Low Cortisol

What to assess BEFORE testing your sex hormones with Christine MacCaroll

In this interview, Laurie and Christine MacCarroll discuss What to assess BEFORE testing your sex hormones as well as a healthy lifestyle.

The creator of the The Bitch Fix in Six: Six Steps to Happy Hormones and host of The Bitch Fix Podcast, Christine is all about one thing: helping other women get out of struggle and start living the badass lives they were designed for.
After completing tanking her own health while helping her then-2-year-old daughter overcome a debilitating neurological speech condition, she learned two things first hand:

1. The way we do health around here doesn’t actually help most people

2. Humans have an incredible capacity to heal when they have what they need

Christine helped her daughter, herself, and now hundreds of other women to heal by demanding more and doing it differently.

This is a transcription of an Instagram live conversation. You can find the full video on Laurie’s IGTV tab on Instagram and on soon on YouTube.



Hello, everyone. Today I’m bringing on Christine MacCarroll. We’re going to be talking about all things, hormones and testing.

I would like to let you introduce yourself, tell us a little bit about what you do and how you got started.


I’m a functional nutritionist specializing in women’s health and hormones. I think you and I do probably pretty similar work. 

How I got started; I think probably everyone you ask that question to probably has a long story. I’m gonna try and keep my story really short. 

Most of the people that I know in the wellness world got into it for personal health reasons or something in their family or friends, there’s usually a personal story. For me, it was my daughter. 

She was diagnosed with a neurological speech condition and it was so hard for me to get any support in the conventional world. Basically they wanted me to just take her to speech therapy, not looking at any underlying root causes, anything of what else could be going on.

I just was not gonna take that for an answer. 

I went in search of my own answers and spent a really long time trying to find some things that I thought would help her. 

The end of that story, which is wonderful, is that my daughter was completely healed using nutritional therapy. So I really thought about those profound effects in her and in that resolution. 

It was just truly like a light flipping on in her brain. And it was amazing to watch that. 

What happened to me in that process? I see a lot of my female clients that when I prioritize all of her health issues, I completely crush my own health.

So I was doing ridiculous things. I was staying up all night. I was drinking multiple pots of coffee every day, just to get through and work my full-time job and help her and do everything. 

Then my body tanked in that process. At that point I had to figure out how to rebalance my own body, hormones and everything that had gone wrong while I was taking care of her. 

I had decided to study nutrition and functional nutrition and get into that space. 

A lot of people thought I would end up working with kids, because of my daughter. 

That was actually almost a little bit too close to home for me. So I do work with kids now, but mostly I work with moms and women and I didn’t start working with kids right away.

I was like “I’m going to help the women who were like me who have done something in their lives that was important to them, but maybe in the process, they kind of crashed.”

That’s where my focus became women’s health and hormones.


Yeah. So you help women with hormones. So let’s talk about that, because a lot of women come to us with hormone issues, with symptoms related to hormone imbalance or something going on with their hormones. 

This talk today is about what to assess before you test. So a lot of women will come and they will approach me right away asking, ”What hormones do I need to test? How do I find out what’s going on?” This is very common. Let’s talk about that. How do you approach it?

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Yeah. My analogy for the sex hormones is that they are the little dogs in hormone balance. And there are some big dogs that we have to address first. When you think about everything as being interconnected. 

My visual is that everything’s like a spider web. Everything’s connected, you can’t just pull one thing. You’re not touching the whole thing. Within that web, we have things that are thicker threads, maybe they’re like ropes. When you pull on those bigger ropes, you can have a bigger impact on the rest of the system. I think by the time women start seeing issues with their hormones, with those little dogs, those little tiny threads on the web, those big dogs have been out of balance for a really long time.

But what we notice is where we’re having symptoms such as “Oh my God, my period is jacked up,” or “I think it’s my thyroid, because I’m cold all the time,” or “I can’t lose weight” or losing hair. 

Some women still ask me about adrenal fatigue or is it whatever. So they’re noticing those little dog symptoms and it’s not that those things aren’t happening. They totally are. 

But if we just jumped to that, like addressing that little dog, we’re actually not solving the root cause. Which to me, that’s what functional means. If your body isn’t functioning there’s a deeper reason. 

Actually it’s maybe not just those hormones. So not that it’s not happening or even not that it’s not important, but we have to think about the other big stuff first.


Absolutely. It’s still a matter of looking at how we got there. Maybe somethings going on with our sex hormones, maybe somethings going on with our thyroid, but how did we get there? We’ve to go backwards and assess that right there. So what does that look like?


I do think that thyroid is a big dog, but I think it is impacted by other things. I am in favor of giving women the most bang for their buck and the easiest access first. 

So I love fun, sexy tests like Dutch and things like that. But it’s harder to get, you do have to know someone, obviously that’s what we’re here for. 

Preliminary blood work can be done with just their general practitioner, their OB or their primary care. 

So I am interested in looking at the big dogs cortisol, which is of course our stress hormones, thyroid and blood sugar, which is insulin. Obviously there’s more hormones involved in blood sugar than insulin, but it’s the easiest one to look at.

I think that before we look at sex hormones, we should be looking at what markers are showing for those other three. 

I absolutely would want to see a full thyroid panel, not just TSH, because that’s not enough. I actually don’t usually go right for cortisol even on blood work. So blood, saliva or urine, I leave that for a little bit later. I think we can see bread crumbs, potassium and sodium. So if those are dysregulated, we can get an idea of what’s going on with adrenals. Honestly, we know a lot of women are stressed. There’s a lot of lifestyle things that we can address without even looking at labs. 

For blood sugar, I do what I’m going to call a full blood sugar panel that I don’t think is typically looked at. I don’t think TSH is enough. I don’t think fasting glucose is enough. 


I don’t either. Fasting glucose to me means nothing. 


That could have been, you drank an extra glass of wine the night before or you were stressed about getting your blood taken in the morning. 

The ones that I like to see is a narrow fasting glucose, hemoglobin A1C, C-peptide and glyko mark instead of insulin. 

I think there’s some other things that we can get from a regular blood test on what nutrients are impacting those particular hormones.


I tend to go straight to the continuous glucose monitors, because we have easy access to those here. I think those give a pretty good picture. I find these to be like gold for checking in on how glucose is doing and insulin as well. 

I love taking it a step back and just assessing, what does the trust fund in lifestyle look like? How is their sleep? How is their stress? How’s their health?  How was their poop? Are they moving every day? 

So sometimes people come and want the test right away and I could easily see just from the assessment, there are some foundational things that, if we can make some adjustments there, which tend to be pretty easy, we can start improving sleep. 

Maybe we can remove wine that might be having an influence on insulin and glucose. There are different things that we can do right away before we even really need to test, because we know that those things are gonna be big influencers on the tests.

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A hundred percent. Maybe you were stressed on the way to your fasting glucose test in the morning, that’ll drive it up, less than seven hours of sleep at night, that’s going to drive your glucose up too. 

All of that is so important. When I was in that process of completely trashing my health when I was helping my daughter, the biggest thing was I was not sleeping. 

I tell people to set a reverse alarm clock, like it’s time to go to bed. No matter what I have to be in bed, I have to get sufficient sleep. I needed to get a lot, like at the beginning I needed like nine hours of sleep to really recover. 


I’ve even noticed that some are needing 10 hours more than the nine even. 

You could be having the most beautiful diet that is perfect for whatever hormone situation you have, perfect for your body, but yet you’re not absorbing it. You’re not digesting it well, and you’re not absorbing those nutrients. We might have to back it up and start there. 


I totally agree. I think everything you just said, all of that lifestyle and clean diet, like that’s the foundation, we can’t even step onto the path of healing or balancing anything until that foundation is set. 

If you’re eating the standard American diet, other parts of the world will say the standard Western diet maybe, and not sleeping and not managing your stress. There’s no lab tests in the world, that’s going to tell us we’re just going to magically give you some B6 and you’re going to be fine. 


Exactly. Tests aren’t always necessary right away to start.

We’re always gonna have to start with those foundations and see how those are going so we can get the test, but that’s not really going to change. Working on the foundations, the tests can also provide a little bit of guidance.

Often doctors can’t really discuss our health as in depth as health practitioners.

How many doctors have the time to ask you “Are you drinking enough water every day?” These simple, very basic questions can be so helpful to just guide you to figure out which direction to go. 

If you don’t pay attention to your symptoms at 35 or 40 they just get worse. Suddenly, your world kind of falls apart and you can’t even lead your life normally. So maybe you quit your job or maybe you have to stop your business. Or maybe you don’t see that next opportunity because you just don’t feel like yourself. 


Or you can’t take care of your kids. I had a client who was hurt recently. Her doctor told her, “Oh, you’re 30 now.”  Because she couldn’t get out of bed. She’s super tired. Hair’s falling out. 

30 doesn’t really seem like old enough for you to not be able to get out of bed. It seems like there’s something else going on here. Then you turned 30. You should be fine. Your body should not be breaking down on you when you’re 30.


Yeah, absolutely. What’s it costing you when you’re showing up every day, not feeling your best. You’re having to drag yourself out of bed in the morning and having to pump yourself up with caffeine and sugar, just to have the energy to get through the day.

Amazing opportunities. Are you missing what you could be doing with your life? What is it costing you?

Find out more:

Connect with Christine MacCarroll on Instagram @christine.maccarroll, her website Christine MacCarroll, or listen to her podcast The Bitch Fix.

This information is for educational purposes only and is not intended to diagnose, manage, or treat disease or serious conditions. Always check with your doctor before making any changes. It’s important to consult a well-informed health practitioner for personal advice about your situation before relying on general information we’re all wonderfully unique.

Laurie Villarreal, FNLP, CHWC, FNS, LMC, CPT, RYT

Hi, I'm Laurie, a functional nutritionist and board certified health coach, athlete, dog-mom, and biohacking adventure-lover. After having struggled for years to find lasting solutions for my own debilitating hormone-related symptoms, I created my online practice to begin helping other active, driven women get the support they need. I now help  women around the world elevate their health, energy, business and life by optimizing their hormones with personalized nutrition and lifestyle tweaks. Together, we discover new tools and strategies that keep you showing up at your best so you can play even bigger in your life and work.

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