five minutes before because I was a little stressed seeing this. I was like, oh my goodness. I like everything to be optimal and there are a few things off, which I'm so happy to talk about, but thank you for elaborating on that.

Stephen: When you look at your testosterone, you probably weren't taking testosterone, right?

Nikkiey: No.

Stephen: So when you look at your testosterone, it's great. It's perfect, right where it should be. You might say, well, why wasn't that affected? Testosterone plays a role in a woman's menstrual cycle. It starts to increase a little around ovulation and boosts libido, strength, ambition, drive, energy, all those different things. But it should stay pretty level overall, and it's not only produced by the ovaries. So what we're looking at there is adrenal health as well as DHEA strength.

Your DHEA is still at 1.7. Now, your testosterone is great, and we like to see it there. If testosterone ever starts to move low, we would use DHEA for probably three to four months and then wean off it. We only use five milligrams twice a day, so a really low dose. About 10 milligrams is about 20 percent of the typical clinical dosage people use. But we always look for the underlying root causes. With you, we already know the underlying root cause of why your hormones are low. So I'm not going to use estrogen support or progesterone support, which are two herbal products that help boost those levels naturally. We don't need to, because we know the reason why. As we move down your lab, we start to look at cortisol.

Nikkiey: One thing on the DHEA. In the last test you mentioned my DHEA was low. It was 1.6, and a year later it's 1.7. You said that if you see it stay low over a year, what would you recommend? Should I consider that? Or is it just because other things are out of whack?

Stephen: We don't know yet. The reason is you just had a major stressor over the 60 days before you took that. Egg retrieval, and I'm not saying this in a bad way, manipulating the hormones is an endogenous stressor on the body. You could say it's exogenous because it came into your body, but it's happening inside your body. So that's a stressor.

But beyond all that, we still haven't solved the evening cortisol. If you remember, last year it was high normal. This year it's high. So I don't want to jump to DHEA in a healthy individual who already has good testosterone. If you had low testosterone, yes, I'd be using it.

Nikkiey: Gotcha.

Stephen: But since you have good testosterone, and I think your estrogen and progesterone are going to rebalance, what I really need to tackle, and one of the major reasons for low DHEA, is the high evening cortisol. Your high evening cortisol is now also affecting your morning energy, your morning cortisol.

Nikkiey: Interesting.

Stephen: What we need to work on is what's called a dysfunctional diurnal rhythm. That's when people start producing not enough energy in the morning for metabolic function and higher energy at night. They can't turn off that engine at night, mind and body. So we need to switch out of fight or flight. It doesn't mean you're running around the house in fight or flight, but we need to switch out of the sympathetic nervous system.

Nikkiey: Oh, Dr. Cabral, you're in my apartment.

Stephen: Maybe you would think so. I'm just kidding. If there is something there, I'll give you the benefit of the doubt. We need to switch that. I always like to say you can be on for 12 hours, but you have to be off for 12 hours. That's difficult in different phases and seasons of life, but eventually we need to get there. I look at it as I'm on from 7 to 7, and then I'm off from 7 to 7. The more off hours you can have, which is just parasympathetic, the more recovery and rejuvenation and the less aging we feel in the body.

So right now we can see we've got low DHEA, low morning cortisol and high evening cortisol, and we're going to look at thyroid in a moment. We can see a real stress-based pattern. So sleep is the number one thing I would work with you on to resolve any energy or metabolism issues or whatever feelings you may have.

Now, keep in mind, we also saw your results. You've lost 10 pounds over the last year. So it's not affecting you metabolically, unless you've had to decrease your calories more or up your exercise more. That's why these things can affect more than just weight. It's not always just about weight and body transformation.

Nikkiey: Yeah, totally. I'm excited. Okay, I'll let you finish. Because sleep, last time we talked about my sleep. I got the Oura Ring, and it's very interesting to see this, talk about it and also track the Oura. The Oura tells me I get two hours of REM, two and a half, and some nights dipping into 1:45. And in my deep sleep, I'm at an hour and a half, an hour 45, an hour 17, an hour and a half. I sleep like a...

Stephen: Yeah, and I remember you talking about that last time, now that you bring it up. I think I probably mentioned this last time too. Some people, when their head does hit the pillow, are able to turn it off. What that means is the evening hours are eating it up. The average human is up for about 16 hours and in bed for eight, so there are still about four extra hours where we're pushing the equation too hard. Do you exercise more at night or not?

Nikkiey: No. Usually like two.

Stephen: These tests are very definitive. Your body is producing more cortisol than it should in the evening. It could be from blue light. It could be from mental energy being expended. So I would work right away on blue light and the 3-2-1. Three hours before bed, no food. Two hours before bed, really no liquids unless you're taking a few supplements before bed. And one hour before bed, no laptop, no phone, no emails, no electronics. Just a calming routine. Maybe it's an Epsom salt bath. Maybe it's reading, journaling, breathwork, or talking with your partner, whatever it might be. That's how I would calm things down.

And I would be using Adrenal Soothe at dinner, no doubt about it, two capsules, and full spectrum magnesium, two capsules. You may not need the liquid melatonin, because you are getting great sleep. The Oura Ring is accurate. I've tested Whoop, Apple, BioStrap, Fitbit, Withings and Oura, and the Oura is the best on sleep. Not the best on activity, though it's getting better, but it is the best on sleep.

Nikkiey: Totally agree. Okay, let's dive into thyroid. Guys, last time we didn't get to talk about thyroid because I don't think I gave y'all enough blood.

Stephen: That's why we never want to take any one measurement as the end-all be-all. I wouldn't say, oh, maybe there's something off with the lab. No, because we've got low DHEA, and we've had that now multiple times. Last time cortisol was starting to creep up. Now cortisol is high at night and low in the morning, and free T3 is low. Free T4, normal. TSH, normal. Free T3, a little low.

So there is a stressor on the body happening more in the evening that's causing this. Even if you're good energy-wise, some people are more of a pitta body type. They're go, go, go. They're type A. They just push through it.

Nikkiey: Hi, nice to meet you. That's the majority of all of my clients too.

Stephen: Myself, I always say I'm a recovering perfectionist and type A. I set parameters up in my own life to save me from myself, honestly, because I will just go and go until there's no more. So what we really need to do is set what I call three anchors per day.

One anchor is in the morning. I ease into the day now instead of getting right after it in the first hour after I wake up. That's just me. Then at lunch, I think of it as two halves of the day. I work hard for four or five hours, then I have lunch, and it's not a working lunch anymore. It's more relaxed. I breathe, calm down, maybe go for a walk. Then I do the second half of the day. After that, I exercise, because I forget about the rest of the day after doing eight sprints. What happened today? I don't remember whatsoever. So I'm good. Then I sit down with my family, have family time and enjoy it. That's how I've set up my day so I can improve my sleep, because unlike you, my sleep scores now look like that, but they didn't used to. My sleep used to be terrible.

Nikkiey: Dang. Okay.

Stephen: We're going to improve the thyroid, but we're really going to improve it by decreasing whatever this stressor is. If it's not mental and emotional, from being an entrepreneur, then there's something else. It could be low levels of magnesium, and we might use certain herbs like ashwagandha, but there's probably something there. So we're going to work on that at the same time and make sure everything is balanced across all levels.

Nikkiey: Okay. You saying that, and this is a little uncomfortable, maybe it's not the thing, but hey, I'm an open book. There's something going on recently, in the last couple of months, with my gut, and I'm trying to figure it out. I actually did the gut test with you guys, and I'm still waiting on the results. Could it be that? How much do I share of this? This is new.

Stephen: If you're feeling bloating or anything like that near dinnertime, then yes, because that's uncomfortable. But also, and I want to be sensitive around this, egg retrieval is not an easy process. That in and of itself is probably weighing a little on your mind, or at least was, and that can affect these results as well.

Nikkiey: Okay.

Stephen: So we attack it from every parameter. We literally look at diet, exercise, stress reduction and toxin removal. For someone like you, I ask: are you exercising too late at night? Are you doing sauna too late at night? Cold plunge at night? Anything that would stimulate you later at night? Because I'm trying to reduce those stimuli for you. Now, some people can get in the sauna at night. I have clients who get in the sauna at eight o'clock at night for 30 or 40 minutes, and their cortisol levels look fine and their sleep is fine. So it's all individualized.

Nikkiey: Okay. All right.

Stephen: Then we move down to blood sugar. Could blood sugar be what's throwing off your cortisol? Because it does for many people. The answer is no. Your insulin levels are phenomenal, and your hemoglobin A1C, which is basically a 90-day measure of blood sugar, is fantastic. So no issues there.

Nikkiey: Okay, beautiful. I like those greens.

Stephen: For most people out there, once A1C starts to creep above 5.5, just because it's within range doesn't mean it's good. We really want it below 5.6.

Now, vitamin D. When you get your blood work done at your doctor, the range is 30 to 100. That's not the ideal. The ideal is between 50 and 80, and you're at 76. So 76 is perfect. For you, I'd say whatever sun you're getting, keep getting it. If you're not getting sun, keep using whatever vitamin D supplement you're on at the exact dosage you're using and not more, because you're right at the upper range. So you're good to go.

That's why we can get precision with nutrition and lifestyle from just one lab like this, and that's why it's really great. When we look at your lab, we say: nothing to do with vitamin D, you're great. Nothing to do with glucose levels or blood sugar, that looks great. I'm not going to overdo estrogen and progesterone, because I know why they're low. Testosterone is great. DHEA is low, but I believe it's low because cortisol in the morning is now low. So we can use Adrenal Energy Support if you're feeling low energy in the morning, and Adrenal Soothe, which calms the adrenals and cortisol, at night along with full spectrum magnesium.

If we need to use liquid melatonin to get to sleep faster, we will, to turn off cortisol, because they're an inverse ratio. If you give someone zinc, it pushes down copper levels. If you give someone copper, it pushes down zinc. If you give someone calcium, it pushes down magnesium. Everything in nature has an opposite. So if you want to push down cortisol levels, you can use liquid melatonin. It doesn't make you groggy in the morning. It just knocks cortisol down.

That's something I still use to this day. I don't use a mega dosage. I use a very small dosage, because I have a more challenging time turning down cortisol at night. I use a small amount, two and a half milligrams of melatonin, and I'm out within 10 minutes. If you had told the 20-year-old, 27-year-old or 30-year-old me that I could fall asleep within 10 minutes, I would have laughed at you. It used to take me hours to fall asleep. So again, everyone needs their own individual plan. That's basically all there is to it.

Nikkiey: That's why I love this test so much, because it is so individualized. First of all, thank you. I appreciate your time so much. I love learning from you, and I appreciate you coming back on the podcast and going through these results with me. Honestly, I'm selfish in a way. It's so soothing to know what's going on and how I can fix it, and I want that for other people. I want you guys to feel inspired by what Dr. Cabral just read. This is at your fingertips if you're feeling like things are off. It could be something internal that needs to be addressed, and this test will show it for you.

One thing I want you to talk about before we wrap up is that I retested. All of these things can change over time, like our hormones and our cortisol. We just saw it. My DHEA stayed the same, and my cortisol was fine in the morning and afternoon but creeping up at night on the last test, and now, as you shared, it's affected. So all these things can change. Can you elaborate on why retesting matters? I know there are WarriorBabes in our community who have done one test, but it's so important to keep retesting, to adapt to these changes, understand them and maintain balanced health. Why is it so important to retest?

Stephen: Absolutely. The biggest reason is that our bodies are not static. We don't go through static stresses in life. You're not going to do an egg retrieval process next month or the month after. You moved through that season of your life, which you wanted to, because in the end it's absolutely worth it. Sometimes you go through some stress to get what you want. Great.

So now we've done that, and we're going to work on a plan for 12 to 16 weeks maximum. That's all the body needs. Then we can retest. But we're going to stay on everything we're doing: no blue light at night, the relaxation, the Epsom salt bath, whatever is relaxing for you in the later half of the day, meaning after 5 or 6 p.m., as the sun starts to set. And we're going to use some nutritional supplements. But again, it's the whole DESTRESS protocol. We're going to do all of the things, not one thing perfectly, just to bring it full circle. And then you'll say, yeah, actually I can feel some results. Then we retest.

Let's say we retest, and you notice, you know what, I've been gaining a few pounds and I don't know why, and I'm doing the right things. Now we look: DHEA is still low, cortisol is now good, but thyroid is still low. Remember, I didn't mention Daily Thyroid Support. Now we'd move to Daily Thyroid Support, because we fixed the stress but the thyroid is still low. That may mean the thyroid doesn't have the nutrients it needs to function well, which is anything from zinc, copper, vitamin A, selenium, iodine and B6. If the thyroid doesn't have those nutrients, it literally cannot make active thyroid hormone.

So we say, okay, we fixed this, now we're going to work on thyroid. It's exactly what your body needs. We use that for about 12 to 16 weeks, and you retest. Everything is perfect. Great. We wean off the Daily Thyroid Support, down to one at breakfast and one at dinner. Weight is still holding well, you still feel good. No bloating, no brain fog, which are some of the symptoms of low thyroid. Things are good. Then we come off that last capsule and the body is balanced.

That's how to use functional medicine and integrative health in an ideal world. It's not that you'll never use a nutritional supplement again. You'd still use a good daily activated multi, omegas, whatever the body would typically use for aging. But you don't need the specialty ones unless the lab results call for them.

Nikkiey: That's what I love about your approach so much. I want to unpack a couple of things there. One was recognizing that cortisol was the thing that was changing. How many patients do you deal with who have high cortisol at night?

Stephen: Quite a bit.

Nikkiey: And you go in and try to fix that first before you fix other things, because that's probably going to fix other things, right? It's kind of like a different version of the champagne flute analogy you talked about. If you fix one thing, maybe other things will be fixed.

Stephen: It's the domino effect. That's probably the easiest analogy. We can make more happen with less if we know which domino to press first.

Nikkiey: I love that. I think you said that before too, because Dr. Cabral comes into our community and talks to our coaching team, or maybe it was on the community calls with the babes. I freaking love that.

Stephen: I only have so many analogies.

Nikkiey: I love it. But to that point, you mentioned that you'll use these and then wean off. It's nutrition, diet, exercise, stress management, and then the nutritional supplements, which we both align on so much. You don't have to take these supplements for the rest of your life. They're a tool in your toolbox to help alleviate some of the symptoms you're feeling.

Stephen: And they make it happen faster. That's the truth. When you have digestive issues, you're not absorbing these nutrients, or they're low because of stress. You can pretend you don't have a deficiency, or you can simply replace it and work on the lifestyle things at the same time.

In the beginning we talked about energy. If you can take something natural, replenish your micronutrients and have more energy, what does that allow you to do? You can get those 10,000 steps a day now. You can stick to your nutrition plan more often, because you're not crashing in energy. Then you can absorb more from your food and you need fewer nutritional supplements.

There's no one best thing. That's why DESTRESS is eight things, and supplements are one of them. Sometimes we get caught up on that one, but supplements don't matter that much if you're not following your nutrition plan and you're sedentary and don't move your body. They can be helpful to fill in the gaps, but they're not going to save you in terms of aging and weight and all that. You want to know which lever to press harder for which individual, and that's what we hope to provide. Your sleep, for example: I'm not going to improve your two-plus hours of REM and hour and a half of deep sleep, but I can improve the three or four hours before you go to bed. That's what I'm trying to say.

Nikkiey: Totally. Before we hop off, I have one last question, but I also want to make sure I know what I need to do moving forward. You mentioned Adrenal Soothe, full spectrum magnesium and the three hours before bed. Am I missing anything?

Stephen: Do you have low energy in the morning, or do you feel okay?

Nikkiey: I would say I have low energy. I've also recently been taking slower mornings, so meditating, waking up, not looking at my phone within the first hour. But I'd say low energy.

Stephen: Yeah. It wouldn't always show as low cortisol, it might just show as normal. So if you feel like you're lower energy, you can use Adrenal Energy Support, which is the opposite of Adrenal Soothe. You might just need two at breakfast, not two at lunch. If you feel good by lunchtime, you don't need two more at lunch. You can just use them at breakfast.

We would use Daily Omega-3 Support to support inflammation, sleep, metabolism and female hormones, if I didn't already mention that. When we give clients a plan, I also give the optional items. The optional one would be Daily Probiotic Support, but I would first like to figure out whether you have any overgrowth, because if so I'm not going to use that. For right now, I might just recommend daily digestive enzymes so you absorb more of the good nutrients from the food you're already eating. If you feel like you've overeaten after a meal, meaning bloated or full, then you're either eating too much, which most people aren't doing, or you're not breaking that food down well enough. So daily digestive enzymes, one or two with a meal, are great.

Then we're going to hold off on DHEA, and we're holding off on Daily Thyroid Support. I'm assuming you're already using vitamin D.

Nikkiey: Yep. Vitamin D and K2.

Stephen: How many IUs or micrograms are you using?

Nikkiey: Oof.

Stephen: You don't have to know. The average person needs about 2,000 to 5,000 IUs per day, which is 50 to 125 micrograms, and that usually keeps them within 50 to 80. I'm just saying, maintain whatever you're doing right now, because it's obviously working great. So you don't have to know.

Nikkiey: Sounds good. And maybe we'll have you back on the podcast when we review my gut results.

Stephen: Yeah, 100 percent.

Nikkiey: There might be something going on there. Well, anyway, Dr. Cabral...

Stephen: The thing I want to say is that all of these things are fixable. So don't feel embarrassed or whatever it is. Everybody has something going on. You were brave enough to share your story, and I've shared my story over and over. Everything is fixable. That's the nice thing. There's nothing we've seen that can't be corrected. That includes digestion, hormones and energy.

Nikkiey: Totally. Thank you. I appreciate that reminder. As we wrap up, what's a key takeaway or message you'd like to leave listeners about the importance of understanding and nurturing their health over the long term?

Stephen: The first is that there's never a perfect time to start. We have to get rid of that idea. There's always something going on. The second is that you're never going to get it all right. You're never going to be perfect. Once you understand there's no right time to start and that you'll never be perfect, you can allow yourself to move through the journey of life, because there will be ebbs and flows. There will be great periods of eating and exercising, and times when you feel low energy and you miss it.

At the end of the day, what I really look at is this. I always use a big calendar. If I have a 365-day calendar, I want to see more days than not, that 80 percent, where I'm moving toward my goal. So for everybody out there, if you do that, literally just put a check mark on the calendar: I did my 10,000 steps today. I ate well. Maybe it's two checks. You just go day by day and accumulate enough of those checks, or shade the days in. Huge wins.

Because what we're talking about is, sure, we can correct things in the moment, but you've got another 50 or 60 years ahead of you. I hopefully have another 50-plus years ahead of me. People in your community have 30, 40, 50, 60-plus years. We need to figure out something we can do for life that we're not going to be perfect at, but that keeps us reaching our goals. That's really the big takeaway. Do things in the moment to balance your body, and then ask what you can do for the rest of your life, understanding that it's not always going to be the same.

Nikkiey: Mic drop. Dr. Cabral, thank you so much for coming back on the podcast and sharing your expertise. Like I've said a couple of times today, I just enjoy listening to you and learning from you about all things hormonal health and metabolism, the tests we went through today, and your insights on retesting and adapting to the changes in our bodies. It's incredibly valuable to understand what's going on so we can take it away and make some change. And as you said, everything's fixable, which I love.

If anybody listening is inspired to take this test, I highly recommend you do, just for your own good, to know what's going on internally. The links will be below in the description for you to check out the test. Either way, I highly recommend you do that, or check out Dr. Cabral and his resources and tune into his podcast. Dr. Cabral, thank you for being on here again. Appreciate you.

Stephen: My pleasure. Thanks so much for having me back.

Nikkiey: Really quick before you go, I have one small favor to ask. If this episode brought you value or sparked something in you, take a moment to hit that review button. Your rating and review make all the difference in helping more women discover the tools they need to transform their fitness and their confidence. It takes less than a minute, but it can change the path of someone else's journey. Thank you so much for leaving that review. I appreciate you so much.