I’ve had the pleasure to interview Dr. Eric Serrano three times. Here’s the second set of interviews I did with him. Enjoy!

JP: How do you detect if someone is overtraining, and is there a way to gauge if stress is the main culprit?

Dr. S: When you’re talking about overtraining, you’ve got to be careful because most people will just look at your training program and say that you’re fine. They don’t look at your sleeping habits or how you eat. Are you married with children and working full-time? You must take into consideration many factors.

To gauge stress, you can always measure cortisol in the blood and now you can even measure its conversion in the urine which gives you a better picture. Research indicates that measuring amino acids is effective as well, specifically the glutamine to glutamic acid ratio. If I measure that in the blood, I can tell right away if you’re overtraining. I discovered this ratio after reviewing a number of research papers, but it’s my little secret!

JP: What’s your opinion of the Adrenal Stress Index test offered by Diagnostechs? This is a saliva test used to measure free cortisol rhythm throughout the day, and it tests DHEA, insulin, progesterone, and a bunch of other things as well.

Dr. S: Saliva testing for cortisol is more accurate than blood, and urine is even more accurate than both of them, but it’s also more expensive. The body gets rid of cortisol by degrading it to cortisone which you can then measure in the urine. For most purposes though, saliva is sufficient and the ASI test by Diagnostechs is pretty good.

JP: By the way, would you check progesterone levels in a male, and would you ever prescribe progesterone to a male?

Dr. S: I would check progesterone levels in a male when their testosterone or DHEA levels do not return to normal after using anabolic steroids, they’re depressed, or they experience joint problems. Progesterone is actually considered the mother hormone.

JP: Hang on a second, I thought pregnenlone was the mother of all hormones?

Dr. S: Well, what comes after pregnenlone? Progesterone, of course! I’d rather prescribe progesterone than pregnenlone to bypass an unnecessary step. To use a loose analogy, why build a house from the basement when you can start on the main floor? I’ve tried this with a few males experiencing low testosterone and it’s worked quite well. Just 100 mg and they feel great – no more depression, no more headaches, etc. – so I do think it has merit in certain cases.

Now it can get quite complicated because progesterone can increase androgen levels (anabolic hormones) or it can increase cortisol (a catabolic hormone). I can manipulate those pathways somewhat by giving the patient just a bit of cortisone to encourage progesterone toward the androgenic route.

JP: Hold up there, doc. If you give cortisone, aren’t you adding fuel to the fire?

Dr. S: Oh, good question! Think about it this way: if you have a patient who is under an extreme amount of stress and they’re already producing quite a bit of cortisol, by giving them just enough exogenous cortisone, it can help lower their endogenous cortisol production significantly through feedback inhibition. It’s a way of tricking the body!

JP: Ahhh, much like the trick you use with patients that experience acid reflux. You give them a bit of hydrochloric acid and it often helps.

Dr. S: That’s right!

Tomorrow in Part 2, we’ll look at issues related to DHEA, testosterone replacement, and other anti-aging therapies, and Dr. Serrano reveals a way to increase your chances of conceiving a male.