Why Is My Cortisol High Even Though I’m Doing Everything Right? Hidden Causes Of High Cortisol, The DUTCH Test & More!

Affiliate Disclosure

Hormones, Podcast

Click here for the full written transcript of this podcast episode.

Cortisol can be confusing.

And frankly, most popular tests for cortisol don't tell you what really need to know…

…things like how fast cortisol gets cleared by your body, what's truly causing high cortisol or low cortisol, how cortisol (and other crucial hormones) are getting created and broken down, and much more…

And this is important, because low cortisol leaves you with zero energy, low drive, brain fog, and feeling overtrained and adrenally fatigued, while high cortisol decreases protein synthesis and amino acid uptake, increases proteolysis (protein breakdown) and bone degradation, suppresses parts of the immune system, and increases serum glucose. So you feel pretty crappy when cortisol is low, and while you may feel good when cortisol is high, if cortisol is chronically high, there are some downsides to that too.

Enter the DUTCH test – which is a new way to measure cortisol and much more.

So what is the DUTCH test?

The DUTCH test is a urine steroid hormone profile that measures hormones and hormone metabolites (called conjugates) in a dried urine sample, and is performed from the comfort of your home. It is the most cutting-edge way to truly see what’s going on when it comes to your hormones, because it doesn’t just measure hormones, but also something called “metabolites”, which are a measurement of hormone production and hormone breakdown.

Measuring both hormones and their metabolites can give you or your health care practitioner a much better overall picture of hormone production. For example, a DUTCH urine steroid hormone profile on someone with low salivary cortisol could show normal cortisol production, but high levels of metabolites. In other words, this would indicate that you are producing enough cortisol, but it’s just getting broken down into its metabolites very quickly. There are also some metabolites that are important markers for cancer risk that can only be measured in urine.

With serum (blood) and saliva hormone spot-testing, it’s possible to track variations in hormone release throughout the day – and this is a great way to measure how your hormones change during a 24-hour period (your circadian rhythm). In contrast, a standard 24-hour urine collection many physicians use reflects your total hormone output in a 24-hour period.

But by using the DUTCH urine steroid test, you get the best of all worlds: blood, saliva and urinary results with just a urine collection.

The DUTCH test measures the following:

-Free cortisol
-Free cortisone
-Creatinine
-Tetrahydrocortisone
-a-tetrahydrocortisol
-b-tetrahydrocortisol
-DHEAs
-Progesterone metabolites (a-pregnanediol, b-pregnanediol)
-Androgen metabolites (DHEAS, etiocholanolone, androsterone, testosterone, 5a-DHT, 5a-androstanediol, 5b-androstanediol, epi-testosterone)
-Estrogen metabolites (estrone, estradiol, estriol, 2-OH-estrone, 4-OH-estrone, 16-OH-estrone, 2-Methoxy-estrone, 2-OH-estradiol)
-6-OH-melatonin-sulfate

My guest on today's podcast, Chris Kelly, is an expert when to the DUTCH test. Two years ago Christopher Kelly quit his job at a hedge fund to start Nourish Balance Thrive, a small functional medicine practice for athletes. Chris is a computer scientist and pro mountain biker and he works with two medical doctors, one of whom is also a pro mountain biker, and the other is Dr. Tommy Wood, a biochemist and Ph.D. fellow. He employs a registered nurse, and works with his wife Julia, who is a food scientist.

During our discussion, you'll discover:

-What the DUTCH test is and why it is far different than an Adrenal Stress Index…

-My own shocking results on the DUTCH test… 

-The difference between free and total cortisol, and why you may think that your cortisol is normal when it is actually quite low…

-Why some women should not use estrogen natural hormone replacement therapy…

-How to know if you should be using a multivitamin…

-How chronically high cortisol can cause high blood glucose, brain damage, and muscle wasting (even if you feel great short-term!)…

-Things that can elevate cortisol if you are already doing everything “right” in terms of stress control, sleep, proper training recovery, etc…

-Whether it's true that high ketosis can cause high cortisol…

-What type of hidden infections in your gut or blood can cause high cortisol…

-Supplements and herbs you may be taking can increase cortisol dramatically…

-Whether there is a link between cannabis, CBD, THC and cortisol…

-The most potent supplements or foods or essential oils for decreasing cortisol…

-And much more!

Resources from this episode:

-Book: Why Zebras Don't Get Ulcers

A sleep article that includes the one-two Sleep Remedy/CBD combo Ben swears by for sleep, along with the essential oils we discuss

Phosphatidylserine for lowering cortisol

The London Biohacker Summit – click here to register and use 10% code “ben”.

The RUNGA “digital detox” Costa Rica retreat Ben is going to in December (mention this show for $75 gift upon registration).

Click here to visit Nourish Balance Thrive and use code BEN10 for a 10% discount on the testing and consulting Chris and I discuss in this episode.

The Little Know Test That Tells You Everything You Need To Know About Your Metabolism podcast with Chris Kelly

-“7 Signs Your Cortisol & Adrenals Are Broken” podcast with Chris Kelly

The Underground Test That Shows You How To Legally Upgrade Your EPO, Increase Your Oxygen Levels, Boost Your Red Blood Cells & Build Double-Digit Percentages In Power And Endurance podcast with Chris Kelly

-Article: “The Ketogenic Diet's Effect On Cortisol

Caffeine may increase cortisol levels. 

CBD increases cortisol release in healthy volunteers

Safety and pharmacokinetics of oral cannabidiol when administered concomitantly with intravenous fentanyl in humans. 

Essential Oil Inhalation on Blood Pressure and Salivary Cortisol Levels in Prehypertensive and Hypertensive Subjects

Blunting by chronic phosphatidylserine administration of the stress-induced activation of the hypothalamo-pituitary-adrenal axis in healthy men

Ben Greenfield's DUTCH test results

ben.greenfield.dutch_.4-12-16

Do you have questions, comments, or feedback for Chris or I about the DUTCH test, cortisol or anything else we discuss in this episode? Leave your thoughts below and one of us will reply, and click here to visit Nourish Balance Thrive and use code BEN10 for a 10% discount on the testing and consulting Chris and I discuss in this episode.


Also published on Medium.

Ask Ben a Podcast Question


Get The Low Carb Athlete - 100% Free!Eliminate fatigue and unlock the secrets of low-carb success. Sign up now for instant access to the book!

51 thoughts on “Why Is My Cortisol High Even Though I’m Doing Everything Right? Hidden Causes Of High Cortisol, The DUTCH Test & More!

  1. Gosia Hughes says:

    Hi I would like to know if there is a Dutch test practitioner near me ( I live in west sussex , England) ?? If so once the test has been done how would I go about rebalancing my hormonal system ? Would I get advice on this from the practitioner ? Thanks Gosia

    1. In terms of doctors, here are a few directories that may help you find a good functional medicine or naturopathic practitioner in your area:

      • HealthProfs.com
      • FunctionalMedicine.org
      • Naturopathic.org
      • PrimalDocs.com
      • PaleoPhysiciansNetwork.com

      That will ensure you find someone who I would likely vouch for!

  2. Ula Gram says:

    Hello,

    I was wondering why some women should not use Estrogen Hormone Replacement therapy?

    Thank you!

    1. Some women are estrogen dominant and wind up getting very poor effects from estrogen replacement therapy. You should definitely do a full test to determine that first.

  3. Susan says:

    My chiropractor just tested my hormones with the Dutch Test and I have low morning cortisol but then it goes higher that it should for the rest of the day. Nighttime cortisol is high and I always want to do something while everyone else is falling asleep.

    I was given some Standard Process Hypothalamex and was told to take two in the morning. She is looking for other items for me to take. I eat super clean and knew hormones were up to no good!

    1. I need to see more on your exercise and health history…and I'd be happy to help you via a personal one-on-one consult. Just go to https://bengreenfieldfitness.com/coaching. and then choose a 20 or 60 minute consult, whichever you'd prefer. I can schedule ASAP after you get that.

  4. jennie says:

    does anyone rate this test. I already know I have high cortisol levels but being post meno I need my sex hormones checking . I am so poorly with Hashi’s

  5. Chris says:

    Just got my DUTCH test results as well. They look similar to yours Ben’s – significantly elevated free cortisol in the morning and mildly elevated in afternoon and ok at bedtime and waking. also high metabolized cortisol. I need to watch your shows to figure out why my levels are so high despite eating clean diet for 6 months, gentle exercise, sleeping 8-9 hours per night, meditating, etc. And I am still tired all day. I found out I have H. Pylori and also had elevated D-lactate on OAT so not sure if those infections are driving it or something else – I have chronic pain, mild depression, am overweight etc and suspect these things can raise cortisol, but in the past saliva testing showed low free cortisol, not high like I am seeing now. very confusing!

    1. If you want to go into detail, feel free to book a consult at <a href="https://greenfieldfitnesssystems.com/ben” target=”_blank”>www.greenfieldfitnesssystems.com/ben and choose 20 or 60 minutes and we'll go over everything there.

  6. Karen says:

    What does it mean when the saliva cortisol test and the DUTCH test show two different things?

    For example, my saliva test showed low cortisol across the board. The diurnal curve was normal, but everything was low, morning, afternoon, and evening.

    My DUTCH test showed a normal diurnal curve, but it showed slightly elevated cortisol levels.

    How could the results from these two tests be so different? My functional MD said he didn’t know what the differences meant and he’s been wondering about it, too.

  7. Brian G says:

    Ben and Chris! I enjoyed this podcast as I do almost all of them. I’m considering doing the DUTCH test. I thought I was possibly suffering from low-T so I did some recent serum hormone test and my Total T came back at 1044 ng/dL but my free T came back at 59.4 pg/mL also my PSA was 0.5 ng/mL and my estradiol was 36 pg/mL. So my total T is at the upper range of the scale but my free T seemed to be towards the lower end of normal. Any insight based on this little bit of info would be appreciated.

    Thanks

    Brian

  8. Tommy says:

    Thanks for this episode. Dutch test done and organics acid on the way.
    Time to get a grip on my Type a personality.
    Btw Ben, if you’re in the north of sweden and need some chiro treatment to calm down the nervous system, send me a message :)

  9. Josh says:

    Ben,

    Having listened to the podcast and the idea that your cortisol is high despite a truly healthy lifestyle – I wonder what your spinal structure is; when the spine is aligned improperly the body can be locked into sympathetic dominance. The lock into sympathetic dominance can lead to excessive cortisol production – in the sense that your body feels stressed even when you are personally not stressed.

    Have you had your spine evaluated to see if that might be the reason your hormone test ready is unusual?

    1. Interesting feedback! Yes, I meet with a chiropractor relatively regularly!

  10. Daniel says:

    Hi Ben, I think you are just overdoing your supplementation and drink a crazy amount of coffee. Everytime when I listen the amount of nootropics and supplements you take, I’m like, man, this guy takes more supplement than food. I guess that might be too much of a biohacking, don’t you think?

    1. I only take fish oil, creatine, a multivitamin in morning, then CBD and sleep cocktail at night. That's honestly not very much.

  11. Wayne says:

    I really believe that the paleo/ketogenic diet is stressful to the system. Please read the work of Ray Peat and some of his contemporaries such as Danny Roddy and Haidut from Idea Labs.

  12. Daniel says:

    What do you do when someone has too low cortisol, like it’s actually hard to wake up in the morning?

    1. In that case, start here; https://bengreenfieldfitness.com/podcast/343/ – fixing adrenal fatigue!

  13. Remy says:

    Caffeine displaces adenosine. High levels of adenosine cause hibernation and a slowed metabolism. That’s the reason caffeine perks you up, not through slowing the breakdown of cortisol. In someone accustomed to caffeine consumption, the effect on cortisol secretion is minimal.

    Now why is the adenosine high? Probably a protective mechanism against stress…

  14. Whit says:

    Been listening for years, interesting episode. Struggling with low cortisol myself, most likely preceded by a long period of high cortisol. I don’t recall you ever interviewing Phil Maffetone. At the risk of being another commenter who knows what’s best for you (I certainly don’t) it seems like a great opportunity to perform an experiment in working with him and of course interviewing him for the podcast midway through. Been having success in getting my energy back (I know that’s not your issue) by dialing down the intensity after basicly 30 years of continuous black hole zone exercise and beer drinking. New book “Primal Endurance” by Mark Sisson and Brad Kearns has been the impetus. Getting a bike computer and chest strap was a real eye opener, it’s almost impossible to go mountain biking, my sport of choice, without going over the 180-age heart rate limit. Psychologically challenging for sure!

  15. Louis says:

    What was the software Chrus mentions? Trillow?

  16. Tim says:

    If you’re not already taking some adaptogen and are interested in a cortisol lowering supplement, would it be worth taking the phosphatidyl serene route (on its own), or taking something like Mark Sisson’s Primal Calm, which also has rhodiola and a few other things?

    Much cheaper to take phosphatidyl serene on its own, but curious if folks think it’s worth getting the cocktail in Primal Calm (about $50/month)

    1. I'd use lavender and phosphatidylserine. That's it. Those are the only ones that clinically lower cortisol.

      1. Josh says:

        How much PS do you supplement, Ben?

        Is lavender in pill form or just via essential oils?

        Cheers

        1. I use the Thorne phosphatidylserine supplement Isophos <a href="http:// (bengreenfieldfitness.com/isophos)” target=”_blank”> <a href="http://(bengreenfieldfitness.com/isophos)” target=”_blank”>(bengreenfieldfitness.com/isophos). And I use two capsules. The lavender that I use is this: https://greenfieldfitnesssystems.com/product/youn…

  17. Nick says:

    Chicken hearts have about 420 mg of phosphyltidylsterine per 3.5 oz.(bovine brain is 715 mg) hearts are difficult to find but I know A local farm that processes them and am able to get 4-5 lb every couple of months. Also when prepared properly and marinated (I use red wine vin, oo, and ginger) they taste Amazing. Very similar to chicken thighs/dark meat.

    I too would like more info on quality control and validation with the DUTCH test. Chris, Ben love the work both of you do.! Thanks.

  18. Isabelle says:

    Hi Ben,

    First and foremost I would question the test. This is a fairly new test. They claim they use healthy subject for the reference range. But how many? Also they use creatinine as an internal standard. How reliable is that? Especially because you are a pretty special case.

    Same thing with HbA1C, this is a fairly new test that was initially developed for people with type 2 diabetes but now they are figuring out that you can get a lot of false positive in healthy individual because red blood cell survive much longer.

    If I were you I would look into other test before doing anything, maybe it’s true but maybe not.

  19. Matt says:

    Ben… My recent DUTCH test came back with almost the same numbers in cortisol along with high end/ low end range markers that you had. Where I differ is that a month and a half ago I took a week long dose pack of prednisone with hydrocodone for a back injury. Once I ended both medications ( 6 days worth) that’s when the insomnia, heart palpitations, waking up in the middle of the night like a tiger was chasing me, anxiety …etc. both of my conventional docs dismissed this as the withdrawal or after effects of the medications.

    I was at one point only sleeping 3-4 hours a night for 2 weeks. I’m up to 4-6 hours a night but cannot break past that

    I finally linked up with a friend and functional med doc who ordered up the DUTCH and got me on a supplement protocol along with an eating plan as to not create undo spikes in blood sugar. It’s only been a week or so and I’ve seen a change but I feel it’s going to be a bit of a longer road than initially thought. I just hope you or anyone else doesn’t end up like me due to high cortisol. Thanks again for this episode!

  20. Matt S says:

    Looks like your getting some interesting advice, Ben! I have to agree with what some others have said- I know you think of your life as “low-stress,” but I think most of us would agree that running several businesses while traveling around the world and doing 12-hr long races would cause some stress.

    Another thought I had…you mentioned that your sleep is awesome, but from past posts and some of your comments during this episode it’s very “hacked” sleep. Do you think you would sleep well without binaural beats, CBD, sleep cocktails, PEMF, etc? Maybe your sleep is great using all the hacks, but perhaps being able to get excellent sleep without all the gear would demonstrate better stress control and a more primal/ancestral pattern of living.

    Enjoyed the podcast…thanks for putting yourself out there and being willing to share your results!

  21. Diana says:

    I loved this show. Thank you! Dutch testing is something i really want to try. My cortisol was very high for years and my hormones have been tanking at the same time.

    Ben, as much as you were saying that you aren’t stressed, I really think your body is. I told myself for years that my personality and high achieving state was just who I was. I always recovered from exercise and never had any issues until …I turned 30 (I’m 32 now). It may have hit me sooner since I’m female and stress affects women differently. I have been lowish carb for over 14 years and hard charging athlete. My test results are similar to yours in regards to high cortisol, higher fasting blood glucose with low insulin, low blood pressure, low body temp, low heart rate. I also show low free t3, low free t4, low tsh, low DHEA, low all female hormones. I’m getting injured and not recovering. My hs-CRP is very high. Chris made some valid points about how your test results are a reflection of your lifestyle. High cortisol makes you feel good, as long as anxiety doesn’t get the best of you. However, after a while your body will start to down regulate things, trust me. Another thing I have learned is that overuse of supplements takes a toll on the body too (I was taking over 30 pills/tintures and multiple bulk powders per day). You mentioned that you don’t have sleep problems but you take supplements to help you sleep. Would you be able to sleep without them? Also, what if you gave up all stimulants for a short while. Would your body respond the same?

    Again, thanks for the podcast and the honesty about your labs. I’m sure you’ll keep us updated on future results.

    1. Mikki says:

      Diana, interesting! What steps did you take to correct?

  22. Steven says:

    Hi Ben,
    Whatever happened to the dry fast PowerPoint?
    Great show!

  23. Trent says:

    Would like to see Ben change up his training routine. Build up an aerobic base where he uses Phil Maffetone 180-age formula for 8-12 weeks then retest. Ben, you train at an extremely high anerobic rate, thus increasing cortisol and the need for sugar burning.

    If you build an aerobic base then the body will be fat adapted an able to burn fat for energy and cortisol levels will lower.

    1. Dr Tamsin Lewis says:

      Ben has a HUGE aerobic base!
      This comment made me laugh a little ;)

  24. Mikki says:

    Great podcast. My DUTCH results for cortisol exactly same – normal patterns but off the chart high for cortisol and cortisone. Classic case of pregnanelone steal going on. I have started doing lots of stress reduction techniques, sought out Phil Maffetone. So knowledgeable and creative w thinking outside the box w how to treat overactive SNS. Have given up coffee for a month, don’t feel too different, just slightly wistful that I’m not drinking it! Ben your podcast last week was great too, and figured I’d try the 14 day, 30 min autonomic reset. Figured I had nothing to lose. Really enjoyed listening. Thanks for delivering.

  25. shari says:

    Loved this podcast. Please, please do a follow up podcast as you explore your cortisol issues. I will be so interested in learning what you find out.

  26. Josh says:

    Very interesting. Chris is a gem. Can’t wait to hear the Dr Walsh podcast – he is a veritable treasure chest.

    Pretty sure coffee affects cortisol secretion though, not just its breakdown http://www.ncbi.nlm.nih.gov/pmc/articles/PMC22579…

  27. celeste kelsey says:

    Loved the episode. Love Christopher Kelly and Dr. Tommy Wood. I listened all the way through so obviously Love Ben. As a 71 year old life-long cortisol junkie…it came as no surprise to me that Ben was off the charts. I believe at his age (young) it is possible to believe that you are “doing everything right” and because of that have very high energy and can run circles around everyone else. It isn’t until you get much older that the lifestyle takes its toll. It is hard to have that self-evaluation when you feel so good…and you can feel like super-man (or woman as I am) when your cortisol is high. My blood pressure and blood sugar did not start to rise until I was much older. I can always spot another “cortisol junkie” and I have never met one who recognized it. It is a very difficult lifestyle to bring under control. Heavens…why would you want to and be like everyone else? ;)

  28. kt says:

    Ben, I find it intriguing that you claim your interests are bridging into “health and longevity”, but when Chris suggests that your high-intensity, hard-charging lifestyle might be to blame for your chronically high Cortisol, you quickly dismiss him.

    1. Simon Hunter says:

      I didn’t think he dismissed him at all, he even mentioned he would try to retest after a quiet retreat to see the effects. I thought the podcast was great.

  29. I use this test exclusively now vs the old Saliva testing! Game changer for my clients..!

  30. David Mosier says:

    So Ben…before I listen to this episode….can you please tell me:

    Is it full of useful and scientifically accurate info that I can apply to my training? 

    Or….is it full of pseudoscience,  woo woo, and a thinly veiled commercial for some product or service of dubious value?

     The last few episodes I listen to were far to low in the ‘signal to noise’ ratio.

    1. Pure content. No woo. I'd listen.

  31. Jess says:

    With #’s that are so “surprising” according to Chris it may be prudent to do a re-test immediately before you go changing lifestyle aspects. I know Chris is new to this testing and hasn’t done a ton but if yours stands out that much as abnormal I think its worth looking into. Labs do make mistakes or it could be a quality control issue. Just a thought:)

    1. Jamie G Ward says:

      Slightly unfair… Chris talks about carrying out two tests in the interview!

      I thought this was one of the best episodes so far, a lot of information to digest. It was nice and juicy boys!

  32. Evan Brand says:

    Wow!! I figured your lab results would look lower than that. I’ve had mixed results using the DUTCH and talked with Dr. Carrie at the lab about it. Would be interesting to see what would happen if/when you ran a biohealth saliva test at the same time as the DUTCH to look for inconsistencies.

    I’ve seen people symptomatically sound like a stage 3 adrenal issue, DUTCH shows no adrenal issues, then the salivary shows the true picture.

    Cheers Ben, hope all is well!

    Evan

  33. Christopher Kelly says:

    Dr. Tommy Wood and I recorded a 25-minute bonus video that you can get here: http://dutch.nourishbalancethrive.com/

    1. Jeanne Locante says:

      Great information and podcast! My question for Dr. Wood and Chris Kelly is regarding female hormone issues. My daughter who is 29 has horrible PMS and hormone issues which no one seems to be able to help, including Dr. Kalish. Is this an area you guys address or is this primarily for athletes?

      1. Dr Tamsin Lewis says:

        Hi Jess,

        I work with women – of all ages to address hormonal imbalances and use the dutchtest.

        You can find me through www.curoseven.com – although the website is currently not reflecting the work we do.

        Best

        Tamsin

Leave a Reply

Your email address will not be published. Required fields are marked *