Mastering Metabolism: Unraveling The Connection Between Stress, Cortisol, Weight, And Immunity With Lisa Tamati

Lisa: Well, hi everyone, welcome back to Pushing the Limits. Today I have another solocast for you and I'm doing a deep dive into cortisol, the HPA axis, sex hormones, and how the interplay between cortisol and sex hormones works, and all the implications of that, and what you can do to lower your stress levels, what stress does to the body, and all that sort of good stuff. So I hope you enjoy this episode of Pushing the Limits.

Lisa: Before we head over to the show, I've a big favour to ask, if you can. We're doing a survey at the moment. We're trying to get some feedback from our listeners to try to understand what you want to hear, what you like, what you'd like more of, what you'd like less of, all your opinion on what you're into. It's anonymous, but if you could do me a favour and head on over to lisatamati.com/survey, that would be super appreciated. It would take about two minutes of your time to give us some feedback on everything around longevity, biohacking, health optimisation, performance, all what the show is about, and what you'd like to see more of, and just give us your two cents.

Lisa: Before I head over to the show too, check out what we do over at lisatamati.com. Check out the anti-ageing and supplement range that we have, the hyperbaric oxygen therapy clinic, the personalised health consulting that I do, speaking of course, the corporate wellness programmes. Lots going on, so I'd love to see you come over to the website at lisatamati.com. And if you don't mind doing a rating review for the show, that would be super appreciated as well. Right, now over to the show without further ado. We're talking everything stress hormones, sex hormones, and everything you need to know about that.

Lisa: Well, hi everyone, Lisa Tamati here from Pushing the Limits, and today I want to talk a little bit about stress, about cortisol, about weight gain and immunity, and sort of connecting the dots a little bit for you. So I wanted to talk a little bit about also the underlying metabolic issues that can happen and what can keep you from being healthy. I also wanted to talk a little bit about sex hormones and how they become more important as you age, and how you can optimise your sleep and why that's sort of key to metabolic health.

Lisa: So I wanted to also discuss the concept of metaflammation and inflammaging. Probably won't go too deep into that today, but let's see how we go. We want to look at some common metabolic roadblocks and where they might be leading you in the future, and we want to discuss your metabolism, what it is, and why it's not just calories in and calories out. That's what we typically think of when we think of metabolism: am I burning enough calories? But it's a whole lot more than that. It's actually the sum total of all of the biochemical processes that are going on in your body. And calories in versus calories out and the old model of weight loss is really not giving you the full story either on why you may not be losing weight when you've got a good diet and you're exercising well and you're like, why the heck am I not?

Lisa: And I know this one all too well. I want to tell you a little bit of a story. So I have a background as an ultramarathon runner, spent 25 years doing the world's toughest running events on the planet. And the reason I started running to begin with was to lose weight. Like many of us, just start out running around the block trying to lose weight and then realising, hang on a minute, I'm not losing any, I have to run further and further and further. And it actually became my sport, but what it never did was help me lose weight. In fact, the opposite was the case.

Lisa: I remember when I ran right through New Zealand at one point doing 2,250 kilometres in 42 days, or 52 marathons. I actually got fatter for my troubles, and that was running all day and half the night sometimes. And the reason why was because I was in a state of a huge amount of cortisol. I had a lot of inflammation, I had hormone imbalances. In other words, the chemistry was out. And so my chemistry was not in a state that would let me let go of the fat reserves. What I did do was go into a catabolic state and start to lose muscle mass, which actually exacerbates the problem, and you start to gain even more fat tissue because you've now no longer got the muscle mass to maintain. So for all those people out there that are running millions of miles thinking that that is going to help you with weight loss, it does to a certain degree, but only to the point where you overtrain and where you become catabolic and your chemistry is out, let's put it that way.

Lisa: So what is metabolism? Metabolism is really the sum total of the metabolic reactions that are going on in your body right now. And when we assess this metabolism, we can get an indication of not only where you are currently, but also what might be looming on the horizon and what your risk factors might be. And one of my favourite tools is just a basic blood test. When we look at people's basic blood work, you can already make some inferences from there about where you may be having trouble, which area, which system of the body you may be having some issues with, and then you have to go and do some deeper digging, typically with functional medicine testing.

Lisa: But today I wanted to start with talking about sex hormones and stress hormones. So sex hormones, turns out that they do a lot more than just helping us reproduce, okay? So there's testosterone, there's estrogen, there's progesterone, there's DHEA, there's pregnenolone, there's all these amazing hormones that we produce, and they're all really important. And what we're finding out is that, for example, there are lots and lots of studies out now showing that men who have low testosterone — which is really important as they age and as they go through say things like andropause, which is the male equivalent of our menopause — their testosterone starts to get low. And low testosterone has been shown to increase men's risk of things like heart disease. They can get mentally a little bit low, they sort of lose their oomph and their get up and go, and they don't feel like doing anything.

Lisa: And for women it's different. We have different hormone combinations, but we also have testosterone, and when women have low testosterone that can also have a massive impact on us. We are unable to perform athletically so well, your sex drive can go down, your ability to hold muscle mass etc. can go down. Then things like your estrogens and your progesterones also can go out of whack. So when they start to shift, we can have a variety of problems, from anything from hot flashes to mood changes to sleep issues to weight gain, et cetera, et cetera.

Lisa: But I really want to look at the stress and the sex hormones and how they're working together. So for example, in your brain you have something called the fight or flight response. When you're under stress, your body — you would have heard of the word fight or flight — you get into the sympathetic state where maybe you've been stressed from something. In the old days it would have been a tiger chasing us. Nowadays it's probably a nasty email from your boss, or a bill that you haven't paid, or some sort of a stressor that's going on in your life. And the problem now is that we have these constantly. We are living in a time where we're just constantly bombarded all day, every day, with stressful events that are just constantly attacking us. And this can very easily put us into a state of fight or flight.

Lisa: And when we're in the sympathetic state, we have a heightened heart rate, our blood pressure goes up, we have more adrenaline, which can lead to stiffness of the arteries, for example. We get more of a tunnel vision, our ability to make executive decisions goes down, and all those sorts of things. Now, this is great for a short-term response when you need to have all your blood go to your muscles so that you can run away or you can fight that tiger that's chasing you or whatever, but when you're having this constantly, that's when it can be problems.

Lisa: So our body's physiology reacts the same whether it's real or just imagined. So if you think someone is standing at your door and it's the middle of the night and they're about to come in and attack you, whether or not they're actually there, you're going to have the same physiological response. So your thoughts have a physiological response. Your heart rate will go up, your blood pressure will go up, your cortisol levels will go up, your adrenaline. All of these things happen whether there's actually a person at the door about to attack you or not, okay?

Lisa: So when you understand this, you understand the power of the thoughts, the power of your thoughts to actually influence your physiology, your actual physical body. And then when you extrapolate this day after day after day, and it becomes a sustained stress situation where you've got everything coming at you at full speed and you're sympathetic dominant, that's when you can start to make too much cortisol and your cortisol can start to go up. Or if you're in a very late stage of this, it can actually go to the reverse and you start to have a very low cortisol. Neither of those are good.

Lisa: What we want is a diurnal pattern with our cortisol. It should rise in the morning and then it should slowly drop off during the day with little spikes along the way, and then it should be very, very low at night so that at night time you can get your melatonin levels up, because cortisol and melatonin sort of counteract each other, and you can go off to sleep.

Lisa: But if you start to make more cortisol, which is a stress hormone, as that cortisol goes up, it starts to branch out and have effects. So when you have chronic issues with elevated cortisol — I'm under sustained stress for a long period of time — something changes. And when you start to release all that cortisol over time, you start to flatten that cortisol curve. You don't get this nice rise in the morning and the drop in the afternoon and then very low at night time, and that melatonin can't come up, and then you can't sleep properly, and then you don't rejuvenate your brain properly as would be normal for the next day. You're meant to have that rejuvenation during your sleep so that the next day you can go back to normal, and so on and so forth. What happens is that you start to get into the cycle of not being able to sleep, which causes more stress, and so on, and you get in this horrible downward spiral.

Lisa: So the cortisol pattern is extremely, extremely important, and it also does so many other things. It's like the quality controller for your immune system. When you don't have a diurnal spike in cortisol in the morning, you're more prone to autoimmune diseases, for example, because the cortisol acts, number one, as an anti-inflammatory in the body. So those achy pains that you get when you first wake up, but then after five minutes they're gone, that's because your cortisol's gone up. It's also an autoimmune controller, so it's like a quality controller, if you can imagine, that cortisol is the bloke who's standing at the factory line pulling off all the bad immune cells, the autoimmune cells, the ones that are going to attack your own cells, as it goes past.

Lisa: On a conveyor belt, if that's a good analogy for you. Then that's not there — he's not there doing his job when you don't get that nice cortisol bump in the morning. So there's a lot of things that we need to keep in this diurnal rhythm that we have.

Lisa: And it inhibits also, when you have a lot of cortisol and it stays high and remains high, you have an inhibition of gonadotropin-releasing hormone. Now what that means is you're not making enough testosterone and other sex hormones. So really what starts to happen is that chronic stress starts to affect your sex hormones. So more cortisol, less sex hormones. Now you may know this yourself, that when you are under stress, things like your sex drive go out the window. It's very low, because it's a physical thing — you've taken all of what would be your sex hormones and you're now using it to produce cortisol.

Lisa: It also inhibits growth hormone, and growth hormone is there for your repair and growing and maintaining muscles and things like that. So you don't repair, and so you also can start then to gain weight and you can't stay as lean. Typically the weight gain, if you have high cortisol, is around the middle of the body, so around the waist, and that's really the most dangerous type of weight gain that you can have. When you have weight gain on your hips or your legs and things, it's not really as bad as the one when it's around the organs. So cortisol can make you gain weight regardless of what you're eating. So this is where the calories in, calories out thing — it's not just about that.

Lisa: So now you've lost some of your sex hormones and that means I'm going to start gaining weight. I've lost my growth hormone and I'm not going to repair. And then your cortisol also makes your insulin receptors not work as well, and when that happens your blood sugars can go up and you again store more fat around the middle, especially that dangerous type of fat. So all this is happening at one time, and this is what's going on with a lot of people.

Lisa: And then with cortisol you also make more adrenaline. So if I scare you and you make cortisol and you make more adrenaline, your blood vessels start to get stiff. So you do this year in, year out over a long period of time and you're stiffening your blood vessels and you're more likely to have things like aneurysms, atherosclerosis, cardiovascular disease and all of that sort of horrible stuff.

Lisa: And then there is a genetic side to this as well. I, for example, have a hell of a lot of adrenaline, more than your average person. So I'm very action-orientated. I need to move a lot. I need to manage myself because of that, and I do genetics in my practice so I'm very aware of releasing that pressure that builds up during the day, that adrenaline release. I have to sort of go and burn it off regularly throughout my day and go for some movement.

Lisa: Now when your adrenaline is up, your blood sugars are going up and I'm starting to gain weight, and then my blood pressure can start to go up, and all this leads to metabolic dysregulation and opens the door to many of those age-related diseases — things like pre-diabetes and diabetes and atherosclerosis and cardiovascular disease, and even then ongoing things can lead to things like Alzheimer's and even to a higher risk of cancer.

Lisa: So one of the biggest things that I also find — a lot of athletes, I've worked with a lot of athletes over the years, and they come in and they've got trouble with stress fractures, maybe they are overtrained, they're training their asses off and they're not getting anywhere and they're wondering why. They used to respond and they're not now. And a lot of the time it's too many stress hormones, and that means your bone has to release minerals from the bone to balance the pH of your tissues. So that's a really important point: if you're under stress all the time, you're more likely to lose your bone mass, which can be really, really detrimental.

Lisa: This is especially for women. You have to be super, super careful. Osteoporosis is a big killer, actually. It's not just the Alzheimer's, cancers and all of those sorts of things, but as you get older, if you have a fall and you break a hip, the chances of you ever walking again on your own steam — I think 50% or something — when you're elderly. Or very often people die within a year of breaking their hips when they're elderly. So this starts already when you're 40, right? This is not waiting till 80, this is already starting. So we need to be aware of these things and we need to understand how we control some of these things.

Lisa: And so cortisol and co are having a global effect on your whole body. So your endocrine system is operating to give you energy, burn fuel, make you feel strong and capable, and then it's also intimately involved in the repair of your tissue. So when these things start to get skewed in their relationship and you see changes in your testosterone and sex hormones, and changes in your stress hormones, and then maybe you're not getting enough sleep and now you're pumping out even more stress hormones — that leads to this vicious cycle and less repair. And so then you start to break down.

Lisa: So yes, we can now also replace our hormones. We can do bioidentical hormone replacement therapy, and I am a big fan of this. I am personally on bioidentical hormones. However, you need to sometimes also address the root cause. Now if you're older, you've passed menopause or you're going through menopause, then maybe you need bioidentical hormones if you want to maintain your youthful appearance, your ability, your muscle mass, your bone density, your cognitive function. But if you're younger and you're losing these, you may want to be looking at why — where is the root cause? Always look for that first before you go and grab the hormones, because the hormones can be very good and very powerful, but they're more for when you're a little bit older and you're not going to be, no matter what you do, producing enough estrogen and enough testosterone etc.

Lisa: And so when you get to that point, that's when you need to be working with a health professional who can guide you through doing the proper testing. I'm a big fan of something called DUTCH testing — dried urine tests, or Complete Hormones — in order to understand how you process out your hormones, what you do with them, what your methylation status is, what your nutrient status is. You can also see in the DUTCH test your cortisol, your cortisol awakening response and a four-point cortisol over the day, or even a five-point cortisol I think it is with the DUTCH. And this can give you a whole lot of information that you need to have before you go and do bioidentical hormone replacement therapy, in my opinion.

Lisa: And if in fact it's something you're interested in, do reach out to me. But also go and look at the root cause. Maybe it's just that you need to lower your stress levels, which is easier said than done, obviously. Maybe you're not sleeping well because you've got something like sleep apnoea going on and you need to go and get a sleep assessment done. There can be other confounding factors is what I'm saying here, before you go and grab hormone replacement therapy. Having said that, I am a big fan of it done right, controlled, so that people have oversight when they're doing it and that it's tweaked and worked out properly.

Lisa: So don't just go to the Band-Aid. Make sure that you're always looking out for the root cause of things and how you can correct it. So just putting in extra testosterone or estrogen or progesterone can be beneficial, especially later in life, but make sure that you are doing that properly. So yes, we have all these amazing tools, and then there are things like peptides, which I'm also a great fan of, that can also help with things like growth hormone releasing hormone and things like Epitalon and different ones that can replace certain things that you may be missing. But always go back to the root cause before you go to those sorts of steps.

Lisa: The one thing that I do love about the DUTCH test, just going on that for a second, is you can do a DUTCH Test Plus a CAR. A CAR means a cortisol awakening response, and you can see the diurnal pattern of that cortisol. Are you getting that nice rise in the morning and then it tapering off over the day? Or are you out of range? Are you completely high with your cortisol throughout the day and then you're spiking at night again? Or are you completely flatlined — there's nothing, you've actually gone to the next phase, which is sort of adrenal issues where you've got an HPA axis problem and you're no longer producing much of anything? That's sort of the next step that can happen, which also has many implications. So understanding how stress plays into your sex hormones can be very beneficial, and to understand how it affects the downstream sort of knock-on effects.

Lisa: So stress also causes an increase in need for nutrients, things like vitamin C. So cortisol has an antagonistic relationship with vitamin C. During periods of stress the body may use up more vitamin C to support the immune system, and so this increased demand can contribute to lower levels of vitamin C. So you may want to counteract that.

Lisa: Magnesium is another one. Chronic stress and elevated cortisol levels may lead to an increased excretion of magnesium through the urine. So magnesium is essential for muscle function, for nerve function, for DNA repair, for methylation, you name it — it's 300 processes in the body — and its deficiency can contribute to stress-related symptoms.

Lisa: Then there's the B vitamins, especially B5 and B6. The pantothenic acid and the pyridoxine, which is the B5 and B6, are involved in the synthesis of hormones including cortisol, and chronic stress may increase the demand for these vitamins, potentially leading to depletion if you don't supplement.

Lisa: Zinc is another really, really important one. So stress and elevated cortisol levels may affect your zinc absorption and utilisation. Zinc is crucial for your immune system, for wound healing, for maintaining a healthy metabolism, for your thymus gland to function properly.

Lisa: Calcium is another one. Cortisol can interfere with calcium absorption and utilisation, potentially leading to decreased bone density over time, and calcium is essential for bone health and various sorts of physiological processes.

Lisa: Then another one that I've had problems with in the past, potassium. High cortisol levels may contribute to the loss of potassium through urine. Potassium is really crucial for maintaining proper electrolyte balance, nerve function and muscle contractions. I had one that was so low when I was an ultramarathon athlete — or it was actually in this case doing an expedition in Alaska, out in the bush for six weeks — my potassium got so low that I nearly died. It was down at 1.7, and the doctor had never seen a living person with a potassium level so bad. I cramped from head to toe. It was the most frightening experience and you don't want to go there.

Lisa: Also antioxidants, things like your glutathione, can be impacted, and other antioxidants. Chronic stress can increase the production of reactive oxygen species in the body, leading to oxidative stress, and antioxidants including glutathione may be depleted as they work to neutralise excess free radicals. One of the ways that I like to sort of tackle glutathione problems, though, is

Lisa: more through using something called sulforaphane, or the precursor actually — the broccoli sprout extract that you can buy in supplement form, or indeed broccoli sprouts themselves. That upregulates something called the Nrf2 pathway, which upregulates your body's own natural antioxidant systems and processes, and this can be even more beneficial than just adding in single antioxidants. Glutathione can quell a little bit of the reactive oxygen species, but when you're really wanting to upregulate your own endogenous systems, then have a look into that. I've done a couple of podcasts — I did one with Dr Christine Horng, who's an expert on sulforaphane. You might want to check that out. I can put the link below in the show notes.

Lisa: So what can you do to address stress? Well, to be honest, as someone who has a very, very stressful life — I have a mum that's 24/7 care and I run three companies — I know what stress looks like. But there are things that you can do to manage your stress well, at least. So you need to put in good inputs for a start. You need good food, you need to avoid processed food, you need to do all the things like good veggies and all of that sort of stuff. I think that goes without saying, that you need good inputs if you want good outputs.

Lisa: Also getting early morning light, getting outside into the sunshine as soon as your eyes open if you can, for a few minutes even, and just getting that sunlight to activate on the eyes. You have these receptors that tell the brain what time of the day it is and increase your cortisol levels, which is when you want it, in the morning, and decrease your melatonin levels, which you don't want in the morning. And so this creates that nice 24-hour rhythm. We used to be outside, right? Our ancestors back in the caveman days, we were all outside in the morning, and at night-time we had no light except for firelight, so that was the orange and red light spectrum. We didn't have blue lights.

Lisa: So in the morning, get that early morning sunshine on your eyes without any glasses, not through a window — that doesn't work. You have to actually get outside, get it on your skin, get it on your eyes, get that vitamin D going as well. You don't want to burn your skin obviously in the midday sun — probably avoid that — but you do need your sunlight every day. You do need a certain amount of sunlight on your skin, getting that vitamin D, and you also want this cortisol response.

Lisa: Now at night-time, you want to be avoiding blue light. So unfortunately all our devices, our LEDs, our lights that we have burning bright at night are all telling our body it's daytime. They're telling our brain and the suprachiasmatic nucleus that it's daytime, and so we don't produce the melatonin then, if we are exposed to all this blue light. So make sure that you avoid blue light. I wear blue light blocking glasses. I find that helps immensely.

Lisa: I also like taking adaptogens like L-theanine. I take that two or three times a day just to really take the edge off my stress levels, and I also like ashwagandha. I particularly like adaptogens because they don't force one pathway, they modulate. They help you respond in the way that your body needs to respond, rather than forcing something down.

Lisa: I'm also a big fan of magnesium. I use magnesium threonate at night-time for sleep, and because it crosses the blood-brain barrier, but also magnesium bisglycinate I use during the day. And then there are other forms of magnesium, and by all means, mix and match. The magnesium oxides — yeah, great if you want to get a bowel movement, but not so well absorbed. So my two favourites are probably threonate and bisglycinate. Threonate for the brain, bisglycinate is a really good general one. Malate for the muscles could be good. But whatever, do make sure that your magnesium levels are adequate. Get them tested, get an RBC magnesium if you can — that's a red blood cell magnesium — to actually see the magnesium. The serum levels can tell you some things, but it's not as accurate as an RBC magnesium, and sometimes you have to pay for that extra, unfortunately. But it's really well worth knowing, because if you're low in magnesium, 300 processes in the body are not operating properly, and that's a heck of a lot. That's your energy production, your DNA repair, your methylation, your calming — it's a calming thing. There's so many reasons that you want your magnesium up high.

Lisa: And I love adrenal support supplements. I use one from Dr Wilson's, Adrenal Rebuilder, a lot. Also taking in things like a good quality sodium or electrolyte drinks. I use Himalayan salt in the morning just to help my adrenals cope with the stressy life I have.

Lisa: Doing things like breath work and meditation. This was a hard sell for me, especially meditation, because I hate sitting still. But honestly, even with breath work, if you can do box breathing a couple of times a day, where you're just breathing in for four, hold for four, out for four, hold for four — something as simple as that. It doesn't have to be the super fancy, fancy, fancy stuff. I do Wim Hof sort of breathing in the morning, doing that hyperventilation and then breath holding and stuff, and that really helps again with that cortisol in the morning and my immune system and so on. But just do some type of breath work. But the box breathing, just a couple of minutes, will already take you down.

Lisa: Or another combination I like is the 5-7-8, so you're breathing in for five, holding for seven, out for eight, and holding for another four. You do that two or three times and you just feel yourself coming down a level. Another one is the physiological sigh, where you go — ideally you'd do it through your nose, but I find that with the physiological sigh it's actually better to do it through the mouth because it's quicker — and that double intake of air and then that super long exhale. Doing that two to three times can immediately bring down that sympathetic state that you're in and get you into more of a parasympathetic state.

Lisa: Also love things like hyperbaric oxygen therapy. Obviously I have a hyperbaric oxygen clinic so I'm a little bit biased there. But that just takes me from — I can be up here, stressed out to the max, I go and have a hyperbaric session and I'm just chill. It's really quite amazing how it drives parasympathetic tone.

Lisa: So red light therapy is also another great thing that you might want to put into the mix. I am again a huge fan. I have a red light in my clinic as well and I use it in various ways, but I just find red light to be so good for healing, for skin rejuvenation, for energy production, for just helping you with a parasympathetic drive. You put it on your stomach — I've got one that's called a Flexbeam, I can put the link down below to that too, it's fabulous — you put it across your stomach and it just really helps that parasympathetic drive, or on injuries. But getting off topic.

Lisa: So yeah, getting enough time in nature, big time. Nature will always calm you down. We are meant to be in nature every day. Go and forest bathe or go down the beach or do something like that. And getting enough sunlight exposure, obviously not burning your skin, but getting enough is also important. So it's not always realistic to say, well, lower your stress levels, because we know life is very, very stressful and we don't always have a lot of choice in that. But do these things to help you manage that stress.

Lisa: Another thing that stress does is it causes you to lose control of your cravings and your hedonic urges. So you're more likely to seek out rewards to calm yourself down and to lower the anxiety if you have a heck of a lot of stress. So you're more likely to lose the plot, and we've all done it. I mean, this still — as evening approaches and I've had a very stressful day, it's very important that I go and do a couple of minutes of breath work or hyperbaric or something. Otherwise, if I lose control at that hour of the day, it can mean that you head to the chocolate or the wine or the chips or the things that you know you shouldn't be eating or doing, and yet you go and do them anyway because you're in the stressed out state.

Lisa: So by controlling this level of stress that you've built up over the day, you're controlling your ability to control your own hedonic urges and cravings. So that can really, really help you so that you don't head to the liquor store or the cookie jar and devour a whole packet of chips and lick the packet as well, just trying to calm yourself down. And when you understand these things, it's not about willpower and it's not about you being a weak person or anything like that. It's actually you're stressed and your body is trying to find a way to calm yourself down. So it's a very natural thing, but you can do that in other ways.

Lisa: And just making sure that you get enough protein and fats over the day, good fats, and you're getting your nutrients taken care of, you're getting your vegetables — all of those things can help with those cravings, especially things like those sugar cravings, so that you don't trigger that reward cascade, meaning that you need satiety, that you need comfort from food. And you won't always win, but if you can win more often than not, then you're on the right track.

Lisa: So if you've been under a huge load and your stress bucket is starting to overfill and you're starting to lose control, just think about that. We can take on so much stress — mechanical stress, physical stress, psychological stress — but when it gets all too much, that's when you're going to lose the plot, so to speak. And then of course you're going to trigger the changes in the way your brain signals and what happens with your nervous system. So you start to then go out and eat the wrong things, and you start to gain weight, feel sluggish, feel tired, you don't sleep as well. Maybe you eat the carbs late at night or you drink late at night, and that has a massive cascade effect on your ability to deep sleep. And then when you don't sleep, you have less control of your urges and your cravings and so on. So really important to dial this back and to understand how that is going.

Lisa: So fight or flight really is helpful in a crisis, and learning how to work through stress is probably one of the biggest things that I try to do when I'm working with people and with myself on a constant basis. This is not something that you've just done once and you've got it under control. You just need to keep working on it. And again, it depends a little bit on your genetics, how much stress hormones you make, as to how stressy a person you will be. Some people are a lot more chill than others. So you have to sort of work in with all of that.

Lisa: So I really like to measure my clients' cortisol and do that DUTCH test if I can. So you can either do it in the serum, which is just a peek at one point in the day, which gives us some information but not really a heck of a lot. I really prefer the DUTCH, or that full 24-hour cortisol that you can do sometimes.

Lisa: And that gives us a really good picture of what's going on in that diurnal pattern, so that you're not getting inappropriate drops at the wrong time, so that you're really, really tired mid-afternoon, or it's too high at night and then you can't sleep. When it's too high at night, you can release something called corticotropin-releasing hormone that blocks you from going to deep sleep as well. So if you see that high cortisol, if you do a DUTCH test and you see that high at night, then you may be blocking that. You release something called corticotropin-releasing hormone and that can stop you going into a deep sleep, so you need to really reset that.

Lisa: And also, if your brain can't rest, it also resets your insulin receptors. So if you're resting properly at night, your insulin receptors are getting more sensitive again, your beta cell production of insulin for the next day starts, and when you get out of that circadian rhythm, that's when it can be messed up.

Lisa: So also start thinking about things like alcohol and coffee. They can mess up your cortisol. So maybe having one coffee in the morning is fine, but if you're having multiple coffees over the day and you're trying to get through the day by keeping yourself awake with coffee, then there's something wrong. You need to address that. And your genetics play a role again with coffee, how fast you process it out of the body. So you might be like my husband, who doesn't process it out very fast, and so it can have an impact for the next, well, at least 12 hours before it gets out of the system, and for some people even longer.

Lisa: So start monitoring things like your HRV, your heart rate variability, on your watch if you have one, or an Oura ring or a smartwatch of some sort. Start monitoring your sleep, your heart rate, your HRV if you can. Your HRV looks at the regularity of your heart rate. So if it's too much the same, like the same distance between each beat, then you're not adapted to the stress well. So you want a big variability, is what you want to see in your HRV. And if it's low, then you're probably in a sympathetic sort of dominant state and you may need to address some things.

Lisa: Start looking at what is disturbing your sleep. If you had a glass of wine at 9:00, did you not sleep well that night? Start to correlate these things. If you ate a piece of cake at 9:00 at night, did you again have a blood sugar drop at about 2:00 in the morning because your sugars rose and then they dropped and then your cortisol came up? Start to make correlations on things if you can.

Lisa: I also like to do the adaptogens in the evening, L-theanine being my favourite go-to there. There are also things like chamomile tea. They can help you just get into that deep sleep. Another thing that I like to do is a yoga session at night, not a hard-out yoga session, just a really relaxing one to sort of drive that parasympathetic tone, or using my red light belt that I have, the FlexBeam.

Lisa: So just start to correlate. I think we've covered quite a lot of things today, and there's a lot more to talk about with metaflammation and inflammaging and all those sorts of things, but I hope to have made a bit of a connection between stress hormones and your sex hormones, and how these interplay with each other, how they affect each other, how it affects your brain and your ability to control your urges and so on and so forth, what testosterone does, and just a few basics that it's really, really good to know.

Lisa: Just before we go, just a couple of things that I see also with athletes. If you're training really hard and you're not getting gains, so you're not building muscle, you're not getting faster, you may want to have a look at what your hormones are doing. Because if your testosterone is low — and this is for men and for women — you're not going to be building, you're going to be more catabolic. And if you can just cut down sometimes the volume, you'll start to see that you'll start to improve, you'll grow muscle, you'll improve your endurance, all of these sorts of things.

Lisa: So just watching that you're not overtraining as well. It's very important that we move, but then some athletes, myself included, have a tendency to overtrain. And so just understanding that it's in the recovery that you make the gains. If you're training your ass off but you're not recovering, then you're not getting the gains from your hard work. So it's really about understanding that.

Lisa: And sometimes when you get, say, ultramarathon athletes that are really pushing the limits, or endurance-based athletes, they can have the metabolic health of someone who's sitting on the couch eating packets of chips and drinking beer every night and pizza. They can look pretty similar because everything is out of whack and out of rhythm. So just take that into account as well.

Lisa: So you need rest cycles. And there are times when you want to get after it and go hard, and then there are times when you need sort of things like yoga and pilates and flexibility, and there are times when you want to be just building muscle. So go through periodisation, work with a trainer if you can, and have a bit of a plan, so that you — or at least understand what your goals are, where you're heading to — and not back to back to back, which I certainly did for a long period of my life, so that you're resetting your nervous system and allowing it to come back into line.

Lisa: Another point is if your resting heart rate is over 62, then you're more likely to have some cardiovascular problems. And so you want it under 62, is a good sort of generalised rule of thumb. And if your heart rate is 10 beats higher than it would be normally — so if you're taking it every morning and you're finding that, oh, today my heart rate was 10 beats above what it normally is — you probably need a day off. You might have trained too hard, or you may be facing some sort of infection or something, and you might need to back off.

Lisa: Also watch your blood pressure. If you're having drops in the evening with your blood pressure, what is your hypothalamus, your HPA axis doing, all of those sorts of things, so that you don't get stuck in that sort of sympathetic overdrive and that you're really counteracting that. So if you're a go-getter, really hard worker, just make sure that you're also filling in the gaps, doing that recovery, doing that rest and relaxation, having that time out when you can, and being in that parasympathetic state as well. When you don't, you're more likely to have even things like leaky gut. So this has massive implications and goes beyond what I wanted to do today.

Lisa: But I hope this was helpful. Please like and subscribe to the channel. I'd really appreciate it if you share it with your family and friends, and check out my podcast, Pushing the Limits. It's been going for eight years and over 300 episodes. Everything about longevity, anti-aging, health optimisation, high performance — that's what we're all about at Pushing the Limits. And head over to my website, lisatamati.com. I'll stick a few links down below if you want to find out more about what we do. And we really appreciate you. Thanks, guys.