Naturopathic Physician Dr. Carrie Jones, on The Types of Laboratory Tests You Should Be Getting

Welcome to another episode
of the WellBe Podcast. I’m very excited about my guest today. Her name is Dr. Carrie Jones
and she’s a naturopathic physician, a.k.a. an MD,
with a master’s in public health. She has over 12 years in the field
of functional and integrative medicine and is an adjunct faculty member
for the National University of Natural Medicine. She specializes in women’s health
and hormones and has taught courses in both gynecology
and advanced endocrinology. She’s been the medical director
for two large integrative clinics in Portland, Oregon
and is currently the medical director
for Precision Analytical, which makes a hormone test
called the DUTCH Test. Carrie, welcome.
– Thanks. Thanks so much for having me. I’m excited.
– I’m so excited too. So you are actually the first naturopath
that I’ve ever had on my show. Which is shocking to me… I love naturopaths. So can you explain what the difference
between an MD and an ND is as far as training
and in practice? Yeah, absolutely and I was en-route
to become an MD, M as in medicine and then switched tracks to become an ND,
a naturopathic doctor. So an ND goes to medical school. We go for four years
and I did a two-year residency but a naturopathic doctor definitely
has the bigger view of like the healing power of nature,
a more vitalistic approach, really getting to the root cause.
We have something that we work on. It’s called the therapeutic order. So it’s kind of going from
the least invasive to the most invasive in that order and I would like to think
that sort of all doctors across the world want to follow this
but as we find a lot of conventionally trained MD’s, you know,
if you have heartburn, you get a pill, right? If you have pain, you get a pill. If you, you know, have heavy periods,
you get a pill, whereas a naturopathic doctor works quite a bit differently.
We work to find like why do you have heartburn? What is triggering that?
What’s going on with your intestines? What’s going on with your stomach?
Why are you in pain? Why do you have an inflammation? What’s going on with your joints
or what’s going on with your muscles? And why do you have heavy periods?
Is that a hormone imbalance? Is it iron deficiency?
Is it low thyroid, what have you? And so we kind of reverse engineer
to figure out more can we do it from a natural approach?
Can we do it from diet lifestyle? Can we integrate supplements
and herbs and if we can’t, then we can move on
to more advanced pharmaceuticals, referring for surgery, that sort of thing. So it’s a really nice option
to be a naturopathic doctor because we have this huge scope
that we can work in and a lot of tools
that we can use for you as a patient. That’s awesome. So what’s that look like
as far as your training? I know that conventional
medical school in America is I think it’s four years and then
it’s a certain amount of residency and usually, in hospitals.
So what’s the equivalent for naturopath? It’s a little bit different.
So we do go to four years of medical school. So it’s four years at a naturopathic
medical school. So you have to have an undergrad
and you have to meet prerequisites, of course, pre-medicine requisites. Four years of medical school
and then much like an MD, we have the option for doing a residency. So not all MDs do residencies
and not all NDs do residencies as well. And so, we go through all of the ‘ology’
classes and we go through even right from gross cadaver lab.
We learn minor surgery. We do gerontology, oncology,
gastroenterology, gynecology and we do rotations not through hospitals
but through clinics instead. Naturopathic doctors are not hospitalists
but more of clinicians and so that’s where we do our rotations through. Okay great. Thanks for explaining that. I feel like it’s something I know about
but not everybody really has interacted with an ND before,
so they’re curious like what that means. Can you talk about your journey? You mentioned that you were on
the path to being an MD that made you decide
to become a naturopathic doctor. Was it any sort of
personal health experience or interests or some moment that lead you down that path?
– It’s definitely a moment. I’ve known it forever since I was a little girl
that I wanted to be a women’s health doctor and I was on that track. I went to college, I was pre-medicine
and I worked in two different hospitals. In one hospital, I worked in
the pediatric wing, which is very sterile. It was just very not humanistic. And the other hospital
that I worked in in town, I worked in their outreach program, where we did a lot of
diabetes education, weight education, blood pressure checks,
blood pressure education. It’s very education based and I loved it. The pediatric wing,
I thought if this is medicine, if this is what I’m going to do,
I’m just going to prescribe and it’s going to be very scrubbed down.
It’s going to be very impersonal. It’s going to be very fast. That’s not the kind of medicine
I wanted to practice. I went to college undergrad in Ohio,
so we didn’t have naturopathic medicine. We didn’t have functional medicine even then. Even massage was kind of considered, you know,
not weird, it just wasn’t common. Acupuncture wasn’t common. And so I moved out to the State of Oregon
and that’s where I found naturopathic medicine and I realize this is the kind of medicine
I want to be and this is the medicine where I can spend time with my patients and I can really work with them
on their lifestyle and dietary choices and learn about nutrients and minerals and herbs before I jump
into prescribing medications. Now thankfully in the state of Oregon
and in other states as well, I can prescribe, so if I have somebody who needs a medication
or if they need thyroid medication or if they need something, an antibiotic,
I can prescribe it but I try to work through that therapeutic order first to figure out
what’s going on and what can we do for this. But yeah, I just got really disillusioned
and I’m really happy that I found naturopathic medicine.
It’s the medicine for me. Obviously, I’m a bit biased
but when you’re describing the naturopathic order,
the therapeutic order, I’m sort of like, “Wouldn’t you think
this is just medicines order for everybody?” It just blows my mind. There are so many things
that we could talk about today and I want to talk about all of them,
knowing a bit about your specialties in hormones and thyroid. I actually have thyroid issue at the moment
that I take Nature Throid for and adrenals and I want to ask you about all of that
but I also know that you have expertise in testing and all things testing. And so I wanted to focus on
that specifically today because a lot of functional medicine doctors
and practitioners right now, I think claim to have cutting-edge testing
and biomarker this and biohack that and they sort of allude to the fact that
conventional medical doctors really aren’t offering
or have any of this kind of testing. And it seems to be covered under
this real shroud of mystery as to how all this amazing testing is being done
and things are being found and so, people ask me all the time like,
“I feel like I have to see a functional doctor but I can’t afford it.
Can you tell me what tests I really need? Maybe, I can just ask
my conventional doctor for them?” What testing is being done when they just run
routine blood work or whatever. Or they said my numbers were fine
but you and I know, Carrie that ranges really matter and that
different labs have different ranges and that people need more
information than just like, “Your numbers look fine,”
especially if they’re trying to sort out a chronic health issue and haven’t been able to
get to the bottom of it. So basically, my question for you is
what is the difference between routine bloodwork that an average conventional doctor
would order in an annual physical and what a functional medicine doctor
or naturopath are currently ordering now? Yeah. That’s actually a really good question
because I think when I talk about this with patients,
what I let them know is when you hear, “I’ll run a full panel on you,” right? You go in your doctor, “I’m tired,”
or, “I’m having hair loss,” you just go in and ask,
“Can I have a full panel?” “Yes, sure.” So what they tend to run is something called
the CBC, which is a complete blood count. It looks at your red and white blood cells
and that’s great but for the average person, it doesn’t give us a lot of information unless
maybe you’re outright anemic or maybe you have an outright infection. And then they run something called
the CMP — comprehensive metabolic panel. So that’s your kidney markers,
some of your liver markers. Usually, there’s glucose in there
and some of your potassium, calcium, those kinds of things.
Again, it’s a quick screen. It may not give you a whole lot of
information and sometimes they stop there. They’re like, “Yeah, everything’s fine.” But they neglect to look at some of
the other important markers like thyroid, like you were saying, you’re handling
a thyroid issue right now. So sometimes, they’ll run
the one screening thyroid marker called the TSH or thyroid-stimulating hormone. And then my second sort of irritation
besides routine blood work, which doesn’t cover very much,
is the ranges, just like you said. So you may get a TSH and the range is
up to four and sometimes, five but functionally, we might want it down
around 2.0 or 2.5. But if you’re at 4.9 and 5.0 is the cut off, you
may get told you’re fine and you’re not fine. You’re like almost there.
You’re like, almost in the abnormal. Why wait to get to the abnormal?
It’s the same for other iron markers. A lot of functional practitioners will run,
like let’s say a ferritin, which is a marker for iron storage
but it’s also an inflammation marker and the range is ginormous.
It’s like 10 to 200 but if you’re at 11, you’re in range
and if you’re at 199, you’re in range. And they’re like,
“Oh, you’re fine. You’re in range.” No. It’s a 190-point spread. We can optimize this,
to optimize you and why wait. Why wait until you fall off the cliff
to do something about it. And so sometimes, just these general markers
that are covered by insurance run in a normal lab like the hospital
or Quest or LabCorp, your general doctor can do them. They’re just going to read them
a whole lot differently. They’re going to look to the literal range
as opposed to maybe optimizing it for you and what you’re looking for. A follow up question to that. More specifically,
what are the most important tests that every person
and then separately, every woman because I think there are different tests
relating to female hormones that are important to test for, should people be having done every year or if it’s a different frequency,
whatever that is. Well honestly, the number one test
that I think people sort of forget about are your lipid markers,
your cholesterol markers but more so than just looking to see
what your total cholesterol is. There are more advanced testing
that even at common labs and hospitals run now that where they look at
what’s called particle size and for some inflammatory markers. Cardiovascular disease for men and women,
it’s the number one killer. You know, we might think something
like it’s cancer, it’s breast cancer, it’s prostate cancer. It’s not but it’s actually
a cardiovascular disease. And just looking at your total cholesterol
is not as helpful as you think. We want to actually see what’s made up of
that cholesterol, how big they are, how small they are, how inflammatory it is,
how sticky your blood is. Some of these other extra cardiovascular things
that you can test every year and then you can track
because it’s the number one killer, so you may be fine in your 30s,
getting iffy in your 40s and by the time you maybe get
into your 50s and 60s, you could have seen the pattern
through the years and been like, “Oh, I need to do something about this.” Same goes for diabetes. You know so much of the world
unfortunately are obese and overweight, which brings an increased risk
for diabetes and pre-diabetes. So I’m a big stickler with my patients,
especially as weight loss is the number one complaint of a lot of my patients,
that I’m looking at their glucose fasting. I’m looking at their insulin fasting. I’m looking at something called
the hemoglobin A1C fasting. Again, I’m trying to get an idea of
how much risk you’re at and then track the pattern through the years. If I see their insulin starting to
get up in numbers and their glucose starting to get up in numbers,
then I can swoop in and intervene and a lot of times,
the early intervention are easy. You know, it’s dietary changes.
It’s lifestyle changes. It’s getting better sleep, believe it or not,
it has a huge impact on blood sugar. Reducing stress has a huge impact
on blood sugar. But if you catch it too late,
if all of a sudden you go in and you’re diabetic,
you went from zero to 10, you know? Like if you fell off the cliff already. And so those are some really big sort of areas
that I feel are really important for people to get tested. On top of that, though,
I’m a big stickler for vitamin D. I find that vitamin D insufficiency
is really big and the range is kind of wide and so, I know a lot of conventional doctors
just follow the range. You know, as long as you’re in range,
you’re okay. But if you’re down at the low end of the range,
you might be an increased risk for, maybe cancer or autoimmune or mood issues
or bone issues and so we have to be careful of that lower vitamin D level. Thyroid, I’m a big fan of testing thyroid
because so much gets in the way of our thyroid and more so than just looking at TSH. TSH is that marker between the brain
and the thyroid but it doesn’t give us the actual hormone that’s out in our system
floating around your T4 and your T3 and then nowadays, autoimmune is so prevalent. There are two forms of autoimmune with thyroid. One is called Hashimoto’s,
which I would imagine a lot of people have heard of or very familiar with and then the other one is called Graves’ disease
and we’re seeing the rise in both. It’s just incredible and if we can catch it
and intervene early in somebody, then that’s so much better
than 10 years from now, where you feel terrible
and you’ve been falling apart for 10 years and everyone looks at just your red and white blood cells and calls you good.
They’re like, “Oh, you’re fine.” I don’t care about red and white blood cells.
I want to know my thyroid is. And so, some of these tests,
it’s taking maybe the basics of what your doctor might order
and just expanding it, so be more comprehensive, be more well-rounded
and then tracking it through the years. And I think people forget that
health is their responsibility, so I’m always telling people,
“Keep your lab results.” If you’re organized,
create an Excel spreadsheet, write it down, keep it in a file folder,
so you can actually go back and see,
“Oh, my gosh. My blood sugars gone from 85 and now it’s 90
and five years from now, I’m 101.” Like, “Oh, that’s really bad. That’s pre-diabetic.” I used to be 85 we need to do something,
versus just becoming diabetic one day and you’re completely blind-sided and scared. But if you track and pay attention
and do it regularly, then it’s so much easier. Yeah. I have mild Hashimoto’s. It’s pretty mild
because it’s so confusing to me as it goes back and forth
from hypothyroidism to Hashimoto’s. I have, at the last blood test, it’s like 35. You know, the number of antibodies was just 35
and I know people that have them in the hundreds and thousands. So there’s some debate,
I think amongst different… kinds of practitioners of that
through and through Hashimoto’s but… Anyway, I’m charting a course as to reverse it
but on that topic of thyroid and other hormonal imbalances
and adrenal issues, are there additional tests
that you think are important? You know, you mention the full thyroid panel
but things that because you specialize in hormones, are there different kinds of tests
for understanding hormonal imbalance that a conventional doctor wouldn’t do? Yeah, absolutely. A lot of conventional doctors
will maybe run an estrogen, which is the main one is estradiol or E2
and maybe they’ll run a progesterone. But the thing about hormone testing
is that a woman needs to be aware of her cycle because your hormones go up and down,
sort of like in symphony throughout your cycle and you need to know what day you’re testing,
so that we can apply the ranges accordingly. So when I’m looking at estrogen or progesterone,
I’m looking about five to seven days after she ovulates
and a woman who has a 28-day cycle, it’s generally like Day 19 or 20 or 21 because what will happen is women will say,
“I got my progesterone run. It’s near zero. My doctor’s freaking out.
What do I do?” And I’ll say, “Well, when in your cycle
did you have it run?” And she’s like, “I don’t know. I had it run on
Monday at noon when I had my appointment.” That’s not helpful because progesterone
are supposed to be really low in the first half-year cycle
and then it gets really high in the second half-year cycle, so… timing counts for the cycling woman. For the menopausal woman,
it doesn’t matter because she’s not cycling, so she can test whenever. But the other thing that I like to check
when it gets into that functional kind of personal biohacker type testing
is I then like to look at pathways. I like to look at we call the metabolites. So you make an estrogen as a woman,
where does it go? So I want to know or am I or you effectively
detoxing it out of your body? Do you go through
what’s called Phase 1 Detox okay? Do you go through Phase 2 Detox?
Do you go through Phase 3 Detox? Because if you don’t, that’s when
you get those increased estrogen symptoms: PMS, weight gain, maybe endometriosis is worse, fibroids, heavy periods, mood swings,
maybe increased cancer risk like breast cancer and endometrial cancer. So I not only want to know your estrogen,
I want to know where it goes. Same for things for women like her testosterone.
We forget that testosterone and the other, another big hormone, DHEA
is super important for us women for sex drive, for lean muscle mass, for energy,
for bone health and not only do I want to know if you make it because we want all those things
but I want to know where it goes because one of the pathway increases our acne
or cystic acne, especially on our jaw line. It increases the hair growth in places
that we really don’t want as women and it increases like our hair loss
but in the male pattern baldness, so we shall lose it, sort of at the temples or receding type hairline
you’ll see women will get. And so she may say,
“I think I need testosterone but if I do it, it makes me angry.
It gives me acne. It makes my hair grow,” and by knowing
these pathways, I can help intervene and we can do something about it,
either from diet and lifestyle or even with supplements to help shift it. So I like this extra testing
when it comes for women. I want it be really pretty comprehensive
because if you’re a woman going to the doctor complaining of hormonal stuff,
you don’t just need the basics. You usually got some serious stuff going on,
enough so that you’re at the doctor and I want to find out…
I want to be very personalized, like here’s where things
are going wrong, right here. Let’s address it.
– Right. I love that. So two things I hear constantly from people
asking for more information from me about is testing for inflammation
and testing for gut health. Basically, how can they tell
if they have not really many symptoms but might have some little gut thing going on and/or you know,
live a pretty standard American life and then think they probably
do have inflammation but don’t really know how to figure that out. Are there any good test for that
that you do regularly? There are two sort of main inflammatory markers we talk about a lot. One is called the ESR and the other
is called the CRP. Typically, we do a CRPHS for how sensitive
and specific it is. They’re non-specific in that
if they’re positive, it doesn’t mean you have inflammation in your brain
or your intestines or your joints. So whereas one person
may be very inflamed in the brain, where they’re having lots of brain fog,
lots of brain fatigue, maybe even headaches. Another person may be very inflamed
in their intestines, so they’re bloated, maybe they have constipation or diarrhea,
maybe they get heartburn but you may not see those markers increase
because they’re not super specific and they may not completely relate
to inflammation in those areas. So inflammation, unfortunately is really hard
to test for broadly. We tend to have to focus in
on where the problem is. So if somebody says, “I get joint pain.
My joints get red and swollen.” They obviously hurt to move. And then if I’m thinking more of autoimmune,
I might test them for rheumatoid arthritis. If somebody says,
“I’m having some intestinal things. I’m getting bloating. I get gas.” Maybe their gas smells and so now,
I’m thinking bacteria, maybe candida and so I’m doing stool testing. So when I’m looking for inflammation, I actually
have to look more pinpoint to the area. There’s not one broad wonderful marker
I can run that says, “Yup, you are inflamed
and here’s where it is.” That would be good if that existed.
It make everybody’s life so much easier. Yeah. There was one I was thinking of. I think you may have already
referred to it but the CRP or… Yeah, CRP is a big one. And if it’s positive, you definitely
have inflammation, for sure. But I have patients who have inflammation,
whether it’s their skin, their gut, their joints, wherever
and their CRP is not elevated. Other markers are elevated that tells me
there’s inflammation but sort of that broad general marker is not, which also goes back
to our sort of conventional MD thought process. If you go to your doctor and say,
“I just feel inflamed,” and they run a CRP and it’s normal,
I don’t want people to get blown off. I don’t want them to feel like
it’s all in their head or, “Well, my inflammatory marker is negative.
It must be wrong,” because when it’s positive, it’s positive
and it absolutely means something but when it’s negative, I’m still searching because I know that I have to go
sort of system by system to figure it out. And there are other markers that will be
thrown off by inflammation, like cortisol. Cortisol tends to go up with inflammation. Another adrenal hormone. DHEAS.
It will go down with inflammation. Estrogen will tend to go up with inflammation. So I will see patterns in people
where I can say, “You know what?
Inflammation is causing these other things to change.
Let’s figure out where the inflammation is.” I didn’t know enough about it and so
when I heard about CRP, I just sort of figured, if you did have any kind of inflammation
in your body, that would be positive but it’s fascinating to hear that people
very clearly have other things going on as represented by their symptoms and that they
can have a CRP that comes back not elevated, that’s wild to me.
And you’re totally right in that a lot of the patient stories of
health recover that we’ve told at WellBe had multiple situations of going to
conventional doctors and saying like, “Something is wrong with me, like my skin,
my gut, my mental health, things are happening
and the doctor’s taking certain tests. Maybe it was CRP or not.
I’m not sure,” and saying, “No. We don’t see anything.
You’re okay. Go home,” and they’re like,
“Are you not listening to what I’m saying? Are you not looking at me?”
You know, that sort of thing, so it’s nice to hear you say that. Okay, so I know that
from my own functional medicine doctor, that there are major differences between labs. But most patients, they have no say
in which lab actually takes their blood, right? They just go to the doctor,
the doctor either refers them to a lab and that’s that or just takes it in the office
and sends it out to a lab and they have no idea
or say about all of that going on. Can you talk about the difference
in lab qualities and you already mentioned the difference in ranges
but as far as I understand, a lot of the labs set their ranges,
so depending on where you’re sending it, it can show up that you actually
are quite vitamin D deficient, for example and in other labs, they’re saying
you’re in range and everything’s fine. And are there any kind of national labs
that you think are better than others that you like to send out to. I know some of the big ones are Quest
or BioReference or LabCorp. That’s a really good question. When we test things, there are
different machines you can test them on. So the cheaper way is by
on something called an immunoassay. It’s not as sensitive and it’s not a specific
but it’s definitely a lot cheaper. So I will absolutely have patients who will… For example, they’ll order their own lab work. You know, they’ll get to the websites,
where you can order your own and they’ll see estrogen,
some estrogen options, testosterone options and they’ll choose the cheap option
because of course, I don’t blame them. They don’t want to spend… Why would you spend $100
when you can spend $25 and it looks like it’s the same hormone. But in immunoassay, it’s not as sensitive
and specific, where as something else on a different machine is called a mass spec. There’s different forms,
so there’s what’s called a liquid chromatography or gas chromatography. So you’ll see it listed as LCMS,
so liquid chromatography mass spec or GCMS, gas chromatography mass spec. Anything mass spec is much more sensitive,
much more specific and I definitely had other practitioners
who have sent me lab work where it just looked crazy.
I had recently a colleague of mine say, “This guy’s estrogen is through the roof.
They can’t figure it out,” and it turned out they had run
his estrogen marker on an immunoassay and when they re-run it on
a mass spec, it was actually in range but the immunoassay, a lot can interfere
and it was a false positive. It was a false freakout really. And so, I know it’s more expensive
but I tell people, “Look, if you can afford it,
if you can pay the money, when you’re choosing these options,
try to choose the mass spec option,” because you want that sensitivity
and specificity and then you can compare
apples to apples every time. Because if sometimes, you’re getting immunoassay
and sometimes, you’re getting mass spec, it’s not apples to apples,
so you can’t really compare and of one time, it’s high
and the next time, it’s low. It’s like, “Well, but it’s the sensitivity
and specificity difference,” and so we don’t actually know
why the first time was high and the next time was low,
depending on which route that you chose. And I know that can be really hard
because working in a lab, I didn’t know this before I worked in a lab
and now, that I work in a lab, I’m like, “Oh, this makes a huge freaking difference.
My goodness.” And so no matter what you pick,
Quest or LabCorp, both are quite good for sure. If you get an option,
try to pick the mass spec option. Try to pick the option that will give you,
especially for hormones, will give you that sensitivity that you want, that you can actually
use the data and compare it to. But when it goes to ranges, yes,
labs set their own ranges. A really classic example
is the testosterone range for men. If you look back in research,
they have been dropping men’s testosterone ranges through the years because men’s testosterone
is naturally dropping. Not naturally. Unnaturally dropping.
It has been dropping. And instead of keeping the original ranges
of these were men 20 years ago, they’re meeting…
Their lowering with the times. And so now men who have low testosterone
are actually really low compared to 20 years ago
and men who are in range may be low compared to 20 years ago
but labs will adjust to the clientele that they have coming through,
which is the same for diabetes. You know, they’ve shifted what’s
considered diagnosis of diabetes because… unfortunately, our blood sugars are rising and so, to accommodate,
they’re kind of raising like “Oh, you don’t have diabetes
until here now, like no.” Right.
– It used to be in the low hundreds. Now, it’s 126, like let’s tighten this up. Why are we allowing pre-diabetes to be a thing. Let’s tighten this up
and really help America… be aware and get healthy. Don’t keep giving excuses and making it easier
for people to be unhealthy. Let’s be real. So that’s
the other hard part with labs, is the ranges are shifting because we as humans
are unfortunately, getting more unhealthy. I’m so glad you brought up that example
because I had that experience with my… functional medicine doctor
and my whole family sees her and my husband started seeing her and he had some bloodwork done
and came to me and said, “Did you know what’s happened
to the mercury range?” He had a little bit of elevated mercury
and heard that because our seafood and our oceans have become so polluted
and increasingly so, especially with mercury poisoning
or with mercury in the oceans and then… people getting mercury poisoning,
they keep upping the range of what’s normal. Of what’s acceptable.
– Yeah, like 20 years ago, same thing. The amount of mercury in people’s blood
would have been very alarming and now, so many hundreds of thousands or millions of
people are walking around with mercury poisoning undiagnosed until like you said before,
they fall off a cliff with something and the whole time, it could have been avoided
had there been an earlier intervention of just like, “Hey, cut it out with
the fish for a while,” or you know, “Have some cilantro,” or whatever.
You got to detox. Yeah, men are a great example
when I do the testosterone range but I’ll say, just because you’re in that range,
it doesn’t mean you’re in the optimal range. You know, just because you’re in your age range,
just because you’re in the range of a 50-year old man, it doesn’t mean
it’s the right range for you and let’s look at your symptoms
and everything else because I know these ranges
are not bogus but kind of bogus. You know, they’re kind of made up. You know, I think about it sort of like
being in school and technically, you can pass the class
and not fail it with an A to D, right? Right, yeah. It’s a great example.
– … Is not optimal, like you did not get much out of that class. Like there’s an issue, you may want
to retake it or figure out what’s going on. Like if you’re getting Cs in
all of your classes, you’re headed for, likely an issue somewhere down the road, unless, of course, you’re like some amazing
entrepreneur that gets all Cs and then… And they can pull it together.
– Right. Somehow, they pull it together, which I think is a great analogy
for health as well that you can have these… sub-optimal numbers
that are technically in range and pull it together before it ever
becomes a disease, like you said, with just a few weeks of diet change
or different lifestyle practices or certain supplements
for nutritional deficiencies and all of that. So the body is so resilient
if you get it in time but reversing those diseases, as you know once you have a diagnosis,
it’s much harder. Right, yup. I agree. Next question for you because I,
at first thought, that DUTCH Test when I looked it up was a consumer-facing,
like at-home kit, which it’s not. But because of that,
I’ve started thinking about that and wanted to ask you a couple of questions
about these direct to consumer, at-home testing kits. So I’m sure you’ve heard of ones like uBiome,
which is currently in some hot water and Viome and EverlyWell and then of course,
the DNA genetic testing kits like 23andMe, Color and there’s a few others. They sound so exciting. Every time I hear about one,
or go on their web site, I want to order all of them.
I think it’s like the coolest thing on earth. Are they accurate?
Worth it? Are there any in particular that you do
or don’t recommend as being more… valuable or worth the money
or an easier test to do with at-home testing and others that you say like, “That’s really not something
that you can do with a kit.” Right. Well so, my only issue
with at-home testing, I’m all about patients advocating for themself. The part that I have a hard time with is
now you have all this information as a patient but you’re not in medicine
and you don’t know how to read it, so you’re just on Dr. Google,
trying to piece it together or you’re in chat boards,
trying to piece together or you’re talking to
your neighbor and trying to piece together and you may actually do more harm than good
and so, that’s my only concern with them. Otherwise actually, a lot of them like
and I think you said, the test that EverlyWell offers,
a lot of EverlyWell are actual every day, standard, functional tests,
just run funneled through, one easy to order site,
which makes it really convenient versus having to try to go to multiple sites
and see what you can do. You just go to EverlyWell
and get everything there that you need. And the same goes for some of
those other like the stool testing. They can give you a lot of great information. I don’t work for Viome
but they’re in a little trouble, so maybe… I think it’s uBiome.
– Oh, uBiome. Not Viome, sorry. Sorry, Viome. It is uBiome.
– Yeah. They’re in a little bit of trouble. But I think a lot of these tests
that are to the consumer, actually a lot of them have
a ‘To Physician’ as well on the backend. They’re just making it available
to people who want it. On the frontend, for the consumer but again,
the hard part that I just find is that now I get all these questions
from people who say, “All right. I have my results.
I have my 23andMe. What do I do?
I have all this data, what do I do?” I know. Now, you have to find a naturopathic
or a functional practitioner who understands it. So yay for you.
I’m glad you ordered it and took initiative but now, you still need help reading it. That’s the only hard part. Well, but that’s exciting to me to hear
that the kits that you mentioned specifically, a stool kit like a Viome or some of
the ones that are on EverlyWell are effective, though. Maybe, the aftermath is
a little bit precarious but I wasn’t sure. If you hear about amazing stool test
and fecal transplants that infectious disease doctors do…
– Right, right. MTHFR gene testing that certain
functional doctors do and so, I wasn’t sure like, do they have totally
different tests from something like EverlyWell or is it just that EverlyWell is making it
available to patient, which is great. Yup, exactly. MTHFR is a really good example
because MTHFR is a snip and a lot of people sort of get hung up on it
and I think they had the, you know, “I had the MTHFR disease.
I’m going to get cancer,” and, “Oh, I’ve been diagnosed with MTHFR.” I’m like, “Well, first of all,
it’s not a diagnosis.” Second of all, it’s one little snip
and now, it does a lot. It’s very important but it’s one little snip
in a sea of snips that make a lot of enzymes,
that do a lot of things. And it’s like the wheels on a clock. You know, it’s like the cogs in a clock,
like everything has to move each other. MTHFR is just not the only thing. When I have people that say to me,
“I have been diagnosed with MTHFR.” I’m like, “Well, that’s one of many
and it’s important but don’t just go after that one.
It definitely is much bigger than just looking at that one snip that makes one enzyme,
so you got to be careful.” Totally and I just had that experience
with my stepmother who went to a functional medicine doctor
and she said, “Oh, I have the MTHFR gene,”
and sorry for anybody listening who doesn’t know what that is…
– MTHFR is a gene that has a lot to do with your folate
and the way that you process folate. So when you eat folate or folic acid,
like from food and greens and stuff, it all gets funneled in
and MTHFR is a big one to help you, to make and have folate,
which is the active form. Folic acid is actually not the active form. In fact, folic acid will bind to receptors
and make them inactive, so you have to be really careful. But folate is super, super, super important
for so many things, so many detoxification pathways, so many…
Like even estrogen, how we clear out our estrogen.
Folate is a part of that pathway. It’s important for… I mean the list is long but we also know that MTHFR or folate
has a lot to do with our mood, right? There’s a lot of depression, anxiety,
fatigue, things that go with it. But because it’s been so sensationalized that… I find a lot of people
hang their hat on this one… snip, genetic snip,
it’s a big picture. You have to look at the big picture
because if you have MTHFR, if you look at them, there’s other ones,
like there’s one called COMT and CBS and BHMT and MAT, so there’s all of these MTR
and so, just because you have MTHFR, maybe it’s functioning just fine.
That’s the other thing. If you get your genetics
and you find out that it’s… broken, you have a mutation, it doesn’t mean that it’s actually a problem. So the gene just tells you what you got
but we have to look at the other end too. Do you actually have a problem with folate? Do you actually have
a problem with detoxification? Do you actually have a problem with estrogen? And if you don’t,
then you don’t have to do anything about it. It’s like, your body has managed
to figure it out, find workarounds, balance. Just because we’re talking about testing, what sort of test would help people
to see those things? Whether it’s working or not,
whether they’re able to… move estrogen through and things like that? Right, so I’ll actually give you a good example
because well, selfishly I work for them. So a lot of people will run
another snip called COMT and COMT helps you detoxify your estrogen. It also helps you to detoxify your dopamine
and your norepinephrine and epinephrine,
which is your adrenaline essentially. So some people will be like, “Oh, my gosh. I have the mutation for COMT.
I have a problem with estrogen detox.” But then I run the DUTCH Test on them
and I see that they don’t. They don’t. Their estrogen is detoxifying just fine
as far as we can tell. They don’t have to do anything about it. The gene is not as maybe broken
or mutated as you thought or the body has found different workarounds. In that case, don’t do anything. Don’t spend the money on extra supplements
that you read about in a chat room. You don’t need to. Everything is fine.
But the reverse can happen. The reverse is I can see people
who have definitely really unhealthy estrogen detox pathways and then I’ll say, “Yes. Not only do you have your genetics. You know your COMT is broken/mutated but it’s also showing up
in your estrogen as well. We have to do something about it.” Right and when you say
showing up in your estrogen, it’s the estrogen levels,
you’re looking at. Yeah, so estrogen levels but really,
the pathway when estrogen goes from Phase 1 detoxification into Phase 2,
which is where estrogen gets neutralized, which is a good thing. We want that. COMT is a big, big, big,
big, big player for that. And so if I’m not seeing her
or his estrogen get neutralized in that Phase 2, then I strongly suspect that COMT, that snip,
which is an enzyme really, is the big issue. And so I’m looking actually at some of those
downstream functional patterns that I was saying,
that you won’t catch in blood work but you will catch
in more specialized testing. Got it. It’s so fascinating. So on the topic of tests
that people can ask for from conventional doctors
that aren’t going to go this deep or are not going to be able to put
the pieces together, it sounds like, under the hood of what the original number
and the test is. What do you recommend for people
that just can’t really afford anything other than a standard annual… appointment from a conventional doctor
that’s completely covered by insurance or doesn’t believe that they can or won’t and just kind of wants to take back
a bit of control about what’s being tested and trying to get more involved
but doesn’t obviously understand the lingo or know what to ask for
or what to make sure they have? What do you recommend for people like that? Just because your doctor
that you’re currently seeing, or your primary care, doesn’t believe in it,
it doesn’t mean other MDs don’t believe in it, right?
Other nurse practitioners, other physicians assistants
and they still may also take insurance. So there are a high number of
functional type or functional leaning or integrative practitioners
who take insurance and so maybe, if you’re not thrilled
with the person you’re seeing, they’re not helping you as much,
they don’t believe in it, they don’t sort of take that
root cause approach, go through your insurance panel. Start doing. You have to do some research, start asking
some friends, do some research online. The great thing with our social media is
that so many of these practitioners, their clinics are on Facebook
and their clinics are on Instagram and you can hashtag search
or you can local area search and see, is there a naturopathic doctor
in my area who takes insurance, which is entirely possible
in a lot of states? Is there a functional practitioner,
an MD, a DO, a nurse practitioner, a physician’s assistant who believes in
functional medicine and is under my insurance? And so that’s actually
a really, really good start because… you don’t have to stick with the doctor you have
for this kind of stuff. If you love your doctor when you get a cold,
when you need a Pap smear, when you’re ready for your mammogram,
when it’s just the family doctor, great. Keep them. But if you want somebody
who does functional, they’re out there. You just have to do a bit of searching
and then just see if they take your insurance because I’m finding that a lot of them do.
A lot of them don’t. A lot of them moved into
the sort of a cash-based model but there are still some out there and you may find somebody
that will work for you, which is really great. The other thing I do suggest is
to get yourself educated. So I know that Dr. Google and… some of the chat boards are not the greatest but look at the WellBe site,
look at some of these really great, sort of educational sites that are trying
to help explain what estrogen is, hormones are, thyroid balance. Start following some of these practitioners
on social media, on Facebook, on Instagram, who are giving away
so much free information. Get their books. If thyroid is your problem,
there are some great authors out there who’ve written about thyroid. Dr. Datis Kharrazian, Izabella Wentz,
Dr. Alan Christianson. They’ve got great, excellent…
You know, spend the $10 on Amazon. Get their book and get educated. PCOS, we’ve got
some great authors out there on PCOS. They’re all over social media.
They’re giving away free information. Not medical advice but at least,
helping you connect the dots to your symptoms and maybe, some of the lab work
that you had drawn. So take advantage of it and study up, you know? Be careful of the chat rooms,
be careful of those kind of things but really follow some of these experts
who are posting every day and doing Facebook Lives,
where they walkthrough this sort of stuff and case examples and their favorite supplements
and why and utilize it. Take it to your advantage. Even if money is not an issue,
take it to your advantage. Right. Why spend however much,
it could be thousands of dollars, when there’s so much free information
and I am such a believer in what you said and that sort of why I started WellBe is that…
the eye roll, that a lot of conventional doctors
gave you about, “Oh, did you read that on Google,”
or whatever. Google can be a really good source. I mean definitely, I’ve had patients
who printed off research studies for me. You know, they’re like, “I Googled this thing. I found this research paper. I’m not entirely sure what it means.
Can we talk about it?” I’m like, “Yeah, absolutely.” Or, “I Googled and I found this site
and this is what they’re explaining. They’re a doctor too. What do you think?” I’m like, “Let’s talk about it for sure.”
– Yes. I find that I have such great resources
if you just know how to tell sites that are really interested
in evidence-based… … information on alternative,
integrative, functional, holistic, whatever people want to call it…
medicine versus just sort of conspiracy minded sites that will talk about some of
this medicine stuff and also talk about politics and like all of these things together
and it’s kind of just like… we don’t believe in the system. And you know, some of their claims
and things that they think are wrong are valid or might be valid
but when you’re looping it all in together, it’s just kind of attracting people
who have issues with all systems in governments, all of it, instead of just being able to
really focus on just the medicine and just looking at
the latest in research on thyroid health or adrenal fatigue
or whatever it might be. And not being fear-based, right? Some of the sites are very fear-based
and then they scare you into thinking. It’s like,
no, this site should be more educational, so you as the consumer
can make an educated decision. It’s your decision no matter what.
– Right, it’s your body. And even if the information is
fear-inducing in the sense that some statistics around like you were talking
about testosterone going down in men and how much mercury is in our oceans, a lot of these issues with glyphosate in food
that they’re seeing or whatever, it’s not just fear for the sake of fear. It’s presenting factual reports and studies
that have come out and might end up inciting a little bit of fear
but it’s good healthy fear in the sense that you make changes
and take more action. Because glyphosate is bad
and mercury is bad. Right. I wonder when I’m putting certain… research things out,
I do this thing called the WellBe wrap up which is this monthly… Now, it’s bi-monthly actually,
kind of overview of the Top 10 or Top 5 things, research and studies,
news pieces related to health and wellness and I feel are really important
for the WellBe audience to know that they may have missed
because I read so much research and they only maybe hear the stuff
that makes at CBS or NBC News or The Guardian or whatever they’re reading
and sometimes, they’re like, “Oh, my god. All this stuff is just so depressing
and terrifying. Do I even put it out there,”
And then I’m like, “Well, I got to put some of that out there
because people should know.” If things are kind of go in the wrong direction
with our food supply or types of medicine or chemicals in our water or whatever, they are voters so they have a day too, so they should be able to
kind of think about this stuff. But I do want to ask you two more questions
about testing before we wrap up today because I know you have a lot to do
and I appreciate your time. I know that you work for DUTCH Test
and it’s a hormone test. So can you just talk a little bit about
what a hormone test is and maybe why DUTCH Test is better than
the other ones that are on the market and what is on the market if people
are interested in getting hormone tests. Yeah, absolutely. So I’ve been
in the naturopathic field since 1999, so a really long time and about a year ago,
my mom who was a huge supporter of me, said to me, “You know what honey? I’m not even really sure what a hormone is
but you talk about it all the time and I listened to everything you say
but I’m still not really sure,” and I was like, “I have failed.
My mom doesn’t know what a hormone is.” So just for people who maybe get confused,
so a hormone is basically a chemical messenger
and our hormone system, the fancy term is our endocrine system.
It’s what we call it. So it’s our thyroid,
it’s our adrenals, it’s our ovaries. For boys, it’s our testicles and so forth
and they put out the hormones like estrogen or progesterone or testosterone or thyroid
that binds to receptors and does the things. So they’re basically chemical messengers. Now, when we,
women primarily talk about hormones, like I feel my hormones are off
or I feel hormonal today, we’re generally talking about
estrogen and progesterone for the most part and to a lesser degree,
things like testosterone, DHEA, cortisol, thyroid. Even though they were very, very important,
I just need for reference when women say, “I’m a hormonal today,” she usually means
estrogen and progesterone. And so when it comes
to testing those things, I work for the DUTCH Test. And so DUTCH is an acronym that stands for
Dried Urine Test for Comprehensive Hormones. And so we look at almost
everything but thyroid. We don’t look at thyroid
but we do look at all the estrogens. You have three of them. We look at progesterone,
we look at testosterone, we look at cortisol, we look at DHEA, melatonin because we want to understand sleep and stress and then we do some other
really cool markers as well. And it’s a urine test, meaning you urinate
on these little pieces of filter paper, kind of like a pregnancy test and you do it four times in the day,
sometimes five. You let them dry and then
mail them back to the labs. It’s a very easy to collect test.
There’s no blood draw. There’s no saliva, if you don’t want to. We do have a specialized,
sort of advanced… test that does have a combination of
saliva and urine but it’s a cotton swab. You don’t actually have to spit in a tube,
for people listening who’ve ever done a saliva test. And we also give you one of those pathways
that I mentioned earlier. We look at estrogen detoxification. We look at testosterone pathways
if you have acne and hair loss. We look at more than just cortisol. We look at cortisol production,
which is called metabolize cortisol and we look at cortisone, which is inactive. So a lot of people think they’re really tired
because they don’t make cortisol and really, they just
deactivate it all to cortisone. You don’t test, you don’t know
and the treatment is different. The low cortisol and too much cortisone,
different treatments and so, it’s important to know both. So that’s what the DUTCH Test is
but there are other kind of specialty tests on the market that are a little bit similar.
So there’s what’s called a 24-hour urine. It’s where you collect literally
all of your urine in a bucket… Well, in an orange jug is what it is,
for 24 hours and so, you get very similar markers.
It’s just a lot harder to collect. It’s more in pain…
It’s more kind of… It’s a lot of collection
to collect your urine for 24 hours. And because it’s in one jug, you also
don’t get your cortisol pattern in the day, whereas in the DUTCH Test we tell you
what your cortisol on the morning, what is it at mid-morning,
in the afternoon before and before bed. And then another test
that I get asked a lot about is saliva testing. So saliva testing is where you spit in a tube,
four sometimes five times in a day and you get your basic hormones,
estrogen, progesterone, testosterone. You do get your cortisol pattern,
which again is very nice. Am I high in the morning or low in the morning?
Or am I high at night or low at night? But unfortunately, with saliva you don’t get
any of those pathways. So you don’t get the detox pathways,
you don’t get the testosterone pathway, you don’t get melatonin,
you sort of miss out on some things but the collection is nice
if you’re afraid of blood draw. Show me who likes a blood draw. So those are kind of
your hormonal options out there and then a blood draw is your most basic. You can get an estrogen and a progesterone
and a testosterone but you don’t get your cortisol pattern. You don’t get your pathways,
your detoxification. You don’t get any of that, so the DUTCH
is nice because it’s easy to collect and you get a massive
amount of information about you. That’s amazing. So it’s something that people
can’t just order themselves, right? They can order themselves.
– Oh. They can order themselves. Yes. We much highly prefer that
somebody go through a practitioner, again because you’ll get about
six pages of data and if you’re new to hormones, you just feel like
you’re hormonal and you run the test. It can definitely be overwhelming
and we don’t want people to be overwhelmed to the point where they do no action. We prefer to refer them to somebody
who can walk them through what it means and then give them a plan of action,
so that they can feel better. Got it. That makes a lot of sense.
– Yeah. So speaking of being
referred to doctors and practitioners, you have been doing this for a long time
and I’m sure know a lot of people in the field of both naturopathic medicine
and otherwise and at WellBe, a lot of people ask us for great
recommendations of doctors and practitioners. So are there any, that you’ve seen
in your own life, that you really recommend? Anywhere in the country, it doesn’t matter. That list can be so hugely long
but I will give people… Actually, this may be… I don’t know.
This may be easier. Just a resource to research. So people can absolutely call, email
or chat with DUTCH Test. If you go to,
we can find you a practitioner in your area. We can also find your practitioner who does
online Skype or Zoom phone call type visits. If you go to,
there’s a ‘find a physician’ link there. And if you go to,
that’s the Institute for Functional Medicine, so They also have a ‘find a physician’ as well
and so, that’s three really great resources for people and they can find
someone in their area, find someone for their country,
find somebody who does online instead, if there’s nobody in their area. And so definitely, there are options out there
with our amazing, amazing functional and naturopathic practitioners
out there. So go find one. That’s super helpful. I mean… unfortunately what I see is that
a lot of people ask me for like, has somebody seen this person
and said that they help them, which at the end of the day,
it’s because humans are so hard wired for trust and connection
and they want to know that somebody that they trust or maybe,
two or three degrees away trust this person
and had a good experience and so sometimes, I totally agree
a lot of the resources that you just mentioned. I’ve used myself but I also find
that people are like, “Just tell me that it worked for you,”
and that’s…” I know. I know. Get on board, instead of just like,
“Oh, there’s 12 options of naturopaths in my area but who of people
who’s really the right one for me.” And I get that question a lot
where people will give me a city. I’ll get an email from somebody
or on social media, I’ll get a message and they’ll say,
“Who do you recommend for…” let’s say like mold.
“Who do you recommend? I suspect mold.
I think I have mold,” and so I’ll recommend someone
and they’ll go, “Oh, no but I don’t live there.
I live in this city, in Minnesota.” I’m like, “Oh, well…” I don’t know functional practitioners
in every single city across the United States or even across the world
but I do try to help direct people, especially in the bigger cities.
It’s a little bit easier. Yeah. Same thing.
I help to try to direct people in big cities but I sometimes get writing requests
and I don’t want to make… you know,
“I found these four people.
One of these will work,” because I don’t know if they’ll really that good.
– Right. It’s a challenge that I’m trying to
figure out for my audience for sure. So I decided to ask you that
and then last but not least, the other thing that the WellBe community
is very interested in is also, how all these incredible experts
who live and breathe this stuff and as you said,
have been practicing since 1999, what do they do in their own lives,
to ensure prevention and reversal of any chronic health issues when they come up. So we say,
“I get WellBe by blah-blah-blah-blah,” so if you don’t mind saying that
and letting us know what are your absolutely can’t miss
wellness routine that you do every day. I get WellBe the most by affecting
my circadian rhythm and what I mean by that is as humans,
we are very affected by the light and dark. Every cell in our body responds
to the circadian rhythm and we are massively screwing it up
because we are on our phones, we’re on our computers,
we’re watching TV late at night, we’re doing all the stimulatory stuff
and then we wake up tired. So I get WellBe by
I’m off my phone at night or I wear my blue light blocking glasses. I do a lot of wind down stuff.
Right. Exactly. I drink holy basil tea, which is called Tulsi. T-U-L-S-I. I drink Tulsi tea at night before bed. I often if I can,
I’ll do either take a bath or a shower. I have a sauna, so I’ll do sauna
and then shower before bed. And then what that does is
it helps lower my cortisol, bring my melatonin up,
so I get good, solid, deep sleep. And in the morning, as soon as you wake up,
I tell people, “Get light exposure.” I can’t stress this enough
and I don’t mean light by your phone. I mean open your drapes or open your blinds
or get a full spectrum light box that you turn on next to your bed
because that full spectrum light immediately goes into your eyes
and it tells your brain, “Get up.” This circadian rhythm is ready to go.
It’s called the cortisol awakening response. And so I have people from all over the world
that write me and say this. They are like, “I now open my blinds
in the morning before I play on my phone or I get up and I take a five or 10-minute walk
or I go sit on my patio for five or 10 minutes and get the natural light in
and it’s made a world of difference.” So if you wind down at night,
if you dark at night, and light as soon as you
wake up in the morning, you will retrain your circadian rhythm
and it’s life-changing. It takes a couple weeks but it works
and it’s cheap, free and easy, so that’s how I get WellBe. I love that. I haven’t had that answer yet
and I couldn’t agree more. I’m a really light sensitive sleeper
and we live in New York City, so I have my shades drawn
and curtains drawn over them, so it’s quite dark at night
but then the issue with that, of course is when you wake up,
it’s still pretty dark even if it’s light out. It’s been an issue for me
because if I fall into bad patterns, then I’m in bed with my phone
and for too long and then like… it’s been kind of dark for a while
and I kind of get up. But if I right away, my husband drag me
out of bed and we open the shades and I go out for a walk first thing,
that sets such a different feeling in my body for the rest of the day. And similarly, try very hard these days
to have that last hour that I’m awake without any phone or TV with me. Obviously sometimes, it doesn’t work
and I fall into bad patterns. – Yup. Guilty. – We’re all human and luckily,
there’s always another day to try it again. So I love that that’s something
that you’re super-dedicated to because I can see from tons of research,
I’ve been reading how incredibly important it is and I am very
dedicated now wearing my blue light blockers. Yes.
– Well, Carrie, this has been so lovely. Thank you so much for your time
and all of your expertise in the area of testing and I could probably interview you six more
times on all the topics that I care about, like thyroid health and other hormonal issues. I have friends struggling with PCOS
and there’s a lot out there for free right now, as you say and a lot of
great books and experts but it’s still really hard to fix,
so I think it’s super important that there are doctors really out there
talking about these issues and that they are fixable and it just takes
a little bit of digging and you get that from testing and also,
that you can use physicians who are really willing to do the work
to roll up their sleeves, whether they’re naturopaths or osteopaths
or even open-minded MDs to help you get there. So your work is so inspiring. I know that people can find you on Instagram. It’s Dr Carrie Jones…
– @Dr.CarrieJones. @Dr.CarrieJones and also
on your website, which is? I have two, so I do a lot there
and then at Okay, great. Awesome. Well, have a wonderful rest of your day
and thank you everybody for listening. Yeah, thank you so much.

1 comment

  1. Love your channel Adrienne. I stumbled upon it with your Kelly Brogan video & have really been enjoying your interviews! Keep it up – R

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