Transcript
Emily Dow: Hello, welcome to LabRat Radio. This is our first encounter. My name is Dr. Emily Dow. I have a PhD in exercise and nutritional sciences. I'm a registered dietitian and a professor.
Emily Dow: And with me today, as always, is my esteemed co-host, Dr. Nathan Jenkins.
Nathan Jenkins: Hello. um Yes, I am Dr. Nathan Jenkins. I am a PhD in a trained exercise physiologist. I am a long time professor as well. And I have a decade or so of experience as a nutrition and fitness coach.
Nathan Jenkins: But we're not here to talk about that stuff today. We're here to talk about, yeah, lab rat radio things. um This is our third episode. I'm glad you all are here with us. And it really is the the the Dr. Emily show. We're here to talk about today cortisol, which is a post that we have we've made together. we we had It's been, a I don't know, at the time of this recording, like a month or so ago now, that was one of our first ones.
Nathan Jenkins: If you're listening to this, you've probably been confused at least at the very least probably confused about cortisol. You probably had you might have thought that your cortisol was high, whatever, the you know, whatever.
Nathan Jenkins: So we're going to dive into that. So, um yeah, Emily, I'll turn it back to you. Like, let's let's let's get into it.
Emily Dow: Right.
Nathan Jenkins: Set it up for us.
Emily Dow: Yeah, I think this is ah this is a conversation that just deserves a little bit more nuance and elaboration because cortisol has sort of just become like an industry scapegoat in recent years.
Emily Dow: And you see all sorts of crazy shit online about how it is the cause of everything that we don't enjoy in life, such as like belly fat accumulation and
Nathan Jenkins: Right.
Emily Dow: it being harmful to your hormones as, especially as a female and all these claims about like coffee being harmful for cortisol and all ah hard training being harmful because of cortisol. And it sort of ends up just entering all sorts of conversations where it doesn't, it doesn't really belong, especially from the perspective of,
Emily Dow: academics and coaches where it really doesn't come up in practice ever. Like sometimes, sometimes, but very rarely.
Nathan Jenkins: right
Emily Dow: And it's always funny how those things just like enter the mainstream and become a new fear for the public.
Nathan Jenkins: Yeah.
Nathan Jenkins: Yeah, it's hilarious. like actually just posted on my Instagram today, I posted a a little short reel talking about like, and it's actually kind of coincidentally recording this now um to the point that you just made.
Nathan Jenkins: it It's a, it's a, it was the, the, the reel was on the broader context of hormone, hormone balance slash imbalance. Um, And my kind my my thought my general thought was like, what what does that even mean? Like, how do we define that term balanced versus not balanced?
Nathan Jenkins: And what hormones are we talking about? Usually when that comes up on social media, it is it does invariably almost involve cortisol, also thyroid hormones, and maybe sex hormones enter the mix there too. But like to your to your point just now, that's that shit doesn't really come up ever in like the nitty gritty of what we're trying to work on in the academic space, like where where we're trying to advance the field, where we're trying to advance health and and wellness and um longevity and all that kind of stuff, like what you and I are trained for and like the fields that we're actively engaged in. You know, cortisol is like a thing, but it's not like anything anyone's freaking out over. But then we open up our Instagram and people are losing their ever loving minds over cortisol. And it's just ah that's a huge disconnect, isn't it?
Emily Dow: Yeah. And we're going to get into the specifics of like, I think it's valuable to, I think it's valuable for everyone to kind of understand some of these physiological mechanisms and like what cortisol actually is. But at the same time, it's also just a good example of how the broader industry, especially on social media, will sort of just select randomly.
Emily Dow: things to worry about. Like you don't hear people talking about other hormones the same way, even we'll get into this when we're talking about the physiology, but like there's a very close relationship between cortisol and melatonin and you don't hear people like panicking over like, well, whether their melatonin curves are appropriate or it's sort of like some of them just get chosen as the ones to blame everything on.
Nathan Jenkins: Yeah. Melatonin. Right.
Emily Dow: And I think it's going to swing in all sorts of directions over time, but it's always just interesting how that happens.
Nathan Jenkins: Yeah.
Nathan Jenkins: Yeah. the the The cortisol and belly fat thing is just like, where where does where does that like somebody, if if if you know the the fucking PMID to send us in the
Emily Dow: Thank you.
Nathan Jenkins: you know, post it in the comments. Cause I'll read the paper, but I've never seen it, you know, that, that strong link. So I'm, I'm, I'm, I'm getting out, I'm getting ahead of ourselves and getting out over my skis. Um, but like you just mentioned, let's talk about the physiology of cortisol. Like let's set the stage you and you and I are both, um,
Nathan Jenkins: professors, we teach students these basic physiological principles. And there are also elements of that that we do in our work with our clients to just like, hey, let's like take a step back.
Nathan Jenkins: Let's make sure we have a basic understanding of like, you know, kind of the facts, the stuff that nobody disagrees on.
Emily Dow: Yeah.
Nathan Jenkins: So let's call it and the minimum necessary understanding of the physiology of cortisol. um What is it? What's its role? when it rises, when it decreases like this, the, the, the variations throughout the day and all that kind of stuff, what's, what does all mean? And you and I can kind of go back and forth and trade some thoughts on this, but why don't you start us off on that, Emily?
Emily Dow: Yeah, so basic physiology. I think everyone knows cortisol is a hormone. It's a glucocorticoid steroid hormone, and those are primarily derived from cholesterol.
Emily Dow: But there's a it's primarily managed by the adrenal cortex, and there's a sequence related to like the hypothalamus activating the pituitary gland, which activates
Nathan Jenkins: Yep. Mm-hmm. Mm-hmm.
Emily Dow: cortisol release and then cortisol has this interesting capability to like self-regulate once it is activated as well so there are processes involved in conditions related to when cortisol is released and when it's sort of potentially down regulated but that is always based on some either initial stimulus or like the cortisol awakening curve which we'll talk more about in just a second also
Nathan Jenkins: if okay
Nathan Jenkins: Mm-hmm. Yeah, and and for me, my background, and I think by this time, if if you've been listening to, we're now on our third episode, if you've been listening a along, you you guys will know that my background is an exercise physiologist. I teach exercise physiology, and Emily, you do too. But I always, when I present cortisol physiology in my class my university classes, it's in the context of fuel availability in and regulation cortisol.
Nathan Jenkins: it's It's very tightly linked to substrate utilization. um So in the context of exercise, so it supports glucose production and substrate mobilizationization mobile mobilization um during all the different states of ah fuel needs and or lack thereof, like fasting, exercise, illness and stress.
Nathan Jenkins: um It is it is what we see most of all in Instagram is it's the stress hormone and all that, but it's so much more than that.
Emily Dow: Mm-hmm.
Nathan Jenkins: But then there's also some like ah less appreciated um functions of of cortisol. I also have a big background in like cardiovascular physiology and and a really cool thing that it does that people don't really appreciate a lot is cortisol helps blood vessels respond to and and also cardiac tissue.
Nathan Jenkins: respond to catecholamines, which is another big word. I'm sorry, everybody, if you're if if I've lost you, but epinephrine and norepinephrine, adrenaline.
Nathan Jenkins: So adrenaline is like the fight or flight hormone. It makes your heartbeat faster when you're excited, when you're stressed, when you're threatened, or when you're exercising, it makes your heartbeat faster. Well, one of the things that makes that...
Nathan Jenkins: that facilitates that process, that, that response is cortisol. Um, that's a hugely beneficial effect of that hormone. So, um, yeah, that's, that's a major, major effect of, uh, cortisol release when we start moving, basically when we start, um, when we start exercise or any other kind of movement. So,
Emily Dow: Yeah, I think like to sort of summarize that easily for people, the way that it's communicated frequently is like cortisol is a stress hormone. And I think the assumption when you hear that is that like cortisol itself is stressful or it it it induces stress of some kind when realistically it's responding to stress.
Emily Dow: And it's once ah once any kind of demand is imposed on our physiology, i like to think of cortisol as like the energy management hormone in regards to
Nathan Jenkins: yeah
Emily Dow: again, pulling substrate, mobilizing substrate for whatever the task at hand requires. And then also, i think that just intuitively relates to like energy and can connect then to like the Chords All Awakening response and how it in how it reacts, I guess, with melatonin to essentially help us regulate our circadian rhythm.
Emily Dow: And To kind of give people an idea of what that curve generally looks like, cortisol naturally begins rising early in the morning, like 2 to 4 a.m., and tends to peak around 8 a.m. and then tends to be at its lowest around midnight.
Emily Dow: And melatonin is sort of inversely related to that, where melatonin peaks when cortisol is at its lowest. And that is why we feel tired at night and awake in the morning.
Nathan Jenkins: Sleepy. Yep.
Emily Dow: So you can see then, if you take that a couple steps further, how
Nathan Jenkins: Yep.
Emily Dow: it could be equally problematic if we're if we're pathologizing high cortisol and that's like the message that's being thrown out there as some sort of hazard that we need to be on the lookout for 24-7, low cortisol is would be equally problematic.
Emily Dow: And either direction, what we're really talking about is like chronic chronically perturbed cortisol rhythms.
Nathan Jenkins: Absolutely. Yeah.
Emily Dow: And that's a lot less common than I think most people would realize.
Nathan Jenkins: Yeah. it's way less common and it's, it is, i mean, I've, I've, I've certainly seen I, you and I both have seen it in our work with clients for sure. And we're going to get into like the actual things that people can,
Nathan Jenkins: do this more like kind of very, a lot closer to like things that they can control to manage that. But it's when you, when you see like a chronically dysregulated cortisol rhythm, it's usually related to like poor stress management or excess or, or it can 100%.
Nathan Jenkins: be stress load that is due to factors beyond the individual's control like oh my god there's a life crisis there's a you know like they insert massive unforeseen stressor here right that we all are dealing with our different things um but then when we're trying to like use cortisol as a scapegoat though for like you know i'm just I just feel tired all the time, but you know in reality, I'm not taking care of myself. I'm not sleeping well. I'm not eating enough or I'm eating too much. I'm training too hard or I'm not training as much as I actually think I am. you know and But all cortisol is a scapegoat for all of the above, right?
Nathan Jenkins: just one kind of addendum or, ah you know, just like a follow-up comment to to to what you just shared before we get into the case,
Nathan Jenkins: the the the the The blunted cortisol awakening response is a very robust, very well documented in the literature sign of HPA, the hypothalamic pituitary adrenal axis stress, chronic stress.
Nathan Jenkins: If the cortisol does not rise, it is a telltale sign of. Of just chronic stress. um and And then, yeah, that that is a major education piece for these folks to to to to explain, hey, yeah, your cortisol is not increasing as much as it so should. and it's like, wait, I thought my cortisol was too high. No, brother, it's too low.
Emily Dow: Well, yeah, that's exactly, that's where I was about to head also, because this is going to be relevant. We're kind of just like dropping some Easter eggs into how we would tackle our case also. um Because that's the thing, whenever you're talking about any like individual component of a mechanism or an individual hormone or something, if you're talking about that specifically as like the outcome that you care about or something that you're interested in measuring, it's important to think through, well, what will I do with that information if I have it?
Nathan Jenkins: Right, right, right.
Emily Dow: And i don't know about you, I've never tested my cortisol. I've never seen value in testing my cortisol.
Nathan Jenkins: I never have. and never I never have. I've only done it when clients wanted to.
Emily Dow: Right. And so...
Nathan Jenkins: i've ah I've only done it when clients wanted to against my better judgment many times.
Emily Dow: Well, because ultimately, like you were just saying, your decision thereafter didn't change based on that information.
Nathan Jenkins: No.
Emily Dow: lot of... Because cortisol is not the problem. It is a... It's like a proxy for the problem.
Nathan Jenkins: system. Yep.
Emily Dow: It's like the response to the problem. And you can identify the problem through the problems themselves also. So if I'm in a state of prolonged psychological stress where I might expect my cortisol to be dysregulated in some direction,
Nathan Jenkins: Yep.
Nathan Jenkins: Yep.
Emily Dow: I already know that and my solution would not change based on that information.
Nathan Jenkins: Yeah. yeah Yeah, and and and this is such a great segue to our case, and I'll i'll let you lead lead that part of the the the discussion for sure.
Nathan Jenkins: hormones are broken. her Her hormones are out of balance. Cortisol is it's too high or too low or whatever. She thinks it's too high. ah Talk to us about our case.
Nathan Jenkins: and yeah And we got to name her. Remember, what was it? was What was our case last time? It's been a couple weeks since we...
Emily Dow: It started with an S. I don't remember.
Nathan Jenkins: I think it Was was it Cheryl? Shirley?
Emily Dow: it was Cheryl.
Nathan Jenkins: Shirley?
Emily Dow: It Cheryl. Let's go with Diane.
Nathan Jenkins: Okay.
Nathan Jenkins: Diane, we're getting, yeah I love it.
Emily Dow: don't know why these names are coming to me.
Nathan Jenkins: Let's go. All right. Diane, the high cortisol runner who is stressed out.
Emily Dow: Let's, okay, so let's paint the picture of Diane and... We'll just get into it. So let's say mid to late thirty s say 38 years old. That is Diane. And she is training maybe for something like a half marathon and she's doing things right. So she's also lifting a couple times a week.
Emily Dow: However, as with many of us, she's also not sleeping quite as much as she thinks she should, maybe like six hours a night. has a demanding job, let's say she works in healthcare care or she is some sort of executive.
Emily Dow: Those are the individuals that tend to flock to us with these kinds of problems.
Nathan Jenkins: 100%. Yep.
Emily Dow: And she's leaning heavily on caffeine to get through the day, to get through everything that she needs to get done, to get through her training.
Nathan Jenkins: Let's.
Emily Dow: She's also, whether intentionally or not, restricting carbohydrates and kind of existing in some sort of under-fueled state at all times, oftentimes training fasted.
Nathan Jenkins: let's let's say she's intentional. I think we should ground this and say she's intentionally restricting carbs because that's, that's, that's most of you all at some point in your lives listening to this.
Emily Dow: she's intentionally restricting carbs.
Nathan Jenkins: So that's what I would say. Like she's intentionally thinking, intentionally restricting carbs because she thinks she's heard that you should do that.
Emily Dow: She's heard that she's supposed to. Okay. So she's intentionally restricting carbs. And one easy way to do that is to train fasted sometimes. So that is also at play here.
Nathan Jenkins: Mm-hmm.
Emily Dow: And she's frustrated because she feels like she's spinning her wheels. She's really tired when she wakes up in the morning, doesn't feel well rested after a full night of sleep.
Emily Dow: But she also feels like she can't fall asleep very easily at night. she's probably starving when she goes to bed, which certainly isn't helping. And she's like, what am I doing wrong?
Nathan Jenkins: here
Emily Dow: Because I'm working very hard, but I'm not seeing the fat loss that I want to see happening. So is it because of my cortisol is the natural question based on what the internet is telling Diane.
Nathan Jenkins: Yeah.
Nathan Jenkins: Right. So like, yeah, she, though so then she opens up Instagram and what is Instagram telling her?
Emily Dow: Instagram's telling her that because she's running, that's raising her cortisol. um The cortisol itself is whatever platform.
Nathan Jenkins: Or TikTok or whatever have you. Yeah.
Emily Dow: And as a byproduct of that, the cortisol is like making her resistant to fat loss for whatever set of reasons. And she shouldn't be training in any sort with any sort of intensity because that's also bad for cortisol and the rest of her hormones, whatever those hormones are referring to, as you discussed earlier.
Nathan Jenkins: Right. Also, she because she's a woman, because she's a woman, that's is especially dangerous.
Emily Dow: And
Emily Dow: especially dangerous because we are very sensitive, allegedly. And fragile, my favorite word.
Nathan Jenkins: Fragile. Yeah.
Emily Dow: And she's basically told that she needs to, like, stop doing everything that she's doing because she's causing her own cortisol to be too high. And that's why she's not seeing the progress that she wants to be seeing.
Nathan Jenkins: Yeah. So, all right, Dr. Emily, the professor, the the published author, the the the, you know, the scholar who's contributing to the knowledge in this area.
Nathan Jenkins: Have you seen anything in the literature that actually supports any of the, any of those things?
Emily Dow: No. No, I have not. i think...
Emily Dow: Spoiler alert, we'll get into more details here, but as like my coaching brain that's informed by my academic brain sees this person and is like, I can identify several things that we need to improve for the sake of her overall health and well-being psychologically and physiologically that do not require us to even think about cortisol for a second and whether or not
Nathan Jenkins: Yeah.
Nathan Jenkins: Right.
Emily Dow: it's in any way slightly dysregulated, those actions would solve her problems.
Nathan Jenkins: Well, that no, I love that. Before we even get into
Nathan Jenkins: we've got some stuff here to to, to some, some bullet points to talk about the physiology of cortisol, which we need to, but you just mentioned the the psychology and I want to let's, let's like take a quick side, side quest, side tangent on the psychology here. Like what, like the, I think, cause I think that's, I think that is the crux of this. That's the essence.
Nathan Jenkins: What is the psychology that you see when you get a client like this asking you, either yeah asking a question about their cortisol or fill in the blank hormone. We're picking cortisol because it's the probably the most common.
Nathan Jenkins: um it almost it's It's the most significant scapegoat. But um yeah, like what what is it? it's a pro It's a psychological proxy for something.
Nathan Jenkins: Let's unpack that. Like what do you what what do you think that is? it And it might be like a three or four or seven things. Like what is it?
Emily Dow: It's a lot of things. I think... So this is a very good example of an archetype of women that I think both of us are very familiar with, interact with on a daily basis.
Nathan Jenkins: Mm-hmm. Mm-hmm. Mm-hmm.
Emily Dow: There's a lot of us out there. i thought I've fallen into this bucket, I'm sure, at different times in my life where... We're looking at a woman who's really frustrated because she is trying to do everything right.
Emily Dow: And yet she's running into roadblocks and she doesn't have the time or the background education required to diagnose all of those roadblocks perfectly. And she shouldn't be responsible for that because she, this isn't what she does for a living. She doesn't have to know all those things, but because she's seeking answers and seeking information because she cares about doing things right and understanding,
Emily Dow: She's finding these scapegoats presented to her by people who are likely trying to sell her something based on those, based on those.
Nathan Jenkins: Mm-hmm. Mm-hmm.
Nathan Jenkins: Mm-hmm.
Emily Dow: I mean, this is discussed amongst coaches. it is a marketing tactic that has been suggested to me on multiple occasions. People are speaking to her pain points and therefore
Nathan Jenkins: Mm-hmm. Mm-hmm.
Emily Dow: Even the most intelligent, like well-intended, well-informed women fall victim to these misconceptions. And it's easy to, when you're looking for an explanation, it's easy to rationalize blaming something, even if it doesn't necessarily deserve that blame.
Nathan Jenkins: Mm-hmm.
Emily Dow: especially when the actual solutions and this can feel invalidating so i don't want it to come across that way the actual solutions are much simpler than they're made out to be but that also doesn't mean that they're easy to implement and that's where having the appropriate guidance really becomes useful
Nathan Jenkins: Right. So, so what, what do you think are the actual problems and the actual solutions?
Emily Dow: i think the actual problems involve the fact that Ultimately, what cortisol is taken to blame for is essentially like we all sort of have a bucket of stress that we're able to tolerate and recover from and progress in the context of.
Emily Dow: And her stress bucket is overflowing. And I think that happens frequently because we don't necessarily consider all the different types of stressors as contributing to that same bucket.
Nathan Jenkins: Yep.
Emily Dow: So if she's working a demanding job, she's psychologically stressed. She's probably overwhelmed, probably having to meticulously map out her entire day.
Nathan Jenkins: Sure. Yep.
Emily Dow: That's a lot of decisions that have to be made on a daily basis. So she's mentally exhausted.
Nathan Jenkins: deal with controlling bosses, deal with subordinates that are incompetent, middle management kind of situation, um people demanding her all day exactly, and still trying to train in the morning, up to sleep at night, spend time with her partner, with her children,
Emily Dow: She's also...
Emily Dow: Right.
Emily Dow: Putting out fires all day.
Nathan Jenkins: um be be all things to everybody all the time all day and then she goes to bed at night still feel like there's not enough she didn't get everything done yet that is what do we name her again uh diane diane diane is in listeners if you resonate with diane
Emily Dow: Diane.
Emily Dow: diane
Nathan Jenkins: But I think that's probably if especially, so we're talking right now for this case and actually our last one too, but we're going to change this probably in the future, but we're speaking mostly to the to the female listeners. Um,
Nathan Jenkins: Ladies, if that is, if this resonates with you, then it well, it probably resonates with all of you is what, and to some degree, right? Like you're, you're maxed out on all seven or eight different priorities that you have in your life.
Nathan Jenkins: And all of them feel like number one all the time. And so that's, so she's looking, she's looking for explanations and finding on the, on Instagram cortisol, right? Okay.
Nathan Jenkins: So
Emily Dow: Right. It's right. And the Maybe, again, like acutely, and we can talk about these details down the line a little bit, but sure, acutely all these things may spiking cortisol periodically throughout the day. It may be increasing her overall exposure to cortisol beyond what you would normally expect under like peaceful life conditions. So every time she gets like a random phone call from her boss that...
Emily Dow: you know, alerts her nervous system, maybe her cortisol is increasing. And so the training is doing that to an extent also, but that's not, again, it's not like the cortisol that is problematic.
Emily Dow: It's the behaviors that are contributing to these like constant, constant stressors becoming activating. And it's just stacking stressor onto stressor onto stressor.
Emily Dow: And I think that message is also kind of, it can be defeating to people because then the next question is, well, what am I supposed to do about that? Like life is stressful, but there are ways to
Nathan Jenkins: Yeah. Yeah.
Emily Dow: like moderate certain variables that are within your control that can help you better tolerate the stressors that are beyond your control.
Nathan Jenkins: Yeah, and ah let's get into that. i do But before we do, I think this is a good place to um you know maybe differentiate ourselves a little bit because this is this is not the first time. most Maybe certainly some listeners, some of our audience has heard about cortisol on the internet.
Nathan Jenkins: the People talking about this, including in good ways like we're trying to do. But let's differentiate ourselves a little bit and dive into um just briefly
Nathan Jenkins: At what point do we actually acknowledge, like, hey, look, cortisol excess or cortisol dysregulation could be an actual endocrine disease.
Nathan Jenkins: And we need to we do need to pay very close attention to this as professionals working with clients. and refer out to medical professionals. And, and Hey, listen, maybe Diane, maybe you do need like, based on what you're, what we're seeing is in your profile here. And the things you're talking about that, the maybe some physical symptoms that you're talking about,
Nathan Jenkins: Like I would talk to your primary, like make it, make a primary care doc appointment like in the next week or two and have them, they're probably going refer you to an endocrinologist based on what we're, we're hearing.
Nathan Jenkins: Let's just briefly speak to that because there are some legitimate cases, but plenty of them. I haven't seen many in my practice and I don't think you probably have either, but you're as an RD, you've probably seen more of this in your training than I have as a, as a mere PhD.
Nathan Jenkins: I don't have the RD credential and haven't had to go through that clinical training. Uh, but curious as to like, what would, what would be a trigger for you to send somebody out to like, all right, this is a medical thing outside of scope.
Emily Dow: Yeah, there would be a lot of, a lot of, it's kind of like one of those things where there's this unexplained myriad of symptoms over a prolonged period of time that aren't easily explained by some of the things that we're going to talk about.
Nathan Jenkins: Mm-hmm.
Emily Dow: Like, okay, well, if you're not sleeping, if you're underfeeding yourself, let's do those first. See if they overcome these signs and symptoms. See if everything sort of stabilizes.
Emily Dow: If that doesn't work, right, if everything is on paper supposed to be going well and these signs and symptoms are still presenting and ill I can go through a few of them, um then it would make sense to explore further testing.
Emily Dow: And you kind of have like two two extreme examples that are most commonly discussed. You've got like Cushing's syndrome, which is excessive cortisol, and then you've got Addison's disease, which is in ah insufficient cortisol.
Nathan Jenkins: Right. but Lack thereof. Yep. Yep.
Emily Dow: Both are equally problematic. Like those who are afraid of the excessively high cortisol, again, low cortisol is just as concerning. You can have really dangerous reductions in like blood pressure, for example, if you don't have sufficient cortisol.
Emily Dow: And that has to be very meticulously managed also. um But there are some like signs and symptoms related to even basic things like hypertension and insulin resistance that coincide with that prolonged exposure.
Emily Dow: um Oftentimes, like one potential contributing factor is like long term steroid use. So if you're someone who has to take cortical steroids for whatever set of reasons, um that's something that is potentially more so on your radar than the average person.
Emily Dow: um And, you know, i think this is also unfortunately become popularized like the moon face. Have you seen that on on the Internet?
Nathan Jenkins: Yep. Yep. Yep. yep yep yep yep
Emily Dow: Because you do have, and this is the part that I think has been blown up out of proportion, like there are shifts in body fat storage patterns that are associated with this de this dysregulation.
Nathan Jenkins: Mm-hmm. Mm-hmm.
Emily Dow: And I think ah a regular person's brain then jumps to like, well, maybe that's why I'm struggling with belly fat, when in reality, that's just a really common fat storage site.
Emily Dow: And if you have body fat to lose, it makes sense that it might be more rule board localized in that area. And same thing with like the moon face situation. I've seen a lot of people who just have like either rounder faces structurally or potentially more body fat stored in that area that are like, oh, it's a cortisol issue when that's not necessarily the case either.
Nathan Jenkins: here
Emily Dow: um
Nathan Jenkins: Yeah.
Emily Dow: But and it's it's when these things are prolonged and unexplained.
Nathan Jenkins: Yeah.
Emily Dow: Yeah.
Emily Dow: There would be a lot of like legitimate red flags. like you would have You'd be dealing with like poor wound healing and like genuine muscle wasting.
Nathan Jenkins: Yep.
Emily Dow: like There would be a lot of red flags where you're like, something is clinically wrong that would cause you to pursue further testing, even if you don't initially suspect that it's a cortisol issue.
Nathan Jenkins: Right.
Nathan Jenkins: m
Nathan Jenkins: It's not just like I feel stressed and I'm tired and I'm stuck and like, what the fuck is going on? Like, it's not just
Emily Dow: Yeah. I'm not as jacked and lean as I want to be, so it must be a cortisol thing.
Nathan Jenkins: Right. Okay. So we're jumping around a little bit, uh, Emily, but, um, maybe all right. So maybe bring it back to our case.
Nathan Jenkins: Um, bring it back to Diane.
Emily Dow: Mm-hmm.
Nathan Jenkins: So how do we, how would we, we've talked to maybe a little bit about this, but like, how do we help her and how do we like bring her but Let's walk through her like three to six months that you're working with her and or and I can do the same mo you interject here and there, but I but mostly want to hear like what you how would you like go about working with her?
Emily Dow: Yeah, so I think ultimately the way that I would communicate this is like, if we're thinking about that stress bucket, let's kind of identify, let's put a name to all these different sources of stress so that we can recognize that they're all piling on in such a way that it is maybe excessive for what Diane can recover from.
Emily Dow: And that's likely what's getting in the way of her progress more so than the the cortisol itself. So again, some of these stressors are going to be far beyond her control. I'm not going to ask somebody to switch jobs.
Emily Dow: I'm not going to ask somebody to neglect their family and like needs um or like pluck themselves out of a stressful situation that's unavoidable.
Nathan Jenkins: Right.
Emily Dow: But we can kind of categorize them into the buckets of, okay, these stressors are within my control and these ones are not. And the two that jump out to me the most, and there's kind of a third in there also, is the sleep restriction and the energy availability problem.
Nathan Jenkins: Mm-hmm.
Emily Dow: um
Nathan Jenkins: Mm-hmm.
Emily Dow: And those are not always psychologically the easiest things to resolve. I think this is going to require a lot of a lot of like trust on Diane's behalf and a lot of experimenting and seeing the evidence for herself firsthand that it is okay to do this because this type of female also tends to be like very high performing, very high standards for herself.
Nathan Jenkins: Yeah.
Emily Dow: So what I'm about to say will feel counter to her nature. It'd be a little spicy.
Nathan Jenkins: It's going to get spicy. Let's hear it.
Emily Dow: But first and foremost, like, why why is sleep being sacrificed? And if Diane is training a lot, and I would imagine that training sometimes does mean sacrificing some sleep for her, ah especially if she's a very busy person and it's either happening before or after work,
Emily Dow: I would tell her for the sake of your health, because sleep is such a critical component that so many people neglect or just don't think, don't value as much as they should because it is possible to get by, i would tell her that it is okay sometimes to prioritize sleep over her training.
Emily Dow: And that's something that will, she would not love to hear.
Nathan Jenkins: That's hard for people. Yeah. Yeah.
Emily Dow: And I've not loved to recognize that within myself either.
Nathan Jenkins: 100 oh god me i i think you and i i know enough about your day-to-day and mine's the same as 100 very guilty as charged as fitness professionals we uh we walk the walk in many ways but one of the things we do not do is uh choose sleep over training when maybe we should from time to time um just being real with you guys is that fair
Emily Dow: And look, yes, and that's like and that's how I like to frame this conversation because I relate so much to that is not that you can't wake up at 4 a.m.
Emily Dow: to get your workouts in because I know that that's also really important for your sanity if you're this type of person.
Nathan Jenkins: Yeah.
Emily Dow: I would also be waking up.
Nathan Jenkins: Yeah.
Emily Dow: I've woken up at 3 a.m. to get workouts in, especially like during my PhD. But i also recognize that if I'm claiming to be doing this for my health,
Nathan Jenkins: Mm-hmm.
Emily Dow: I have to consider the whole picture. And there is ah component of having to earn the training that i want to do.
Nathan Jenkins: Mm-hmm. Mm-hmm.
Emily Dow: And sleep is a part of how you earn that.
Nathan Jenkins: Yeah. Ooh, that's good. That's good.
Emily Dow: So maybe we compromise a little bit. and some days we sacrifice the sleep to get training in.
Nathan Jenkins: here
Emily Dow: And some days we sacrifice the training to get more sleep.
Nathan Jenkins: Yeah.
Emily Dow: And that's the middle ground that I would trim straight with her.
Nathan Jenkins: That's right. Yeah. that's like That's a good middle ground is like, yeah, that's going to, I think that's going to resonate with a lot of folks, Emily, uh, that the, the, the, the middle ground of like, all right, maybe, okay. Since I woke up at 5 AM m today and got my, you know,
Nathan Jenkins: hour long run in before seven 30 before I had to get my kids to school. Um, maybe tomorrow I sleep until seven and then get up and get the kids to school.
Emily Dow: Yeah,
Nathan Jenkins: And then the next day I do the different thing, like the other thing, um, you just kind of feel like take a day by day and as opposed to always seven to six, five to seven days a week for a lot of these folks running on empty and drag like,
Nathan Jenkins: ah four hours of sleep getting out of bed and just crushing yourself um and then blame it on cortisol my cortisol is messed up right like mm-hmm
Emily Dow: because if we're honest at that point, right. Because at that point, like if we're being honest with ourselves, it's no longer for the sake of our health. It's like a compulsion. It's like we want to train. We have we feel like we have to train.
Emily Dow: And therefore, we're willing to sacrifice this other really critical part of our health that arguably has just as much of an impact on because ah eventually like if you're not sleeping and six hours doesn't feel like a huge sacrifice but it is and even with that level of sleep restriction you're not going to get as much out of your training as you want to be so then it's
Nathan Jenkins: Huge.
Emily Dow: then it becomes less productive regardless.
Nathan Jenkins: Right?
Emily Dow: And the way you frame that, like structurally, like, okay, today I'm doing it, tomorrow I'm not, is exactly how I suggest people go about it.
Nathan Jenkins: Yeah.
Nathan Jenkins: Mm-hmm.
Emily Dow: I think a good rule of thumb to have is to not, sacrifice like for myself, I try not to sacrifice the same thing twice in a row. And that has worked well for me to hold myself accountable.
Nathan Jenkins: Mm-hmm. Mm-hmm. I don't know that I've actually articulated that for myself, but I think intuitively there's like we're habit that I've fallen into that pattern.
Nathan Jenkins: yeah As you say that, I recognize that for myself, too. It's like, oh, Josh, shit all right. Like, I'm not going to sacrifice, like you said, the same thing multiple days in a row or stack stack this. I'm going to stack stressors on top of each other, but i'm not going to stack the same ones.
Nathan Jenkins: yes um so
Emily Dow: Exactly.
Nathan Jenkins: so So, yeah, that's really good. um Speaking of stressors, let's like we we could beat the the dead horse of sleep. We we should probably do a whole – I don't think we have it in our plans right now, but we could do a whole thing on sleep.
Nathan Jenkins: um We'd probably have to get a ah guest in on that. because Well, you're you you can speak to sleep better than I can, but um we also, in both of our circles –
Emily Dow: not directly within my expertise either.
Nathan Jenkins: Yeah, yeah. we have i actually have – I can think of a couple folks who are very well-versed in sleep that could educate the folks on that. So that's actually a good idea to get somebody in to talk about sleep. But um let's move on from sleep and talk about some other things that – come back to Diane. So she's we're gonna she's she's sleeping six hours. you know That's probably okay but not great. she's She's training for half marathon, which is a higher volume than people like to – think it's actually really high volume.
Nathan Jenkins: She's also lifting because she probably comes from a strength background who, you know, she doesn't want to lose their muscle that she's been worked so hard for all these years to to to accumulate, has a demanding job. She's using caffeine highlighted here for my notes to to ask you about specifically. She's and we we touched on earlier is restricting carbohydrates.
Emily Dow: Mm-hmm.
Nathan Jenkins: And she's under ah she's she's objectively no argument data speaks for itself. You've done, we've done the seven day audit of her nutrition and you've seen that she's like, she's under fueling for her long runs.
Nathan Jenkins: um I would like, I would love for you to like, let's, let's dive into that. And to, to begin that, that deep dive, what numbers would you put to that? Like if you you look at her macro tracking app data for,
Nathan Jenkins: seven days and she's does, let's say three to four. Let's say she does four runs, four or five runs during that time, but two of them are long and her carbohydrate intake is X. And you see that as it's typical from what you've seen with from your clients, but very classically under fueled. Can you define that? Like what number, like put some numbers to that.
Nathan Jenkins: does that look like?
Emily Dow: I would say what a good representation of what I often see that I'm like, Ooh, this is some work is like, i would say 1800 calories a day and ah around or below carbs.
Nathan Jenkins: Yeah, it it triggers. Yep.
Nathan Jenkins: fuck.
Nathan Jenkins: And still running, running like say, and running and running what distance correlates with that in your experience.
Emily Dow: women are yeah
Nathan Jenkins: And let's put this to Diane. What is Diane doing? That's the, the, the running volume that correlates with that.
Emily Dow: Yeah.
Nathan Jenkins: That's, that's making you freak the fuck out.
Emily Dow: Yeah, she's probably running, I mean, minimum like 15 to 20 miles a week on the low end.
Nathan Jenkins: at one, right.
Emily Dow: And right.
Nathan Jenkins: And trying and trying to survive on 150 grams of carbs a day.
Emily Dow: And that's,
Emily Dow: yeah, that's not good. Yeah.
Nathan Jenkins: Yeah, Emily, I don't think 150 grams of carbs a day would fuel my left, um i'm gonna i'll beat I'll be PG with this, my left calf, right?
Nathan Jenkins: Like for that volume, that's insane.
Emily Dow: Right. Right. i had 150 grams of carbs in breakfast alone. So that, and I, like, I understand not everybody has the frame of reference that someone like you or I do.
Nathan Jenkins: Right, right.
Emily Dow: Like I've looked at, I've looked at calories every day since I was about 17 years old, just in my education and not necessarily for myself, but
Nathan Jenkins: Sure.
Nathan Jenkins: Yeah, we we're we're we're in it. We're in the trenches of it all. Yeah.
Emily Dow: we know what numbers are normal. We know what numbers are optimal. We know what is definitely suboptimal. And a so couple things with Diane. a i i do not condone dieting intentionally at the same time as you're building for race.
Emily Dow: That is never something that I'm on board with, especially as a more like performance focused dietitian.
Nathan Jenkins: Those don't go together. Yeah.
Emily Dow: And it's interesting
Nathan Jenkins: Yeah. We covered that last episode. If you guys haven't listened to. Yep.
Emily Dow: It's interesting because if we're fearful of cortisol or like cortisol contributing to our hormones being wrecked and because we're these like fragile women, under fueling is the most legitimately harmful thing that you could do to yourself and especially to your hormones.
Nathan Jenkins: Mm-hmm. Mm-hmm.
Emily Dow: Not irreversible, like I'm not trying to fear monger in that domain either, but Everyone wants to be afraid of everything except for the most common actual issue, which is under fueling. And again, I understand that a lot of people just don't have reference points. But if you're training this amount and you're consuming less than 200 grams of carbs a day, and that's like very low, I would say still, and less than 2000 calories a day, you are severely underfed. And that is going to cause problems somewhere in your life.
Nathan Jenkins: so well said um and that's a huge like education point for clients like diane isn't it
Emily Dow: Yes. And it's, I'm, I'm so, I've had this conversation so many times and I'm so empathetic to the fact that it is intimidating to trust someone when they say that when, or maybe not a hundred percent comfortable in your body.
Nathan Jenkins: mm-hmm
Emily Dow: And you've heard so many conflicting messages for so many years of your life. And you've been like conditioned to think about your nutrition in this particular way. That's consistent with the way women are spoken to societally.
Emily Dow: And
Nathan Jenkins: Right.
Emily Dow: it's scary to increase your calorie intake on purpose, especially when your appetite doesn't necessarily match that intake yet. So you feel like you're force feeding yourself.
Nathan Jenkins: Right. Yep, yep, yep.
Emily Dow: And so then you also feel maybe a little more bloated. Like maybe you're just, you're not used to it. Your gut isn't used to it. Your body's not used to it. So then you're getting this feedback that almost like aligns with your previous thought process. And it's very, it can be very confusing initially, but When I've never known a female who's given that a legitimate chance, who has regretted it, not a single time.
Nathan Jenkins: Yo.
Emily Dow: Every time it's like, thank God i I finally fucking solved this because I didn't realize I could actually feel this good.
Nathan Jenkins: Yeah. Yeah. And now we're getting like, we can come back to cortisol at some point, but this is actually more important. I think is, is, is like you just said, like give it a chance and watch how, watch, watch everything that you care about. And yeah like, like what I would do with a client, I've done this actually before is write down on a piece of paper, the thing that you want to be better at in six months.
Nathan Jenkins: It doesn't matter what it is. Like right like ah in the performance and fitness body composition realm, write it write it down. And fold it up and don't show it to me. um Don't show it to anybody. Just only show it to yourself.
Nathan Jenkins: And then, and then let's fix your, let's, let's get a better match in the next month of three to six months. We're going work together. We're going to work together for three to six months, but in the next month, we're going work on finding that right match between your output and your, it and your intake, like the fueling versus your work output, the, the, the exercise that you're doing, the training you're doing.
Nathan Jenkins: If we can match those. Then whatever it is that you wrote down on that piece of paper, it's, like you said, I've never seen it not You know, and I like most of time it's performance stuff. It's like, I want to run faster. I want to get better. i want to, I want to be leaner, but usually actually let's be honest. Usually just aesthetics, but there's a performance goal tied to it.
Nathan Jenkins: I want to be able to, to, to not feel like shit.
Emily Dow: Yeah. Right.
Nathan Jenkins: Um, I want to be a better, I want to look better naked, you know, all like all this stuff. Um, it's that, that's, that is usually like you get that batch, right?
Nathan Jenkins: It's not just like restrict, restrict, restrict. it's match the two it's matched the input and the output with each other put the right amount of gas in the tank don't overflow the tank that's it that's excess body fat don't but certainly don't run try to run an empty because you then you end up stranded on the side of the road which is like what we're that's that's diane right
Emily Dow: Yeah. And that's like a, that's an important caveat.
Nathan Jenkins: so
Emily Dow: Cause I think, what we're not saying, and we've made this point, I think in our last episode too, it's, we're never saying you need to eat in excess. I, we're, what we're saying though, is that what your actual needs are higher than you think they are.
Nathan Jenkins: Right.
Emily Dow: And a lot of these like unsolvable problems, like why do I need four cups of coffee every day? Why do I have no libido?
Nathan Jenkins: and
Emily Dow: Why do I feel like I cannot get through?
Nathan Jenkins: Yeah.
Emily Dow: Like men, the brain fog is so extreme. Why am I getting sick every couple of weeks? Why, These things that we don't necessarily connect to our energy intake oftentimes are connected to our energy intake in some fashion.
Emily Dow: And and like it's so the caffeine thing, because we characterize Diane as someone who relies on that heavily, like that's always an interesting conversation because it's it's simulating energy that we're, for some reason, not giving ourselves because the actual unit of energy is calories and we need to be consuming sufficient calories
Nathan Jenkins: Oh, they're they're completely, yeah.
Nathan Jenkins: Quite literally, yeah.
Emily Dow: to have actual energy as opposed to just like relying on stimulants to overcome a problem that could actually be solved.
Nathan Jenkins: Yeah.
Nathan Jenkins: Yeah. Um, and I guess, yeah, speaking of solving it, um, let's talk, all right, let's come back to cortisol, like physiology a little bit. Um,
Nathan Jenkins: You know, just just to like... so And what we're what I would like to do here, i think what we should do is give folks a mini physiology lesson lesson here on cortisol so that they can understand like...
Nathan Jenkins: Basically, like i don't want I'm not trying to convince anybody or change anybody's mind too much, but also like it might be useful for our potential like our audience, our past clients, our current – neither you nor I have many current clients, but um you know the people who like listen to us, why are we not that concerned about cortisol from a physiological standpoint? like Specifically, why?
Nathan Jenkins: you know There's a cortisol response to exercise. There's a cortisol response to food. These are normal things. um Cortisol in the broader context of stress. like Let's wrap on let's let's ah like riff riff off of that a little bit.
Emily Dow: Yeah, I think because I think a lot of the online conversations do almost imply that keeping cortisol as low as possible is the goal, where realistically we both know that it's supposed to be a very dynamic hormone.
Emily Dow: It's supposed to, it's entire job, and it has many of them as you described earlier, it's entire job is to respond.
Nathan Jenkins: Right.
Emily Dow: according to whatever demand is is placed on it.
Nathan Jenkins: Mm-hmm.
Emily Dow: And so that's why like balancing it and all that, all that language is so confusing because it's supposed to rise in response to these things. Exercise being one, you know, uh,
Emily Dow: one potential trigger food consumption being another so like we can't avoid it we don't want to avoid it and our physiology is very well equipped to regulate that on its own and it's similar in that sense to like insulin and the way that we've talked about blood glucose and insulin relationships it isn't pathological just because it rises and i'm i'm not even concerned about how much it rises ah it It can become pathological when it's you know chronically you know being over-
Nathan Jenkins: It's a stimulus. Yep. Mm-hmm.
Nathan Jenkins: Right.
Nathan Jenkins: Yeah, it doesn't go away. Yeah.
Emily Dow: Right. But it's funny because like tying back to the previous conversation, yes, cortisol increases in response to exercise. That is part of the adaptation process also because we are an impos we are imposing a stressor on our physiology and that is the point.
Nathan Jenkins: Mm-hmm. Mm-hmm. Mm-hmm.
Emily Dow: We're supposed to respond accordingly and therefore we adapt to become better equipped to handle that stressor when we're exposed to it in the future. And one other attribute that contributes there is like cortisol part of what reduces that response as it's stimulated is like carb consumption so if you train and cortisol rises and you're freaked out about that eat something and you're good to go yeah
Nathan Jenkins: yeah
Nathan Jenkins: Eat more carbs. Yeah. It'll, it'll, it'll, it'll, it'll reduce it. Absolutely. Yeah. That's the, that's the most hilarious thing actually, because like the low carb zealots are like, you're eating too many carbs and you're increasing your cortisol.
Nathan Jenkins: And it's like, actually turns out, it turns out that in, in the face of any given stressor, when you're more adequately, of carved up the the magnitude of the cortisol responses a bit lower it's it's at least it's at least better regulated um and there's that's very that's very clear in the literature um so yeah that there's so many like little nuances here um but yeah you know i was just quickly like briefly as briefly as i can be add to that like
Emily Dow: Mm-hmm.
Nathan Jenkins: you know i think I maybe touched on the beginning, but like in the context of exercise, exercise is one of like one of inarguably one of the most beneficial things that people can do for their health. right and the benefits tend to scale with intensity and duration. um There's an interplay between the two, but high-intensity exercise is a powerfully it's ah it's a powerfully beneficial thing to do. It's also incredibly stressful on the body.
Nathan Jenkins: And also long duration type and endurance type exercise is very stressful on the body. Guess what? Both of those elicit a massive cortisol response.
Nathan Jenkins: And you might think like listener, you might think like, okay, wait, exercise is so good for me. Why is it listening?
Emily Dow: Mm-hmm.
Nathan Jenkins: this The quote unquote stress hormone. Well, again, exercise is a huge stressor. This is like the but like, we're going back to basics of exercise physiology here, and they weren't repeating. some of Some of the listeners will be like, okay, yeah, this is boring. But actually, I think maybe even some advanced listener, people who think they're advanced, maybe have forgotten this or haven't, maybe never even took an exercise physiology class. There's a lot of coaches in the online space that never took exercise physiology in in like ah a college-level exercise physiology class. So you know if I may say, here we are, two professors, we can like,
Nathan Jenkins: educate some folks a little bit. um Yeah, one of my, I think it's the third lecture that I would give every year when I was teaching ex-phys was the hormonal responses to exercise and in in the context of control of substrates. And cortisol is the one of the four or five different hormones that respond to exercise again of varying durations and intensities that do things like liberate glucose stores from liver glycogen to increase, to to sustain glu blood glucose levels during prolonged efforts or high intensity efforts. And also is a massive stimulus for adipose tissue lipolysis. That is to say, breakdown of fat stores and liberate those fat stores so that you can use them to support the muscular work.
Emily Dow: Right.
Nathan Jenkins: Um, so the, the spike in cortisol is actually a massively favorable thing. Uh, it helps with providing fuel for the muscles in the context in which they need it.
Nathan Jenkins: And then and so it's, so like, oh, a spike in cortisol is like, it's killing my belly fat or it's, it's, it's, uh, it's, it's making me gain, but it's making me retain my belly fat. Um, that doesn't make any sense. It's, it's, it's,
Emily Dow: It quite literally does the opposite job.
Nathan Jenkins: It quite literally does the opposite. Yeah. So, and then and then the acute stressor of exercise resolves after you're done training and the the cortisol response resolves and gets back to normal and then you go to bed and it goes... Melatonin goes up, right? And other hormones we're not talking about today, like DHEA sulfate and and and the ah you know the the anabolic hormones, they are they they rise while you sleep and promote repair and and tissue recovery and growth and all these good things.
Nathan Jenkins: And guess what? You wake up the next day and you're better off. You're fitter. And you do that.
Emily Dow: Yeah.
Nathan Jenkins: That compounds over time, day to day, and you become a more formidable human being. And guess what? The cortisol spikes come and go along the way and it's not a big deal. It's actually a good thing.
Emily Dow: Yeah, it's like
Nathan Jenkins: So.
Emily Dow: ah Cortisol is part of why it's one of the good guys. It's part of why we're capable of doing all that we want to do training wise.
Nathan Jenkins: Yeah.
Emily Dow: Like before you give a big presentation, like it is it has a role in allowing us to execute those things.
Nathan Jenkins: Yeah. Yeah.
Emily Dow: And it's like exercise is a good example of it where something that's
Nathan Jenkins: Mm-hmm.
Emily Dow: ubiquitously it's good for you like no one's arguing that exercise is good for you but if you were to zoom in on the acute physiological responses it looks bad for you because cortisol increases the inflammation and the immune system suppressed and there's like all sorts of all sorts of responses that look like we should be panicking over them but that is part of the adaptation process
Nathan Jenkins: It looks bad. Yeah.
Nathan Jenkins: Yeah. And that's actually maybe the, that's maybe the, that's actually the point that you just made it like, is like, if you just look at things like a snap, if you look at exercise as a fucking snapshot, it looks like it's horrific for your body.
Nathan Jenkins: And so too are so many things when you look at things like cortisol in isolation at a snapshot and it's high and it's like, oh, this is crisis, right? And it's right and it's like
Emily Dow: The whole point is like micro dosing systemic stress.
Nathan Jenkins: Yeah. It's, you micro systemic stress and let it resolve and then you'd adapt better, but also and the context of like measurements and, and looking at the the values of things, it's like, you got to understand the context in which you get the that blood data.
Emily Dow: Mm-hmm.
Nathan Jenkins: If you're in an acute stress response, then yeah, it's going to be high. And maybe coming to like a practical point too, for listeners like, oh, you measured this acute stressor, this acute stress response in a state of acute stress.
Nathan Jenkins: which you may or may not have been aware of when you signed up for like this, maybe like a blood spot, home blood spot test or like saliva test or whatever the fuck.
Nathan Jenkins: And you were pressured by some influencer to say, oh, we need to get this tested and then therefore buy this product to fix it. Right.
Emily Dow: Mm-hmm. Mm-hmm.
Nathan Jenkins: It's like, well, you know what? Maybe it's understanding that the fact that this is an acute stressor or an acute stress response, I should say. Maybe it's better to look at just like the the root cause and that's actually my life stress and how I'm managing it. Or maybe I'm sticking my head in the sand about how stressed out I actually am.
Nathan Jenkins: um Maybe I have unrealistic expectations on how many things I can get done in a day. um maybe Maybe I'm working a ah big a real big a real big job. Maybe Diane's working a real big girl job. She's got a couple of kids. She maybe has a side hustle. I'm just going to fill in some blanks here. um she's got some like Maybe she's a coach herself and trying to get back to clients every day ah you know like and and constantly being barraged by both And her boss and her clients and and and it's a constant stream and never it's never ending. And she's always got things to deliver on.
Nathan Jenkins: Oh, it must be cortisol. yeah um No, maybe it's not the cortisol. The cortisol is a symptom of the problem, but let's look look at the root cause of the problem.
Emily Dow: Yeah. Yeah. What are you doing that is demanding so much of cortisol?
Nathan Jenkins: Right. Yeah. The cortisol is are is is ah is ah is ah is a flag. So, yeah.
Emily Dow: I just, I think it's so funny because like as a final note, this is just something that like popping in my brain is an intrusive thought as we were talking about this. Like I feel like, cause people, for example, supplement melatonin and that's, that's a hormone.
Nathan Jenkins: hear
Emily Dow: It's a powerful supplement. It's one that I i kind of like, I tread lightly with people on that, um especially in terms of like, yeah, like guys out there, just a side note, be careful with taking like especially high doses of melatonin constantly because that is not, it is a hormone and your endogenous production can be somewhat dysregulated by relying on that.
Nathan Jenkins: Oh, yeah. I'm super cautious with it. I've never actually recommended it. Yeah.
Emily Dow: It's, the dreams are crazy. So
Nathan Jenkins: Mm-hmm. The dreams are nuts, yeah.
Emily Dow: Anyway, that's like that's so normalized. And i feel like if cortisol just has bad marketing, I'm not saying that you should take cortisol as a supplement. There's a lot of repercussions if you were to do that. But like I'm kind of surprised no one is at the same time.
Emily Dow: It just has gotten this like bad rap for some reason when it's a hormone just like all the rest.
Nathan Jenkins: Mm-hmm.
Emily Dow: And some of them we're like super cavalier about and we don't worry about the repercussions of taking them.
Nathan Jenkins: Mm-hmm.
Emily Dow: Whereas others, that would be like absolutely terrifying.
Nathan Jenkins: Mm-hmm.
Emily Dow: And it's just an interesting like societal distinction that has occurred for some reason.
Nathan Jenkins: Yeah. Well, I think it's like, I think in that context, I think, uh, the internet, Instagram, TikTok, all these weird, like social media platforms, they're all fucking weird places.
Emily Dow: Yes.
Nathan Jenkins: Um, and, and, and narratives get like, you know, they get the, the, the narratives to get put out there get captured by the algorithm and then they get propagated.
Nathan Jenkins: And then you get people like us being like, wait, what the fuck? Where where does that, like, how did this happen? Like, we're we're like 10 years down the road or probably more down the road in this conversation talking about this on this podcast today. And it's like, um and literally in preparation for this podcast, I looked in the literature. i actually did a search of like horror like cortisol balance or imbalance. Yeah.
Nathan Jenkins: and and weight loss or something. I just put i just like put a search term that's kind of adjacent to the conversation.
Emily Dow: Mm-hmm.
Nathan Jenkins: And my God, the the the the the hits that were that returned were like completely, if you look in scientific literature, it's like completely nonsensical because because there's not actually really anything concrete there.
Nathan Jenkins: like There's not a lot of real, actual, fucking empirical evidence on these things. It's like, and i And I got more granular with it.
Nathan Jenkins: It's like cortisol and belly fat. It's like what I got, the most concrete thing I got was like some like sociological research about like people, surveys about people's beliefs on health trends based on their Instagram consumption.
Emily Dow: Yeah.
Nathan Jenkins: It's like, that's actually, there's actually a scholarship on what we're talking about. that it comports with what the message that we're trying to send, which is like, look, you're being your yeah Instagram. It's, it's a weird place. It's borderline toxic, I think. um And you're just getting, you're just getting a lot of grifters. lot Most of what you hear you're hearing on this area is like a lot of grifting.
Emily Dow: a lot of grifting.
Emily Dow: Stay safe out there.
Nathan Jenkins: Yeah. Stay safe friends. listen Yeah. It's NS tough. It's, it's difficult. It's, it's not easy even for professionals. It's just certainly not easy. easy it's just like a intel, like, and most of our listeners are like very intelligent, educated, but lay in, not, not in our air. Like they, they might be you know,
Nathan Jenkins: ah Diane is a high-level, like a high-performing executive in like a you know a corporate job. um Let's say she's a you know a PR person, advertising executive or something like that, ah a lawyer.
Nathan Jenkins: you know But I i mean, I've even had people who work in the medical profession who come to me very confused because they're not in the trenches of like what's current in the literature.
Emily Dow: Yeah.
Nathan Jenkins: So yeah, it's tough.
Emily Dow: yeah
Emily Dow: It is tough. It's a whole, like, people don't recognize that this is a whole scientific field. And so just because it's like, it is plastered all over social media, and it is relevant to the layperson's everyday life doesn't mean that everyone is expected to know all the ins and outs of these things.
Nathan Jenkins: Mm-hmm.
Emily Dow: And
Nathan Jenkins: Mm-hmm. Mm-hmm.
Emily Dow: yeah, like even like I could easily get confused about some niche, even within this field that I was less familiar with if I weren't careful.
Emily Dow: And thankfully, like because of our training, we kind of at least understand how to tread lightly and how to like ask the right questions and prod. And those are skill sets that you are had to have to kind of like be trained up on. But still, it's That's why we like refer out for so many things.
Emily Dow: Like how many clients have asked you about injury rehab when we're not like we're coaches, but we're not PTs.
Nathan Jenkins: Oh God.
Emily Dow: And so that's way over my head.
Nathan Jenkins: Yeah. A hundred percent.
Emily Dow: Yeah.
Nathan Jenkins: with like There's a lot we don't know about. Yeah. But okay, Emily, we're so we're getting a little bit long in the tooth on this episode.
Nathan Jenkins: um Let's land the plane on um on Diane and the whole conversation here. So maybe like real quick.
Nathan Jenkins: I think, well, let me just like, I'll just throw out some things to like summarize what we might do with Diane. And then I might, then have a couple of rapid fire questions for you to close us out. So, I mean, I think, I think the step one is to just take a real hard look at the life stressors.
Nathan Jenkins: right and figure out where her goals or her fitness goals that she's hired us for fit into the broader context of those life stressors right like nutrition and fitness and training those things are important but then like we got to look at all her the other things in her life like work and family and sleep and there is like a bunch of like different pots on different burners
Emily Dow: Yes.
Nathan Jenkins: And it's like what goes in the back burner, what goes in the front burner? And that's a conversation with her, right
Emily Dow: Yes, I would say, yeah, Diane's cup doth runneth over at this point, and we need to we need to like balance scales a little bit.
Nathan Jenkins: Yes. The cup doth runneth over. um then And then we also like work on, like, let's say we established that we find the right place for her training, her goals and the things that she actually has hired.
Nathan Jenkins: Well, it's actually not us. It's like some of you coaches who are listening to this, right? Diane's hiring you guys. um Then we work on appropriate fueling because it sounds like she's she's objectively under fuel. She's the like 150 grams of carbohydrates per day running. What did you say? Like 20 miles a week.
Nathan Jenkins: So like roughly four to seven miles on a given day if she's doing four or five days a week.
Emily Dow: and fasted
Nathan Jenkins: We got it. We got India training fasted. We didn't, we, we probably could have spent more time on that, but like, what would we do? We'd probably get, we'd want to double that at least. Right.
Nathan Jenkins: At least double that. And not even that's on training days and not, and not, and not even not, it's not even getting including like for the longer runs, not even including intra carbohydrate intake.
Emily Dow: at least on training days minimum
Emily Dow: correct.
Nathan Jenkins: Um,
Emily Dow: I would have her at least consuming 30 to 60 grams of carbs an hour with intentions of bumping that up.
Nathan Jenkins: and
Nathan Jenkins: Right. And then there's a whole conversation around gut training and all that. God, we should maybe part two of the cortisol episode one day down the line is like, all right, with the the specifically very specifically, like really niche, but very with also but broad impact is like carbohydrate intake in somebody who's physically active and trains a lot and relate that to their hormonal profile.
Emily Dow: Yes. Yes.
Nathan Jenkins: That's a big topic. That's a big physiological. That's ah that's a super, like that's a whole like fucking class. Class would be in session that day.
Emily Dow: there's even some, there's some interesting stuff in this. We can save the bulk of the content for that episode, but there's some interesting stuff in female athletes on even like large within day energy deficits where, you know, if you train, you kind of create a deficit over a span of several hours.
Nathan Jenkins: Mm-hmm.
Emily Dow: And then if you sustain that for too long, like there are hor hormonal perturbations that happen even within a given day, if we're not consuming fuel, appropriately like spread and distributed throughout that day so yes we absolutely should
Nathan Jenkins: Yeah, so good. We should, yeah, do that. All right, real quick, rapid fire, and then we're going to close this out. um to to to to To bring it home, Dr. Emily, does cortisol prevent fat loss?
Emily Dow: no how rapid fire do i need to be that was one more
Nathan Jenkins: Yeah. Well, does it, the the answer is no, is I, and I would, agree well I would agree that the answer is no. um There's real quick, also still rapid fire can override energy balance.
Emily Dow: doesn't override the concept of energy balance no in some of those like
Nathan Jenkins: Does, does anything in, does anything and override the concept of energy balance when it comes to weight control?
Emily Dow: nothing overrides it that's the cat like nothing overrides it no these are basic laws of thermodynamics they cannot be altered however the inputs and outputs can be influenced by other variables and that's the piece that i think confuses people
Nathan Jenkins: Sure.
Nathan Jenkins: It does. it and Yeah, there's a message out there that like energy balance doesn't like, I think this is like probably five to 10 years ago now, but I still hear it often enough that it's worth mentioning.
Nathan Jenkins: The, and we're still rapid fire. So gotta be Jenkins, be, be, be, be succinct. No, there's, there's no such thing as, as it, despite what you might hear, insulin, cortisol, those things might modulate how calories are handled, but calories in calories out at the end of the day,
Nathan Jenkins: rules everything when it comes to weight control and fat storage. So if you have a, you can't, you cannot be in a caloric deficit and have a cortisol response that is uh, it is making you hold onto belly fat.
Nathan Jenkins: Like there is zero evidence for that. That is the the craziest myth. That is one of the craziest myths that I've heard and seen quite a bit on Instagram. Even to like, like this morning was scrolling and I see it.
Nathan Jenkins: So like, it's crazy.
Emily Dow: Yeah, it's still a thing.
Nathan Jenkins: Okay.
Emily Dow: Yeah, by definition, calorie deficit results in weight loss, period.
Nathan Jenkins: That's as rapid as I can get.
Nathan Jenkins: Right. Yes. Okay. Uh, should people avoid high intensity interval training because of the cortisol response?
Emily Dow: No, no. High intensity interval training is incredibly health promoting and good for your fitness, but you do need to make sure that you're being responsible with your recovery and your nutrition to support that.
Nathan Jenkins: Right. Is low intensity exercise better for cortisol?
Emily Dow: No, ideally we have a combination of both because they elicit slightly different adaptations that are complementary towards one another.
Nathan Jenkins: Does coffee raise cortisol?
Emily Dow: fuck no. It, no, um sure doesn't.
Nathan Jenkins: she she She broke out. she that was That was beautiful. You broke out into song. I loved that.
Emily Dow: Thank you.
Nathan Jenkins: more More songs. Like and subscribe and share if you want more songs from Dr. Emily because that was great. um
Emily Dow: They're only coming after an hour and 15 minutes and when the real OGs are here.
Nathan Jenkins: Yeah. yeah When they're still here. um Do any supplements lower cortisol? Do you recommend anything for that?
Emily Dow: I don't recommend anything regularly. Like there are some products that can kind of support general stress management, such as like magnesium is a big one. um L-theanine I like, ashwagandha sometimes, but those are not things that I won't jump to immediately for most cases.
Emily Dow: Magnesium potentially because it's just hard to consume enough of. So that's pretty broadly reasonable.
Nathan Jenkins: Yeah. And well, yeah, have magnesium, we should, God, we should fucking have an episode of magnesium
Nathan Jenkins: Yeah, that's a whole tangent. I'm not going to go down that rabbit hole, but it's just Google google search like benefits of magnesium if you're not familiar and you'll learn a lot. So, okay.
Emily Dow: Mm-hmm.
Nathan Jenkins: um Yeah, okay. I think we've done a pretty thorough job here. um Cortisol, it seems like cortisol is is neither bad. It's not irrelevant, but it's not bad.
Nathan Jenkins: The acute responses are pretty normal and adaptive. It just depends on the context.
Nathan Jenkins: Maybe we get concerned about chronic dysregulation for sure. um But really we're looking at like, what are the root causes? And it's usually like stress.
Nathan Jenkins: stress management. It's a stress management issue more often than not. And you probably don't need the labs to help you come to that conclusion in the first place.
Emily Dow: Nope. Agreed. You would, if you, if you were a candidate where the labs would be really relevant to you, you would feel very sick in a lot of ways. And this, it wouldn't be a matter of like, am I doing slightly too much training? Am I, that would not be, that would not be the like trigger.
Emily Dow: But Yeah, don't be afraid of the C word. There's no reason for that here.
Nathan Jenkins: Yeah, this this the C word is, and this in this context, the C word is just fine.
Nathan Jenkins: What a great way to end it. What a great way to end it, Emily. All right, take us home.
Emily Dow: ah Fuck. I'm on the spot. um Okay, so we have a wonderful... rest of the season coming up but if you haven't already like and subscribe and do the things you're supposed to do with podcasts maybe downloads also are important um there's share share it all over the place um let us know any comments or feedback we're open to that sort of thing i think in spotify you can comment at least so we'll be paying attention to all that stuff
Nathan Jenkins: Send to a friend, send to into a loved one.
Nathan Jenkins: Yep.
Nathan Jenkins: Do we want to tease anything coming up?
Emily Dow: we have some We have some guests on the docket. Nick, the one that's coming soon is very prolific, so you will want to you will want to be tuned in. And ideally, you're already you're already a subscriber so that you find out immediately when these things happen.
Emily Dow: Because we are and we're new to the podcast game, but we're not new to this network.
Nathan Jenkins: That's right.
Emily Dow: So we happen to have, we are we are privileged enough to have access to some really cool people that we will be bringing in on relevant conversations.
Nathan Jenkins: Yeah. Yeah. We've got some fucking great, great guests, great content, great conversations to come. i'm I'm anxious to like throw it out there like what it is, but I'm going to, I'm going to restrain myself. So.
Emily Dow: By the time this episode is released, we'll we'll have lots and teasers out there.
Nathan Jenkins: Yeah, 100%. hundred percent All right. Lab Rat Radio, episode three. That was awesome. Thanks, Emily.
Emily Dow: Thank you, Jenkins.
Nathan Jenkins: ah All right. We'll see you guys next time.
Emily Dow: Laura's out.
