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Dr. Robert Rountree and Dr. Amanda Frick took Thorne’s at-home Weight Management Test, and the results are in! Listen here or watch on YouTube to follow along as they explain how the test works, what it measures, and how to interpret their personal test results for better health.
During this episode you’ll learn about:
Resources to topics mentioned in this episode:
Products mentioned in this episode: Weight Management Test, Weight Management Bundle, Meta-Balance™, Phosphatidylserine, FloraMend Prime Probiotic®, Super EPA, Broccoli Seed Extract
Other health test kits from Thorne: Biological Age Health Panel, Vitamin D Test, Stress Test, Thyroid Test
Subscribe to More Content
Subscribe to the show wherever you listen to podcasts so you never miss an episode. You can also learn more about the topics in the episode by checking out the latest news, videos, and stories on Thorne’s Take 5 Daily blog.
During this episode you’ll learn about:
Resources to topics mentioned in this episode:
Products mentioned in this episode: Weight Management Test, Weight Management Bundle, Meta-Balance™, Phosphatidylserine, FloraMend Prime Probiotic®, Super EPA, Broccoli Seed Extract
Other health test kits from Thorne: Biological Age Health Panel, Vitamin D Test, Stress Test, Thyroid Test
Subscribe to More Content
Subscribe to the show wherever you listen to podcasts so you never miss an episode. You can also learn more about the topics in the episode by checking out the latest news, videos, and stories on Thorne’s Take 5 Daily blog.
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Dr. Robert Rountree (INTRO):
This is The Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet, supplements, and lifestyle approaches to good health. I'm Dr. Robert Rountree, Chief Medical Advisor at Thorne and functional medicine doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease.
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Hi, everyone, and welcome to The Thorne Podcast. This week we're going to be giving you the details on Thorne's Weight Management at-home test kit. To help you follow along, in addition to our regular audio episode, we're also releasing the video from this recording as well, so be sure to check that out on Thorne.com or on our YouTube page so you can follow along as we go over our results and see all the graphs and charts. Joining me once again to talk about the Weight Management Test is my friend and colleague, Thorne's Vice President of Medical Affairs, Dr. Amanda Frick. Welcome back, Amanda. How are you doing?
Dr. Amanda Frick:
I'm great, Bob. How are you?
Dr. Robert Rountree:
I'm good. Yeah, we've had a bit of a chilly winter here in Colorado, but I think by the time everyone's listening to this, it will be back to the warm season again.
Dr. Amanda Frick:
I'm ready for a warm season too, although I'm sure it's not as cold as where you are. It's still cold for me here, and I need some sunshine. We don't get a lot of gray, and we’ve got a lot of gray.
Dr. Robert Rountree:
I think you’ll be taking your surfboard out of storage and hitting the waves again. I can just see you out there now.
So, Amanda, you and I have both taken the Weight Management Test, just for fun and out of intense curiosity, because I know we’re both really curious people. So we’re going to walk our listeners through the results in a bit, but first, let’s talk about the process of actually taking it. So why don’t we start with your experience, what that was like. Just give the listeners the sense of what they would be doing.
Dr. Amanda Frick:
One important thing to note, which is different for mine than from yours is if you’re having a menstrual cycle, you do have to collect on a specific day, and that date is only in a three-day window, so you have to make sure you’re collecting at the right time. The reason for that is because of the hormone collection.
But from my experience, it was making sure that I could catch a day where I could not only do a first morning waking saliva, but also a before bed one and also hit the three-day window for my blood collection, and I did it! But it just takes a little more careful planning.
Overall, I think we’ve talked about this before with the blood collection, it can get tricky getting it in the right area of your finger. I don't think it's discomfort, but just getting through the process. For me, it’s more like making sure I keep it on the card and not get it everywhere else. And I tend to be really great for blood collection, so for me, it took a couple extra gauze pieces. Maybe I'm just an old pro at this, but for me it was no issue to collect the six samples or the drops that I needed for my card and then the saliva sample.
Dr. Robert Rountree:
Well, yeah, you're exactly right. I didn't have to track my menstrual cycle, so that made it a little easier for timing when I was going to do it. I have to say that I've done a few of these tests now, so I knew what to expect and I found that somewhat helpful. For example, I want to make sure my hands are nice and warm before I do the finger prick. So I usually will run my fingers under a little cold water– I'm sorry. Yeah, no, what did I just say?
Dr. Amanda Frick:
Please don't.
Dr. Robert Rountree:
Yeah, put your hand in some ice, that will really help a lot. No, well, I've just pointed out what's important here is you want to have it nice and warm so that you increase blood flow. And having done that a couple of times, I've found it really makes a difference. Sometimes even I have to say slapping your hands a little bit can help. If you do that right before the collection, then you can make sure you get plenty of blood. Now it's still not unusual for me to have to prick twice, so that's why they do include an extra lancet in the kit in case you need to do that.
The other issue that's come up for me in the past is I'm not a big spitter.
Dr. Amanda Frick:
Yeah, we've talked about that.
Dr. Robert Rountree:
[Laughs] We've had that discussion. I'm not a big spitter, and I think, "Do you really need to collect this much saliva?" Well, for the first morning one, yeah, it's a fair amount of saliva, so be forewarned, if you're a dry-mouth kind of person, then you may want to do something to lubricate a little bit. There's all kinds of tricks to get the saliva going. You can actually put a little tiny rock under your tongue; that's an old trick that's done.
Dr. Amanda Frick:
A rock?
Dr. Robert Rountree:
Yeah, just a little stone, that's like 5 millimeters. That’s something that athletes do sometimes when they get they’re prone to dry mouth, just putting something under your tongue will help get the saliva flowing. So if you happen to be worried about it, it’s probably not going to be an issue. Just take your time. The spit will come, if you allow it.
Dr. Amanda Frick:
It takes longer than... It feels like forever at the time. It takes longer than you think it's going to take. So I wouldn't do it trying to be in a rush out the door. Give yourself time to relax because you don't want to be stressing while you're doing your stress-hormone collection.
Dr. Robert Rountree:
Well, it's a really good point because the first time I ever did this, I actually had that experience. I said, "OK, right before work, I'll do it. I'll just spit in a cup and I'll be done." And then I realized, "No, it actually took some time to do that," so I had to be prepared. So those are two things you can do to prepare is put your hands under warm water, not cold water, to make sure you got good circulation going, it even helps to have your fingertips even a little bit red, that way you can make sure there's plenty of blood flow. And I think you get more accurate results if you do it ahead of time than you do if you prick your finger and then you squeeze to try to get the blood out. I think that can actually influence the results a little bit. So preparing for it is everything. And again, making sure you have good salivary flow, and the first morning collection's going to be a lot more saliva, so take your time. Be prepared to spend a little bit of time collecting all that spit.
So Amanda, who should be taking this test anyway? Why would someone want to do this as opposed to just saying, "Well, I'm going to wing it. Maybe I need to exercise a little bit more." Etc. What's the advantage of doing a test like this? What's included, etc.?
Dr. Amanda Frick:
So I think you could wing it if you want, but I think when people are looking at the test, probably they've already either tried to do that or they've made some efforts already at changing their diet and exercise program or they feel like there's a missing piece. The great thing about the test is it's taking in so many different aspects which you may not be getting from your doctor. So it does include a thyroid check and a hemoglobin A1C to get an idea about your blood sugar, but it's also including some hormones. That's why it's included for women to do it at a certain point in their cycle because it includes some sex hormones that are important for weight management.
And then of course you're getting, like you talked about, the saliva collection for the adrenal stress hormone. So even if you had the hormone information about your cycle or related cycle hormones and you've already done a hemoglobin A1C and you already know about your thyroid, you're still getting that extra piece of information. So the great thing about the Weight Management Test is putting it all in one spot. So you're going to get more of a picture of multiple different aspects that could be affecting your weight management and see it all in one spot.
Dr. Robert Rountree:
So this test really casts a big net.
Dr. Amanda Frick:
It does.
Dr. Robert Rountree:
It's looking at a lot of different things. Now, I remember years ago, a colleague named, I think her first name was Diana Schwarzbein. She wrote a book called The Schwarzbein Principle, and she talked about how people who go on an extreme weight-loss program would actually get into a counterproductive cycle because they would be starving and their cortisol levels would go up and that would actually make them gain more weight. So it can be very helpful to know ahead of time what your cortisol levels are.
Dr. Amanda Frick:
Agreed. I think it's completely underrated, and there's things on TV or silly little videos that come up on Facebook about cortisol and belly fat, but they don't really explain whether that's about too much or too little or how it could be both or how either one could be contributing, so there is a bit of misunderstanding and assumption, I think, that high cortisol is the only thing that could make you gain weight, but I mean it's more important to know how your body's responding to stress in general and whether you have a dysregulation of pattern there.
Dr. Robert Rountree:
So this test is really looking at a whole system really because it includes the reproductive hormones, it includes adrenal hormones, it includes how the pancreas is functioning. So it's actually useful in a lot of different ways.
Dr. Amanda Frick:
I think so, yeah. I think that's why it's great to have it all in one spot because a lot of times your physician is looking at a snapshot here and a piece there, or we're looking at them for a particular reason, but maybe not putting the whole picture together and how it affects someone's weight management goals.
Dr. Robert Rountree:
Now, is this a test that you just do once and you're done, or is this a test that we are recommending that people do repeatedly to follow up over time? And I say that even if some of the results might be normal, is it still going to be useful to do a follow-up test?
Dr. Amanda Frick:
In my opinion, many if not all of the tests that we have would be good to do a follow-up test. So you're getting the information that you need about what changes to be made. But other than just seeing the change on the scale, like you were saying, not always is rapid weight loss only a good thing and it can have other effects, you could use the Weight Management Test as a retest even if you've reached your goal weight to help realize what changes you've made, maybe it's just to confirm that the changes you've made are still good for your blood-sugar balance, maybe you want to check and see if your body's handling stress the same way or if you've done some kind of change with your cortisol because of your diet, but you could use the Weight Management Test as a recheck to keep going, or you could use it as a recheck to maintain and help keep you where you want to be.
Dr. Robert Rountree:
Now everybody is aware of these blockbuster weight-loss drugs that are on the market out there. I wonder if clinics, I mean even places like Weight Watchers are prescribing these drugs, I wonder if they are all measuring these different markers. I suspect not. Maybe they're measuring hemoglobin A1C, but I suspect that most of these places are not measuring cortisol and reproductive hormones or even thyroid. So do you think a case could be made for recommending that people do these even if they're being put on a weight-loss drug?
Dr. Amanda Frick:
I think that case could be made for anyone for any program, but particularly with the weight-loss drug. And we know now as people are coming off the drug how the rebound effect is happening and how severe that can be. Just like any rapid weight-loss program, it's not anything new or unique, but I think it's important for people to see and have other information, even if you utilize the drug – which I would support for anyone who thinks that that's the right step for them and their physician agrees – but there's still information that you could use for all these other aspects. And what good is sort of counteracting or trumping something that's physiologically out of balance if you don't even know what it is? So at least you have the information. And the way I practice and the way you would practice would be to find and treat the cause and make sure you can maintain homeostasis. The drug is stronger than the cause, so it works, but maybe sometimes that's what happens with the rebound weight gain as well.
Dr. Robert Rountree:
So more information is always a good thing. And don't assume just because your doctor didn't order these tests that they wouldn't be useful.
Dr. Amanda Frick:
Agreed.
Dr. Robert Rountree:
Because a lot of times the doctors, they're focused on that one thing: What's your weight? What's your body fat? Maybe what your blood sugar is. But they're not necessarily doing a more comprehensive evaluation like you would get from this test. It's actually a pretty comprehensive test. I think as our listeners will see when we put up our results, there's a surprising amount of data that's included on these tests.
So with that as a background, we're going to take a short break and then when we come back, we'll put up our results, and we'll bare it all to the public.
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And we're back. And now it's time to see what the Weight Management at-home test has to tell us. So both of us have taken our tests. We then got an email notifying that our results were ready. We logged in to Thorne.com and we're going to show you what we found. So Dr. Frick will go first and she can help explain the results, and then we will swap and show you mine. So let's go for it. Tell me what your results showed.
Dr. Amanda Frick:
Yep. I have some fun things to talk about. You and I have had some relatively normal test results before, and so this one, we actually have some things we can speak about here. So in my overview section, as you can see, sex hormones are out of balance. So for this test that included estradiol, progesterone, testosterone, and DHEA. So that's what my overview is. Let me just scroll here, and we can start. Estradiol looks pretty normal, which I would expect, probably not the problem or anything causing any weight management issues for me.
Dr. Robert Rountree:
And again, you did this at a certain point in your cycle.
Dr. Amanda Frick:
Correct, which is day 19, 20, and 21 for women. So mostly I think what they’re trying to do is catch, or we are trying to do, is catch an optimal progesterone level. So estrogen and progesterone are shifting through your cycle, of course, but you want to catch that peak progesterone level from 19 to 21, so it should be the highest point, and then the estradiol numbers adjusted based on where you would be expect it to be in your cycle at that point. So my estrogen is keeping up with my age at this point, and it appears that my progesterone is not.
Dr. Robert Rountree:
It's not. And I know progesterone can also be inadequately produced during a premenstrual phase, which is one potential explanation for PMS.
Dr. Amanda Frick:
Correct. But then because of this, and you should be catching it before you're entering premenstrual phase, it shouldn't be on this low end. I'd venture to say we're not even on the low end, we're bottoming out here pretty good.
Dr. Robert Rountree:
I see. That's something to address.
Dr. Amanda Frick:
Yeah, we're hitting sand. So that's one thing that I think will come up again later. It goes through some issues about what that means. So I have low progesterone, and they talk about what that means for your body and what that's doing for you physiologically, and then included what some of these symptoms are. So I can relate to these, not all of them, but some of them. And of course, weight gain is showing up here in the middle, which is the reason why someone might be looking at the test. Transparency, for me, I don't have recent weight gain, but I have been struggling to lose the last bit of weight that I would like to lose, which is maybe more than I'd like to admit, but this is helpful for me to understand what I can and maybe what I cannot do so much about and sort of what my struggles are here.
And then testosterone is the last hormone, which is showing in the normal range, basically as low in the normal range as you can get. For women, that could be related to things like lower libido, sense of motivation, probably not making a huge contribution to weight management struggles for me. But still of note, as my hormones are shifting.
Dr. Robert Rountree:
I got to point something out here. That measurement, I mean we see that number 10, that sounds like a nice robust number. But we're measuring picograms, right? That's a tiny, very tiny, tiny amount. I mean, what is that? What's a picogram 10 to the minus 12? It's like a drop of water in a swimming pool. And it's amazing to me, these very, very infinitesimally small amounts of hormones are enough to make a huge difference in our overall physiology, as in the tendency to gain weight or have a difficulty losing weight. So I just want to point out, it's pretty remarkable that we can take a few drops of blood and measure something that's in what, parts per billion? That's an amazing thing. So the less people take for granted what's going on with these tests, "Oh, I did a few drops of blood and my testosterone is at 10," 10 as in parts per billion, 10. It's kind of phenomenal where the technology has taken us.
Dr. Amanda Frick:
Well, and if you think about it this way, as this is showing, you can have too high of a level too. So 10 drops in a swimming pool is OK, but 62 drops in a swimming pool is–
Dr. Robert Rountree:
Way over the top. And our bodies are tuned in to those kind of levels, which that's the amazing thing. Our bodies can recognize these small changes, which is again, the reason that we're measuring this.
Dr. Amanda Frick:
Exactly. And then, DHEA. So that looks to be in normal range. Although if you have taken our Biological Age tests, you may have noticed or learned that maybe on the higher side would be better for maintaining or helping to decrease biological age. So normal here, according to test result, but because I know more information from other tests, I wish that my DHEA were a little higher. And then if DHEA is on the low end, it's sort of a cascade. I like to call it Plinko; it's like dropping it in, and it has the capability of being so many other things. So how many Plinko chips do you have? And I have a decent amount, but some people have a lot more, that have the capability of producing more, and you drop it in because your body can take that mother hormone and sort of create what it needs to do with it. So I still have enough tools in the toolbox for that, but I wouldn't mind having some more.
Dr. Robert Rountree:
The amazing thing to me about DHEA is how variable the response is. And I do prescribe DHEA, and we'll talk about it with my results, but some women take 5 mg of DHEA and they grow a beard.
Dr. Amanda Frick:
Thanks for scaring me, Bob.
Dr. Robert Rountree:
And she's like, “No comment.” But certain women with autoimmune diseases like lupus, they can take 100 to 200 mg, and they have no masculinizing effects from the DHEA at all. So there's clearly a lot of variability in response here.
Dr. Amanda Frick:
I mean, from a personal standpoint, I haven't had any masculinization or anything that I would worry about from taking DHEA. But for me, if I take a higher dose of DHEA, which when I'm saying higher dose, I'm saying 25 mg, I feel irritated and edgy. I like to say my scalp is crawling. I just feel overly tense from it. And so everyone is different. We do not make recommendations for DHEA in this test, but if you're speaking with your doctor about it, just know how sensitive and different that is for everyone else. It's important to work with a physician or someone who can assist you with that.
Dr. Robert Rountree:
And now we're at the real meat of the testing, which is the cortisol levels, which is-
Dr. Amanda Frick:
Yeah. [Laughs]
Dr. Robert Rountree:
I want to hear what you have to say.
Dr. Amanda Frick:
Which we've looked at before, and I'm just going to give myself a little pat on the back and be proud that actually all of my cortisol levels are within normal range. Now, do I like the way that they look as far as from the morning through the afternoon? Maybe not necessarily, but I have seen a worse cortisol rhythm for myself. And so at least what we're seeing here is that each of my four cortisol measurements were in range and still higher in the morning and lowest at night as good as I can expect from my past history. So a good sign for me, as well. Still having it highest in the morning, lowest at night. Wish it was a bit higher in the morning, so I had more of that ski slope sort of reaction. But I'll take this for now.
Dr. Robert Rountree:
So what we don't see is hypercortisolemia, right? You don't have excessive amounts of cortisone, so you can't say it's the Schwarzbein effect that I was mentioning. “I have too much cortisol, and so that's making me gain weight.” It's a really helpful thing to know if that's part of the issue.
Dr. Amanda Frick:
Yeah, so I don't have that reason here. I can't blame my work stress.
Dr. Robert Rountree:
Darn.
Dr. Amanda Frick:
[Laughs] And then hemoglobin A1C, which is a measure of blood sugar. So what I would say to my patients would be you can do a fasting blood glucose, which is a snapshot in time. If you had a bit of coffee or even something else, a bite of food, it can change in an instant and it's constantly changing through the day and we would expect it to. So the good thing about the hemoglobin A1C is that it's giving you more of an average picture over three months. I would explain it like, the sugar that's attached to your red blood cells, which because they live about 90 days, when you're summating that up, you're getting a better picture of what your blood sugar looks like over a three-month period instead of in a micro snapshot. And where normal is less than 5.5, mine is 5.3. So still looks good there. I will say it's a little higher than it has been in the past, I usually for me would expect to be in the high 4s, but still normal, not concerned, but something I'm paying attention to because it's sort of floating.
Dr. Robert Rountree:
Well, you said your number normally is in the high 4s?
Dr. Amanda Frick:
Mm-hmm.
Dr. Robert Rountree:
OK, well, I will congratulate you for that. I would say an average person that I see is somewhere around 5.5, and I see a lot of people who are up around 5.9, 6.1, which is in the pre-diabetic range because it's a huge problem in our society, and it's a big part of what's going on with weight.
Dr. Amanda Frick:
And that would have popped here too. You get into, we're calling it moderate risk between 5.5 and 6.5, but you're correct, then you're getting into pre-diabetes, definitely some dietary intervention that should take place to help manage that.
Dr. Robert Rountree:
Great. All right, well congratulations.
Dr. Amanda Frick:
Well, thanks. I have been in a pre-diabetic range before, so the work's been done. So maybe I should look at it that way, this is a reflection of the work that I've done. And then we've seen these before, but this test does a TSH for an overview of thyroid function. And we discussed that further in our other podcasts around the thyroid health test. But for me here and in this test, it's again, normal. Not a thyroid problem.
Dr. Robert Rountree:
Not a thyroid problem.
Dr. Amanda Frick:
And then vitamin D, I didn't scrape the bottom, but I'm getting into shallow water here. This is about as low as I would want it to be personally. I'm a little disappointed in this. I'd like to see it higher. So I'm going to modify what I'm doing with my vitamin D dosing plan, what we call clinically normal range in our test result is 32 to 80, and I would rather be closer to 80 personally. So for me, even though it's showing normal, I think I'd like to optimize a bit more.
Dr. Robert Rountree:
Are you a “lather on the sunscreen” kind of gal?
Dr. Amanda Frick:
If I were laying on the beach every day, I would not maintain my current aging status. So I have a little bit of a melanin challenge, and so laying on the beach is not friendly for me. I don't really have an in between. It's either this or I'm really uncomfortable.
Dr. Robert Rountree:
Or you burn?
Dr. Amanda Frick:
Or burn. Yeah.
Dr. Robert Rountree:
Yeah. Yeah.
Dr. Amanda Frick:
So no, I'm a sunscreen girl and a hat on and big sunglasses, as much as I can. I do have a history of sun damage and hyperpigmentation, so I'm especially sensitive to that.
Dr. Robert Rountree:
So in other words, you really need a supplement.
Dr. Amanda Frick:
I really need a supplement.
Dr. Robert Rountree:
So we got to say that to some of the pundits that are out there, "You don't need vitamin D." And we'll get into that in a later podcast in some detail.
Dr. Amanda Frick:
Yeah, I can save it for that one. But I was going to say it does matter or there is research saying that it matters where you grew up or where you spent the majority of your early life, too, as far as that goes. So I'm from Michigan, so lets drop that as a teaser.
Dr. Robert Rountree:
All right.
Dr. Amanda Frick:
That was the last measure. So we got into recommendations here for me. So some of mine, these diet and exercise recommendations are based on the health profile that you fill out before you take the test, and then some of them are based on the information that were provided in the objective data that we just looked at. So they're recommending a weight management diet program for me, which gets into detail about serving size for protein, carbohydrates, and fats. It gives you through some general recommendations about timing of meals and how to space them out. And then in general, the maintenance plan for a modified Mediterranean diet, which year over year seems to be the winner in a lot of categories as far as maintaining or attaining good health.
Dr. Robert Rountree:
So nothing radical here. They're not saying, "Hey, you need to starve yourself. Just go on 800 calories a day and you'll be fine." It's all reasonable, achievable kind of dietary things that you could do.
Dr. Amanda Frick:
Yes. And then it gets into this section here where it gives you two different meal plans or options that you can link through based on how much you do want to reduce your calorie. So nothing crazy, nothing 800, but a 1,200 and a 1,500 calorie option. So I can tailor that to what makes sense for me.
Dr. Robert Rountree:
Support your bones.
Dr. Amanda Frick:
Yep, I got to support the bones.
Dr. Robert Rountree:
Because your hormones are low.
Dr. Amanda Frick:
Because my hormones are low. Got to take care of the bones. Lots of food options here. What that means, what nutrients you're getting from those food sources so that I can add those changes into my diet. And then exercise recommendations. So full transparency, I did not indicate an excess or even probably an adequacy of the amount of times that I exercise, and so I'm getting recommendations for weight management and what some of those things may look like and some of the resources that we use that are recommended as exercises for weight loss specifically. You can read all about those here, making sure strength training is a component. And then some basic recommendations since I have not been exercising to make sure that I can avoid injury and start at a proper speed.
And then we get into the products. So because I had indicated that I would like to lose weight, mine started with Weight Management Bundle that we offer on Thorne.com, which includes three different products and a probiotic and a fish oil, which is really interesting. And then of course I got additional bone support. So in addition to diet, I got a product recommended because of my low hormones to support bone health, which will be important as I continue to age. And then because of my low progesterone levels, I got recommended Meta-Balance, which is Thorne's support for perimenopause and menopause, and women who are starting to have their hormones ebb and flow in a way that has not been the pattern for years prior. It's the nicest way I can say that. [Laughs]
Dr. Robert Rountree:
I like that ebb and flow. The ebb and flow of hormones, which is someone that lives near the beach, that's how they think about the world.
Dr. Amanda Frick:
Yeah, that's all I can get from it. Oh, I said bottomed out in the sand, we made a surf reference, so we might as well ebb and flow here, too. So that was the last recommendation that I received. So we saw from my results that my sex hormones are a little bit out of balance, and so the majority of my recommendations were to help rebalance those because my blood sugar and thyroid were normal, I didn't get extra recommendations for that. And then the majority or the bulk of what I got here was based on diet and exercise change so I can help modify my lifestyle to support my goals.
Dr. Robert Rountree:
So you learned a lot.
Dr. Amanda Frick:
I did learn a lot.
Dr. Robert Rountree:
You found out some things about your body that maybe you suspected but you didn't know.
Dr. Amanda Frick:
I think I probably knew, I just didn't want to look at them on paper, but here they are.
Dr. Robert Rountree:
Here they are, and you had some practical recommendations for things that you can do.
Dr. Amanda Frick:
Exactly.
Dr. Robert Rountree:
So in other words, this test goes beyond just saying, "You should exercise more and eat less." It's a total body management program.
Dr. Amanda Frick:
Agreed.
Dr. Robert Rountree:
OK, so now we're going to talk about my results, Dr. Frick, and so I'll appreciate any insights that you have. And just personal perspective, yeah, I'd like to lose probably about 5 pounds and I come from the Deep South and grew up eating a really crappy diet. And there's a lot of obesity in my family, both in my close family and my relatives. I mean, basically almost everyone I know has weight management issues. The whole area I'm from, I think they nicknamed it the “Stroke Belt.” So I was curious to see what these results showed.
First of all, it says my hormone levels are out of balance, and we'll see what that means because I think a lot of that's based on the DHEA. So when we scroll down we'll talk about that. So let's go see what the actual results show, which is the estradiol is right in the normal range. Well, that's good. Glad to know. I don't have high estradiol levels. My progesterone levels are in the normal range, which is also good. And as I said before, we're talking about picograms. I mean, these are tiny amounts. And it is normal for men to have some progesterone, not very much, but progesterone is kind of the starting point for a lot of sex hormones, all of which are made from cholesterols. So it makes sense that there'd be some around, but I have a normal level. I don't know if I've ever actually seen elevated progesterone levels in a man. Have you ever seen that?
Dr. Amanda Frick:
Only with hormone use.
Dr. Robert Rountree:
Oh, if a man was actually taking progesterone, yeah, then it would go up. It's a very unusual thing to have high progesterone, but still helpful to know. My testosterone level was reasonable. Of course, most of the guys that I know, especially my age, would always like a little bit more. Certainly being in the normal range is a healthy thing for my age group. So that's a good thing. And then we come to DHEA, which this test reads as abnormally high at 12 with the normal range up to 6. OK, confession, I take 25 milligrams of DHEA and I have for decades. And I actually did the Biological Age test from Thorne, and because my DHEA levels were a little bit on the high side, it actually scored my biological age as being lower than my chronological age. So it’s a good thing. We could probably debate the pros and cons of DHEA forever. I know I see in some of the textbooks it could increase the risk of cancer, but the reason that they say that is because it could theoretically get converted into estrogen.
Dr. Amanda Frick:
Well, Bob, I guess when we were talking about having patients that grew a beard, that must be working for you there.
Dr. Robert Rountree:
Yeah, it's kept my chin hair nice and robust. I certainly haven't seen any downside of taking it for years. And I do think it's helpful for hormonal health, for bone health, for anti-aging, immune health. That's a whole other discussion, but I was happy to see that that was normal. So they say abnormally high is not common, but that's not in people that take a supplement.
Dr. Amanda Frick:
I think we should note, too, if you did this with a partner at home or with a friend, if we remember mine was 10 and barely on the bottom of normal, yours is 12 and showing too high. But there is a difference between the male and female measure for DHEA, so mine was measured in picograms and yours is measured in nanograms.
Dr. Robert Rountree:
Nanograms, yeah.
Dr. Amanda Frick:
So if you're looking at that.
Dr. Robert Rountree:
Yeah, that's a huge difference. So again, we in laboratory medicine, all the units are set up so that everything comes in teens or maybe hundreds. So if you're just thinking, "10, my number was 10," or, "My number was 6," then you've got to look at the units. So I would just point that out to our listeners. So again, nanograms are a lot more than picograms. My levels are a magnitude higher.
So I think it's a good thing. It has a lot of positive effects and so I wasn't concerned about that contributing to my weight.
But here's where it gets really interesting, you and I have talked about my cortisol levels before. I start out in the morning not too bad, that number was taken close to around 9 a.m., which is early for me, probably before I've had my espresso, hopefully before I've had my espresso. So the morning cortisol was technically in the normal range, but it was a little bit towards the high end, and then it doesn't come down as much as it should. You can see the 3 p.m. level, the 6:45, the dinner and the evening. Now this could interfere with the ability to fall asleep, would you think?
Dr. Amanda Frick:
I do think so.
Dr. Robert Rountree:
You'd think so, maybe that's why it takes me so long to unwind at night before I can usually fall asleep. I have an Oura Ring, and it tells me that I need to be in bed for quite a while before I fall asleep, and so one of the advantages of using that Oura Ring is it's told me, “You need to go to bed earlier because it's going to take you a while to chill out because of that evening cortisol.” And we'll see what the recommendations are later, but I can have a pretty good guess what the program's going to tell me that I should take in the evening, which I have done on and off.
So keep scrolling down. Hemoglobin A1C, OK, I'm happy with a 5.5. That maybe, it's a little higher than yours, but in the past I have run 5.9, 6 percent, really depending on how strict I've been with my diet. So 5.5, I'll take it. I'll take it, because I do think I have the genes that set me up for pre-diabetes. And so again, this was positive feedback in this particular case. But this is, when I talked earlier about doing longitudinal testing, the A1C is something that anybody who's concerned about it should be doing several times a year. So one good reading, OK, that's a start, but that's not really enough because you never win this game completely.
So TSH, right in the center, I'm very happy with that and I have no reason to think that I have thyroid problems. I get asked about thyroid problems all the time, and people that say, "Hey, I don't have the classic symptoms, but could I have a subtle hypothyroidism that's contributing to metabolic disorders, fatigue," etc.
And then my vitamin D was 42. I, like you, don’t like to lay in the sun. We have a lot of skin cancer here in Colorado because of the high altitude, and I found that, especially in the summer, I can be out doing yard work in the backyard for a half an hour and get sunburns. So I cover up, I wear hats and long sleeves, etc. I'm not a “lay in the sun” kind of guy. So I'm totally dependent on supplementation to keep my levels up. And if I don't supplement, my levels plummet pretty quickly within a month or two. So this is taking 5,000 units of D every day, and that's what it takes for me to keep my levels up.
So recommendations, first recommendation is their weight management diet, which we talked about before. Nothing really radical. A good mix of protein, fat, and carbohydrates. I don't see a bowl of sugar on here as a daily recommendation. So I think they're saying if you are going eat even grains, then limit that. So not a lot of carbs on this diet, but it's not a ketogenic diet or anything like that. It's just a reasonable carb intake diet. But not a lot of grains, breads and things like that. Make sure you get a lot of sleep. And again, I think that cortisol level, that to me was the take home for this is I really need to lower that cortisol curve in the evening if I ever want to manage my weight better.
And then the long-term maintenance diet is the Mediterranean diet, which again, everybody could probably benefit from that, that plus allergenic foods. Fortunately, I'm not aware of any foods that I'm allergic to, so it's not been a problem for me. So low glycemic index foods, certainly. They say the A1C level is elevated, yep, compared to yours, it's elevated. So I should probably be really careful with the low carbs and really try to focus on that as my main dietary strategy. And eating a lot of probiotic foods. I love fermented cabbage, I try to have a little bit of that every day. And I do take probiotics, which I rotate all the time.
Practice meditation, I do that. Heart math and exercise, the same general kind of recommendations, lots of cardio, which I do try to get in as much as I can. Maybe it would help to add some jump rope or rapid stair climbing, etc. Swimming is actually my favorite exercise, which I use a lot. So very detailed recommendations here. Very helpful. And not working out at night, that may be the most important take home message is not going to the gym at 7 o'clock and working out. I should do my workouts more in the morning and try to burn off that excessive cortisol.
Let's see, what else have we got here? So the No. 1 product here, I don't think it's a surprise, Iso-Phos, because there is published data, more than one study I think, that shows that Iso-Phos, which is phosphatidylserine, can actually help lower excessive cortisol production. I'm not sure if we know what the mechanism is for that. Do you know what the mechanism is? I am not sure... I think it's just a clinical observation that it does that. So that to me, it's like, "Yeah, I've done that in the past and I continue to have this problem." So this is just a reminder that I should go back and do that again.
So the other thing is to take a good probiotic. I do rotate on and off FloraMend Prime. I think it's excellent. Fish oil, a good reminder to take EPA. And broccoli seeds, which is what Crucera is, an extract of broccoli seeds, to help regulate hormones, make sure they're going down the right metabolic pathway. I thought this was a very useful test. It kind of reminded me of some things I've been concerned about in the past. It lets me know, yeah, that high cortisol at night is still a problem, that explains a lot of things. So I'm writing this down as we speak, "Get Iso-Phos, get Iso-Phos," because that's just a really good thing for me. And Iso-Phos is also good for a lot of other things. It's good for your brain, etc.. So I think that's going to be it for now. That's about all we have time for this week. Do you have any other comments at the end about the experience?
Dr. Amanda Frick:
I don't think so. I think the only thing we'll see... This made me curious about which thing to do next, and so I think what I'll be looking at are some other female hormone testing and some future options to get a little more of a deep dive for what I need for what I saw that was out of balance. And you could consider coming back and doing just a Stress Test if you wanted to mostly check in on your cortisol rhythm, but there's pieces you can pick out of here to hone in on what you need to for budget concerns or whatever it fits for your health plans to come and do a retest of what's most important to you and your goals.
Dr. Robert Rountree:
All right, well, Amanda, thank you so much for coming on the podcast once again. We always love having you on the show. And as always, if listeners want to know what you're up to, what's the best way for them to follow you?
Dr. Amanda Frick:
I think LinkedIn's the best place to follow me. Adding new additions for things that get featured or interviews that I have, I put everything up there, and that's where you'll find the newest greatest stuff.
Dr. Robert Rountree:
All right, that was Thorne's Vice President of Medical Affairs, Dr. Amanda Frick on Thorne's Weight Management at-home test kit. As always, thank you everyone for listening. Until next time.
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This is The Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet, supplements, and lifestyle approaches to good health. I'm Dr. Robert Rountree, Chief Medical Advisor at Thorne and functional medicine doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease.
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Hi, everyone, and welcome to The Thorne Podcast. This week we're going to be giving you the details on Thorne's Weight Management at-home test kit. To help you follow along, in addition to our regular audio episode, we're also releasing the video from this recording as well, so be sure to check that out on Thorne.com or on our YouTube page so you can follow along as we go over our results and see all the graphs and charts. Joining me once again to talk about the Weight Management Test is my friend and colleague, Thorne's Vice President of Medical Affairs, Dr. Amanda Frick. Welcome back, Amanda. How are you doing?
Dr. Amanda Frick:
I'm great, Bob. How are you?
Dr. Robert Rountree:
I'm good. Yeah, we've had a bit of a chilly winter here in Colorado, but I think by the time everyone's listening to this, it will be back to the warm season again.
Dr. Amanda Frick:
I'm ready for a warm season too, although I'm sure it's not as cold as where you are. It's still cold for me here, and I need some sunshine. We don't get a lot of gray, and we’ve got a lot of gray.
Dr. Robert Rountree:
I think you’ll be taking your surfboard out of storage and hitting the waves again. I can just see you out there now.
So, Amanda, you and I have both taken the Weight Management Test, just for fun and out of intense curiosity, because I know we’re both really curious people. So we’re going to walk our listeners through the results in a bit, but first, let’s talk about the process of actually taking it. So why don’t we start with your experience, what that was like. Just give the listeners the sense of what they would be doing.
Dr. Amanda Frick:
One important thing to note, which is different for mine than from yours is if you’re having a menstrual cycle, you do have to collect on a specific day, and that date is only in a three-day window, so you have to make sure you’re collecting at the right time. The reason for that is because of the hormone collection.
But from my experience, it was making sure that I could catch a day where I could not only do a first morning waking saliva, but also a before bed one and also hit the three-day window for my blood collection, and I did it! But it just takes a little more careful planning.
Overall, I think we’ve talked about this before with the blood collection, it can get tricky getting it in the right area of your finger. I don't think it's discomfort, but just getting through the process. For me, it’s more like making sure I keep it on the card and not get it everywhere else. And I tend to be really great for blood collection, so for me, it took a couple extra gauze pieces. Maybe I'm just an old pro at this, but for me it was no issue to collect the six samples or the drops that I needed for my card and then the saliva sample.
Dr. Robert Rountree:
Well, yeah, you're exactly right. I didn't have to track my menstrual cycle, so that made it a little easier for timing when I was going to do it. I have to say that I've done a few of these tests now, so I knew what to expect and I found that somewhat helpful. For example, I want to make sure my hands are nice and warm before I do the finger prick. So I usually will run my fingers under a little cold water– I'm sorry. Yeah, no, what did I just say?
Dr. Amanda Frick:
Please don't.
Dr. Robert Rountree:
Yeah, put your hand in some ice, that will really help a lot. No, well, I've just pointed out what's important here is you want to have it nice and warm so that you increase blood flow. And having done that a couple of times, I've found it really makes a difference. Sometimes even I have to say slapping your hands a little bit can help. If you do that right before the collection, then you can make sure you get plenty of blood. Now it's still not unusual for me to have to prick twice, so that's why they do include an extra lancet in the kit in case you need to do that.
The other issue that's come up for me in the past is I'm not a big spitter.
Dr. Amanda Frick:
Yeah, we've talked about that.
Dr. Robert Rountree:
[Laughs] We've had that discussion. I'm not a big spitter, and I think, "Do you really need to collect this much saliva?" Well, for the first morning one, yeah, it's a fair amount of saliva, so be forewarned, if you're a dry-mouth kind of person, then you may want to do something to lubricate a little bit. There's all kinds of tricks to get the saliva going. You can actually put a little tiny rock under your tongue; that's an old trick that's done.
Dr. Amanda Frick:
A rock?
Dr. Robert Rountree:
Yeah, just a little stone, that's like 5 millimeters. That’s something that athletes do sometimes when they get they’re prone to dry mouth, just putting something under your tongue will help get the saliva flowing. So if you happen to be worried about it, it’s probably not going to be an issue. Just take your time. The spit will come, if you allow it.
Dr. Amanda Frick:
It takes longer than... It feels like forever at the time. It takes longer than you think it's going to take. So I wouldn't do it trying to be in a rush out the door. Give yourself time to relax because you don't want to be stressing while you're doing your stress-hormone collection.
Dr. Robert Rountree:
Well, it's a really good point because the first time I ever did this, I actually had that experience. I said, "OK, right before work, I'll do it. I'll just spit in a cup and I'll be done." And then I realized, "No, it actually took some time to do that," so I had to be prepared. So those are two things you can do to prepare is put your hands under warm water, not cold water, to make sure you got good circulation going, it even helps to have your fingertips even a little bit red, that way you can make sure there's plenty of blood flow. And I think you get more accurate results if you do it ahead of time than you do if you prick your finger and then you squeeze to try to get the blood out. I think that can actually influence the results a little bit. So preparing for it is everything. And again, making sure you have good salivary flow, and the first morning collection's going to be a lot more saliva, so take your time. Be prepared to spend a little bit of time collecting all that spit.
So Amanda, who should be taking this test anyway? Why would someone want to do this as opposed to just saying, "Well, I'm going to wing it. Maybe I need to exercise a little bit more." Etc. What's the advantage of doing a test like this? What's included, etc.?
Dr. Amanda Frick:
So I think you could wing it if you want, but I think when people are looking at the test, probably they've already either tried to do that or they've made some efforts already at changing their diet and exercise program or they feel like there's a missing piece. The great thing about the test is it's taking in so many different aspects which you may not be getting from your doctor. So it does include a thyroid check and a hemoglobin A1C to get an idea about your blood sugar, but it's also including some hormones. That's why it's included for women to do it at a certain point in their cycle because it includes some sex hormones that are important for weight management.
And then of course you're getting, like you talked about, the saliva collection for the adrenal stress hormone. So even if you had the hormone information about your cycle or related cycle hormones and you've already done a hemoglobin A1C and you already know about your thyroid, you're still getting that extra piece of information. So the great thing about the Weight Management Test is putting it all in one spot. So you're going to get more of a picture of multiple different aspects that could be affecting your weight management and see it all in one spot.
Dr. Robert Rountree:
So this test really casts a big net.
Dr. Amanda Frick:
It does.
Dr. Robert Rountree:
It's looking at a lot of different things. Now, I remember years ago, a colleague named, I think her first name was Diana Schwarzbein. She wrote a book called The Schwarzbein Principle, and she talked about how people who go on an extreme weight-loss program would actually get into a counterproductive cycle because they would be starving and their cortisol levels would go up and that would actually make them gain more weight. So it can be very helpful to know ahead of time what your cortisol levels are.
Dr. Amanda Frick:
Agreed. I think it's completely underrated, and there's things on TV or silly little videos that come up on Facebook about cortisol and belly fat, but they don't really explain whether that's about too much or too little or how it could be both or how either one could be contributing, so there is a bit of misunderstanding and assumption, I think, that high cortisol is the only thing that could make you gain weight, but I mean it's more important to know how your body's responding to stress in general and whether you have a dysregulation of pattern there.
Dr. Robert Rountree:
So this test is really looking at a whole system really because it includes the reproductive hormones, it includes adrenal hormones, it includes how the pancreas is functioning. So it's actually useful in a lot of different ways.
Dr. Amanda Frick:
I think so, yeah. I think that's why it's great to have it all in one spot because a lot of times your physician is looking at a snapshot here and a piece there, or we're looking at them for a particular reason, but maybe not putting the whole picture together and how it affects someone's weight management goals.
Dr. Robert Rountree:
Now, is this a test that you just do once and you're done, or is this a test that we are recommending that people do repeatedly to follow up over time? And I say that even if some of the results might be normal, is it still going to be useful to do a follow-up test?
Dr. Amanda Frick:
In my opinion, many if not all of the tests that we have would be good to do a follow-up test. So you're getting the information that you need about what changes to be made. But other than just seeing the change on the scale, like you were saying, not always is rapid weight loss only a good thing and it can have other effects, you could use the Weight Management Test as a retest even if you've reached your goal weight to help realize what changes you've made, maybe it's just to confirm that the changes you've made are still good for your blood-sugar balance, maybe you want to check and see if your body's handling stress the same way or if you've done some kind of change with your cortisol because of your diet, but you could use the Weight Management Test as a recheck to keep going, or you could use it as a recheck to maintain and help keep you where you want to be.
Dr. Robert Rountree:
Now everybody is aware of these blockbuster weight-loss drugs that are on the market out there. I wonder if clinics, I mean even places like Weight Watchers are prescribing these drugs, I wonder if they are all measuring these different markers. I suspect not. Maybe they're measuring hemoglobin A1C, but I suspect that most of these places are not measuring cortisol and reproductive hormones or even thyroid. So do you think a case could be made for recommending that people do these even if they're being put on a weight-loss drug?
Dr. Amanda Frick:
I think that case could be made for anyone for any program, but particularly with the weight-loss drug. And we know now as people are coming off the drug how the rebound effect is happening and how severe that can be. Just like any rapid weight-loss program, it's not anything new or unique, but I think it's important for people to see and have other information, even if you utilize the drug – which I would support for anyone who thinks that that's the right step for them and their physician agrees – but there's still information that you could use for all these other aspects. And what good is sort of counteracting or trumping something that's physiologically out of balance if you don't even know what it is? So at least you have the information. And the way I practice and the way you would practice would be to find and treat the cause and make sure you can maintain homeostasis. The drug is stronger than the cause, so it works, but maybe sometimes that's what happens with the rebound weight gain as well.
Dr. Robert Rountree:
So more information is always a good thing. And don't assume just because your doctor didn't order these tests that they wouldn't be useful.
Dr. Amanda Frick:
Agreed.
Dr. Robert Rountree:
Because a lot of times the doctors, they're focused on that one thing: What's your weight? What's your body fat? Maybe what your blood sugar is. But they're not necessarily doing a more comprehensive evaluation like you would get from this test. It's actually a pretty comprehensive test. I think as our listeners will see when we put up our results, there's a surprising amount of data that's included on these tests.
So with that as a background, we're going to take a short break and then when we come back, we'll put up our results, and we'll bare it all to the public.
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And we're back. And now it's time to see what the Weight Management at-home test has to tell us. So both of us have taken our tests. We then got an email notifying that our results were ready. We logged in to Thorne.com and we're going to show you what we found. So Dr. Frick will go first and she can help explain the results, and then we will swap and show you mine. So let's go for it. Tell me what your results showed.
Dr. Amanda Frick:
Yep. I have some fun things to talk about. You and I have had some relatively normal test results before, and so this one, we actually have some things we can speak about here. So in my overview section, as you can see, sex hormones are out of balance. So for this test that included estradiol, progesterone, testosterone, and DHEA. So that's what my overview is. Let me just scroll here, and we can start. Estradiol looks pretty normal, which I would expect, probably not the problem or anything causing any weight management issues for me.
Dr. Robert Rountree:
And again, you did this at a certain point in your cycle.
Dr. Amanda Frick:
Correct, which is day 19, 20, and 21 for women. So mostly I think what they’re trying to do is catch, or we are trying to do, is catch an optimal progesterone level. So estrogen and progesterone are shifting through your cycle, of course, but you want to catch that peak progesterone level from 19 to 21, so it should be the highest point, and then the estradiol numbers adjusted based on where you would be expect it to be in your cycle at that point. So my estrogen is keeping up with my age at this point, and it appears that my progesterone is not.
Dr. Robert Rountree:
It's not. And I know progesterone can also be inadequately produced during a premenstrual phase, which is one potential explanation for PMS.
Dr. Amanda Frick:
Correct. But then because of this, and you should be catching it before you're entering premenstrual phase, it shouldn't be on this low end. I'd venture to say we're not even on the low end, we're bottoming out here pretty good.
Dr. Robert Rountree:
I see. That's something to address.
Dr. Amanda Frick:
Yeah, we're hitting sand. So that's one thing that I think will come up again later. It goes through some issues about what that means. So I have low progesterone, and they talk about what that means for your body and what that's doing for you physiologically, and then included what some of these symptoms are. So I can relate to these, not all of them, but some of them. And of course, weight gain is showing up here in the middle, which is the reason why someone might be looking at the test. Transparency, for me, I don't have recent weight gain, but I have been struggling to lose the last bit of weight that I would like to lose, which is maybe more than I'd like to admit, but this is helpful for me to understand what I can and maybe what I cannot do so much about and sort of what my struggles are here.
And then testosterone is the last hormone, which is showing in the normal range, basically as low in the normal range as you can get. For women, that could be related to things like lower libido, sense of motivation, probably not making a huge contribution to weight management struggles for me. But still of note, as my hormones are shifting.
Dr. Robert Rountree:
I got to point something out here. That measurement, I mean we see that number 10, that sounds like a nice robust number. But we're measuring picograms, right? That's a tiny, very tiny, tiny amount. I mean, what is that? What's a picogram 10 to the minus 12? It's like a drop of water in a swimming pool. And it's amazing to me, these very, very infinitesimally small amounts of hormones are enough to make a huge difference in our overall physiology, as in the tendency to gain weight or have a difficulty losing weight. So I just want to point out, it's pretty remarkable that we can take a few drops of blood and measure something that's in what, parts per billion? That's an amazing thing. So the less people take for granted what's going on with these tests, "Oh, I did a few drops of blood and my testosterone is at 10," 10 as in parts per billion, 10. It's kind of phenomenal where the technology has taken us.
Dr. Amanda Frick:
Well, and if you think about it this way, as this is showing, you can have too high of a level too. So 10 drops in a swimming pool is OK, but 62 drops in a swimming pool is–
Dr. Robert Rountree:
Way over the top. And our bodies are tuned in to those kind of levels, which that's the amazing thing. Our bodies can recognize these small changes, which is again, the reason that we're measuring this.
Dr. Amanda Frick:
Exactly. And then, DHEA. So that looks to be in normal range. Although if you have taken our Biological Age tests, you may have noticed or learned that maybe on the higher side would be better for maintaining or helping to decrease biological age. So normal here, according to test result, but because I know more information from other tests, I wish that my DHEA were a little higher. And then if DHEA is on the low end, it's sort of a cascade. I like to call it Plinko; it's like dropping it in, and it has the capability of being so many other things. So how many Plinko chips do you have? And I have a decent amount, but some people have a lot more, that have the capability of producing more, and you drop it in because your body can take that mother hormone and sort of create what it needs to do with it. So I still have enough tools in the toolbox for that, but I wouldn't mind having some more.
Dr. Robert Rountree:
The amazing thing to me about DHEA is how variable the response is. And I do prescribe DHEA, and we'll talk about it with my results, but some women take 5 mg of DHEA and they grow a beard.
Dr. Amanda Frick:
Thanks for scaring me, Bob.
Dr. Robert Rountree:
And she's like, “No comment.” But certain women with autoimmune diseases like lupus, they can take 100 to 200 mg, and they have no masculinizing effects from the DHEA at all. So there's clearly a lot of variability in response here.
Dr. Amanda Frick:
I mean, from a personal standpoint, I haven't had any masculinization or anything that I would worry about from taking DHEA. But for me, if I take a higher dose of DHEA, which when I'm saying higher dose, I'm saying 25 mg, I feel irritated and edgy. I like to say my scalp is crawling. I just feel overly tense from it. And so everyone is different. We do not make recommendations for DHEA in this test, but if you're speaking with your doctor about it, just know how sensitive and different that is for everyone else. It's important to work with a physician or someone who can assist you with that.
Dr. Robert Rountree:
And now we're at the real meat of the testing, which is the cortisol levels, which is-
Dr. Amanda Frick:
Yeah. [Laughs]
Dr. Robert Rountree:
I want to hear what you have to say.
Dr. Amanda Frick:
Which we've looked at before, and I'm just going to give myself a little pat on the back and be proud that actually all of my cortisol levels are within normal range. Now, do I like the way that they look as far as from the morning through the afternoon? Maybe not necessarily, but I have seen a worse cortisol rhythm for myself. And so at least what we're seeing here is that each of my four cortisol measurements were in range and still higher in the morning and lowest at night as good as I can expect from my past history. So a good sign for me, as well. Still having it highest in the morning, lowest at night. Wish it was a bit higher in the morning, so I had more of that ski slope sort of reaction. But I'll take this for now.
Dr. Robert Rountree:
So what we don't see is hypercortisolemia, right? You don't have excessive amounts of cortisone, so you can't say it's the Schwarzbein effect that I was mentioning. “I have too much cortisol, and so that's making me gain weight.” It's a really helpful thing to know if that's part of the issue.
Dr. Amanda Frick:
Yeah, so I don't have that reason here. I can't blame my work stress.
Dr. Robert Rountree:
Darn.
Dr. Amanda Frick:
[Laughs] And then hemoglobin A1C, which is a measure of blood sugar. So what I would say to my patients would be you can do a fasting blood glucose, which is a snapshot in time. If you had a bit of coffee or even something else, a bite of food, it can change in an instant and it's constantly changing through the day and we would expect it to. So the good thing about the hemoglobin A1C is that it's giving you more of an average picture over three months. I would explain it like, the sugar that's attached to your red blood cells, which because they live about 90 days, when you're summating that up, you're getting a better picture of what your blood sugar looks like over a three-month period instead of in a micro snapshot. And where normal is less than 5.5, mine is 5.3. So still looks good there. I will say it's a little higher than it has been in the past, I usually for me would expect to be in the high 4s, but still normal, not concerned, but something I'm paying attention to because it's sort of floating.
Dr. Robert Rountree:
Well, you said your number normally is in the high 4s?
Dr. Amanda Frick:
Mm-hmm.
Dr. Robert Rountree:
OK, well, I will congratulate you for that. I would say an average person that I see is somewhere around 5.5, and I see a lot of people who are up around 5.9, 6.1, which is in the pre-diabetic range because it's a huge problem in our society, and it's a big part of what's going on with weight.
Dr. Amanda Frick:
And that would have popped here too. You get into, we're calling it moderate risk between 5.5 and 6.5, but you're correct, then you're getting into pre-diabetes, definitely some dietary intervention that should take place to help manage that.
Dr. Robert Rountree:
Great. All right, well congratulations.
Dr. Amanda Frick:
Well, thanks. I have been in a pre-diabetic range before, so the work's been done. So maybe I should look at it that way, this is a reflection of the work that I've done. And then we've seen these before, but this test does a TSH for an overview of thyroid function. And we discussed that further in our other podcasts around the thyroid health test. But for me here and in this test, it's again, normal. Not a thyroid problem.
Dr. Robert Rountree:
Not a thyroid problem.
Dr. Amanda Frick:
And then vitamin D, I didn't scrape the bottom, but I'm getting into shallow water here. This is about as low as I would want it to be personally. I'm a little disappointed in this. I'd like to see it higher. So I'm going to modify what I'm doing with my vitamin D dosing plan, what we call clinically normal range in our test result is 32 to 80, and I would rather be closer to 80 personally. So for me, even though it's showing normal, I think I'd like to optimize a bit more.
Dr. Robert Rountree:
Are you a “lather on the sunscreen” kind of gal?
Dr. Amanda Frick:
If I were laying on the beach every day, I would not maintain my current aging status. So I have a little bit of a melanin challenge, and so laying on the beach is not friendly for me. I don't really have an in between. It's either this or I'm really uncomfortable.
Dr. Robert Rountree:
Or you burn?
Dr. Amanda Frick:
Or burn. Yeah.
Dr. Robert Rountree:
Yeah. Yeah.
Dr. Amanda Frick:
So no, I'm a sunscreen girl and a hat on and big sunglasses, as much as I can. I do have a history of sun damage and hyperpigmentation, so I'm especially sensitive to that.
Dr. Robert Rountree:
So in other words, you really need a supplement.
Dr. Amanda Frick:
I really need a supplement.
Dr. Robert Rountree:
So we got to say that to some of the pundits that are out there, "You don't need vitamin D." And we'll get into that in a later podcast in some detail.
Dr. Amanda Frick:
Yeah, I can save it for that one. But I was going to say it does matter or there is research saying that it matters where you grew up or where you spent the majority of your early life, too, as far as that goes. So I'm from Michigan, so lets drop that as a teaser.
Dr. Robert Rountree:
All right.
Dr. Amanda Frick:
That was the last measure. So we got into recommendations here for me. So some of mine, these diet and exercise recommendations are based on the health profile that you fill out before you take the test, and then some of them are based on the information that were provided in the objective data that we just looked at. So they're recommending a weight management diet program for me, which gets into detail about serving size for protein, carbohydrates, and fats. It gives you through some general recommendations about timing of meals and how to space them out. And then in general, the maintenance plan for a modified Mediterranean diet, which year over year seems to be the winner in a lot of categories as far as maintaining or attaining good health.
Dr. Robert Rountree:
So nothing radical here. They're not saying, "Hey, you need to starve yourself. Just go on 800 calories a day and you'll be fine." It's all reasonable, achievable kind of dietary things that you could do.
Dr. Amanda Frick:
Yes. And then it gets into this section here where it gives you two different meal plans or options that you can link through based on how much you do want to reduce your calorie. So nothing crazy, nothing 800, but a 1,200 and a 1,500 calorie option. So I can tailor that to what makes sense for me.
Dr. Robert Rountree:
Support your bones.
Dr. Amanda Frick:
Yep, I got to support the bones.
Dr. Robert Rountree:
Because your hormones are low.
Dr. Amanda Frick:
Because my hormones are low. Got to take care of the bones. Lots of food options here. What that means, what nutrients you're getting from those food sources so that I can add those changes into my diet. And then exercise recommendations. So full transparency, I did not indicate an excess or even probably an adequacy of the amount of times that I exercise, and so I'm getting recommendations for weight management and what some of those things may look like and some of the resources that we use that are recommended as exercises for weight loss specifically. You can read all about those here, making sure strength training is a component. And then some basic recommendations since I have not been exercising to make sure that I can avoid injury and start at a proper speed.
And then we get into the products. So because I had indicated that I would like to lose weight, mine started with Weight Management Bundle that we offer on Thorne.com, which includes three different products and a probiotic and a fish oil, which is really interesting. And then of course I got additional bone support. So in addition to diet, I got a product recommended because of my low hormones to support bone health, which will be important as I continue to age. And then because of my low progesterone levels, I got recommended Meta-Balance, which is Thorne's support for perimenopause and menopause, and women who are starting to have their hormones ebb and flow in a way that has not been the pattern for years prior. It's the nicest way I can say that. [Laughs]
Dr. Robert Rountree:
I like that ebb and flow. The ebb and flow of hormones, which is someone that lives near the beach, that's how they think about the world.
Dr. Amanda Frick:
Yeah, that's all I can get from it. Oh, I said bottomed out in the sand, we made a surf reference, so we might as well ebb and flow here, too. So that was the last recommendation that I received. So we saw from my results that my sex hormones are a little bit out of balance, and so the majority of my recommendations were to help rebalance those because my blood sugar and thyroid were normal, I didn't get extra recommendations for that. And then the majority or the bulk of what I got here was based on diet and exercise change so I can help modify my lifestyle to support my goals.
Dr. Robert Rountree:
So you learned a lot.
Dr. Amanda Frick:
I did learn a lot.
Dr. Robert Rountree:
You found out some things about your body that maybe you suspected but you didn't know.
Dr. Amanda Frick:
I think I probably knew, I just didn't want to look at them on paper, but here they are.
Dr. Robert Rountree:
Here they are, and you had some practical recommendations for things that you can do.
Dr. Amanda Frick:
Exactly.
Dr. Robert Rountree:
So in other words, this test goes beyond just saying, "You should exercise more and eat less." It's a total body management program.
Dr. Amanda Frick:
Agreed.
Dr. Robert Rountree:
OK, so now we're going to talk about my results, Dr. Frick, and so I'll appreciate any insights that you have. And just personal perspective, yeah, I'd like to lose probably about 5 pounds and I come from the Deep South and grew up eating a really crappy diet. And there's a lot of obesity in my family, both in my close family and my relatives. I mean, basically almost everyone I know has weight management issues. The whole area I'm from, I think they nicknamed it the “Stroke Belt.” So I was curious to see what these results showed.
First of all, it says my hormone levels are out of balance, and we'll see what that means because I think a lot of that's based on the DHEA. So when we scroll down we'll talk about that. So let's go see what the actual results show, which is the estradiol is right in the normal range. Well, that's good. Glad to know. I don't have high estradiol levels. My progesterone levels are in the normal range, which is also good. And as I said before, we're talking about picograms. I mean, these are tiny amounts. And it is normal for men to have some progesterone, not very much, but progesterone is kind of the starting point for a lot of sex hormones, all of which are made from cholesterols. So it makes sense that there'd be some around, but I have a normal level. I don't know if I've ever actually seen elevated progesterone levels in a man. Have you ever seen that?
Dr. Amanda Frick:
Only with hormone use.
Dr. Robert Rountree:
Oh, if a man was actually taking progesterone, yeah, then it would go up. It's a very unusual thing to have high progesterone, but still helpful to know. My testosterone level was reasonable. Of course, most of the guys that I know, especially my age, would always like a little bit more. Certainly being in the normal range is a healthy thing for my age group. So that's a good thing. And then we come to DHEA, which this test reads as abnormally high at 12 with the normal range up to 6. OK, confession, I take 25 milligrams of DHEA and I have for decades. And I actually did the Biological Age test from Thorne, and because my DHEA levels were a little bit on the high side, it actually scored my biological age as being lower than my chronological age. So it’s a good thing. We could probably debate the pros and cons of DHEA forever. I know I see in some of the textbooks it could increase the risk of cancer, but the reason that they say that is because it could theoretically get converted into estrogen.
Dr. Amanda Frick:
Well, Bob, I guess when we were talking about having patients that grew a beard, that must be working for you there.
Dr. Robert Rountree:
Yeah, it's kept my chin hair nice and robust. I certainly haven't seen any downside of taking it for years. And I do think it's helpful for hormonal health, for bone health, for anti-aging, immune health. That's a whole other discussion, but I was happy to see that that was normal. So they say abnormally high is not common, but that's not in people that take a supplement.
Dr. Amanda Frick:
I think we should note, too, if you did this with a partner at home or with a friend, if we remember mine was 10 and barely on the bottom of normal, yours is 12 and showing too high. But there is a difference between the male and female measure for DHEA, so mine was measured in picograms and yours is measured in nanograms.
Dr. Robert Rountree:
Nanograms, yeah.
Dr. Amanda Frick:
So if you're looking at that.
Dr. Robert Rountree:
Yeah, that's a huge difference. So again, we in laboratory medicine, all the units are set up so that everything comes in teens or maybe hundreds. So if you're just thinking, "10, my number was 10," or, "My number was 6," then you've got to look at the units. So I would just point that out to our listeners. So again, nanograms are a lot more than picograms. My levels are a magnitude higher.
So I think it's a good thing. It has a lot of positive effects and so I wasn't concerned about that contributing to my weight.
But here's where it gets really interesting, you and I have talked about my cortisol levels before. I start out in the morning not too bad, that number was taken close to around 9 a.m., which is early for me, probably before I've had my espresso, hopefully before I've had my espresso. So the morning cortisol was technically in the normal range, but it was a little bit towards the high end, and then it doesn't come down as much as it should. You can see the 3 p.m. level, the 6:45, the dinner and the evening. Now this could interfere with the ability to fall asleep, would you think?
Dr. Amanda Frick:
I do think so.
Dr. Robert Rountree:
You'd think so, maybe that's why it takes me so long to unwind at night before I can usually fall asleep. I have an Oura Ring, and it tells me that I need to be in bed for quite a while before I fall asleep, and so one of the advantages of using that Oura Ring is it's told me, “You need to go to bed earlier because it's going to take you a while to chill out because of that evening cortisol.” And we'll see what the recommendations are later, but I can have a pretty good guess what the program's going to tell me that I should take in the evening, which I have done on and off.
So keep scrolling down. Hemoglobin A1C, OK, I'm happy with a 5.5. That maybe, it's a little higher than yours, but in the past I have run 5.9, 6 percent, really depending on how strict I've been with my diet. So 5.5, I'll take it. I'll take it, because I do think I have the genes that set me up for pre-diabetes. And so again, this was positive feedback in this particular case. But this is, when I talked earlier about doing longitudinal testing, the A1C is something that anybody who's concerned about it should be doing several times a year. So one good reading, OK, that's a start, but that's not really enough because you never win this game completely.
So TSH, right in the center, I'm very happy with that and I have no reason to think that I have thyroid problems. I get asked about thyroid problems all the time, and people that say, "Hey, I don't have the classic symptoms, but could I have a subtle hypothyroidism that's contributing to metabolic disorders, fatigue," etc.
And then my vitamin D was 42. I, like you, don’t like to lay in the sun. We have a lot of skin cancer here in Colorado because of the high altitude, and I found that, especially in the summer, I can be out doing yard work in the backyard for a half an hour and get sunburns. So I cover up, I wear hats and long sleeves, etc. I'm not a “lay in the sun” kind of guy. So I'm totally dependent on supplementation to keep my levels up. And if I don't supplement, my levels plummet pretty quickly within a month or two. So this is taking 5,000 units of D every day, and that's what it takes for me to keep my levels up.
So recommendations, first recommendation is their weight management diet, which we talked about before. Nothing really radical. A good mix of protein, fat, and carbohydrates. I don't see a bowl of sugar on here as a daily recommendation. So I think they're saying if you are going eat even grains, then limit that. So not a lot of carbs on this diet, but it's not a ketogenic diet or anything like that. It's just a reasonable carb intake diet. But not a lot of grains, breads and things like that. Make sure you get a lot of sleep. And again, I think that cortisol level, that to me was the take home for this is I really need to lower that cortisol curve in the evening if I ever want to manage my weight better.
And then the long-term maintenance diet is the Mediterranean diet, which again, everybody could probably benefit from that, that plus allergenic foods. Fortunately, I'm not aware of any foods that I'm allergic to, so it's not been a problem for me. So low glycemic index foods, certainly. They say the A1C level is elevated, yep, compared to yours, it's elevated. So I should probably be really careful with the low carbs and really try to focus on that as my main dietary strategy. And eating a lot of probiotic foods. I love fermented cabbage, I try to have a little bit of that every day. And I do take probiotics, which I rotate all the time.
Practice meditation, I do that. Heart math and exercise, the same general kind of recommendations, lots of cardio, which I do try to get in as much as I can. Maybe it would help to add some jump rope or rapid stair climbing, etc. Swimming is actually my favorite exercise, which I use a lot. So very detailed recommendations here. Very helpful. And not working out at night, that may be the most important take home message is not going to the gym at 7 o'clock and working out. I should do my workouts more in the morning and try to burn off that excessive cortisol.
Let's see, what else have we got here? So the No. 1 product here, I don't think it's a surprise, Iso-Phos, because there is published data, more than one study I think, that shows that Iso-Phos, which is phosphatidylserine, can actually help lower excessive cortisol production. I'm not sure if we know what the mechanism is for that. Do you know what the mechanism is? I am not sure... I think it's just a clinical observation that it does that. So that to me, it's like, "Yeah, I've done that in the past and I continue to have this problem." So this is just a reminder that I should go back and do that again.
So the other thing is to take a good probiotic. I do rotate on and off FloraMend Prime. I think it's excellent. Fish oil, a good reminder to take EPA. And broccoli seeds, which is what Crucera is, an extract of broccoli seeds, to help regulate hormones, make sure they're going down the right metabolic pathway. I thought this was a very useful test. It kind of reminded me of some things I've been concerned about in the past. It lets me know, yeah, that high cortisol at night is still a problem, that explains a lot of things. So I'm writing this down as we speak, "Get Iso-Phos, get Iso-Phos," because that's just a really good thing for me. And Iso-Phos is also good for a lot of other things. It's good for your brain, etc.. So I think that's going to be it for now. That's about all we have time for this week. Do you have any other comments at the end about the experience?
Dr. Amanda Frick:
I don't think so. I think the only thing we'll see... This made me curious about which thing to do next, and so I think what I'll be looking at are some other female hormone testing and some future options to get a little more of a deep dive for what I need for what I saw that was out of balance. And you could consider coming back and doing just a Stress Test if you wanted to mostly check in on your cortisol rhythm, but there's pieces you can pick out of here to hone in on what you need to for budget concerns or whatever it fits for your health plans to come and do a retest of what's most important to you and your goals.
Dr. Robert Rountree:
All right, well, Amanda, thank you so much for coming on the podcast once again. We always love having you on the show. And as always, if listeners want to know what you're up to, what's the best way for them to follow you?
Dr. Amanda Frick:
I think LinkedIn's the best place to follow me. Adding new additions for things that get featured or interviews that I have, I put everything up there, and that's where you'll find the newest greatest stuff.
Dr. Robert Rountree:
All right, that was Thorne's Vice President of Medical Affairs, Dr. Amanda Frick on Thorne's Weight Management at-home test kit. As always, thank you everyone for listening. Until next time.
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