Reset Retreats

Why are my hormones low? Debunking the pregnenalone steal, cholesterol fear, low T and mitochondrial issues with Sam Miller


This week on The Less Stressed Life Podcast, I am joined by Sam Miller. We discuss root cause of low hormones, hormone testing, and where to start if you are feeling fatigued or concerned about hormones.



  • Top Causes of Low Hormones
  • Hormones that drop under stress
  • Why hormones are depleted under stress
  • Debunking the pregnenalone steal
  • Debunking Cholesterol fear


  • Hormone testing recommendations
  • Where to start if you are feeling fatigued or concerned about hormones



Sam has a masters degree from NC State Univ and has spent the last decade in the health, fitness and space, building his reputation as an online coach, author, educator, podcast host, and mentor dedicated to providing simple, yet strategic ways to amplify your results either as a coach or in your own transformation…. (without being a dick about it).

Through workshops, classes, mentorships, and his specialization program Sam has served over 2,500+ coaches worldwide and been featured as a speaker for companies like Linken In.



Instagram : @sammillerscience
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Sam (00:00):
Someone who feels less than optimal and maybe has some form of hormonal abnormality of some kind. It's not always the same person to person, and it's largely gonna be driven by their past health history. You know, their past diet choices, past exercise, routines, and different things that they've sort of engaged in over their lifetime

Christa (00:19):
Stress is the inflammation that robs us of life, energy and happiness. Our typical solutions for gut health and hormone balance have let a lot of us down we're overmedicated and underserved at the Less Stressed Life. We are a community of health savvy women exploring solutions outside of our traditional Western medicine, toolbox and training to raise the bar and change our stories each week. Our hope is that you leave our sessions inspired to learn, grow, and share these stories to raise the bar in your life and home

Christa (01:02):
Access to functional or specialized medicine testing and standard blood work is a big piece of personalizing care plans to help our clients succeed, but getting accounts with multiple labs and ordering and tracking results from many different web portals slows efficiency by bogging us down in admin work. This is why I'm completely obsessed with our podcast sponsor Rupa health. It's a single portal that allows you to order from over 20 specialty labs in one incredibly simple dashboard, I'm talking less than 30 seconds to set up your free account and about 30 seconds to order the labs you need, all the results are in one place, and I can securely send clients their results with a click of a button. A big advantage for our clients is that standard blood work can be ordered for almost two thirds, less than other direct to consumer lab sites. Rupa is a lab concierge.

Christa (01:49):
So they send the lab invoices on your behalf of a client pays for their own labs. They help them get set up with a lab, draw, navigate testing questions, and they provide the requisition forms. It's literally a dream. Go sign it for free to help streamline your practice and simplify ordering labs for your [email protected], that's RPA and let them know I sent you when you sign up, you can also check out the show notes for this episode for a short video walkthrough of how I use Rupa health in my own practice today on the less stress life we have Sam Miller, who has his master's degree from North Carolina state university. I spent the last decade in the health and fitness space building his reputation as an online coach author educator podcast, host and mentor dedicated to providing simple yet strategic ways to amplify results, either as a coach or in your own transformation. And this is my favorite part without being a Dick about it through workshop

Sam (02:39):
I in my bio for probably two to three years, the end tagline was in a number of different forms, right? So first it was like 62% chance of coach or coach without being a Dick about it. And then it kind of evolved into goal, know all the things without being a Dick about it. And then now it's kind of in its current form and you have the most recent book bio version without being a Dick about it. So I just felt like a lot, a lot of folks on social media where maybe you can get some information, but sometimes it can be a little bit abrasive in the process, or at least that's what I felt like when I was kind of on my health and fitness journey. So try to make the information applicable and also

Christa (03:18):

Sam (03:19):
Somewhat approachable in the delivery. I add puppies to the mix, which always seems to help. So even if I mess up on a given day, you do get to balance it out with some puppies there too.

Christa (03:28):
So, so maybe this is where, when I first found your content, I was like, oh, I kinda like this guy because I feel like I don't seek out a lot of men for, I mean, we've had plenty of men on the podcast for sure.

Sam (03:38):
But do you talk a lot about women's health? So that probably balances it out. I actually have a Instagram reel where it's like me with this random container of tampons. And it's like, how did you get, it's like the air Budd reel where he's like, yep, that's me, you know, and just kind of going into it. So it is interesting when you find someone who's equally passionate about men's health and women's health and talking a lot about reproductive hormones and stress and kind of the intersection and how it can lead to physiological dysfunction for, you know, reproductive physiology purposes. But I noticed, you know, as I had more and more and more female clients, it was just something that wasn't really discussed. So I am that dude that tends to we talk quite frequently about P C OS Metro cycle health, high estrogen, low progesterone, red as all the hormone things, if you wander over to my page or podcast. So definitely a lot of women's health stuff going on.

Christa (04:27):
Well, on that vein, one of my favorite hormone mentors is actually a man and I always just find it somewhat interesting. Right. But, and let's jump in at the beginning for you. So I know that you had, this was at high school that you had this head injury. And

Sam (04:39):
So you're my teams. I had a pretty bad TBI had a concussion. Definitely. You know, there's a combination I would say, had the physical injury itself, but I would say my nutritional knowledge and practices at the time were not best suited for someone who had a significant injury <laugh>. So you combine kind of the nutritional knowledge that I had with being relatively overactive undereating and then had a pretty, pretty bad concussion snowboarding. And it was just kind of this perfect storm effect of, Hey, like your body is probably actually under stress and needs a bit more nutritional support, only wish I knew more about the gut brain connection at that time knew more about endocrinology, knew more about physiology, but I didn't. And so I was coming from the approach of this, you know, very active, younger guy who probably needed to be eating significantly more calories.

Sam (05:26):
But unfortunately, most of the nutrition advice that you would find would be, you know, in a magazine related to health and fitness, or, you know, just kind of your basic stuff that was out there. So a lot of that information was either not appropriately applied to my situation, or it was just bad information in general, which is kind of, I think while there's definitely some drawbacks to social media, one of the positive things, I think there's just more information in general, which can be a bad thing if you don't have a filter. But at the time I was just sort of left a little bit to my own devices and some things that weren't maybe the best approach, also things like functional medicine, integrative health, weren't quite as popular at the time. So, you know, going back like, well over this is probably over like 17, 20 years ago.

Sam (06:11):
You know, for me, that kind of sent me on the path to have this interest in the endocrine system, better understanding hormones, better understanding kind of how things work. And then I also noticed that just a lot of the clients that were coming to me as a health, fitness, nutrition, professional, it was like, you know, this, isn't always just kind of this basic, like do sets and reps and, you know, eat X, Y, Z, and generate, you know, ABC results. So that really sent me down the rabbit hole to learn more and continues to play out today. I think if anything, it's just become more relevant as I've spent more time in the health, fitness, nutrition space is that there's been a greater need for understanding those complex concepts and what we used to view as kind of the conventional case. I think honestly, a lot of that like higher levels of stress, reproductive dysfunction, you know, adrenal and gut stop. That's just becoming more the norm, whereas maybe not as much several decades

Christa (07:03):
Ago. Yeah. So we'll have to talk a bit more about reproductive dysfunction. I like the way you term that I usually just call it fertility <laugh>, but I like, it's not always a sexy topic, but you can make it more sexy on the podcast. And I think we have to bring so much light to it going back. I highlighted overactive and undereating, and I think this is a plague of the health conscious individual when they're getting started, because there is so much just like not helpful information as you described with your own brain injury or traumatic brain injury, what were some of the outcomes that happened in your own health? And this was like you said, this was kind of the catalyst for you becoming interested in the endocrine.

Sam (07:41):
Yeah, for

Christa (07:41):
Sure cetera. But what happened to you personally? So

Sam (07:43):
I think it's pretty natural for most folks to see changes or aberrations in that situation related to thyroid reproductive hormones. For me, I noticed some changes in overall immune health. So it's definitely less resilient from like getting sick perspective, fatigue, general lethargy. So I'm big on tracking biofeedback. So at the time I didn't realize, Hey, this is gonna impact your energy levels. This might impact your overall, how you kind of manage stress and handle stress or overall bandwidth there, you know, sleep quality, all of those things, exercise performance. So that's how it kind of would manifest in terms of biofeedback. And then in terms of labs, I was just not seeing necessarily what you would expect from someone who's really relatively young individual in terms of what you're striving for in terms of optimal, like reference range values. And didn't really know much about like serum labs at the time, or testing my own health or having an idea of my health status.

Sam (08:36):
So that kind of sent me down this rabbit hole, both through less conventional health avenues, as well as working with Western medicine professionals in like an endocrinology office and beginning to acquaint myself with the idea of lab testing and understanding that also had, you know, several different MRIs and different pituitary scans and all of those things. And then they just use big words like heterogeneous enlargement of your pituitary, you know, then you kind of go, go Googling from there. So that's kind of where it started. But I would say for me, definitely just in terms of overall like energy levels, cognition, biofeedback, and, you know, being a pretty, like I enjoyed being active. So not being able to necessarily have that kind of optimal quality of life, certainly being frustrating as well.

Christa (09:20):
Yeah. So we're gonna talk a little bit about low hormone status today and the causes of low hormone status and debunking some myths about that. But first to set this up, let's talk a little bit about causes of low hormone. And maybe I should set that up a little bit further because I think it's such an innocent question. When people ask me, how do I test my hormones? I'm like, well, what are you talking about? Are you talking about your sex hormones, your stress hormones, et cetera. So you can take this wherever you want, but let's talk about top causes of overall hormone status and what that might look like on the other side. Why would someone care about it?

Sam (09:51):
Yeah. So when I look at metabolism and hormones, that kind of think of, well first, what is our body really trying to do in maintaining sort of homeostasis or overall kind of balance if you will. And really from a physiological perspective, when we see changes in hormones, a lot of those changes are adaptive. So that could be to due to a change related to energy coming in overall energy availability, which would essentially be, you know, the quantity of the calories I'm consuming, but also within those calories and being that food is sort of instructions for your metabolism in that food we're eating. We also have micronutrients and certain micronutrient deficiencies can certainly impair hormonal function as well, actually gonna be kind of dropping a podcast on that soon. So we can see both the energy side, but then we have this really strong stress component to a hormonal related changes.

Sam (10:37):
So when we're under stress, our body is essentially, you know, we've probably heard of the fight or flight response before. So when we're under stress, whether that is from a perceived stressor in our life, or maybe we have some internal health issues, there's inflammation could be a form of stress that we're experiencing. So maybe GI stress, you know, circadian stress is a big one. So folks where it, whether it's actual jet lag, social jet lag, core, sleep, quality, not great circadian hygiene, all of those things are stressors in terms of our hormones and metabolism. So when I think about, okay, this is where, you know, hormonal dysfunction can kind of stem from, or maybe not optimal hormone levels. Typically we can tie it back to something related to stress, something related to energy. Now that could be undereating, but we also see in terms of Western society, if we move outside of the health and fitness bubble and folks who tend to like to exercise and like to kind of monitor their food intake, we do see folks with a standard American diet and sedentary lifestyle where overeating is actually a stressor and we have too much energy kind of coming through the system that we can't necessarily manage.

Sam (11:39):
And that is where we see insulin resistance in metabolic syndrome. So it can be on both sides, undereating, or overeating. Now, as far as what that adaptation looks like and the resulting or model dysfunction, that's gonna play out a bit differently depending on the individual and their lifestyle. And that's why looking at habits and behaviors and lifestyle and choices really does matter, but in terms of how that manifests for an individual, it's also why it's important to understand biofeedback and testing, as you mentioned, whether that's blood work or otherwise. So I really draw back to kind of that energy availability aspect, as well as stress. Now, stress can be different for different people. So for some folks it's that perceived in psychological component or some sort of, you know, traumatic component instance in their life that is contributing to that. And we see that a lot with autoimmunity, for sure, but there's definitely other things that can sort of compound and build over time.

Sam (12:28):
And maybe for an athlete it's, you know, training a little too much relative to their recovery bandwidth that can certainly lead to hormonal changes or hormonal aberrations. And then for other folks, remember I mentioned that sedentary person that in itself can be a bit of a stressor too. They're not actually moving enough. So I definitely like to look at kind of the full picture of multiple scenarios. And that's where context is really important because you know, someone who feels less than optimal and maybe has some form of hormonal abnormality of some kind, it's not always the same person to person, and it's largely gonna be driven by their past health history, you know, their past diet choices, past exercise, routines, and different things that they've sort of engaged in over their lifetime.

Christa (13:11):
So we'll come back to testing in later, but I wanna ask this question because I know I talk about it in a certain way. Do you feel like hormonal shifts are a primary? You know, when people come in, they're like this must be my hormones or hormones primary or secondary to everything else that's going on.

Sam (13:26):
I would say kind of depends on the like hormones themselves, right. We're kind of opening Pandora's box mm-hmm <affirmative>. So I do think sometimes hormones can be a bit of lagging feedback relative to other things, and it's kind of which came first chicken or the egg. So for someone who is a full blown stress cadet and everything from rush hour traffic to picking up the kids to, you know, living their daily life and maybe trying to go to high intensity exercise classes twice a day, that strong stress component, maybe a lot of their issues driven by some sort of adrenal related stuff, right. That could be one sort of avatar. So where, you know, our hormones to blame there, you know, there's obviously their behaviors, their lifestyle and their way of kind of moving through things and their habits are certainly kind of at the cornerstone.

Sam (14:12):
But I have used the analogy before that we have sort of these foundations. So sometimes, you know, maybe it's a gut health issue or there's something else going on and hormones are like on the second floor of the house. And so if we don't have that solid foundation, sure. Maybe your second floor is a little bit crooked, but maybe it's because the foundation is off. Yeah. And there's something else going on beneath the surface. So I wouldn't say that hormones are always kind of that primary thing. Sometimes it can lag a little bit behind or it's signs that there's other dysfunction beneath the surface that we need to address. So kind of the longer that I've been around in my career and seen, seen more and more cases, I realize, Hey, let's look at that foundation of the house. And the first floor before we start worrying about like, okay, on the second floor, the floor is ever so slightly, you know, off to an extent.

Sam (14:58):
And that's kind of like using a women's health example. A lot of times we'll see, okay, maybe suboptimal, progesterone values impacting what's going on from a fertility perspective, but it's like, okay, it's not like the progesterone just ended up and decided one day, like, okay, I'm not gonna be in optimal progesterone value. Something else happened in terms of either the woman's life, nutrition, stress, you know, there's probably something else going on. That's leading to what we're seeing in that person's L phase. Right? Yeah. So that might be an example of where reproductive hormones. I do think a lot of times it can be an indication that something's going on, but usually you have to go a little bit like a layer deeper is the way I would kind of explain that

Christa (15:37):
I like the second floor of the house example. I always say hormones are secondary to gut health, toxic burden, micronutrient stress, blood sugar, because that's, or what seem to affect them the most. So I think we're on generally the, the same page there.

Sam (15:52):
I think there's always, yeah, that's very similar to my kind of when we teach kind of the core four, so catabolic physiology, oxidative stress, resistance, insulin, or insulin resistance and excess inflammation. So a lot of those are gonna go hand in hand, like if you're that stress cadet that I mentioned, that's certainly catabolic physiology, but that's probably also influencing reproductive hormones. You may have low androgens, you know, high cortisol to some extent then, okay. That can also influence your gut health, micronutrient status, and then rounded round. We go every the, the more you time you spend in the trenches with those cases, you realize everything's really connected. I can't really separate it out other than for the purposes to maybe teach something slightly for 10 minutes in isolation. And then you'll end up in a conversation talking about something that's just kind of peripherally related to it. So very, very hard to parse out because I firmly believe that it's all so integrated that we can't really look at it in like a silo based approach. So I think we're pretty similar on that front.

Christa (16:49):
Everyone wants better progesterone for the most part. <Laugh> generally it's like, oh, can I just like take something, increase my pressure ster? No, not just one thing. Sorry. There's several things, but probably stress is for JustOne and actually that's gonna be part of our discussion, but before we go there, which I should go there next I wanted to touch on the way you talked about biofeedback, which is essentially measuring markers of health. Talk to us about how, if you're doing that really officially or unofficially, are you basically just having people track certain things so they can get a sense of awareness for themselves?

Sam (17:19):
Yeah. So a couple years ago I basically came up with, you know, I was working with clients and also realized as I was teaching other professionals and practitioners tracking biofeedback clients need the easy way to remember what they're supposed to track. So I use shreds, which is sleep, hunger, recovery, energy, digestion, stress coming from a background where I did have a lot of clients who had body composition and fat loss oriented goals. It was very easy for them to remember. And we look at both qualitative and quantitative markers. So in terms of sleep, yes, I would like to know how rested you feel from a subjective perspective, but I'd also like for you to rate that same thing with stress, like how stressed are you let's rate it on a scale, but then also tell me about your week. What about it was stressful? So for some folks working professionals, maybe there was unexpected travel, you know, for family oriented folks, maybe there was something going on in terms of kids, or you had to, you know, pick up some extra slack for your sister or something.

Sam (18:13):
There's all sorts of different reasons why our biofeedback may change. So I always like to have room for a client to elaborate and give a little bit more of what's going on subjectively in their life, but then also create sort of a numerical marker that we can track over time. And then usually I'm trying to look at things like biofeedback and some of the basics, like a food log with, you know, blood work and more of an objective marker of what's going on from an internal perspective. So I like to integrate those, but as far as what I use for clients and also helping coaches kind of remember that I mainly teach, Hey, let's use shreds and then let's have a quantitative component. And then a little bit more of that qualitative component as well.

Christa (18:51):
Cool. Because sometimes when you think about biofeedback, you think about actual physical measurements, right? Like a aura ring or something like that. And it doesn't have to

Sam (18:59):
Be, yeah. If clients doesn't have to be like that, access to that. I mean, that's wonderful. I mean, we've used whoop, we've used aura. We've used some people now there's like beds that are supposed to be tracking things. But I think the most important thing too, is that a person is able to sort of tune in to the feedback that's being provided by their body and what they actually need there. So there is a bit of, Hey, you know, technology can be helpful, but I've also had some folks where it's like, we need to put the aura ring in airplane mode. So it's not transmitting the scores because their mood will change seeing that their score was lower. Versus if they just put it on airplane mode woke up and asked themselves, how do I feel today? They'd be like, oh, I actually feel pretty good.

Sam (19:40):
And you know, they go about their day versus someone sees a 74 versus an 85, or they don't get the crown on aura. And then they think, oh, well, I'm just gonna have the worst exercise session today or training session today, or whatever work is crappy because I didn't sleep as well. So I do try to leverage the information as best we can to look at patterns and trends, but really my favorite way to use those tools is to take about a week of data and then look in review and say, okay, how did I do in terms of like my pre-bed routine? How did my sleep show up? You know, this week in terms of score overall sleep quality, you know, and look at it as kind of providing that marker. So I'm not anti-US using the tool. I think I just have my own way of using the tool.

Sam (20:21):
That's a little bit different than how people who look at it on a day to day basis. I would much prefer kind of looking at it holistically, kind of like if you had a client do a seven day food journal, and then you look at what happened across seven days, rather than examining one meal in isolation. Because I think when folks are very granular with their aura or whoop or take whatever track, same thing with a continuous glucose monitor, you could find something to be less than ecstatic about, right. Even if you are striving for optimal health and doing all the things. So I like to use those tools a little bit differently, more from like a trends analysis perspective, rather than solely looking at a particular hour or day in isolation.

Christa (21:01):
And if you are struggling with sleep and you have something that confirms that it's not creating positive neural pathways either, it's like, then it becomes a hindrance as well. Yeah. Which I think is a different way of saying it. So let's get into hormones that do drop under stress and why they drop under stress. This could go a lot of different ways. Maybe we'll just itemize hormones that get the brunt of it right away.

Sam (21:24):
For sure. So I would say no, this can vary person to person, but some big ones, obviously we've already talked about progesterone today from a fertility perspective for females. I think testosterone definitely seeing both men and women experiencing lower testosterone for sure, thyroid, as a result of that upregulation of the HPA access and having increased cortisol, nutrient deficiencies inflammation, all of those things can impact the free T3 that we end up with and how we feel from a thyroid biofeedback perspective and kind of having those subclinical thyroid symptoms. I think a lot of times that can be very stress driven and naturally just by being stressed and experiencing stress, we, we all sort of think of cortisol as the stress hormone. So you kind of have to bring cortisol into the equation when we're talking about those things. But if I had to just rattle some off, definitely progesterone testosterone, thyroid, eventually in females.

Sam (22:16):
Now, if you do push that stress long enough for an extended period of time, and especially if we have any sort of nutrient deficiencies or we're not eating enough, estrogen can also fall in time. And then naturally because our adrenals are involved in blood sugar regulation, insulin can come into the equation as well. Now that can vary person to person, as far as, you know, the severity of the stressor, what their diet looks like. Also their exercise and movement patterns can influence what's going on with insulin too. But I'd say some of the big ones that you tend to see on social media for sure would be thyroid progesterone, testosterone. But obviously if you're working in more of a clinical setting or you're working with clients, I would definitely encourage you to bring in some of those other factors as well. And, you know, maybe spot check things like fasting insulin and stuff like that too.

Christa (23:03):
So let's talk about the concept of the pregnant alone steel. And let's go into a little bit of creating low progesterone, for example, because this has been something that has been until I went to Dutch Fest in probably 2019. I didn't know we were debunking the pregnant alone steel. That was just like how I had learned it at that time as well. So let's talk about pregnant alone steel, what it is and why it's not exactly how it works.

Sam (23:27):
Yeah. So essentially the pren and steel is this idea and kind of to think about the pren and steel, you have to have a basic understanding of how adrenal hormones are created. So we'll kind of think of the basics, but you know, in most instances, people are thinking of what seems like this logical idea, which is the way that hormones are synthesized through a steroid pathway. So you can picture like a textbook flow chart. And so according to this pathway hormones like progesterone, testosterone, estradiol, and D H E come from this single pool of pren. And so it seems like, you know, predone is almost like this holding tank or this fuel reserve, you know, to, to then play a role in this kind of trickle down of everything else. But basically it all starts with cholesterol. So cholesterol's the first raw material where, you know, from which adrenal hormones, sex hormones in their precursors are created.

Sam (24:14):
And then some of the final products are gonna be, you know, steroids, right? So whether that's testosterone, estradiol progesterone and things like that. So with a lot of women's health cases, when folks are under stress, they say, oh, well, your progesterone's low because of pregnant alone steel. Now, when we kind of move further up in this process, we have to understand that, you know, this theory of pregnant and steel basically states that in times of chronic stress, more pregnant alone is shunted towards cortisol production and less towards our sex hormone precursors, right? So more towards corticosteroids and less towards, you know, androgens or estrogen. And it's implying that the amount of pregnant alone that's available is the right limiting step for steroid hormone synthesis. And this sounds good in theory, but as far as you know, when we think about it, there are a couple issues with this concept.

Sam (25:04):
And so basically cholesterol binds to a protein called star within the mitochondria of the cell. And the conversion of two pregnant alone happens within the mitochondria of each cell type that creates its respective hormone, meaning the cells that create D H E a for testosterone production, cholesterol is converted to pregnant alone. And then multiple steps later, it's gonna be converted into that DHA. So rather than robbing between different cells, we want to think of it as like, okay, the cholesterol is in that cell. And then, you know, we're essentially binding to that star protein. So in situations where we are under stress, what we have to understand is cortisol can inhibit star protein, but also what's happening is when we have stress, we have negative feedback to the hypothalamus, to the brain. So whether we're talking about, you know, H HP access H P T access, or otherwise H B T a for men or HB G or hypothalamic pituitary, variant axis for women, a lot of folks forget the brain part of it, which I think is so important when we're talking about hormones.

Sam (26:03):
And we're talking about stress is that your brain is like constantly, you know, sort of evaluating these signals in these chemical messengers and looking at it from there. So if you want to think of an analogy, if you imagine a situation where there are multiple different factories that specifically produce one item that's made out of wood, one factory produces, you know, wooden saunas and the other produces mobile homes. And this analogy, the factory that produces the wooden saunas or the cells that produce cortisol. And the one that produces the mobile homes are the cells that produce like DHA or testosterone or progesterone, et cetera. And you have these raw logs that are delivered to each factory. In this analogy, the logs are basically your cholesterol. So if the logs are already within each factory, meaning cholesterols already in each cell, the logs then gotta get cut into boards that are the correct size to further create the product.

Sam (26:50):
And these boards are pregnant alone. So the factory that produces the saunas, isn't gonna be like stealing away the cut boards from the factory that produces the mobile homes. So I always like to zoom out and think, okay, well, there's other aspects here that are gonna impact hormone production. And while there are signals and chemical messengers that play a role, we're not just all of a sudden, you know, showing up one day and we just robbed all of this pregnant alone to where, you know, we can't make progesterone anymore. It's really more of cortisol is going to create negative feedback. That's gonna impact Lutin hormones. So the gada Tropin that plays a role between the communication between the pituitary and the ovaries. And we see that LH is such an important part of reproductive hormone dysfunction, both in terms of low progesterone states. So in like our high estrogen, low progesterone females, but also when we have maybe some LH imbalance to FSH and P C O S.

Sam (27:40):
So I think a lot of times, because it is a little bit more nitty gritty because it is a little bit more sciencey, the gonadotropins and LH and FSH don't get as much love when we're having these conversations. People really like to talk about progesterone and testosterone estrodiol, they don't necessarily love to talk about what's happening from the brain down to that reproductive tissue or to that reproductive gland. So whether we're talking about the ovaries for women or testicular production of testosterone and men, and we see that pattern as well, you know, for men low T could be, you know, cortisol, inhibits star protein stress also has that negative feedback to LH. Also, if we are, you know, accumulating body fat, that can impact the conversion of testosterone estrogen in terms of aromatase. So when they really, really drop what we need to think about when we zoom out is, you know, it's not that pre steel decreases our sex hormones.

Sam (28:27):
It's a nice thought of something that I think whoever started this process of teaching, it was really more of a simplified way of kind of looking at a textbook, looking at a flow chart and trying to make sense of something. But I think the body is, you know, amazingly complex and kind of this beautiful way when we think about physiology. And so what we need to understand is there's different physiological and cellular mechanisms by which this lower reproductive hormone level is occurring. But one large one is really the brain. So from an evolutionary point of view, if an individual's under stress, think of like, you know, basically there's a animal that you're worried about in terms of a predator or you are, you have conflicts with other humans or war going through famine, traveling with, you know, maybe an unsafe environment. None of these situations are super conducive to fertility.

Sam (29:19):
And so when you kind of had that saying earlier of like re fertility, I thought that was really well stated in terms of how that kind of relates to this process. But also, you know, I kind of use whether it's reproductive hormone dysfunction or low progesterone, it kind of makes sense in that we need progesterone to sort of protective in the sense of fertility. And so the brain is basically, downregulating some of these signals, we see this with men's health all the time as well. We also see this in studies where if you actually provide mammals or humans with, with exogenous cortisol, and it's administered, anytime we see cortisol administered from the outside, we see drops in gonadotropins, such as LH, and then subsequent drops in testosterone. So, you know, LH, once again, is that luteinizing hormone from the pituitary. So we not only have sort of this study, isolating the variables and showing us what's happening when you administer cortisol, exogenously basically you take an external hormone and you are adding it to the body. And then what happens to our reproductive hormone cascade as a result that is a really big component, but then also even after you know, that signaling in terms of the LH signaling, we also have sort of this inhibition of star protein. So if I had to come up with like one or two reasons, as far as, you know, your strongest evidence for debunking that pregnant alone steel, those are going to be my answers there.

Christa (30:34):
So if I was gonna summarize a little bit, overall stress is depleting hormones, but the mechanism by which it is depleting them is more complex than the simple version of you're going into the factory and stealing the raw boards, which I do really love this analogy. So thanks for bringing that up. So it's not that you're just stealing those boards. You can't just, I think that the concept there is that we like an easy button. And so some of the conversations that have come up over time are, well, could I just go take pregnant alone? No, <laugh> you cannot just go take pregnant alone and correct all of your low hormone situations. I think like if I highlighted a couple things, I think the mitochondria is often the bottom line. I always call mitochondria the fountain of youth, but a lot of this action is essentially happening in mitochondria, right?

Christa (31:18):
Which is all the little organelles in the cells that do so much including produce energy. And so if your mitochondria is suppressed, which it will become damaged from a lot of stressors in life, whether that's mold or over exercising and undereating or stress of any type, any kind of oxidative stress as you called it. Right? All of those things are gonna totally screw mitochondria, which is gonna make it look like you have no resilience. And then I also wanna mention is you so well stated about the brain? Like it's not as sexy to think about use everything starts in the brain down to the reproductive glands, hormones, et cetera. And when I think about even in your traumatic brain injury, I find TBI is so freaking fascinating because it's amazing what happens nutritionally in the body when you have a TBI, because if everything starts in the brain and you have brain inflammation from one reason or another, whether it's a physical inflammation or a mental or stress inflammation, a trauma, whether you think it was a trauma or it wasn't a trauma, it's really quite fascinating how that is like going down the rest of those pathways.

Christa (32:17):
And so it's just, it's not that the overarching factor is like, well, your brain is still in charge and stressors are still gonna create low hormones, but it's just more complex. And you can't just like stick in pregnant alone.

Sam (32:28):
Yeah. So the more of that symphony, you know, to kind of use a musical analogy, instead of, you're not really a factory person just thinking of it from a music perspective is what's going on with one particular instrument and the sound impacts, you know, entirely what we're experiencing. You know, if you were listening to a violin at the same time as a cello, like there's, there's just multiple things going on as well as kind of the conductor and think of the brain as sort of playing a role with, you know, ultimately the orchestra that is our hormones. When I have seen folks supplement with pregnant alone, it seems to be more of what's going on at the neurological level as opposed to providing raw substrate. Because I think also when people think about cholesterol and pregnant alone, well, if the bottleneck is pregnant alone, then you're also forgetting that well, the body can make cholesterol.

Sam (33:12):
It's not solely dependent only on our dietary cholesterol. So there's multiple sort of flaws there. Even if you go further up one step in the chain, you can also say, okay, well, not only am I consuming dietary cholesterol, which, you know, we have that side Cleo Genzyme where we're essentially cholesterol gets a haircut and becomes pregnant alone. So not only would the body, you know, assuming nutritional status would just eating would provide that cholesterol, but the liver also synthesizes cholesterol. So really whether you look at the top end in terms of the brain and what's going on, if you look at the mitochondria and star protein and that binding, or you even look at further up from predone, which would be cholesterol prior to the predone, there's just multiple flaw. There's really sort of two to three sort of flaws with that line of thinking.

Sam (33:54):
And it's great that people want to learn about hormones and speak about hormones, but I think it's so much easier to just say, Hey, you know, when you're under chronic stress, there's going to be, you know, feedback to the brain. That's going to impact hormone production. And we need to think about what's going on at a cellular level too, and at the level of the tissues and you know, between those, the reproductive anatomy and glands and the brain, we end up with this resulting dysfunction. And I think it's okay to kind of approach it from that angle. We're just slowly but surely moving away from the pren and steel one debunk at a time.

Christa (34:25):
Yeah. Love on all of those organs, love on your liver, love on your brain, consider your brain support your mitochondria. So one question that came up here. Well, there's two things I wanna just state and ask. If you have anything to add, you know, we didn't really talk about what it feels like when those hormones are low, the ones that we described, or you, you mentioned were progesterone, testosterone, thyroid cortisol, I would say in general, you feel exhausted and you don't always recover. <Laugh> that's like the bottom line. You just feel like not awesome from any of those things. You just do not have the energy, stamina, et cetera, and you cannot recover and he'll always call testosterone kind of a maintenance man. The thing that pops up, I think that we should address would be since cholesterol is a starting point. There has been a historical focus on low, low, low cholesterol, historically, right over the last few decades. Probably it functionally I've been my opinion. It's totally wonderful for cholesterol to be higher. End of normal. Do you have any comments about this?

Sam (35:20):
So I think even in Western lit reviews, we're seeing changes here because I think of 2021 study the most recent one, they actually found the best all cause mortality was currently above the Western reference range. I think it was around one 40 or one 30 in terms of LDL. So I think we've demonized cholesterol for a long time. If you do have family history or cardiovascular risk factors, I would definitely encourage you to look at other markers like your C R P your fasting insulin, you know, bring your triglycerides and HDL into the equation. Instead of just LDL. I would also look at APO B and LP little a, so you can definitely consider that personally, I have a family history looked at a calcium score. I think there's ways you can get more data instead of just demonizing cholesterol. We also see a lot of not so fun effects and side effects.

Sam (36:06):
When you use something like a statin drug to manage quote unquote, manage cholesterol. That's not so great for mitochondria, as you mentioned very eloquently earlier in terms of your conversation around mitochondria. So I don't love the implications of statin drugs for men's health and testosterone. You know, we do actually in some statin drugs also see a bit of, you know, mild insulin resistance that can occur as well. So I'm not really loving that from a metabolic perspective. So I do feel like there was a lot of scrutiny around cholesterol for a really long time. And we need to look at a bigger picture than solely, you know, making claims based on LDL. I just don't think that's appropriate at this point in time. I think our knowledge of nutrition has grown. I think our understanding of the human body has grown inflammation, insulin resistance. A lot of the folks that we're seeing who have sort of these skewed lipid profiles.

Sam (36:55):
Well, a lot of it, you know, there's inflammation, there's insulin resistance, there's metabolic dysfunction. And you know, it's, cholesterol's there. Yes. But is that the sole issue really that's like driving this entire problem. I think we need to continue to look deeper there. So I don't love that cholesterol's always demonized in that fashion. I think there's a lot of things we can do from a nutritional perspective to, Hey, you still have, you know, your cholesterol values and maybe they're not bottomed out, but I, you know, that doesn't necessarily mean that you are automatically at risk for, for things from a cardiovascular perspective. So we actually have been very much down that rabbit hole from a cardiovascular health perspective and also networking with a lot more functional cardiologist because it's something I'm passionate about. My dad actually had multiple stents and significant sort of cardiovascular issues.

Sam (37:40):
So it's been something that I've explored over the years, just outta my own curiosity and based on a lot of the misinformation that's out there. But even if you look a little bit more towards the Western medicine side where even seeing those journals kind of change, I think that most recent publication in 2021 was like a one 30 or one 40 LDL was actually found to be best for all cos mortality. So too low was actually a bad thing. You actually didn't live as long. So just to kind of simplify the research for folks at home, and I'm hopeful that will get some more information like that coming out soon to kind of continue to debunk it. Cuz I always get a little bit of a chill or a little bit of a herky kind of feeling when I hear two old ladies at the grocery store talking about whole eggs and you know, how there's these different myths around how all these things are so bad for you. So it's

Christa (38:22):
Hard to get these things to die. <Laugh> these, this St I like use that all the time. Cause it, sometimes it feels like it's just an, a bit of an uphill education battle sometimes with trying

Sam (38:33):
To say lots of diet dogma, that's for sure.

Christa (38:35):
Oh, so much diet dogma. So thanks for talking about statins because I do not appreciate them very much at all with the symptoms, the muscle pain and the mitochondrial dysfunction, just not always worth it. So something to look at,

Sam (38:50):
Put some Coke, you 10 in, if you are in the unfortunate situation, please,

Christa (38:52):
Please do throw some cookie 10 in there. If you're like, I took statins and now I'm exhausted. Like please <laugh> support your mitochondria. You can now go wrong. Typically supporting mitochondria. Typically I wanna wrap up with, I think let's talk a little bit about testosterone as a man here. I'd love to talk about testosterone, but testosterone, a woman is so important. I always call it the maintenance man, right? You need a little bit, not a lot to just help with repair and recovery, but I see low testosterone, you know, something I've been paying more attention to lately is where this year is just low testosterone and presence of low cortisol or normal cortisol. It's pretty dang hard to get the testosterone up with herbs and other things if your cortisol is low or from stress. So what do you wanna tell us about low testosterone weather and men or women or whatever?

Sam (39:36):
Yeah, so I think testosterone is actually super important for women and men. Obviously we have the energy perspective libido perspective, but also what gets lost sometimes is testosterone. In addition to kind of being the maintenance man, as you described, it actually serves this really nice role in thwarting, the accrual of body fat. So if optimal body composition is your goal, testosterone is very helpful in terms of maintaining optimal body composition, building lean muscle tissue. And, you know, I like that you mentioned having sort of the right amounts there, but I think in women, some of the biggest things we'll see as, you know, low libido, impaired recovery altered performance from an exercise perspective in terms of men, it can be very similar there as well. Definitely some mood changes, so low testosterone can impact, you know, mental health increase, depressive symptoms, energy levels, brain fog, cognition, overall output.

Sam (40:27):
And I think of testosterone almost as like the gregarious kid on the playground. And so, and testosterone can almost be a magnifi. So if you have certain personality traits, I think testosterone actually when optimized can sort of magnify the positive, when, you know, we get into that kind of appropriate range that we're talking about. So obviously there's a lot of sort of stigmas and myths around testosterone, but I think, you know, getting to that optimal level, you know, whether it's for a woman or for a man is not only important for libido, but it is important for your overall health and cognition energy levels. And you know, if you have any fitness centric goals, it's gonna be super important from a performance perspective as well. When you bring cortisol into the equation, as you mentioned, obviously that's impacting testosterone through what we chatted about a little bit earlier in terms of LH, but also star protein.

Sam (41:15):
And, you know, just having, you know, that cortisol off is likely also compounding and contributing to any brain fog, cognitive, you know, challenges, or just your ability to kind of have that steady energy throughout the day. So really both go hand in hand, you know, testosterone is kind of that signal in terms of, from a drive perspective, especially for guys, it makes sense that if cortisol was elevated or we progressed through stages of basically adrenal insufficiency, testosterone's not gonna be an optimal place because if stress is super high, it's basically saying, Hey, maybe right now is not an optimal time to reproduce. So let's exert less energy on doing that. It kind of throttles that back. We see that a lot with thyroid as well. So super, super important. I'd say both from a body called perspective and just overall quality of life. And doesn't always get all the love on the women's health side, which I think is unfortunate because I think when women get into a more optimal range with their testosterone can actually lead to some pretty positive improvements in terms of overall quality of life.

Christa (42:13):
I think we better address testing because people are gonna have questions about this. And I think this is a, this is a broad topic because hormones are broad. And so when someone says, oh, could I just test my hormones? And I'm like, but which ones would you like to test? Would you like to do urinary testing syrup testing? So are you testing hormones with clients or do you help guide them to test their own hormones and then how to evaluate those? Or how do you go about testing

Sam (42:37):
With clients? Yeah, so, so right now I'm, you know, mainly supporting professionals in terms of their education around sort of the intersection between nutrition and, and endocrinology, which obviously requires a bit of testing. As far as my personal preferences with clients. I do think serum labs are really strong foundation to get a picture of everything from, you know, your complete blood count metabolic panel, things related to insulin. We talked about lipids earlier, triglycerides inflammation, all that good stuff, thyroid obviously is gonna be sort of best assessed through that serum lab. Marker. I think for certain more nuanced cases, there could be some value to incorporating something like a Dutch Testin looking at overall metabolites in the pathways. So for example, maybe your P C O S female with increased five alpha reductase activity where we're seeing higher levels of DHT, which is gonna be more antigen than testosterone.

Sam (43:25):
And we're concerned about antigen symptoms. I think something like a Dutch, which is that dried urinary test for comprehensive hormones could be super valuable there using a DOD adrenal or salivary four point cortisol could be helpful in terms of looking at circadian or diurnal rhythm. But I think from a budget perspective, and if someone's really trying to get a complete picture, I do like serum labs. And I think we also have a lot of evidence to support their use both with, you know, whether we're looking at, you know, testosterone and free testosterone progesterone in the Lal phase, estradiol level, thyroid really gives you a nice picture there. And then since we did talk about some of the root causes of hormonal dysfunction, I think it's really great that with those serum labs, well, you could also look at something like, you know, insulin resistance, you can look at inflammation and you can really get a complete picture of everything that's going on there.

Sam (44:11):
Whether that's C R P fasting insulin, the list goes on really. It's like I look at lab lists. Sometimes it's like a kid in a candy store once you actually know what you're kind of working with. So I definitely am an advocate for testing, but I think we have to be very careful that you're not solely hyper focusing on numbers. You have to remember, there's a real person in front of you. You need to have that conversation around biofeedback, what are they doing from a quality of life perspective? And then I, I like to always go in with, you know, a comprehensive intake form and a really nice kind of glance at like a food journal and activity logs. So have an idea of what this person's life looks like, because otherwise it can be very easy to get almost two granular horse with blinders on and look at things in isolation when really I wanna see how everything is sort of interacting together between the person's life and also what's going on with the testing as well.

Sam (45:00):
So I think there's a lot of great testing options out there. It just really depends. Am I sort of looking at what's happening from like a metabolite perspective and concerned about those things? Do I have a specific use case maybe with a women's health situation where I need that? Or am I just looking for a really nice broad picture of what's going on with our health and having a lot of different markers and sort of references to work with? I think, you know, we could kind of go a different direction there. So I would say testing depends on the case. I know that it depends answers are not a lot of fun, but I think as of right now, we have the most evidence to support serum and then using a Dutch as we need to for reproductive hormones. And then we have a couple different options for cortisol, not really a big fan on salivary for reproductive hormones, but that's sort of a whole separate conversation. So mm-hmm, <affirmative>, I'd say that's kind of my base list, but I think you can go really, really far with some of the basics and biofeedback as well. So don't underestimate the power of conversation in a client relationship as well.

Christa (45:57):
Yeah. I just wanna highlight, is there a use case? So like if someone's got breast or cervical cancer in their history and they wanna look at those estrogen metabolites or like you have

Sam (46:05):
A piece you wanna

Christa (46:06):
Look at those testosterone metabolite or those androgen metabolites more. So

Sam (46:09):
That makes sense. I really like, I think from a metabolite perspective, right, then we'd be talking about the Dutch test with the Dutch test, you're getting those organic acids with the Dutch complete, you're gonna get diurnal rhythm or circadian rhythm. So if you're concerned about someone's, you know, cortisol, awakening, response, circadian hygiene, I think you get a nice picture there, the estrogen metabolites. So basically what you'd be discussing, there's the proliferative pathway versus more protective pathways. And then what I mentioned in terms of a P C O S case, let's say we have hyperandrogenism, we think maybe insulin resistance or inflammation would be driving five AR activity. We can look at that and basically see, okay, these androgens are kind of feeding into this pathway because of this enzymatic activity. We're seeing more of this particular metabolite. So I think it has some value there or situationally in maybe a premenopause setting or when we're looking, we've kind of isolated our variables and we have a really good idea of what's going on from a baseline health perspective.

Sam (47:01):
And we're really trying to dial in reproductive hormones. I've also seen use cases on H R T, although I do think having that strong foundation of serum labs and understanding what's going on from like a cellular health perspective, inflammation, things like that can be really helpful though. I still think we're accumulating a lot of really positive data and anecdotal evidence to support, you know, including things like maybe a Dutch or organic acid test and things down the road. It's just a little, little bit newer in terms of the industry. And also all of the evidence we have to kind of combine it with our clinical experience of what's going on as coaches and health professionals. And then that would bring us into a conversation of like gut brain access or mold or different things that you mentioned earlier, where I think we might go down a different testing rabbit hole based on that person's sort of unique lifestyle, history, symptoms, environment, all of those different things.

Sam (47:54):
So I think that's where the practitioner or client or coach client or provider client relationship gets to be really, really important. So, you know, okay, this is what I'm gonna order. And I also try to remember too, a lot of these sort of functional health testing methods. It's not super functional if no one can afford it. So I like to kind of structure, okay, what's gonna be the most bang for our buck based on what I'm seeing in terms of your complaints from a quality of life perspective and what I know about your health history. Cause if I can take those, I can get some pretty powerful information for like a few hundred dollars and we can be off to the races and like improving things through the coaching relationship.

Christa (48:29):
Yeah. I agree. I think that hormone testing can be useful, but we usually want it to be like a cure. All thing we think, oh, it must be a hormone imbalance and it may or may not be, but there's a lot of opportunities to spend a lot of money on a lot of things, but there's just a priority right. Position. And so

Sam (48:43):
You might even see for some people it's like, Hey, you know, hi homocystine and maybe you see some different complaints where you're like, oh, we're gonna look at methylation. And some, you know, basic adjustments there where I think you can get pretty, you know, it'd be very, very easy to spend over a thousand dollars in testing really, really fast. So we just need to prioritize like, okay, what's gonna be most important for this person. And that's why I love intake forms by feedback, food journals, seeing what's going on from a life perspective, having some conversations there and then strategically testing. And then if you need to do some follow up tests, right? Like you can always go back for more, right. It's not like the buffet closes at midnight. It's like tomorrow you can order another test. If you need to. Ideally we kind of bundle things together to where, you know, we make it efficient for, for the client. But overall definitely a huge fan testing seems like we have some parallels there in terms of stuff that we like. And also agreeing that, you know, sometimes it's nice to go beneath the surface of just those reproductive hormones.

Christa (49:38):
So if someone's listening to this and they're thinking, man, I feel kind of fatigued or not my best, or I wonder if I have low hormones or I'm just concerned in general, where do you suggest they start today?

Sam (49:50):
So as far as those general complaints, like obviously tracking that kind of look at your nutrition, sleep quality, those are kind of my favorite things. So just kind of keeping a little bit of a, you know, checklist with yourself like, Hey, am I feeling kind of run down? Cause I just haven't slept super great lately or is it, you know, I was trying this little diet for summer. I was trying to look a little bit better. So I maybe I've been under eating a little bit. I'd kind of start with some of those basics or Hey, has work been super stressful, try to think about those life variables. And then from that perspective, maybe, you know, do kind of your own little version of, you know, my version of shred. So you're looking at sleep, hunger, recovery, energy, digestion, stress. And then from there, if you're like, you know what, I, I don't know that I've really changed a ton of things, but you know, I feel like, you know, I should be eating enough and I, I think I have all these other things going on, you know, then maybe approach the idea of a coaching relationship or seeking out and, and doing that.

Sam (50:42):
There's also, you know, I think now more than ever the ability to get testing done, if you do have a good relationship with a provider who's willing to work with you in terms of ordering some tests, then by all means, you know, especially if it's been a while, like if it's been more than six months, 12 months, or maybe a couple years since you've had any health testing, I definitely love to get some of that baseline information. Also, when we're thinking about these changes in your health, like have you had any major like changes in medication or anything? Right. So if, if from a more of a Western perspective, if you just saw your primary care provider and they changed something up, maybe it's important to assess like, Hey, was there medication change? So I'd recommend kind of starting there. And then if you need a little bit more assistance, I think having that bird's eye view of a coach and someone who can provide the strategy, have conversation with you. I think that's super powerful. And then you can kind of explore and begin to troubleshoot what might be, you know your unique situation from that point, but definitely a huge fan of coaching. And then also testing when necessary,

Christa (51:41):
Sam, this has been really fun. Thanks so much for coming on today. Where can people find you online?

Sam (51:46):
So I'm similar science on all platforms in terms of podcast Instagram. I briefly dabble with TikTok here and there, but mostly mostly spend the most time. We were chatting about this before the podcast went live is just podcast about three episodes per week. And that's similar science anywhere you listen to podcast, but mainly on apple podcast is Spotify similar science on Instagram. And my website is Sam where you can find links to, you know, our programs for coaches and practitioners, as well as the functional nutrition and metabolism specialization. So that is where I hang out most. And for folks looking to learn more or read more, I do have book coming out, which will be on Amazon Q4 timeframe. So late fall, early winter around November, 2022. And that is metabolism made simple.

Christa (52:31):
Perfect, thanks so much for coming on today.

Sam (52:33):
Okay. Thanks for having me

Christa (52:35):
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