HFYH: Clearing the Confusion About Cortisol! | Dr. Carla DiGirolamo, Endocrinologist

**Dr. Vonda Wright** (0:02)
Hi, I'm Dr. Vonda Wright, and this is HOT For Your Health.
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Hi, everybody. I'm Dr. Vonda Wright. Thank you so much for joining us again on HOT For Your Health. And this interview has been a long time coming because the ladies at Feisty Menopause said, you got to get to know this doc because the two of you could really take over the world. And I think what they meant by that is we could help so many people. And when I introduce her, you'll see that our fields of study where both physicians, both surgeons are so aligned with what we're doing. So, Dr. Carla DiGirolamo, did I say that?

**Dr. Carla DiGirolamo** (1:06)
You were close. It's Digirolamo.

**Dr. Vonda Wright** (1:09)
Oh, my God. It's so much more beautiful when you say it. Digirolamo.

**Dr. Carla DiGirolamo** (1:12)
I've been saying it for a while.

**Dr. Vonda Wright** (1:14)
You have a little bit. Dr. Carla DiGirolamo is a double board certified obstetrician, gynecology with a specialty in fertility and reproductive endocrinology. So, she didn't just get those degrees.
She got them at the IVs at Brown and at Harvard. So, on top of that, she lives what she preaches in terms of her practice in athletic aging. She is not only a CrossFitter herself, but a CrossFit instructor. So, we have so much to talk about, Dr. Carla. I'm so glad to have you here today.

**Dr. Carla DiGirolamo** (1:54)
I'm so happy to be here, Vonda. Thank you so much for having me.

**Dr. Vonda Wright** (1:57)
Absolutely. You know, as women have noticed what I'm talking about on Instagram, I have this theme of questions that many people have. And I just wanted to go through some of those today.
The second of those questions will be all about HRT.
But the first one, I want to talk a little bit about cortisol, if you don't mind, right? So I'm going to tell you my history, and then you can do your expertise. I was a marathon. I was a dancer, then I was a marathon runner, and then I got on to the high intensity interval training every single day, because I like that dopamine and adrenaline and I get bored. I'm like, let me pound this out. But every time I did that for a series of time, I would get left Achilles tendon, I would get a right, because my mechanics, right hip flexor, and it would shut me down because I was so intense all the time.
So now I've gotten smarter as I age, and I still do high intensity a few times a week, but I am zone twoing and I'm lifting heavy shit all the time. And I don't get hurt, and I don't feel as revved up. So I want you to talk to us about this whole cortisol debate, is working on making us too stressed out? Don't we need good stress? What is you stress versus stress, stress? You know what I mean? Because you're an endocrinologist, you are the hormone doctor of the doctors. Let's talk about cortisol first.

**Dr. Carla DiGirolamo** (3:34)
Yeah, this is a hot topic, and I've done a number of podcasts, and I've been invited for a number of podcasts on this particular topic because it's so controversial and it can get very heated out there. And there's also a lot of misinformation.
So cortisol, it's not just one hormone, it's a system. So the stress response system is not just cortisol, although cortisol is at the center of it, but there's lots of other stuff that goes on in the stress response system, mediated by the brain, the brain stem, norepinephrine, epinephrine, those are your adrenaline hormones. There are lots and lots of hormones involved in this system, but we refer to it as cortisol just because that's what people are familiar with. So it's essential for life. It's a hormone we cannot live without, and there are diseases. Madison's disease is one where cortisol isn't being produced and people will die without replacement of cortisol. So it's an essential life hormone.
And it is tied in with the stress response system because it is also a hormone that is integral for survival. If we are presented with a threat, whether it's physical, mental, or whatever, our cortisol system jacks up so that we can immediately combat that threat. So it's essential for our normal daily living and it's essential for survival.
And the survival piece of it is a lot like when we engage in sports. So when you're running a marathon, those same systems that will help you fend off a threat are going to get you through that marathon. So the cortisol system is essential for physical performance.