Dr. Dalal Akoury, MD
In this episode
In this episode, we spoke with Dr. Dalal Akoury, MD, an anti-aging medicine doctor with 40 years of clinical experience combining modern, traditional, and alternative medical methods to optimize longevity, health, and well-being. Dr. Akoury shared some surprising facts about how daily stress can affect our genes and sex hormones and emphasized the importance of a holistic, personalized approach that considers the unique way your body responds to stress.
Also in this episode:
- Dr. Patti Shelton, MD, LongevIQ medical communications officer
- Amir Ginsberg, LongevIQ founder.
Medical disclaimer: This podcast is for informational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease or to provide or replace medical advice. Please use this information to educate yourself as much as possible and share this information with a qualified health practitioner that you trust.
Stress is a conversation between our genes and our environment. 25% of our genes are affected by the stress hormone cortisol. Acute stress influences genes linked to health and longevity; chronic stress – genes linked to disease.
- (00:00) What is stress really?
- (01:52) What is our purpose?
- (03:00) How stress impacts hormones and gene expression
- (06:30) Stress impact on dopamine and tyrosine
- (09:30) Foods high in tyrosine
- (11:44) Stress and genes
- (14:48) Cortisol steal and cholesterol
- (16:27) Cholesterol is not the bad guy
- (22:42) Genetic testing and stress
- (24:13) Plant sterols and cholesterol
- (25:31) Stress, genes, and evolutionary adaptation
- (28:06) Allostasis – the body’s reserve to handle stress
- (31:18) Modern life’s hidden stressors
- (33:39) Stress and HRT
- (35:04) Stress and the immune system
- (37:15) Tips to optimize stress response
- (43:03) Testing stress levels and their effect on pace of aging
This podcast episode was edited to improve readability.
What is stress really?
Dr. Akoury (00:00): Stress, most people think, is something, the elephant in the room, but really stress is your response to something. So most people think stress is something like I have an accident or I lost money, or people think that’s stress, but really it’s not. That is an environmental kind of trigger, and the stress response is your reaction or action to that thing. So if you become reactive, you become more on the stress side. If you’ve been exposed to it before and developed a system to improve your response to stress, then you act instead of reacting.
So most people think stress is something, but stress is really nothing except your reaction. So I could be exposed to the same environmental thing, it’s not stressing me out, but it may be stressing you out. Okay. So it’s an environmental change that causes us to react. And that’s the stress response. Does that make sense?
Why do we have the stress response anyway? Well, the stress response is because we are here equipped for one thing, and one thing or maybe one or two things and two things we do one or two things only, and one is to survive. It’s really survivorship. So that stress is because you wanna survive. I know you like what I say, Amir. I really do. <Laugh> He really said, what is that woman talking about?
Amir: No, you got me. You got me.
What is our purpose?
Dr. Akoury (01:52): So, when you talk about the key to stress is survivorship. We’re supposed to come here and survive.
The other thing that is important for us is to really procreate. We are here to perpetuate life. So those are the two things really that are governing everything – we should survive, and we should perpetuate life. Why is it that important? When you strive, and you grow to that critical time where you are able to be productive, and it’s sad, and I don’t want anybody to get upset with me, but once you are productive, you really are not needed anymore. You finish your job on the planet, which is to make more children. Then your hormones decline, and everything declines.
How stress impacts hormones and gene expression
Dr. Akoury (03:00): Now we are surviving longer. So we have been able to use optimization of hormones. We can call it hormone replacement, but it’s better to optimize hormones to make us survive and thrive beyond that peak period when we are productive. So if you think about survivorship, you understand that we are equipped for survivorship.
So what are the things we need to survive? You need a set of genes that respond to your needs for survivorship. So if you are in a situation where you are meeting a lion, you turn on special genes that then transcribe into a certain protein that is trying to plug into a certain metabolic pathway that becomes functional. And the function of that is to help you survive, right?
So enter stress. You are gonna turn on the genes that are helping you to survive. What are the genes? The genes would be the genes that work on speeding the heart rate, the genes that would help you not urinate or pee while you’re having to get away.
The blood flow is going to go to the most important organs during that time. So it really shifts a lot of things. It speeds up your metabolism. It speeds up the heart rate. It gives you bigger contractility of the heart. It makes sure that you do have relative ischemia, which is low blood in certain areas of the body in favor of the areas that are important for survivorship. So the gut is gonna have relative ischemia. The skin is gonna have relative ischemia cause you want the heart to work, and you want the brain to work. Does that make sense so far?
So the genes that govern certain hormones are gonna be turned on. So 25% of the entire gene system or genome is governed by one hormone, which is cortisol, which is crazy. Like one-fourth of all your genes are turned on or off by cortisol. So if you’re under stress, there are things that do happen. You are going to be using and creating cortisol too high or too low, but also, you’re going to create a high level of adrenaline or no adrenaline, which really needs to be part of dopamine’s composition. Okay. Now the dopamine, if under stress, now you need to remember that dopamine needs a certain amino acid. Okay.
Stress impact on dopamine and tyrosine
Dr. Shelton (06:30): I think you were just about to say dopamine. When it’s being used to make adrenaline and noradrenaline, will people then have lower dopamine in the nervous system?
Dr. Akoury: So what really happens? It’s really not dopamine. It’s the amino acid that is called tyrosine that is important to make thyroid, to make adrenaline and noradrenaline, and to make dopamine. So these three systems depend on a pool of tyrosine, okay? So under stress, guess what’s gonna happen? All the tyrosine that is gonna be needed is gonna be used to create adrenaline and noradrenaline. So relatively, you’re gonna have a deficiency of that particular amino acid to create dopamine or to create thyroid, right? So you become hypothyroid, and you become dopamine depleted, and you have more disorders.
So there is a competition for the amino acid tyrosine because you have just one pool. What we don’t understand, we have a budget for whatever it is, especially if you are eating a tyrosine-poor diet. So if you have a tyrosine-poor diet, you are already at a disadvantage. So under stress, guess who’s going to react more? A person with relative tyrosine deficiency because they’re not eating the right protein that gives them that particular acid, or a normal person.
So your reaction to stress is gonna be also based on your diet, is gonna be based on your emotion, is gonna be based on what we call toxic load, okay? Or stress load. Now, if I have a bucket and I have this much stress in the bucket, then I have that much reserve to do good if I have a bucket, but I have that much stress here. I’m getting closer to having a problem, and I’m using all the tyrosine that I can. Now, if we have a bucket and we’re overflowing, then we are depleting the system completely. So as long as your body is capable of dealing with the deficiency, you have homeostasis, okay? You’re able to continuously reach a balanced level. Does that make sense at all?
Foods high in tyrosine
Dr. Shelton (09:30): Yeah. Well and automatically leads to this question. What foods contain tyrosine, and how can people make sure they are getting enough of that?
Dr. Akoury: Well, a lot of good cheeses will have tyrosine. Now contrary to what most people think of amino acids, fish and meats would have tyrosine, and eggs would have it, but most people that are vegan or vegetarians, especially vegan, if they don’t have eggs or they’re not pescatarians, the tyrosine level may be low. So you really want to have a diet that is healthy and rich in tyrosine.
Dr. Shelton: Are there any plant sources of tyrosine? Like how could a vegan keep their tyrosine high?
Dr. Akoury: They can, but there’s not gonna be enough. I would recommend that people at least try to add eggs to their food or cheese. Fermented cheeses like blue cheese would be very rich in tyrosine. Well, it’s protein, right? So if you’re eating a carbohydrate-rich diet, you do not have enough proteins, so you’re not having enough of this amino acid.
Now, can you get amino acid supplementation? Yes. But is that what you want? I don’t. Because you really do not know how much L-tyrosine you need, too much of it can cause a really high thyroid. It can cause anxiety and stress. It can cause rapid heart rate because you have an excess of that. So you may be turning on the production of epinephrine, norepinephrine, and dopamine.
Stress and genes
Dr. Akoury (11:44): It’s just by understanding that balance is very important. So now, if we go back to stress, most people don’t understand what stress is. We’ve talked about this, a response to an environmental change. And it’s really important for survivorship to really maintain a balanced place.
Now, like the Starling law, when you stretch the heart enough, you have a great response. So a little bit of stress is called acute stress. Acute stress helps you to stimulate the production of certain genes that would really help you to be alive and healthy. And it’s just like a muscle that is improving. And it is a conversation between genes and the environment. If that stress becomes chronic and it causes that (bucket) overflow, then it really would create a massive issue.
So you are gonna turn on the cortisol either too high or, after you get fatigued, too low. So I don’t wanna be too technical because it’s gonna be confusing to people, but we have sets of genes that are a blueprint that are necessary for you to survive. So any trigger from the outside environment creates a response to either turn on those genes or transcribe them to create more of the proteins that are necessary for you to be able to survive. But understand, if you’re doing it for too long and you have relative ischemia to the gut for too long, you’re gonna have GI problems.
You’re going to have all sorts of colitis-like symptoms or leaky gut syndrome. So all that happens from the relative ischemia that is happening as a result of stress. Now, what else happens during stress? You cannot make sex hormones. Imagine if a lion is trying to attack you. Would you be able to have sex? No, it’s taken away.
So it’s turned off, right? So GI things are turned off. Kidney blood flow is turned off. Skin blood flow is turned off. Guess what’s gonna happen to the skin? Guess what’s gonna happen to the gut? Guess what happens to sex organs?
Cortisol steal and cholesterol
Dr. Akoury (14:48): So high cortisol makes you create something called cortisol steal. Cholesterol is what gives us a chance to have either sex hormones or cortisol. So cholesterol can be either sex hormone or cortisol. If you’re pushing every cholesterol to go toward the production of cortisol, what is gonna happen? Your cortisol steals everything from producing sex hormones, including testosterone, estrogens, and progesterone.
So if those are deficient, you have issues, and you suffer. What kind of suffering? So what hormones are they not important for? Longevity? They’re very important. So if you are depleting the source of estrogens and testosterone or progesterone at the expense of creating more cortisol, you can survive. You’re stealing it away. Are you going to age gracefully, or are you going to age fast? Do you have questions?
Dr. Shelton: So cholesterol, if people wanna make sure they have the right amount of cholesterol, it has got a bad rap for a while.
Dr. Akoury: Sad. Very sad.
Cholesterol is not the bad guy
Dr. Shelton (16:27): How do people make sure that they have enough cholesterol in their body that they’re able to make the cortisol they need? And also the sex hormones that they need?
Dr. Akoury: Increase the awareness that cholesterol is not a bad guy. It’s the kind of cholesterol in your body that is the bad guy. Okay. So you could have a genetic predisposition for stickier cholesterol. Okay. But really, the production of cholesterol is so important because all the brain cells are made of cholesterol. All the cell membranes are made of cholesterol. All the sex hormones are made of cholesterol. Cortisol is made of cholesterol.
So if you don’t have an adequate amount of cholesterol, you really are gonna be suffering. And if you don’t have enough and you have a cortisol steal, you’re not making sex hormones. And on top of that, if you restrict cholesterol, you’re gonna make the cortisol even worse. Cause you have no cholesterol at all to go on that pathway.
So you have that much cholesterol, the same thing as the reserve you have with tyrosine. That’s all that you got. That amount goes to cortisol production or sex hormone production. Now, if we start with this much, it will go to cortisol. Are you gonna have anything for sex hormones? If you don’t have sex hormones, do you age (faster) or don’t age?
Amir: So that actually begs the question. How do people make sure they have enough cholesterol? And this is a big rabbit hole for vegans and vegetarians, or there’s also this notion that we don’t have to eat cholesterol, dietary cholesterol in order to make cholesterol. So how does a person know how to optimize their cholesterol intake?
Dr. Akoury: Well, number one, we got to overcome all the myths that we had. Remember, at some point in our life, they said this staple of our food should be carbohydrates. And then gradually we understood no, it’s not exactly right. You really have to have more protein, more fats, and fewer carbohydrates. So we got to really be vocal.
We got to say, listen, cholesterol can be a friend. Too much or a lack of it is not okay. Like everyone who has a considerable cholesterol issue, they really don’t realize that maybe they have a testosterone issue when they’re not making enough testosterone. That pathway is not working. So you increase the cholesterol because it’s not going. You have that pool, and you’re not using that pool. What’s going to happen to that cholesterol? It’s going to accumulate. So really helping that pathway to work may be a good thing.
Dr. Akoury: Okay. So if you’re under a tremendous amount of stress, you become fatigued. So you’re not even making cortisol anymore, right? What is gonna happen to that small amount of cholesterol you have? It accumulates. So under a tremendous amount of stress, you eventually become cortisol poor. That’s what we call fatigue. When you’re cortisol poor, it means your body is stopping the genes from converting cholesterol into more cortisol.
So that cholesterol that you already have that may be natural and normal has never gone down. So it’s relatively high to what it needs to be because it’s not converting. Okay. So if you have a genetic predisposition to not converting, to begin with, you’re not able to convert it to step one to get to cortisol. If you already have a compromise there, now you are under more stress, and you’re not making cortisol. So eventually, you are gonna be depleting the cortisol at the expense of increasing cholesterol.
The job of cholesterol is to either become a sex hormone or cortisol. It’s like the building block for either sex hormone or cortisol, or both, right? At the beginning of the stress response, you make a lot of cholesterol. You make a lot of cortisol. Under the chronic phase, you make a lot of cortisol. Eventually, you stop making cortisol. So initially, you have a cortisol steal that steals away from the sex hormones, but eventually, you stop making cortisol because your adrenals are already fatigued.
Dr. Akoury: So your cholesterol accumulates. So first, do you think under less stress, would you be able to adjust more? If you help the adrenals, wouldn’t you really be able to help the cholesterol issue? The second thing is to learn that when testing, you need to know which cholesterol is up. Is it the small particle cholesterol, or is it the large particle cholesterol? So they fractionate the cholesterol to see what part is the problem. So if you have a lot of small particle cholesterol, they become sticky, and that’s where you have a problem.
Genetic testing and stress
Dr. Shelton (22:42): Yeah. And you talked about the genetic predisposition for converting cholesterol. Is there a test that someone can do to see?
Dr. Akoury: Yes, we do genetic testing, and there are a massive amount of genes that we check, and some of them have to do with hormonal formation. Some of them have to do with methylation, and all this works together, some of them have to do with dopamine production, and they all work together in conjunction. So everything is influenced by what genes were turned on because of the environmental stressors.
Amir: And I think one big key takeaway, from what you’re saying, is it seems like they all influence each other. If somebody hears that and knows they have a lot of stress for an ongoing period of time, probably the best thing to do is just to go and get tested in a functional setting when they’re looking at everything.
Dr. Akoury: Exactly doing the testing.
Amir: So rather than going to Amazon and ordering some tyrosine or even vegans say, oh, maybe I need to eat meat now because of the cholesterol and all this. Maybe it’s not even that at all. They need to test and know.
Plant sterols and cholesterol
Dr. Akoury (24:13): And then you have plant sterols – the cholesterol that can come from plants, and those are very good. Because if people have very high cholesterol, they can take supplements that have plant sterols in them. And that would help them to adjust their cholesterol levels.
Amir: You’re talking about things like saw palmetto and pumpkin seed oil, beta-sitosterol, right?
Dr. Akoury: Yes. And plant sterols come from plants and have the same sterol ring, and they would help you to adjust the level, so a lot of good omegas, especially omega-3, would also help you to get over high cholesterol. But anything that helps you convert your cholesterol into cortisol or helps you convert cholesterol into sex hormones is really an answer as well.
Stress, genes, and evolutionary adaptation
Dr. Akoury (25:31): The body is the smartest thing there is. There is one thing that I really wanna point out here that is really important. Our genes have not adapted fast enough to the change in the environment we have. It takes thousands of years for the genes to adapt and mutate, to become responsive to what is happening. So the genetic makeup we have still stems from the fact that we were flying away from lions. So when I am at my weakest point and the limbic system, which is the primitive brain, is taken over under stress, maladaptive stress, your primitive brain works.
That’s why you’re very excited. So when your primitive brain has the genes that are working on the primitive brain or the genes that are regulated by the primitive brain, you can say Dalal, I don’t like you. Okay. You still trigger the same genes that when I saw a lion, I had to turn all the same genes. So what I’m saying is our makeup or blueprint has not adjusted enough to it because recently, we had a fast-paced change in everything. Everything is changing so fast that our genome commands have not adapted. So you don’t have enough adaptation.
Amir: Yeah. It’s like the future human is here, but the body that we have is not equipped to address that properly. If there’s a gap, and this is where the evolution is, then the intelligence of life is gonna take place. But like you said, it’s not gonna happen overnight.
Dr. Akoury: It’s not catching up.
Allostasis – the body’s reserve to handle stress
Dr. Shelton (28:06): This goes in a pretty particular direction, which is how, if somebody is under stress, like how do they shift from a maladaptive stress response into a more adaptive stress response?
Dr. Akoury: Okay. So we talked about homeostasis, but there is something called allostasis. It’s how much reserve you still have. And that reserve is based on a lot of things. Some of the things are sleep. If you do not have a good circadian sleep pattern, you are already allostatically depleted. You are already at a disadvantage. If you are not eating properly, you are also at allostatic depletion. If you don’t have enough love in your life. If you don’t feel comfortable knowing that you’re not always going to be attacked. It’s not an attack. It’s just a criticism that may be very innocuous.
You know, there are a lot of problems right now because we have a global economy. So imagine you are coming from Japan, and I’m from this country here, the U.S., or I’m originally from Egypt or whatever that is. Your genetic makeup is different.
Dr. Akoury: So for the Japanese, their reaction to stress is maybe different. So what I say to a Japanese person may not be as offensive if I say it to you. Or, if I say it to you when you are very inflamed or when you have no reserves, it’s not the same. Allostasis is very important, and allostasis depends on sleep. Allostasis depends on good food. Allostasis is about comfort. And that’s really very important to really be allostatic balanced.
This is not homeostasis which is what the body does to reach a homeostatic level, which really is a state of balance. But allostasis is what your reserves are, what you have in order for you to be able to maintain that balance. So if you’re allostatically overloaded, there’s not much you can do. So you need to keep enough reserve.
Dr. Akoury: That’s what allostasis is. Once you exceed the need, like when I need more tyrosine, because now I am thyroid deficient, and I need to create more adrenaline and noradrenaline. So I create relative poverty in tyrosine.
Modern life’s hidden stressors
Dr. Akoury: (31:18) So, one other thing that is important is to understand stressors. So if we said stress is a response to environmental issues, what are those environmental issues that we can discuss?
So you have internal environmental issues, and you have external environmental issues. Most people think stress is an external environmental issue. But let me tell you, if you’re constipated, that’s a stressor, okay? People don’t even know that. If you have pain, that’s a stressor. If you are not feeling love, that’s a stressor.
Dr. Akoury: If you are having heart problems, that’s a stressor. If you have an infection, that’s a stressor. If you have toxins in your body by eating the wrong food, if you have digestion issues, those are also stressors, and we call them hidden stressors.
Why? Because people don’t even know that these are stressors. Most people, if you ask them, are you constipated? They’ll say no, but they’re pooping every other day. That’s constipation. They’re pooping every third day. And guess what? For most of us, this is not a priority, isn’t it? But if you don’t poop three times a day, at least once a day, you are already in trouble because that creates a stressor, so if your body is already allostatically stressed by the internal environment, then all it takes is a small touch, is it not? They say the straw that broke the camel’s back?
The camel is already allostatically overloaded. And then you tell them good morning, but it’s not the way they like it. Now they react in a survivorship mode. They turn on all the survivor genes that will shift the blood that will stop the GI thing. It will stop the sex areas. It will stop the blood flow to the skin. So what happens to the skin? It becomes sick. All these people have all these rashes.
Stress and HRT
Amir (33:39): I’m just going to say one key takeaway I think people that are into anti-aging must hear. All the hormone replacement therapy, when people go, and they test their testosterone, they test their growth hormone or say, okay, it’s low, I’m gonna take more.
Maybe they should consider seeing if there is stress or overly chronic stress that’s the cause of things instead of masking those low levels by taking those hormones. So it is possible that they would address the stress, and then their testosterone is gonna go up, or their growth hormones gonna go up. And these are anti-aging hormones, I don’t need to tell you. Most people who are into longevity always go into this rabbit hole of those hormones.
Dr. Akoury: But also, you go to people who don’t understand these hormones, and all they do is treat numbers. You don’t treat numbers. You treat the whole system. My concern is sometimes, with functional medicine or integrative medicine, we still have the Western mentality approach that really still is based on one size fits all, which is really not truly exact.
Stress and the immune system
Dr. Akoury (35:04): Also, there’s the immune system and the stress response. So again, stress is stress. The response is how your body responds to it. And it has to do with your mental understanding of if this is a threat or not a threat. Okay?
So if you consider me saying to you, what’s going on with you, Amir? If you consider this a threat, then your body responds to that, causing the stress response. So when under acute stress, the cytokines that are released are not pro-inflammatory cytokines.
They are a healthy immune system response. Is a little bit of stress good? Yeah. It really helps create the reserves that are ready to go for you if you have a threat. So you’re turning the gene enough to create the protein, to stay in small binding proteins that would help them to be released if needed. So that little small stress is gonna be creating the reserve for you. But the long-term stress creates pro-inflammatory chemicals called cytokines that are really creating more inflammation and more leaky gut, more destruction. So small stress helps your immune system. Chronic stress is the stress response that is really bad and creates a pro-inflammatory state.
Tips to optimize stress response
Amir (37:15): Do we wanna maybe talk about some of the tips to optimize stress? We talked about the holistic view of the diet and the sleep, etc., but let’s say somebody hears this and they realize, okay, she’s right, I’m stressed. Where do I start from? Is there something I can do like meditation or tools or some tips that people that can read can start right now because they realize, okay, I’m stressed?
Dr. Akoury: The first thing is to stop. We need to learn to stop for a minute. Ooh, stop that. When you stop, this is really the first step toward healing. Then when you stop, you’re able to listen to your body, to the environment, and you react differently. Okay.
Second, breathing is the key to really achieving inner calmness. And, so if you train yourself to breathe in, hold, and you breathe out. There is a reason it’s called inspiration and expiration. Expiration gets rid of toxins. If you don’t get rid of all the emotional toxins during the expiration moment, you really have not improved. So during every minute, you are able to get life in by inspiration and expiration, 13 times a minute. If you are taking advantage of that, You are helping the body to really achieve calmness. Okay?
Also, find ways to laugh. Laughter helps you to overcome stress.
Sleep helps you to overcome stress. You can’t sleep if you’re not creating a ritual to help you sleep. You can’t sleep if you’re not exposed to the sun during the day. You have to be able to be exposed to the bright sun during the day but keep severe darkness at night. Otherwise, melatonin cannot be produced. Melatonin is the most anti-aging drug there is. It’s more important than even growth hormone. Growth hormone is only produced when melatonin is produced.
Amir: I’m really geeking out here because it’s super inspiring. Is there any name for that breathing technique you mentioned?
Dr. Akoury: There are so many, but really, the main thing is for you to achieve it by breathing in as deep as you can. You hold and exhale. Whether you do this with meditation, listening to meditative music, or in nature. What matters is really to be able to know that breathing is everything.
Amir: It’s so beautiful, just as you said. I sometimes remind myself that if I’m breathing, that is proof that life flows through me, and I’m not separated from everything else because if life goes through me, well, obviously, everything else I witness is life too. So that kind of helps me. I know it sounds silly, but it’s so profound when you’re in that state that you kind of realize you are connected to everything. And it all started with just acknowledging and appreciating the breathing.
Dr. Akoury: So anything that helps you to achieve an alpha brain wave is the best thing. We live in a beta wave continuously. You gotta be able to slow that brainwave down, whether it’s breathing or meditating or driving. And you’re not thinking (when you are driving). Most of the driving happens subconsciously. Because you developed the system, and during that moment, you’re in an alpha wave. So anything that helps you to calm down this way. I made every one of us here, including me, feel better just by me doing that.
Amir: I felt it. Yeah.
Dr. Akoury: I think all of us felt it, including me. I’m telling you.
Testing stress levels and their effect on pace of aging
Dr. Shelton (43:03): I wonder how you would link stress and longevity. So what are the kind of biological markers that you might measure to see whether someone’s stress levels are starting to affect their pace of aging? Or how would you see what the impacts of stress have been on someone’s aging process?
Dr. Akoury: So one of them is that it’s important to know your inflammation marker. So if you have a cardiac CRP, it will help you to know your inflammation marker.
The second is to take a very good history. Remember that the hidden stressors are as strong, if not stronger, than the ones that we believe are stressors.
It is really important to check methylation because a lot of the genes that have to do with the detoxification of things that cause stress are related to methylation. Another thing is the genes that are affecting B vitamins, including the methylating vitamins because B vitamins are methylated – folic acid could be methylated, and B12 could be methylated. These are very important. B6 and B1 are very important. The deficiency of these can make you allostatically depleted.
The other thing is we do a lot of genetic testing, but you gotta have someone who specializes in these. I mean, you are dealing with almost 700 to 800 genes that we are testing for. If you don’t understand how to play with this, you really don’t know how to help people.
Your sex hormones would tell us about your stress levels. If you’re under a lot of stress, guess what’s gonna happen to your sex hormones? They’re down. Cortisol could be either up, down or normal based on where you are on the curve of adrenal fatigue. Are you at the beginning, which is gonna be normal? Are you in the accelerated phase or in your declining phase that you’re not making cortisol anymore? So checking cortisol would be very important.
Checking the metabolites adrenaline and noradrenaline would be very important. Checking the amount of tyrosine in the body would be very important. Checking the dopamine level through metabolites from the urine would be very important, but you have to have someone who understands how to do these things.
So you can do them functionally by getting a urine sample and finding metabolites. Or you can do it genetically to see if you’re predisposed to this. You can do inflammatory markers and hormonal levels to see, including adrenaline and thyroid. Most people who are under stress, guess what? Their thyroid is always down because they’re not making enough thyroid – that’s an indicator.
Low melatonin levels would also show, so we do urine metabolites or saliva. But you have to have someone who knows what to order and how to interpret the order.
Dr. Shelton: And because it’s all connected and interrelated, if you just get one test, you don’t really have a full picture, and it’s complicated to figure out what to do about it.
Amir: Yeah. And we started by saying cortisol affects 25% of our genes. So you can just imagine. I mean, once it’s out of whack, 25% of your genes potentially can be out of whack too.
Dr. Akoury: They are either over-expressed or under-expressed and depending on if they’re overexpressed, it causes something, and being under-expressed causes something else.
Amir: And I would say something really weird, but evolutionary speaking, evolution doesn’t wanna support any creature that spends its entire life running away from the lion <laugh> they would let the lion have it <laugh>, so that’s, you know, that’s the wisdom of life. If you, if we’re chronically stressed all the time, then maybe we’re not supposed to be here.
Dr. Akoury: We won’t be here because then your sex hormones are down, you age quicker, and you’re not going to procreate.
Amir: And I’m just thinking that it’s starting to become the chicken and the egg, not literally because of all these vegan talks, but <laugh> if somebody’s stressed, for example, and because their dopamine levels are down now, they’re also depressed. Then now, they’re all even more susceptible to stress, and there’s no hope, so should they start with their tyrosine? No, they should start with getting a complete checkup and see what’s the best way to start. Because everything is influenced by everything.
Dr. Akoury: And if you wanna be vegan or vegetarian, you need to be an educated vegetarian or vegan. So you have the proper B vitamins that are very important. The MSM is very important, and the TMG is very important because most people don’t even know what these are.
We need to create my book about stress because that’s very important to me, and we need to really start talking more and having webinars and stuff like that. I really want to raise awareness. We’re here on a mission. All of us. And we also have intertwined missions. So yours and mine could now be meeting for a purpose.
Amir: And the empowerment piece about stress is that just by somebody reading it and doing what you said with just stop, just breathe, relax. Maybe that’s all they need. They don’t need drugs. They don’t need anything. They just need somebody to say it’s okay.
Dr. Akoury: It’s okay. Yeah. It’s okay. I think we have to have a program called it’s okay.