A: Nurse Doza didn't hesitate — 223 is right where you want to be. He told the class he likes to see DHEA-S land between 180 and 300 across your lifetime, which means Megan's adrenal glands are firing the way they should. No alarm bells. But the reason he had her check DHEA-S in the first place is the part worth slowing down on.

He made the case that DHEA-S is a better stress marker than cortisol — and that surprised the room. Cortisol swings all day long: it reads differently in the morning, the afternoon, at night, when you're scared, when you're tired. He said it's almost impossible to get a consistent picture from cortisol alone, so he'd rather order DHEA-S and see whether your adrenals are actually keeping up with your life.

Here's where it gets personal. He explained that when you're young and under heavy stress — especially real trauma — your DHEA-S spikes high early, then crashes fast, bottoming out in your twenties and thirties instead of declining gently later in life. He kept meeting people in their thirties diagnosed with "fatigue," told their labs were normal, sent home — because nobody ordered DHEA-S. When he ran it, the numbers came back at 50, 70, 110. His read? "You're in burnout mode." That's the adrenal fatigue almost nobody is testing for.

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A: This is the question that got the room quiet, because almost everyone has lived it. Nurse Doza said the very first thing he thinks when someone is tired all the time is: adrenal glands. They make cortisol, they fire in times of stress, and when they're depleted you simply don't have the gas left to feel awake. Low DHEA-S plus low adrenal function, he said, is the textbook signature of someone who's burnt out and can't figure out why.

Then he gave the part I wish every doctor handed out on a card. There are four tests he runs together when someone is exhausted: DHEA-S, HS-CRP (you want it under 1), vitamin D (he likes 60 to 80), and a CBC to confirm you're not anemic and your blood cells are in range. Run those four side by side, he explained, and you've quietly screened for infections, deficiencies, active inflammation, vitamin D deficiency, autoimmune issues, and chronic adrenal fatigue — all at once.

So why doesn't this happen? Because, as he put it, almost nobody orders these four together. He said it can be a real struggle to get a doctor to run all of them unless they really like you, and even then they may never walk you through the results. He told us that in his own practice he trains other practitioners to run these on top of their standard panels and watch the patterns emerge — and that the women who came into his clinic with thyroid problems, especially Hashimoto's, almost never had a DHEA-S in range. The adrenals were off, and nobody had looked.

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A: This is where Nurse Doza turned it into a protocol, and it's refreshingly simple. If your DHEA-S is running too high, he reaches for Chill — built around GABA and theanine to bring an overactivated system back down. If it's too low, he reaches for Zen, which is bovine adrenal gland, to bring it back up. In a healthy range and just maintaining? Bovine adrenal gland again. (Both live over at goodpoops.org if you want to see what's inside them.)

He was firm on one thing: he does not recommend taking straight DHEA. He explained it's a precursor hormone that feeds too many other pathways, so he'd rather you take bovine adrenal gland — safer, with a long track record going back to the early 1900s for Addison's. The goal isn't to keep dumping cortisol or steroids in like a Band-Aid; it's to coax your adrenal glands into making their own again. He wouldn't let anyone skip the basics either — vitamin D3 with K2 at 5,000 IU, the D3 form specifically, which he called one of the easiest deficiencies in the world to fix.

The last piece costs nothing. He walked us through tracking HRV — heart rate variability — as a daily, visible readout of how your body is handling stress. He wants to see it in the 60 to 80 range, sitting higher than your resting heart rate, because raising it lowers your risk for everything from heart disease to dementia to autoimmune flares.

To move it, he came back to the simple stuff he swears by: legs up the wall, belly breathing, and a 4-second box-breath done a few times a day. He said legs-on-the-wall genuinely pulled him out of insomnia once. And here's the hopeful part he closed on: a low DHEA-S — the marker of adrenal fatigue — is a starting point, not a verdict. Your adrenals can rebuild when you finally give them what they've been missing.