Reply To: Male 28, issues with weight loss, food intolerances, low energy, low metabolised cortisol and Gilbert’s Syndrome

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Welcome! Forums Male 28, issues with weight loss, food intolerances, low energy, low metabolised cortisol and Gilbert’s Syndrome Reply To: Male 28, issues with weight loss, food intolerances, low energy, low metabolised cortisol and Gilbert’s Syndrome

Carrie Decker, ND

Hello Tess,

Thank you for contributing this case here.  It sounds like this man has struggled with some issues surrounding weight and food as a focal point in his life off and on. Given your description of his history it sounds like focusing on the food and weight at times has been in effort to control other things. I am glad that he has been working with a therapist for the last couple years as well.

Given the results of the stool testing it sounds like there is significant fat malabsorption. I am surprised he does not have more digestive symptoms. In addition to the supplement Beta-TCP, you may want to consider supplemental bile to support his fat absorption. Given the poor fat absorption he also may benefit from supplemental fat-soluble vitamins. As hormones, including cortisol, are made from fats, making sure his body is absorbing the fats in his diet is important. Adequate bile flow is important for healthy gastrointestinal motility and flora balance as well.

Although the support team for the DUTCH test may have additional input, from my perspective he could use adrenal support given his low DHEA-S as well as overall cortisol numbers which all are on the lower end. I personally like to work with glandular and botanical support when the collective levels are significantly depressed, and symptoms also suggest a hypofunctioning state. By supporting the body with glandular substances you are also providing necessary precursors for the body to use as food such that normal function of the gland can be restored.

Although both whole adrenal glandular and just the cortex are available, given his symptoms associated with mood as well I would suggest working with the whole glandular tissue. If he does not tolerate the whole glandular, you may want to switch to adrenal cortex alone. The adrenal medulla is the principal site of the conversion of the amino acid tyrosine into the catecholamines; epinephrine, norepinephrine, and dopamine. As these neurotransmitters have importance for his mood, the whole adrenal glandular may also improve this. At times, people who are higher on the end of anxiety do not do as well on the whole glandular, and for that reason you may want to use the adrenal cortex alone.

Rhodiola rosea is an herb that is considered an adaptogen, however it also can positively impact mood, memory, and weight. It can be found in one of the adrenal supportive combinations detailed in the suggestions below. This herb also has evidence for reducing binging behaviours.

Cifani C, et al. Effect of salidroside, active principle of Rhodiola rosea extract, on binge eating. Physiol Behav. 2010 Dec 2;101(5):555-62.

Perfumi M, Mattioli L. Adaptogenic and central nervous system effects of single doses of 3% rosavin and 1% salidroside Rhodiola rosea L. extract in mice. Phytother Res. 2007 Jan;21(1):37-43.


DHEA supplementation in combination with a low energy, high fibre diet has been shown to improve weight loss in animal studies. The 7-keto metabolite of DHEA also supports healthy thyroid function, which generally looks to be fine for this man, but additional support may promote weight loss. Research has shown that 7-keto DHEA increases thermogenic enzyme activity, which may enhance the body’s basal metabolic rate, helping to promote weight loss without requiring significant alterations to caloric intake or activity levels.

MacEwen EG, Kurzman ID. Obesity in the dog: role of the adrenal steroid dehydroepiandrosterone (DHEA). J Nutr. 1991 Nov;121(11 Suppl):S51-5.


Although the stool test did not find pathogens or significant dysbiosis, in the future you may want to consider testing for small intestinal bacteria overgrowth (SIBO) which often presents with symptoms of gas and bloating. However, additional support for bile may help alleviate these symptoms as well. SIBO can be assessed for with a breath test through Regenerus Labs (codes which cover SIBO are CMI26 and CMI27), and they can be contacted at or by email on or tel +44 (0)333 9000 979.  Biolab in London also offer a breath test for SIBO and can be contacted at or tel 020 7636 5959 / 5905.

The topic of Gilbert’s syndrome has been addressed quite extensively in multiple discussions on the Clinical Education Group.  Please do see some of the discussions pertaining to this topic at & &

If you are not yet familiar with it, you may find the Control-IT Programme from Antony Haynes available on the Nutri Link Ltd Clinical Education site also to be useful in supporting healthy weight loss –


The following supplements are suggested for you to consider in light of your relevant expertise and understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.

To support fat digestion:

Beta Plus (BRC): 1 tablet before meals.  Provides bile salts, digestive enzymes.


Ox Bile (ARG): 1 capsule before meals.

Vitamin D3 Complete (ARG): 1 gelcap once daily with meal. Provides fat-soluble vitamins.

Support for adrenal function and healthy weight:

ADB5-Plus (BRC): 2 tablets once a day in AM.  Contains vitamins and minerals to support adrenal function as well as adrenal glandular and rhodiola.


7-Keto-Zyme (BRC): 1 tablet once daily between meals.  7-keto-DHEA supports normal metabolic function.

If ADB5-Plus is too stimulating, consider:

Adrenal Cortex (ARG): 1 capsule in AM. Sensitive individuals may need to start with lower dosage (1/2 capsule) which can be added to food or liquid.

Please consider these suggestions in light of the other clinical information pertaining to this individual.  If you have any more information about the specific problems this individual is experiencing, further refinement of these suggestions may be considered.  I hope this information is helpful, and if you have any further questions or information specific to the problems this individual is experiencing, please do provide feedback.

In health,

Dr. Decker