A Practitioner’s Guide to Stress Patterns, Cortisol & Recovery

In this episode, Dr. Jaclyn Smeaton and Dr. Donielle Wilson discuss Dr. Donielle’s clinical philosophy, research findings, and personal journey around understanding and treating stress. 

Their discussion also covers: 

• The stress response and how it’s highly individualized, shaped by genetics, and impacted by prior stress exposure 
• How standard cortisol testing misses most of the cortisol picture 
• Chronic stress and its cascade to multiple body systems, including the reproductive system in women 
• The five clinical stress patterns practitioners should be aware of 
• Small, consistent actions toward stress recovery, like mindfulness and deep breathing, can make a big difference 

Show Notes 

Learn more about Dr. Donielle Wilson and follow her on Instagram @drdoniwilson! 

Check out the study mentioned in this episode, and learn more about Dr. Wilson’s book, Master Your Stress, Reset Your Health and her podcast, How Humans Heal. 

Become a DUTCH Provider today to see how the DUTCH Test can profoundly change the lives of your patients. 

Transcript

00:00:00:00 - 00:00:07:02
Dr. Donielle Wilson
What's their awakening response? What's their cortisol? Later in the day, I want all of that information because it's going to influence their treatment.

00:00:07:03 - 00:00:32:10
Dr. Jaclyn Smeaton
Welcome to the DUTCH podcast, where we dive deep into the science of hormones, wellness and personalized health care. I'm Doctor Jaclyn Smeaton and chief medical officer at DUTCH. Join us every Tuesday as we bring you expert insights, cutting edge research, and practical tips to help you take control of your health from the inside out. Whether you're a healthcare professional or simply looking to optimize your own well-being, we've got you covered.

00:00:32:12 - 00:00:54:00
Dr. Jaclyn Smeaton
The contents of this podcast are for educational and informational purposes only. This information is not to be interpreted or mistaken for medical advice. Consult your health care provider for medical advice, diagnosis and treatment. Hey, thanks for joining me on this week's episode of the Dads podcast. Today I get to have someone who I really admire and have learned a ton from on the podcast.

00:00:54:06 - 00:01:23:19
Dr. Jaclyn Smeaton
Doctor Doni Wilson. And we're going to talk about a really important topic. We've talked about this before, and Doctor Wilson is one of the most experienced clinicians I know of who's been treating people for this for over 30 years. That topic is stress and burnout. Now, Doctor Wilson is a naturopathic doctor and also a certified professional midwife and a certified nutrition specialist with over 30 years of experience helping patients recover from burnout and hormone imbalances and adrenal dysfunction and fertility.

00:01:23:21 - 00:01:46:09
Dr. Jaclyn Smeaton
Really, the whole gamut of that we do with the intersection of reproductive hormones and stress hormones and she has a very unique point of view. And this goes back to her work as a midwife. She shares this on the podcast, where she sees women undergoing this tremendous amount of stress and the impact that stress has on labor. That really opened the door for her to continue to explore this in more depth throughout her career.

00:01:46:14 - 00:02:11:10
Dr. Jaclyn Smeaton
She's written five books on stress, and she has a great model that helps you understand how you can use lab tests and patient observations to put your patients into different types of patterns that you see for stress imbalances. And then we, of course, we talk about what you can do about it. And Doctor Doni, what I love about her is she does talk about herbal medicine and all the stuff, but also gets to the root of what are the drivers of stress.

00:02:11:11 - 00:02:32:05
Dr. Jaclyn Smeaton
And I know she lives as herself, so you're going to walk away with so many juicy tidbits that you can put into practice, whether you're just a person listening or whether you're a clinician, and if you are a clinician, how you can put this into practice with your patients. So let's go ahead and dive into the episode. So, Doctor Doni, we've been friends for quite a long time, colleagues for quite a long time.

00:02:32:05 - 00:02:55:14
Dr. Jaclyn Smeaton
And you've been talking about stress and burnout for longer than anyone else I know of. Or I can think of in naturopathy or integrative medicine. Can you start us off today by sharing why this is such a mission for you to really help us better understand stress and stress physiology, and helping women work through stress, not just women men as well.

00:02:55:14 - 00:02:59:04
Dr. Jaclyn Smeaton
But why is this so important?

00:02:59:06 - 00:03:33:08
Dr. Donielle Wilson
It's it's such a good question. And it brings me back to, you know, my deepest passion and purpose. What wakes me up every day. And all I can say is from from many years ago, it just became one of those things that I would just wake up thinking about every day, right? Like it's the thing that would just keep making me ask questions and keep making me look at the research and, and bring such curiosity to the clinical cases that I'm working with.

00:03:33:10 - 00:03:55:08
Dr. Donielle Wilson
And so it just kept pulling me that direction. And at first I didn't know exactly why. I can I can share more about how I think I first became aware of my interest in stress when I was studying to be a midwife. So when I was ambassador studying to be a naturopathic doctor, I also completed a midwifery program.

00:03:55:08 - 00:04:11:00
Dr. Donielle Wilson
And in the midwifery program there was a requirement to do research and the research that I chose was to research how stress and trauma and abuse affects women in labor.

00:04:11:02 - 00:04:23:01
Dr. Jaclyn Smeaton
That's really forward thinking because this is not this is something that we're talking a lot about now. But, you know, that was, you know, a number of years ago before this was kind of a mainstream conversation.

00:04:23:03 - 00:04:25:06
Dr. Donielle Wilson
It was you know, I was at least 30 years ago.

00:04:25:08 - 00:04:27:08
Dr. Jaclyn Smeaton
So I think things that you found.

00:04:27:10 - 00:04:53:13
Dr. Donielle Wilson
Well and this is the thing is what I learned from those women is what inspired the rest of my research and work around stress. And so I really want to honor, you know, the women in labor who inspired me to say, hey, we can learn so much from women in labor, because, of course, you know, as a mother to of of multiple children, that labor is it's a beautiful process.

00:04:53:13 - 00:05:34:05
Dr. Donielle Wilson
It's a process that women go through to bring children into the world. And yet it also is a stressful experience, especially depending on the various interventions that could happen during labor. And so we're looking at an example of something humans go through that stressful and observing what happens and how does that impact different women differently. And so what I learned from that, that I still that's still rings true for me today, not just for women in labor, but for men, women and children of all different ages is that stress is not one size fits all.

00:05:34:06 - 00:05:58:15
Dr. Donielle Wilson
It's very individualized and unique to each of us. And it's not about having zero stress. The goal is not to have zero stress, because a lot of times we think we hear the term stress free, right? I want to be stress free, right? We think we're aiming for having no stress and actually that's not what we're aiming for.

00:05:58:17 - 00:06:30:00
Dr. Donielle Wilson
What those women showed me is that they needed to have just the right amount of stress hormones in order for labor to progress most smoothly and effectively, and if they had too little stress hormones, then labor doesn't happen at all. And if they have too much stress hormones, labor gets stalled and doesn't progress. So it's about how do we attain that optimal level, of stress in our lives.

00:06:30:00 - 00:06:55:14
Dr. Donielle Wilson
And that actually is what we need in order to survive and thrive. And another aspect of this is how do we support ourselves through this stress? Instead of, oh, I wish I had zero stress, no. How do we support ourselves through the stress ourselves? And how do we choose people in our life to support us through the stress?

00:06:55:14 - 00:07:03:21
Dr. Donielle Wilson
Because it's by supporting ourselves through the stress that we can get through it without it having a negative impact on our life.

00:07:03:23 - 00:07:42:13
Dr. Jaclyn Smeaton
I love that you bring that up because when it comes to stress management, you can modify external factors. So for example, you're in a bad relationship. You can leave you your job is an unhealthy environment. You can get a different job. And that might be a piece of stress management. What I'm hearing you saying is that it's also an inside job because and maybe you can talk a little bit about this because I think one thing that's really fascinating that people struggle to understand is that perception of stress is reality when it comes to stress, and that two people can experience the same situation but have a different resilience or a different stress response internally

00:07:42:13 - 00:07:56:01
Dr. Jaclyn Smeaton
to that same stimulus and have really different outcomes. Can you talk a little bit about how stress, resilience or stress stress management? I'm not sure what term you might use varies from person to person. And why is that?

00:07:56:03 - 00:08:22:18
Dr. Donielle Wilson
There's several factors involved. I have definitely looked into this. I have lots of curiosity around it. In fact, I even did a research study myself. Of 127 adults. A retrospective study looking at these factors. What is it that made the stress individual to each of them and looking at everything from age and and stress exposures, different types of stress, exposure to we.

00:08:22:18 - 00:08:48:08
Dr. Donielle Wilson
I even took into account their blood types and their location. And I looked at their cortisol and adrenaline levels and I was like, okay, how can we as practitioners try to even anticipate how stress is going to impact the person sitting in front of us, right. Based on these various factors, maybe their symptoms that they're presenting with, let alone other factors.

00:08:48:10 - 00:09:06:00
Dr. Donielle Wilson
And what I saw is that, first of all, it's not one size fits all. And there's there's definitely some genetic component. And that's always an interesting piece. Right. How much of how we experience stress is related to our genetics. And there's definitely a piece of that. We know there's certain genes.

00:09:06:00 - 00:09:09:06
Dr. Jaclyn Smeaton
Like for other kind of like things like that that you're thinking of.

00:09:09:08 - 00:09:33:10
Dr. Donielle Wilson
Yes. And also genes related to how how we respond to cortisol and even say clock genes and all kinds of, yes, survival mechanism type genes that are going to influence how an individual responds, you know, to different people, could have the same stress and can respond completely differently some degree because of their genetics, but also because of their past history.

00:09:33:13 - 00:09:59:02
Dr. Donielle Wilson
Right. So if they so, so much of just like the rest of our health, we know that genetics is not 100% of what we experience. Genetics is probably less than 20% of what we experience. But what the big piece of it is, our environmental exposures. And what is the impact? The major environmental exposure is our stress. Our prior stress influences how we respond to future stress.

00:09:59:04 - 00:10:30:18
Dr. Donielle Wilson
And and that includes physical stress. So even physical injuries, emotional stress as well as I consider toxins in our environment as another stress on the system. Right. So these environmental factors influence how each one of us is going to respond to stress going forward. And so in the research that I did, I when I looked at their cortisol and adrenaline levels, I was also curious, could we say, hey, this person comes in with fatigue.

00:10:30:20 - 00:10:59:00
Dr. Donielle Wilson
Can we assume that they have low cortisol? And what the study showed is, no, we can't. We can't assume based on any symptoms. I looked at over 20 different symptoms, but them the one that correlated slightly was fatigue. If someone has severe fatigue they're slightly more likely to have a low cortisol. But it's important to know that even someone who has high cortisol can have fatigue.

00:10:59:02 - 00:11:01:05
Dr. Donielle Wilson
So we can't just go by the symptoms.

00:11:01:05 - 00:11:26:05
Dr. Jaclyn Smeaton
Yeah. It's that's interesting that you bring that up because I think the like the clinical measurement of stress and the HPA axis is far more complicated than the average even well-educated integrative or functional provider knows. You know, it's just it's far more complicated. And I've learned a lot since coming to docs because I was taught to do adrenal salivary testing.

00:11:26:05 - 00:11:49:15
Dr. Jaclyn Smeaton
And that looks at free cortisol. But free cortisol is only one element of the cortisol story. You have things like metabolized cortisol, cortisol awakening response, cortisol clearance rate, the downstream metabolites, how they're eliminated, the tag and CHF. There's so much more to the picture and to the story that I'm not surprised to hear you say that we don't see patterns.

00:11:49:16 - 00:11:59:18
Dr. Jaclyn Smeaton
I think people assume free cortisol is high. People are anxious. Free cortisol is low associated with fatigue. But the biochemistry is so much more complex than that.

00:11:59:20 - 00:12:25:02
Dr. Donielle Wilson
And really is it really is. And so that's why I as a practitioner, I mean, I've been measuring cortisol levels, thousands of cortisol levels for over 26 years. And and when someone says to me, oh, I can probably guess what this patient's cortisol level is, I'm like, I don't I can't guess even after seeing that many cases, I would rather do the do it test and see it.

00:12:25:04 - 00:12:48:11
Dr. Donielle Wilson
So then we can also see those, those really like you're saying even not just watch their cortisol in the morning, but what's there. What's their awakening response. What's their cortisol later in the day I want all of that information because it's going to influence their treatment to me. Right. If a test can influence the treatment and the outcome for the person, then it's worth it.

00:12:48:13 - 00:13:11:08
Dr. Donielle Wilson
Yeah. And so that's why what my research essentially showed me was that testing, not just cortisol once, but cortisol at different times a day is going to make a difference. And not only cortisol. I also found that it helps to look at adrenaline levels. Of course, that's also made by the adrenal gland. So what we don't want to just have one piece of information.

00:13:11:08 - 00:13:16:09
Dr. Donielle Wilson
We want as much information as we can. If we're going to help humans recover from stress.

00:13:16:11 - 00:13:34:06
Dr. Jaclyn Smeaton
Can you talk a little bit about what you typically test for in patients and and why? And I think the other side of that is that I think if if patients are going to their conventional doctors and asking, they're getting a morning serum cortisol. And I'd love you to comment on like, why are we doing that. Is it valuable?

00:13:34:06 - 00:13:40:03
Dr. Jaclyn Smeaton
And if so, what value does it offer and how is it different from what we measure when we're looking at a full panel?

00:13:40:05 - 00:14:19:18
Dr. Donielle Wilson
I mean, sometimes I do, I'll even sometimes order, fasting cortisol, especially if it's a case where maybe the person isn't isn't as ready to order. More specialty lab and let's say pay out of pocket, right. They can probably get a fasting cortisol covered by insurance. So if I'm, if I'm in a situation where I want to at least get some information and a ballpark, but I'm also going to be aware that the reference range on a, on a fasting cortisol in, in the blood is going to be a pretty wide range, and it's going to be pretty easy to fall into normal.

00:14:19:19 - 00:14:46:18
Dr. Donielle Wilson
And yet it it may not actually be normal. And I have to keep in mind that. And I say to the patient, we're checking your cortisol at the time you have your blood drawn. Only we don't know what it's doing the rest of the day. But it's a it can be at least some piece of information. I actually think that cortisol should probably be on all general bloodwork, so that we can catch many more people who need to do more testing, because right now it's not even in standard bloodwork.

00:14:46:18 - 00:14:52:06
Dr. Donielle Wilson
So most people will have even more severely abnormal cortisol. They don't know.

00:14:52:09 - 00:15:10:12
Dr. Jaclyn Smeaton
Right? I think another thing that's interesting with serum is that like it's like testosterone. There's total and there's free. And when you're measuring serum cortisol you're measuring total. But cortisol has a binding protein also cortisol binding protein which would be like sex hormone binding globulin that I think more people are familiar with. So that's another piece of it.

00:15:10:12 - 00:15:25:07
Dr. Jaclyn Smeaton
Is that it? Sometimes I've seen it doesn't correlate so well with symptom picture, because it's the free cortisol that has activity, and we don't really know what the binding protein is or how much of that total is available for use by the tissue.

00:15:25:09 - 00:15:52:01
Dr. Donielle Wilson
So it's a good to keep in mind. You could do it. You could do a, a serum cortisol and it could still look normal. And the person might still have not optimal cortisol levels. And the other factor is that still in standard medicine and endocrinology, usually cortisol is only addressed if it's a flatline. Essentially. Right. If the if the adrenals are out of sync, Pletely stop working.

00:15:52:07 - 00:16:18:10
Dr. Donielle Wilson
And that's not what I'm looking for. I'm looking for where is it that this person's stress hormones have been so impacted by their stress exposure, and that they're no longer optimal? Because what happens from the way I look at it is it's that the stress that we've been exposed to and the that then has turned on whatever genetic expression in our bodies, it becomes a set point, so to speak.

00:16:18:15 - 00:16:43:09
Dr. Donielle Wilson
So then, even though the person might not still be under stress, they might the person might be saying, hey, I retired, my kids grew up. I'm, you know, I'm living on an island. They could be saying like, hey, I really don't think I have any more stress. And I say to them, we still need to check because your stress from the past, your body remembers that unless we've helped it fully recover.

00:16:43:13 - 00:17:07:12
Dr. Donielle Wilson
And lo and behold, then when we measure, say, cortisol at multiple times a day, and, or we can measure the catecholamines metabolism and neurotransmitter levels, and then we actually see what the impact of their stress is on their system. And then that's when people go, oh my gosh, I'm so grateful they have this information because it's validating.

00:17:07:16 - 00:17:15:18
Dr. Donielle Wilson
They they finally have results that show what they're feeling in their body. That's not going to show in regular blood work.

00:17:15:20 - 00:17:36:07
Dr. Jaclyn Smeaton
Well I'd love to talk a little bit about why this is so critically important. And I want to talk about really a more extreme patient experience that we would call it burnout. Someone who is really they've been priming that axis for a very long time, you know, and we start to see changes in the cells and how they respond to cortisol, just like we see changes in insulin.

00:17:36:09 - 00:17:55:14
Dr. Jaclyn Smeaton
People have chronic high blood sugar. But these calves a lot of downstream physiological problems. It's not just feeling stressed. There's a lot of impacts on our other physiological systems. I always I think I bring up brought this book like 20 times on the podcast. But I love Sapolsky, whose book Why Zebras Don't Get Ulcers. I'm sure you read that one.

00:17:55:19 - 00:18:20:00
Dr. Jaclyn Smeaton
And he goes through like chapter by chapter, how stress impacts each physiological system. It's old, but it's still a really I mean, the research has come a long way since that time, but it's a really cool book to think about the cardiovascular system, the musculoskeletal system, the reproductive system, and the stress impacts. But can you talk about what is most damaged by like a high stress burnout situation in patients?

00:18:20:06 - 00:18:25:02
Dr. Jaclyn Smeaton
Which symptoms of the body?

00:18:25:04 - 00:18:58:13
Dr. Donielle Wilson
It I mean to say it varies depending on the person. Okay. You know, it I would say just like the name of the book, Why Zebras Get Ulcers. I think the digestive symptom is one of the first places that gets impacted it. Right. We know I mean, I think we have an awareness for. But it's always so good to remind ourselves, like even before a person gets to an ulcer, if they're having reflux, if they're having bloating, if they're having constipation or diarrhea, very likely it has something to do with their stress exposure.

00:18:58:15 - 00:19:27:03
Dr. Donielle Wilson
And very often when I help patients to recover from stress, that's one of the first things they say is my digestion feels so much better. And of course, we know that the digestion in, you know, impacts so many other areas of the body right? So if if the person then is more likely to have a gut permeability or leaky gut, now they're having inflammatory responses to foods, they're also more likely to get nutrient deficiencies.

00:19:27:09 - 00:19:51:13
Dr. Donielle Wilson
They're more likely to have microbiome imbalances. And then those factors just flood the rest of their system. Right now this their whole body's flooded with inflammation, the impact of nutrient deficiencies and the impact of microbial imbalance. And that can show up in so many ways. One of the one of the ways that I really observe is in terms of susceptibility to infections.

00:19:51:15 - 00:20:17:16
Dr. Donielle Wilson
So patients who have chronic or recurrence, whether it's sinus infections, skin infections, bladder infections, vaginal infections, a lot of my research now is in looking at women who are susceptible to HPV related cancer in the vagina and cervix as well as. Right. There's this the immune system is suppressed by the impact of stress, whether the cortisol is too high or too low.

00:20:17:16 - 00:20:42:02
Dr. Donielle Wilson
By the way, it's not just high cortisol. It could be low cortisol. The immune system is not functioning to protect from infections. And meanwhile the person's more susceptible to autoimmunity and cancer. And so then we start seeing that when we start seeing infections, autoimmunity, cancer risk. And we have to be I think we have to be addressing the adrenals and the cortisol.

00:20:42:02 - 00:21:00:00
Dr. Donielle Wilson
And adrenaline, because if not, we could go for some, you know, all kinds of fancy ways to address an infection and, and try to go after an infection. But if we're not addressing the stress, we're not going to be ultimately preventing this from recurring. Again.

00:21:00:02 - 00:21:21:03
Dr. Jaclyn Smeaton
You know, I've got so many questions like just from that statement, I think one thing that's so interesting, and you mentioned this is like digestion is a parasympathetic experience, right? We say fight or flight and the opposite is rest and digest. And so when you're under chronic stress of course it affects digestion. But I also think about people who rush when they eat.

00:21:21:05 - 00:21:39:00
Dr. Jaclyn Smeaton
And I used to tell my patients, when you're eating, just eat. And it seems like the dumbest advice. But my point is like, don't scroll on the news, don't do it in your car. Don't you? At your desk at work, like take the time to actually stop, take 3 or 4 deep breaths and then enjoy your food and don't rush through it.

00:21:39:00 - 00:21:59:13
Dr. Jaclyn Smeaton
And because actually, even just the secretion of gastric juices is impaired when you are stressed and eating or resting and eating. So I wanted to point that out because I think that's something that is so common that we are we're eating food on the go, and it's something that's very different. Like we talk a lot about like European people's health, their stress, their weight stuff like that.

00:21:59:17 - 00:22:14:19
Dr. Jaclyn Smeaton
One big difference is the way they eat. They don't tend to like have convenience foods. They also don't have the super sizes, but they just the environment in which they consume food. Even if the food was the same, the environment so different.

00:22:14:21 - 00:22:37:00
Dr. Donielle Wilson
I know. Imagine something so simple. I know even when I'm, I start to talk to patients about taking digestive enzymes, and then I stop myself and I say, wait a minute, even before you take a digestive enzyme, I want you to, like you said, sit and breathe. Takes some deep breaths before you eat, deep breaths after you eat and just eat mindfully, paying attention to each bite of food.

00:22:37:01 - 00:22:52:23
Dr. Donielle Wilson
How does it taste? How does it feel? We have to intentionally give signals to our digestion to let it know that we're eating. If we're racing to our day, our our digestion. Never knew that it was supposed to start digesting.

00:22:53:00 - 00:22:53:08
DUTCH Podcast
Yeah.

00:22:53:12 - 00:23:20:20
Dr. Donielle Wilson
So we we I think as humans we have to learn how what are ways that we can help our body out. And that's one of the things we can do. And it does take it seems so simple, but it's so powerful to actually sit down with our schedule each day. And this is what I do with my schedule, by the way, all of these things I talk about, I, I it's I get myself to implement them too, because I, I'm never going to just say, oh, somebody else should do this.

00:23:20:20 - 00:23:40:20
Dr. Donielle Wilson
If I'm not doing it. I test my cortisol levels, I test my adrenaline levels, and I, I put it in my schedule to sit down and eat. And not only that, Jaclyn, but now my intention is to sit and eat in a beautiful location where I can observe nature. Either that or be in nature. But we want to.

00:23:41:00 - 00:24:10:15
Dr. Donielle Wilson
Why not add? Why not stack some of these other stress recovery activities at the same time, right? Why not look at nature, listen to the birds while you're breathing and eating your food and enjoying your food? Why not take at least 15 minutes to do that and then you actually end up not only getting more from your food, but you also then are more likely to choose food that's healthy for you because, right, you're putting so much intention into it.

00:24:10:15 - 00:24:26:11
Dr. Donielle Wilson
You're like, I want to eat healthy food and I want to enjoy it. And then you come away from it feeling so much more restored. And research shows then we can be so much more productive when it's a it's a false sense that if I keep going, keep going, I'm going to get more done.

00:24:26:13 - 00:24:59:23
Dr. Jaclyn Smeaton
Yeah. This is something I'm so glad you're talking about. That's because people are listening to that's probably thinking one of two things. Yeah, this is so easy. Of course, you could take 15 minutes to eat your food or they're thinking, that sounds good for your life, but it would never work for my life, right? So I think they're in 1 or 2, 1 or 2 of these phases, but it's, you know, if we can't take 15 minutes to eat a meal because we're doing something that we perceive is more important, I think that's and I say that relating to that this is not a judgment or criticism, because there's times in my life I was

00:24:59:23 - 00:25:16:03
Dr. Jaclyn Smeaton
saying about yesterday, like I ate a salad in a meeting, you know, I just because some days are like that and they're very busy, or you're driving your kids to after school activities and you're eating in the car and the quick like that happens to all of us. But it shouldn't be so hard for us to carve that time out.

00:25:16:05 - 00:25:25:13
Dr. Jaclyn Smeaton
And I think I love that you say I do that too, because you can probably relate to the times where it can be challenging for your patients and help them problem solve, because you've been there and you've done that.

00:25:25:15 - 00:25:47:15
Dr. Donielle Wilson
Absolutely. And it is one of those things where I end up looking at it as our life experience is practicing this, this is what it's about, is how do we practice each day learning how to take better care of ourselves. And we're not going to get it right all the time. And there's going to be certain days where it's like, okay, I had to kind of like rush to eat my salad.

00:25:47:15 - 00:25:58:20
Dr. Donielle Wilson
And yet we can be aware, okay, even if I'm rushing, I can still take a couple breaths. I can still even even the thought of saying, hey, stomach, I'm about to eat. Let's get ready.

00:25:58:22 - 00:25:59:14
Dr. Jaclyn Smeaton
Like.

00:25:59:16 - 00:26:27:18
Dr. Donielle Wilson
You know, like so there's things we can do very quickly. And I think that's the thing is, a lot of times people think, well, I'm going to do that one day, or I can do that on the weekend or I can eventually I'm going to do that because we we make it so big, like stress recovery. The interesting thing I like to say is that, you know, stress feels like it takes up so much space and time and yet stress recovery, it doesn't have to be equally as large.

00:26:27:20 - 00:26:41:15
Dr. Donielle Wilson
The stress recovery we can do where our bodies are so good at it, actually, when we give our bodies the opportunity that we even if we give it 15 minutes or even five minutes, our body can recover from a whole bunch of stress in a short amount of time.

00:26:41:15 - 00:27:03:13
Dr. Jaclyn Smeaton
Yeah, well, and I think that takes practice. Like I think about this and I think this is probably a relatable experience. But when you go on vacation, like you go to your favorite place, let's I'm imagining like a beach vacation and you have a week's vacation when you first go, like in a busy time, it takes you days to get to a state where you're like, oh, I feel different right now.

00:27:03:13 - 00:27:23:11
Dr. Jaclyn Smeaton
I feel relaxed and I think this is something that we should be asking ourselves, right? So maybe it takes you three days to stop thinking about work, stop ruminating on the problems that were going on and just be relaxed in the moment. But if you sit with that and you think this is how life should feel, most of the time this is what relaxation feels like.

00:27:23:11 - 00:27:42:05
Dr. Jaclyn Smeaton
This is what low stress or stress management feels like. And then it takes a lot of practice to get there and to shorten the span of time that it takes you to get from stress to relax. And I think it is a practice. And I think about my mom, who you know, we grew up with like a summer place on a lake and my parents still live there.

00:27:42:07 - 00:28:00:00
Dr. Jaclyn Smeaton
And my mom says when I drive over the bridge, I exhale like there's a specific point. And that's because she's done that for so long that that's become the routine, that there's these triggers that are in her life, and she knows when she's driving. As soon as she hits that bridge, which is one mile from the house, she can relax.

00:28:00:00 - 00:28:09:11
Dr. Jaclyn Smeaton
And now she gets that relaxation before she even arrives, you know, so but I think that takes training. And that's a really hard thing to, to make time for and to do.

00:28:09:12 - 00:28:39:01
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00:28:39:03 - 00:28:46:10
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00:28:46:12 - 00:28:49:07
DUTCH Podcast
Welcome back to the DUTCH podcast.

00:28:49:09 - 00:29:04:19
Dr. Donielle Wilson
I mean, that's one thing I like about measuring cortisol levels is because then it has an objective in front of you. And you can we can then align with that and we can make a goal. We can say, okay, I'm going to do this, this, this is this for the next six months. And then I'm going to recheck it.

00:29:04:21 - 00:29:25:15
Dr. Donielle Wilson
Now you can also do that with heart rate variability. A lot of times people will be measuring heart rate variability because it's something you can get a device and you can kind of and I've had a lot of patients benefit from that and be like, oh my gosh, now I finally get it that if I even if I work out too intensely, my HIV is impacted.

00:29:25:15 - 00:29:45:07
Dr. Donielle Wilson
So now I'm going to change the intensity of my workout. So I think any of these tools, they can give us more information about our bodies and how they're responding to the stress that we're putting them under. Then we can use that information to implement and make tweaks and adjustments.

00:29:45:09 - 00:30:06:11
Dr. Jaclyn Smeaton
Now I want to get back also to what you were saying about the immune system, because it's such a complex system of the body and it is. You mentioned how stress it can have this like multimodal impact, where it can reduce your immune system's capability to fight an infection. But then you also mentioned autoimmunity. Well, and I guess cancer would be another place where the immune system is no longer able to keep up.

00:30:06:11 - 00:30:26:04
Dr. Jaclyn Smeaton
That's like a reduction in function. But then you talked about inflammation and autoimmunity where that's driven by this overactive immune system. And I think it's hard for sometimes for people to reconcile those two things happening. And it's kind of a bugger because it's like you have more inflammation. It makes the other side of the immune system even less responsive.

00:30:26:09 - 00:30:41:02
Dr. Jaclyn Smeaton
Can you speak to that a little bit? A little bit. And then also understanding how once you get in that cycle, because you said even when the stressor is gone, the the reaction remains. How does that impact our ability to recover from burnout?

00:30:41:04 - 00:31:07:23
Dr. Donielle Wilson
So with the immune system, the what helped me to think about this and understand this is in the more now that we understand the immune system. And when we understand that the immune system has this one function, the one being that that's to me where we want the immune system, we want it to be protecting us from microbes.

00:31:07:23 - 00:31:28:17
Dr. Donielle Wilson
And of course, we know now that we have all these beautiful trillions of microbes in and around our bodies that are hopefully protecting us from other invaders and helping our immune system. Right. And yet, if that, we're also going to get exposed to microbes that could be harmful to us, whether that's a bacteria or a virus or, you know, any.

00:31:28:17 - 00:31:58:20
Dr. Donielle Wilson
Right? There's so it's this and a lot of times as humans, I think that's that's already something that's difficult for us to kind of be okay with. How can I be so okay with having microbes that are helping me, but also aware that there may be microbes that could be harmful, and the one immune system is part of helping us to manage that and prevent something from becoming what we call an infection, where it could cause more issues, especially with, let's say, high risk HPV.

00:31:58:20 - 00:32:25:00
Dr. Donielle Wilson
That's associated with cancer risk. We're like, whoa, wait a minute. A virus that can cause cancer, that's a whole nother ballgame. That's not just I need antibiotics. That's right. Whoa. And so when I talk with women about that, I really help them understand that we have when our immune system is functioning optimally, it's going to be in ATH1, format where it's helping us prevent infections like HPV.

00:32:25:01 - 00:32:57:07
Dr. Donielle Wilson
And when the immune system is stressed, right. Or has an impacted by stress, it shifts into a different, stage of the immune system, which is more associated with autoimmunity, inflammation and cancer. And so to some degree, even if we can think about it as we need to just flip the switch back to TH1. And so because sometimes if we talk about it in terms of like hyper responses or hypo responsive, it gets very confusing and people start to think, well, can I take this herb?

00:32:57:07 - 00:33:22:01
Dr. Donielle Wilson
Because if I'm taking this herb to help prevent an infection, is it also going to stimulate autoimmunity? And so I help them to go. It doesn't help to think about it that way. Think about it instead as what can we do at a deeper level to help switch our immune system back to t one? And the way we do that is with the stress recovery, you know, because the more that we can help patients too.

00:33:22:03 - 00:33:47:11
Dr. Donielle Wilson
And when I say stress recovery, I'm referring to, yes, resetting cortisol to optimal levels, resetting adrenaline to optimal levels. But it's also resetting the impact of stress. So healing the gut, healing any leaky gut microbe imbalance. Also healing the hormones because we know that stress disrupts all that can potentially disrupt all our hormones like insulin, estrogen, you name it.

00:33:47:11 - 00:34:09:11
Dr. Donielle Wilson
All thyroid, all. We need to rebalance the hormones that have been impacted by stress. And we need to rebalance the neurotransmitters to the serotonin Gaba. And so I look at how do we rebalance all of these bio all of this biochemistry in our body. This impacted by stress. But it actually doesn't even stop there Jaclyn it we that's all on the physical level.

00:34:09:13 - 00:34:30:23
Dr. Donielle Wilson
Now I've also gone into how do we help people to recover on an emotional level and a spiritual level from stress because we know that we're interconnected beings, mind, body, spirit. If we only working on even if we're only living, if a person has completely optimal.

00:34:30:23 - 00:34:32:01
Dr. Jaclyn Smeaton
Cortisol.

00:34:32:03 - 00:34:55:10
Dr. Donielle Wilson
And a healthy gut, but they haven't healed on an emotional and spiritual level, they their immune system might still be pulled away from t one back into this pattern up toward autoimmunity and cancer. And so now I integrate into my work, helping to heal on an emotional and spiritual level too, because I see it having an impact.

00:34:55:12 - 00:35:03:02
Dr. Jaclyn Smeaton
Are there tools that you're utilizing like eMDR or psychedelic therapy or anything that you've seen to be really helpful in that category?

00:35:03:04 - 00:35:29:04
Dr. Donielle Wilson
All of those, and I look at it really like a menu of possibilities in it here. It needs to fit for the individual. So at this point I, I really connect with each individual and say, hey, what seems to resonate with you at this point in time? I mean, it could start as simple as breathwork, which we already talked about some with our with the eating, but it could also be meditation and mindfulness or biofeedback or it could be eMDR or somatic therapy.

00:35:29:06 - 00:35:59:16
Dr. Donielle Wilson
And it and it could be psychedelic assisted therapy. That is something that now I've been trained in I'm completed that integrate the Integrative Psychiatry Institute, psychedelic assisted therapy, certification. And I'm actually a licensed facilitator for psilocybin in Colorado. And it's to me, after looking at all of that research, is like, wow, this really has such a capacity to help humans heal and recover from stress and burnout.

00:35:59:18 - 00:36:09:11
Dr. Donielle Wilson
In fact, we oftentimes we think that we would think psychedelics are only helping on an emotional and spiritual level, but they also work on a physical level, too.

00:36:09:16 - 00:36:33:18
Dr. Jaclyn Smeaton
That's fascinating. And I mean, I'm not an expert in that therapy. We should probably do a whole nother episode on it, because, I mean, there's so much curiosity around it and still a bit of stigma around it as well. But the the impact, like the studies that I've seen on things like PTSD, like very complex chronic stress related, hugely impactful issues, even with a short duration of therapy, the results are pretty astounding.

00:36:33:18 - 00:36:44:22
Dr. Jaclyn Smeaton
And when you think about a life on medication versus a short term treatment like this, that's long lasting, there's just we need to do so much more research.

00:36:45:00 - 00:37:13:14
Dr. Donielle Wilson
We in and it's so true. That's the real you're exactly pointing out Jaclyn. The point is that what if there can be substances from nature? Here we are back to nature again, nature helping us heal, substances that can help us actually reset and recover from stress and trauma. To the extent that we're recalibrating the nervous system, nervous system regulation we hear a lot about.

00:37:13:19 - 00:37:41:00
Dr. Donielle Wilson
But not only that, but helping the vagus nerve heal and all the neuroplasticity, resetting all these neural pathways so that a person could finally be free of things like what's currently called treatment resistant depression, I would say is depression that we just haven't found the right treatment for and anxiety, let alone, you know, all the other impacts of stress and trauma.

00:37:41:05 - 00:38:05:12
Dr. Donielle Wilson
And so there is a ton of research on it. So if anyone is, it's a new concept. I encourage you to definitely dig in to the research on psychedelic assisted therapy because it's it's now more and more becoming an amazing tool to help people. It's not like everything. It's not the only thing, but I definitely would want people to know that it can be it can really help.

00:38:05:12 - 00:38:31:23
Dr. Donielle Wilson
It help me a huge amount. And so even coming back to your original question of me, Jaclyn, what I learned along the way of all these decades of researching stress was that no wonder I was so interested in stress and stress recovery because the more I realize how I was impacted by stress from complex PTSD, from my childhood and and subsequent, trauma in adulthood.

00:38:32:01 - 00:39:03:00
Dr. Donielle Wilson
And so I was interested in something that because that's what I experienced. And so through this process of research and implementing on myself, I've been able to experience so much recovery in my house, including with, the past eight years or so, use, psychedelic assisted therapy has made a huge impact on my life and my health and things like, I mean, I have a long history of migraines.

00:39:03:00 - 00:39:24:00
Dr. Donielle Wilson
I had severe migraines for over 20 years that I don't have anymore. And so when I and if someone can say, well, here's someone who was in chronic pain and nothing worked and now they're gone, what's what's possible, then? You know, you can leave in a minute.

00:39:24:02 - 00:39:44:06
Dr. Jaclyn Smeaton
And I think it just goes to show you the far reaching impact of stress and the stress hormones on our body in, like, such layered ways that right when you think about migraines, you might not think about that as a predominant driving force. You might think about neurotransmitters or magnesium or, you know, nutritional deficiency or something else inflammation.

00:39:44:08 - 00:39:47:04
Dr. Jaclyn Smeaton
So, I mean, thank you so much for sharing your story.

00:39:47:06 - 00:40:09:19
Dr. Donielle Wilson
Yeah. And it's and for me, addressing the migrants wasn't just one thing. It was I had to do all those things right. I had to do the gut healing the home, the cortisol balancing the learning, mindfulness and meditation. All of that, all of that. And little by little it would improve. But it was it was the whole process overall.

00:40:09:19 - 00:40:37:01
Dr. Donielle Wilson
And so any any practitioners or anyone listening, if you've been dealing with chronic pain, literally physical pain and it wouldn't have to necessarily be a migraine, it could be body pain, joint pain, which I was in, I was in also physical pain for for years. If you're in physical pain and or emotional pain, when I say emotional pain, I mean like depression, anxiety that's weighing on you every day.

00:40:37:03 - 00:41:01:19
Dr. Donielle Wilson
I want you to know that it's possible to recover, because oftentimes we're going into standard medicine and feeling like we're getting a dead end. We're hitting a dead end over and over again. And and the only options are medications that suppress the physical or emotional pain. But it's not really getting at why is it present and how do we recover from it.

00:41:01:21 - 00:41:23:11
Dr. Donielle Wilson
And so, you know, just letting people know that, hey, it's possible. And if if as practitioners two that I believe if we're here to help others, right. We're here to help others with their health, we also need to be helping ourselves with our own health. And I think as providers, we we tend to not talk about that or do that even.

00:41:23:11 - 00:41:40:04
Dr. Donielle Wilson
Right. We're almost like sacrificing ourselves into our practices and getting burned out. And what we really need to be doing is integrating in stress recovery as practitioners so that we aren't becoming burned out, because how can we help anyone if we are in pain?

00:41:40:04 - 00:42:11:22
Dr. Jaclyn Smeaton
I couldn't agree more. And I think that stress management, one of the reasons why well, I think I'll just share my point of view or this is my opinion when it comes to what we do as integrative providers, functional providers, there's so much growing in this area, but it's application of new therapies. And I think that we all recognize, like, I wouldn't I can't think of a single person I've ever spoken to that doesn't think stress is a key driver of disease, and not one person who would push against that.

00:42:12:00 - 00:42:40:17
Dr. Jaclyn Smeaton
However, the majority of practitioners don't actively work with their patients to improve it, and I really think a lot of it is because we don't know how to do it for ourselves. We don't either. We're either not comfortable going into that space or we're struggling to slow down. So while we're great at herbal medicine and nutrition and spinal adjustment and, you know, peptides or whatever you're using as therapies, we it's so difficult to practice this.

00:42:40:17 - 00:42:58:16
Dr. Jaclyn Smeaton
And I love what you said. It doesn't have to be so big. It can be small. You don't have to meditate an hour a day. It could be something like eating lunch in nature. I love that suggestion, but I think it's it's like the black box that we've yet to really opened fully and address fully. And even the psychedelic assisted therapies is interesting to me.

00:42:58:16 - 00:43:19:00
Dr. Jaclyn Smeaton
But I also think it leans on let me give you something and it creates an experience of healing, which is great. But versus something like meditation, which I think is a lot harder to engage in, it takes more time, it takes more thought. It's a practice. So it's just a very interesting, like philosophical piece. Like, I think we do need to do better for our patients in this area.

00:43:19:02 - 00:43:22:18
Dr. Jaclyn Smeaton
And I think the reason why we don't is it's really hard to even do it for ourselves.

00:43:22:20 - 00:43:43:02
Dr. Donielle Wilson
And that's exactly it. And that's okay to recognize that, hey, it's I a lot of times I'll say to my patients, I'm like, it's hard to exist in a human body. It's not. It's we don't come with an instruction manual. We have to figure it out as we go. And we got exposed to a lot of stress and trauma in our childhood.

00:43:43:02 - 00:44:04:05
Dr. Donielle Wilson
We know that majority of humans were exposed to a huge amount of stress and trauma. Even now, even the pandemic we all just went through is was a major trauma. So we we have to just give ourselves some a break first. You know, I, I use this, you know, butterfly hug, right. Just be like, oh my gosh, I've been through a lot.

00:44:04:07 - 00:44:07:05
Dr. Donielle Wilson
We're actually lucky to be here this moment.

00:44:07:07 - 00:44:19:03
Dr. Jaclyn Smeaton
Doctor Ronnie. And for those of you who are only listening, my audio doctor Doni, like she's got her arms wrapped around each other, I would say, like holding onto each shoulder like a hug. So that butterfly hug. So, just because if some of you can't see what she's doing.

00:44:19:03 - 00:44:44:03
Dr. Donielle Wilson
Yeah. This is a, a classic. It's used in eMDR and somatic therapy. Even tapping side to side to just say, yeah, like, we've been through a lot. And it's not easy to exist in a human body. So if we're trying to put expectations on ourselves or to try to be perfect and sometimes even I think with longevity, we put a lot of pressure on ourselves to be like, I'm going to live forever.

00:44:44:03 - 00:45:07:12
Dr. Donielle Wilson
And a lot of times, too, what I find with patients is that they're we're so willing, especially as women, but men too, we're so willing to do whatever we're we'll push ourselves past our, our point of stress, right? Our our comfort zone. It's this is the thing is, we have to push a little bit outside of that window of tolerance in order to create change.

00:45:07:17 - 00:45:39:10
Dr. Donielle Wilson
But we're so willing to do more that we end up pushing ourselves too far, and then we end up creating more stress and so if anything, it's just being aware of how do I how do I, first of all, have compassion for myself as a human and as a practitioner and then how do I identify even little small changes that just go a little bit outside of that window of tolerance to create change, but also be aware, did I do too much and end up creating more stress?

00:45:39:10 - 00:46:04:00
Dr. Donielle Wilson
And so this is where I think my dream is like even if we can, the more we can become aware of how does my cortisol respond even with with small changes so that I can learn? How do I how much can I do? And so that's what in a in a body that I exist in, because I also have Ehlers-Danlos syndrome, which means my body is super sensitive to stress.

00:46:04:00 - 00:46:26:06
Dr. Donielle Wilson
Like probably more than most people, I'm very aware any I'm right now in a standing desk. Right? I've learned I have to be at a standing desk or I'm likely to be in pain. So I'm I've had to figure out, oh, what are these little small incremental adjustments I can make that make a big difference in my energy mood functioning.

00:46:26:10 - 00:46:37:20
Dr. Donielle Wilson
But doing it in a way where I'm not creating more stress in the process. So I say to my patients, I'm here to help you recover from stress without stressing you more.

00:46:37:22 - 00:46:57:21
Dr. Jaclyn Smeaton
That's that's the key. Well I want to talk a little bit more about testing. And this is something like you've mentioned you've done thousands of tests on the adrenal and HPA axis. I and I also want to get your perspective as a midwife because you've done women's health also your whole career. So you have this deep expertise in cortisol and in reproductive hormones.

00:46:57:23 - 00:47:09:15
Dr. Jaclyn Smeaton
And we know that there is this connection there. What does that look like or fear like for women, especially in terms of their cycle or their fertility when they're under chronic stress?

00:47:09:17 - 00:47:46:14
Dr. Donielle Wilson
Well that's one of the impacts of, of stress and cortisol is on ovary function. Right. I think about it as like I mean as human as human experience. Right. While the body's not going to want to allow for pregnancy and reproduction if the person is under stress and and and what's more important is survival. And so if you start to think about it that way and you go, oh my gosh, am I in a constant survival mode stress response, then of course, my ovaries are not going to get the signals we need them to get.

00:47:46:15 - 00:47:53:21
Dr. Donielle Wilson
The brain needs to be able to send a signal to the ovaries and say, hey, it's safe enough for you to ovulate. Now.

00:47:53:23 - 00:48:08:17
Dr. Jaclyn Smeaton
You know, there was this really interesting study. I don't know if you've seen it. I've talked about it before on the pod, and we'll put the link again in the show notes. It came out like last month that I think it's in nature, and it was a predominantly a male study, but they did some human imaging where they showed that it was post-menopausal women.

00:48:08:21 - 00:48:17:19
Dr. Jaclyn Smeaton
There was this entire visualize sympathetic nervous system in post-menopausal women that wasn't there at birth in the ovaries. Did you see this? You're nodding, so you must.

00:48:17:20 - 00:48:18:23
Dr. Donielle Wilson
I, I didn't see it. Okay.

00:48:18:23 - 00:48:52:14
Dr. Jaclyn Smeaton
So it's really interesting because what it showed was essentially, throughout the lifespan, women developed intense innervation with sympathetic nerves within the ovaries. And they believe because we've always seen, you know, stress impacts ovarian signaling. This means that goes beyond just cytokines, prostaglandins and hormones. It actually is like direct nervous system innovation. And it just shows how much the ovaries have to listen to stress signals that they would have essentially direct communication from the brain.

00:48:52:16 - 00:49:12:18
Dr. Jaclyn Smeaton
When women are under stress, that you can pick up and visualize in the ovary, it's really impactful, not just for fertility, but when you think about aging, we know that the longer your ovaries work, the more estrogen you're exposed to in cycling, and that is associated with, you know, longevity because that's something that protects your bones, protect your heart, etc., your brain.

00:49:12:20 - 00:49:24:15
Dr. Jaclyn Smeaton
It's just so fascinating to see this deeper layer of communication that just goes to demonstrate how important or how impactful, let me say stress is to the ovarian function.

00:49:24:17 - 00:49:54:01
Dr. Donielle Wilson
Absolutely. And and we see that in practice. Right. So much of the time if a woman comes in and saying, I have irregular cycles of some form, whether they are the periods coming too frequently or too far in between or, and we might even start referring to it as PCOS, right? PCOS sort of. As this almost becomes this catch all of an irregular cycle and and or they have they're having trouble conceiving or they're having perimenopausal symptoms.

00:49:54:07 - 00:50:12:16
Dr. Donielle Wilson
Maybe they're even in their 30s or early 40s and they're already having perimenopausal symptoms. I mean, like what? Why is this happening now? And she's not she's not any she's not even over 45. And we start we have to start thinking, I think we have to start saying, what is her stress exposure? Is she getting enough stress recovery?

00:50:12:18 - 00:50:41:10
Dr. Donielle Wilson
What's her cortisol level? You know, like angle from there and help to recover and help her to understand that it is optimal to have your ovaries functioning for as long as possible. And so that in itself should be a motivation to say, hey, let me not only get adequate sleep at night, but also regular meals and blood sugar levels throughout the day, because those are signals when we get enough sleep and we have regular blood sugar.

00:50:41:14 - 00:51:09:11
Dr. Donielle Wilson
Those are ways that our ovaries know that it's safe. We're being fed and we're getting sleep. Now the ovaries are like, okay, we can ovulate and make as many hormones as we can. And so yes, it helps. Like I, I absolutely use the precision analytical dried urine testing to then help women to see what is their estrogen and progesterone level so that they can also connect with that and see and make that.

00:51:09:12 - 00:51:32:16
Dr. Donielle Wilson
And so they can see their cortisol, they can see their estrogen and progesterone, and they can go, oh, those are related. And oh, now what can I do about that? Starting with lifestyle changes. Like we're always right one to start with. Yes we could we can jump to chase tree berry to support ovary function. Yes, we can use prescription hormones.

00:51:32:21 - 00:51:44:20
Dr. Donielle Wilson
But I always will start with how do we help in your day to day environment to signal to your ovaries that it's safe for them to make these hormones?

00:51:44:22 - 00:52:01:12
Dr. Jaclyn Smeaton
And when you are using the tools to shift a little bit, tell me about what are the patterns that you commonly see when it comes to HPA axis and cortisol? What are the things that stand out to you around your patients who are under a lot of stress?

00:52:01:14 - 00:52:10:18
Dr. Donielle Wilson
I, I look for well, in my research I identified five stress patterns. And so I'm looking for those five stress.

00:52:10:19 - 00:52:13:11
Dr. Jaclyn Smeaton
About those five cycles.

00:52:13:13 - 00:52:41:00
Dr. Donielle Wilson
The first one I call the stress magnet, which is someone who has high cortisol and high adrenaline. So when I'm looking at a HPA axis or cortisol result, I'm looking for, is there any time in the day that their cortisol is too high? And it may be that they have high cortisol from morning to night? That does happen sometimes, but a lot of times it may be that it's either too high in the morning, or maybe their awakening response is going too high, or maybe it's too high at night.

00:52:41:02 - 00:53:05:22
Dr. Donielle Wilson
Any of those I would categorize as they're having some times where their cortisol is too high, and because that's going to then tell me to prescribe or recommend treatments to help bring it back in, right. It reset that in inhibitory feedback loop to so that the but the brain knows hey we don't need that much cortisol actually we can get we can turn that down a notch.

00:53:06:00 - 00:53:16:10
Dr. Donielle Wilson
And we can use things like phosphor digital serine and ashwagandha and, and all of those good. Herbs for but non-belief is another one of my favorite magnolia roots.

00:53:16:12 - 00:53:20:01
Dr. Jaclyn Smeaton
Yeah. I was going to throw out. There is another one from Magnolia that's beautiful. Yeah.

00:53:20:03 - 00:53:41:07
Dr. Donielle Wilson
There's we know from research that they're really good at bringing cortisol down that's too high. We're probably not going to give those to someone who has cortisol. That's too low. I mean, I wouldn't write it, but that's a that's one of the most common mistakes I see. Jaclyn, when, when patients come to me after seeing other providers and they say, oh yeah, I had my cortisol tested.

00:53:41:07 - 00:54:06:20
Dr. Donielle Wilson
And then I'm like, okay, great. What was it? And what did they recommend for you? And I can't tell you how often I see that the recommendation was directly opposite to what the results were. Right. So this person might have had low cortisol, and they're being recommended to take supplements that are used to lower cortisol. This to high.

00:54:07:02 - 00:54:27:03
Dr. Donielle Wilson
And I'm like, what's the point that you plainly missed a little point. So I, I really encourage practitioners to not only test cortisol, but then know that not everybody gets the same treatment. The whole point is to test it so that you can give them the correct treatment. So the first the first type I'm looking for is high cortisol.

00:54:27:03 - 00:54:55:07
Dr. Donielle Wilson
And I'm looking at adrenaline. So I see high cortisol high adrenaline together. The opposite of that would be what I call the black and blue which is low cortisol low adrenaline. So the case where the cortisol is like even sometimes low in the optimal zone, or definitely if it's below the optimal zone, then I'm like, okay, this person's adrenal glands are really needing some help to recover in order to make enough cortisol.

00:54:55:09 - 00:55:19:20
Dr. Donielle Wilson
And if they also have low adrenaline, that's in that category. So I can my treatment is going to be based on having both low cortisol low adrenaline. There's there's two in between two types. One is that has high cortisol with low adrenaline and the other is the opposite where they have low low cortisol with high adrenaline. And those also have then different different treatment protocols.

00:55:19:22 - 00:55:26:20
Dr. Donielle Wilson
And the fifth is when they have high cortisol adrenaline at night specifically I call that the night owl.

00:55:27:00 - 00:55:28:17
Dr. Jaclyn Smeaton
Yeah. Night owl okay.

00:55:28:19 - 00:55:52:02
Dr. Donielle Wilson
Because then because it's to emphasize that we need to give the treatment for high cortisol at night. Because and this is another mistake I see from practitioners is they the patient might know they have high cortisol and they might be taking, let's say some faces, it'll see urine or some ashwagandha. But they're taking it in the morning when their cortisol was high at night.

00:55:52:02 - 00:56:00:06
Dr. Donielle Wilson
And so we have we know that it's going to work much better if you time your treatment to the time when the cortisol is too high to out range.

00:56:00:07 - 00:56:21:13
Dr. Jaclyn Smeaton
Yeah. And I think there's so much to that because so many people like that struggle with insomnia. We actually think about sedatives or we don't think about cortisol lowering. I think that's one of the benefits of functional medicine. And actually, when I was in the supplement industry, like one of the top selling supplements across the entire industry is what I'm sure you use a lot of cortisol manager.

00:56:21:15 - 00:56:36:13
Dr. Jaclyn Smeaton
With integrative therapeutics, where that would be used at bedtime. And it helps. So it's a cortisol lowering. It's like magnolia, honeysuckle and other ingredients. But it's so impactful to improve sleep because so many of us get stimulation of cortisol overnight.

00:56:36:15 - 00:57:06:00
Dr. Donielle Wilson
Exactly. And so we want to that's why we want to test see if that's going on. We don't want to just give it to everybody. We want to say, hey is your cortisol high at night? Or another common one I see is their cortisol goes up but too early in the morning like at 4 a.m.. It might have been low at night, but then it's jumping up at 4 a.m. and so I'll still give them a dose of, of a supplement to lower cortisol at night with the effort to delay that cortisol rise to a little later.

00:57:06:00 - 00:57:08:17
Dr. Donielle Wilson
So they're not waking up too early.

00:57:08:19 - 00:57:25:06
Dr. Jaclyn Smeaton
Well, I mean, gosh, I feel like I could talk to you about this for hours and hours more, but it's been so insightful to cover this. I think the last question that I want to end with is one with you thinking about practitioners in mind, because I think all of us want to get better at what we do.

00:57:25:06 - 00:57:43:05
Dr. Jaclyn Smeaton
And I you've seen more patients for stress and burnout than most providers in this space. What are practitioners? Where are they making the biggest mistakes? Or I think differently, like what would you want every clinician who's listening to do differently starting now.

00:57:43:07 - 00:58:15:12
Dr. Donielle Wilson
Yeah. Thank you for asking that. And I'm and I'm here as a resource. I have I'm sure you, you mentioned my book. Well I have written five books on stress, but the most recent one is The Master Stress to Reset Your Health. And that's a great, a great resource if you're wanting to learn more about how I think about this, one thing is that I want I want practitioners to know that I, I have broken free of this sort of like, standard model that we were taught of, like the stages of adrenal fatigue.

00:58:15:12 - 00:58:41:06
Dr. Donielle Wilson
I don't think about it that way. Because what I found is that it it didn't serve me in a clinical practice. The reason why is because that's more of a physiological model of what could happen over time to humans. But we're as practitioners, we're seeing patients at this moment in time. And so we need more of a cross-sectional model of stress.

00:58:41:08 - 00:59:07:12
Dr. Donielle Wilson
And when we think about stress, the effects of stress as happening over time, we start to make assumptions. We assume that low cortisol happens when someone's older, for example, and that's not the case. Even a child could have a low cortisol. So it's so I, I really challenge the way we think about adrenal, the stages of adrenal, whatever we want to call it fatigue or exhaustion or, or stress on adrenals.

00:59:07:17 - 00:59:28:04
Dr. Donielle Wilson
And I look at it as, I want to know how stress is impacting the patient in front of me at this moment in time. And that's where the testing helps. Right. And so because sometimes people will say, well, if patients will say to me, if I test my cortisol today, is that going to help me with tomorrow or the next day?

00:59:28:09 - 00:59:55:07
Dr. Donielle Wilson
And so I say to them, yes, because when we understand the cross-sectional view of our stress response, then we want to know how is stress impacting your stress response system now? And that's a set point. That's your stress set point at this moment in time. And what I see in my research is for most people, that's it's almost like your fingerprint that becomes like, this is how your body responds to stress.

00:59:55:07 - 01:00:20:07
Dr. Donielle Wilson
And so when you can do this testing, you can now start to understand how your body responds to stress. And you start to understand what you can do to help your body recover from stress. And so when you start to think about this more as providers, you know, think about and test yourself. If you're listening to this and you haven't done you tested your cortisol levels, I really encourage you to do your own cortisol test right away.

01:00:20:07 - 01:00:52:06
Dr. Donielle Wilson
You need to know because again, as providers, we are doing really important work to help other humans to heal and to prevent health issues. And that's such important work that we need you to take care of yourselves better. And the way to take better care of yourself is to know your cortisol. Know that it's the impact of stress on your human experience at this point in time, and that there's things you can do to help yourself recover from stress.

01:00:52:08 - 01:00:58:13
Dr. Donielle Wilson
And in so doing, you're going to feel better, but you're also then be able to help more patients.

01:00:58:15 - 01:01:12:10
Dr. Jaclyn Smeaton
What a beautiful way to end. But Doctor Danny, thank you so much. On top of your book, which I will link to in the show notes, master your stress, Reset Your Health, your newest book. What are the other ways people can learn more about you? Like website, social media, etc.?

01:01:12:12 - 01:01:35:08
Dr. Donielle Wilson
My website is Doctor danny.com. Just you can go to DRDO and I or you can spell it out doctor audio and Icom. And my podcast is called How Humans Heal and on How Humans Heal, which has over 300 episodes. I interview other practitioners and other guests on various topics related to exactly what I'm talking about today. Right?

01:01:35:08 - 01:01:55:12
Dr. Donielle Wilson
How do we think about the human experience and what is information we currently have that can help us to, to connect with our purpose and to resolve health issues as best as we can so that we can live with a most optimal experience.

01:01:55:14 - 01:02:14:20
Dr. Jaclyn Smeaton
Wonderful. Well, thank you so much for joining us. We've it's been great to see you. And just to hear how you're doing and certainly the insights you're sharing from your clinical experience. We're just so grateful for for those of you who are listening today and liked what you heard and you want to hear more from guests just like Doctor Danny, I encourage you to follow us.

01:02:14:22 - 01:02:24:18
Dr. Jaclyn Smeaton
You can subscribe to our podcast, follow us on all the socials at DUTCH Test and make sure you tune in next week. Every Tuesday we release a new episode and I'd love to see you there.

01:02:24:20 - 01:02:37:14
DUTCH Podcast
Thanks for joining us on the DUTCH Podcast. Join us every Tuesday for new conversations with leading functional health experts. If you like what you've heard, be sure to like, follow, and subscribe wherever you get your podcasts.