Jan
09
2021

Melatonin Is More Than a Sleeping Aid

Notably, the January 2021 issue of the Life Extension magazine informs you that melatonin is more than a sleeping aid. It contains an interview between Dr. Roman Rozencwaig and a Life Extension (LE) magazine reporter. It must be remembered that Dr. Rozencwaig dedicated much of his career to the healing effects of melatonin. Another keypoint is that in 1987 Dr. Rozencwaig published a paper together with two other researchers. Specifically, it showed that melatonin production by the pineal gland declines in older age. Markedly, they stated that this is the reason why people age and why diseases of aging develop. Another key point is that Dr. Rozencwaig also stated that taking oral melatonin can promote a healthier life.

Melatonin deficiency causing aging and various illnesses

With the aging process the pineal gland calcifies and melatonin production is steadily declining. Surely, along with this is a deterioration of the circadian hormone rhythm. Meanwhile, the neuroendocrine system in the brain gets disorganized. Accordingly, this causes various diseases to occur. To emphasize, Dr. Rozencwaig says that a proper balance between melatonin and neurotransmitters is what we need to maintain health and longevity. As a result, a daily intake of melatonin supports healthy aging and longevity.

The many clinical effects of melatonin

Oral melatonin tablets help you to fall asleep easier, particularly the population that is older than 60 years.

But besides that, melatonin has many other clinical effects.

  • Melatonin improves immunity, which improves resistance against infections. It helps also in cancer prevention
  • Melatonin maintains the circadian hormone rhythm by synchronizing pituitary and hypothalamic hormone production
  • It protects the brain and may prevent Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, autism, and others
  • Melatonin modulates anti-inflammatory cytokinins in different diseases

Dr. Rozencwaig mentioned that melatonin slows down the aging process. There are multiple intertwining reasons for this. 

Melatonin’s actions against the aging process 

  • Melatonin regulates gene expression. This means that some signs and symptoms of aging can be reversed through genetic switches
  • Because melatonin regulates the immune response, the body is more protected against viral, bacterial and parasitic infections
  • Melatonin helps to overcome chronic inflammation that produces cytokines
  • Melatonin is also liver-protective through stimulation of an enzyme (AMPK). This enzyme regulates cellular metabolism.
  • There are other processes that melatonin is involved in: energy metabolism by protection and restoration of mitochondria.
  • Melatonin protects against osteoporosis by balancing and regulating bone formation versus bone loss.

More actions of melatonin

  • An important function of melatonin is the stimulation of antioxidant enzymes like glutathione peroxidase and superoxide dismutase (SOD)
  • Melatonin regulates sirtuins, which are proteins that maintain cellular health. They protect you from obesity, type 2 diabetes, cancer, heart attacks and strokes, dementia and more
  • As already mentioned, melatonin is a neuroprotective agent and may prevent Alzheimer’s and dementia
  • Melatonin stimulates apoptosis of cancer cells.
  • Oral health and melatonin are related. Melatonin suppresses herpes infections and periodontal disease. Melatonin prevents oral cancers to a certain degree. In addition, dental implants survive better when melatonin is present in saliva.

Prevention of cognitive decline

Dr. Rozencwaig mentioned that melatonin stops much of the cognitive decline of aging. To achieve this the following processes take place.

  1. Melatonin improves the sleeping pattern and increases the amount of REM sleep.
  2. During sleep melatonin removes toxic amyloid and tau proteins. We know that with Alzheimer’s disease these are the proteins that accumulate in the brain.
  3. Melatonin improves myelination of white matter in the brain. This prevents brain atrophy of old age.
  4. The brain is metabolically very active and produces toxic free radicals. But melatonin is a strong antioxidant dealing with free radicals. Melatonin can cross the blood brain barrier and stimulates enzyme production to eliminate toxic reactive oxygen species.
  5. Chronic inflammation also increases with age, but melatonin deals with this condition in the brain.
  6. Here are 3 subtypes of melatonin receptors. The body integrates the multitude of actions of melatonin with the help of these receptors.
Melatonin Is More Than a Sleeping Aid

Melatonin Is More Than a Sleeping Aid

Conclusion

Melatonin is a powerful antioxidant that has many other useful protective qualities as explained. The body integrates various functions like anti-aging, anti-free radical activity, neuroprotection in the brain and more. Melatonin even synchronizes pituitary and hypothalamic hormone production. This helps to integrate the effect of melatonin, which benefits the body in many ways. Melatonin prevents Parkinson’s and Alzheimer’s disease, multiple sclerosis, autism, obesity, type 2 diabetes, cancer, heart attacks, strokes and dementia. Melatonin production deteriorates from the age of about 60 onwards. It is important to supplement with melatonin at nighttime from that age on. Usually, you only need small amounts of melatonin, between 1mg and 3 mg at bedtime. This prevents most of the serious diseases of old age, stimulates your immune system and lets you age gracefully.

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May
13
2017

Results Of Insomnia Studies

Results of insomnia studies are focusing on all angles of insomnia. We know for some time that the circadian rhythm is linked to deep REM sleep, which we only reach about 2 hours into our nightly sleep. There are several reasons why our normal sleep pattern can get disrupted.

1. Night owls have a CRY1 mutation

A recent publication on March 27, 2017 has detected a mutation of the human circadian clock called CRY1. This is a dominant gene that is responsible for delayed sleep phase disorder (DSPD). People with this genetic feature tend to go to sleep 2 hours later than the average person every day.

It occurs between 0.2% and 10% in the general population and is inherited by the autosomal dominant mode.

This gene is responsible for the phenomenon of persons being “night owls”.

2. Sleep deprivation in nursing homes

Another publication has zeroed in to what happens in the frail elderly who live in nursing homes.

Here is what sleep researchers have found out about nursing homes.

  • Older people also need 7 to 8 hours of sleep per night, not less as previously thought.
  • Let people sleep at night, and give them undisturbed sleep. The practice of waking them up every 2 hours is unnecessary and undermines a restful sleep with normal amounts of REM sleep.
  • The color of light matters: Blue/purple light coming from TVs, iPod’s, laptops or cell phones stimulates serotonin production that wakes you up. In contrast to this orange/red light stimulates melatonin production that facilitates sleep. A nursing home owner, Guildermann said: “We have made it darker at night, and what light they do have is orange/amber/red light, and we are having phenomenal results.”
  • Sleep, exercise and nutrition are the biggest components of health.

3. Night workers

One of the news stories in 2016 was about health risks of night shifts. The Bureau of Labor Statistics reported in 2000 that 15 million workers (16.8 % of the working population) were doing alternative shifts (night shift work mixed with daytime shifts). In 2016 they reported 14.8% were working alternate shifts. Among blacks, Asians and Latino Americans the percentage of working alternative shifts was higher, namely 20.8%, 15.7% and 16%, respectively.

Effect of shift work on your diurnal hormone rhythm

Shift work is more common in certain industries, such as protective services like the police force, food services, health services and transportation.

Your body rewards you, when you sleep 7 to 8 hours during the night, but it will penalize you severely, if you turn it upside down. The reason is the diurnal hormone rhythm that we all have built in. Sleep is regulated by melatonin during the night, which is released by the pineal gland (on the base of the skull). Daytime wakefulness is regulated by the stress hormone cortisol from the adrenal glands. These two hormones inhibit each other, cortisol inhibits melatonin and melatonin inhibits cortisol. All the other hormones are also regulated according to the diurnal rhythm: testosterone, for instance is highest in the morning, human growth hormone is highest between midnight and 3 AM.

Studies about the effects of shift work

There are examples of what happens when you do shift work for several years:

  1. A) A Swedish study found that white-collar shift workers had a 260% higher mortality compared to a control group of daytime white collar workers: Shift work and mortality.
  2. B) A study compared night workers in the age group of 45 to 54 with daytime workers and found a 147% higher mortality rate in the night shift workers: Shift Workers’ Mortality Scrutinized. Shift workers work at night and sleep during the day. This can be done, but it is against the physiology of your body, as I explained above. Remember that melatonin does not only regulate your sleep, it also is one of the main stimulant hormones of the immune system. If you manipulate your diurnal hormone rhythm by staying awake during the night and sleeping during the day, you pay the price by an increased risk of mortality (increased risk of death). I think this is not worth it!

4. What to do when you cannot sleep?

The first step is to take 3mg to 5mg of melatonin at bedtime. It should be taken between 10PM and 11PM. It takes 20 to 30 minutes for melatonin to take effect. If you do not fall asleep within that time frame you are likely thinking too much! Relaxation before going to sleep should be part of your evening ritual. It can happen that we experience demanding, stressful days, and despite all better effort, it is difficult to be entirely relaxed. After demanding days like that I would recommend taking 1 or 2 capsules of valerian (500 mg strength) from the health food store. This combined with the melatonin should help in more than 80%-90% of insomnia cases.

Medical tests and sleep studies

If you cannot sleep, see your physician. Sleep studies may be required or you may have problems of the thyroid (hypo- or hyperthyroidism), which may need to be checked. Other medical problems including depression have to be checked out as well. Melatonin and valerian are safe. Other sleeping pills have multiple side effects including memory problems the next day or the feeling of a mild hangover.

5. Telomeres and insomnia

Some people have no problem disciplining themselves to go to sleep between 10PM and 11 PM, which seems to be the window of opportunity to catch a good night’s sleep. Others are so used to do their late night activities (reading, watching TV, being online, going to the pub etc.) that they finally drop into bed at 1 or 2 AM. People need 7 to 8 hours of good sleep; even hard-core party goers need to get that much sleep. Nature does not make exceptions! When you go to bed only at 1AM or 2AM, it is difficult to get enough sleep.

Healthy telomeres with healthy sleep pattern

It is true that you can suffer multiple health problems, as all of your hormones depend on the resetting during your deepest sleep between 2AM and 4AM triggered by the nighttime melatonin response. Even your telomeres, the caps of chromosomes in every cell get shortened from too much stress and too little sleep. Shortened telomeres mean a shortened life span. The reason for this is that people with shortened telomeres develop heart attacks, strokes and cancer. This is what shortens the life span. How do we avoid this risk? Go back to healthy sleep habits. As mentioned above it is best to start going to sleep between 10 PM and 11 PM and sleep for 7 to 8 hours.

6. Electronics in the bedroom

There is new research showing that electronics in the bedroom can interfere with a normal sleep pattern. Dr. Ben Carter is the lead author and a senior lecturer in biostatistics at King’s College London. He completed a study involving 125,198 children with an average age of 14½ years. There were about equal amounts of males and females. Both sexes had the same problem. Allowing the use of electronic media interfered with their sleep time. What electronic devices are we talking about? Watching TV, using the computer, the cell phone, tablets and computer games. The study was originally published at JAMA Pediatrics.

The blue/purple light of the TV screen or a computer screen stimulates the brain to produce serotonin. This undermines the melatonin production and as a result the person finds it extremely difficult to fall asleep.

What contributes to better sleep habits

Here is a list that contributes to better sleep habits and better sleep quality:

Sleep friendly environment in the bedroom

Ensure that the bedroom is dark, soundproof, and comfortable with the room temperature being not too warm. It is important to develop a “sleep hygiene”. This means going to sleep around the same time each night, to have some down time of 1 hour or so before going to bed and getting up after the average time of sleep (for most people between 7 to 9 hours). Sleeping in is not a solution, and an alarm clock will also help to develop a sleep routine.

Avoid stimulating drinks, drugs and nicotine

You need to avoid caffeine drinks, alcohol, nicotine and recreational drugs. Smokers should butt out no later than 7PM, as nicotine is a stimulant.

Adopt a regular exercise program

Getting into a regular exercise program, either at home or at a gym is beneficial.

No heavy meal at night

Avoid a heavy meal late at night. A light snack including some warm milk would be OK.

No computer in the bedroom

It is not a sensible idea to use the bedroom as an office, reading place or media center. It stimulates by cortisol production, which keeps us awake. The bedroom is a place of rest and should be comfortable and relaxing.

What to do when waking up at night

Some sleepers wake up at night, and they are wide-awake! Leaving the bedroom and relaxing in the living room for a while can help. It goes without saying that playing video games will not help! An alternative is to take 3 mg of melatonin, which will helps to fall asleep faster, but melatonin will wear off after about 4 hours.

Self-hypnosis recording

A self-hypnosis recording is a useful adjunct to a sleep routine. Listening to it before going to sleep helps to focus on relaxation and to stop ruminating about the day and its events. Keep the volume low.

Results Of Insomnia Studies

Results Of Insomnia Studies

Conclusion

Recent results of insomnia studies have reconfirmed that we need our regular sleep to maintain our health. We have seen that some nursing homes have a practice of waking the client up every 2 hours. Nursing homes must abandoned this as it interferes with the restorative deep REM sleep. In turn this will interfere with hormone restoration overnight.

Children and adolescents must limit their time in front of the TV, iPhones and computer screens. The blue light has the frequency that over stimulates the brain and interferes with melatonin production. Some people work overnight as shift workers or party until the wee hours in the morning. This causes your telomeres in your body cells to shorten. As people restore their sleeping pattern to normal, the telomeres length will remain stable.

Important to restore normal sleep pattern

Even people who are night owls due to an inborn CRY1 gene that is responsible for delayed sleep phase disorder can normalize their sleep pattern by following a strict sleep hygiene. As people get older they lose the ability to make melatonin, but they can counter this by taking melatonin tablets at bedtime.

Remember what I said earlier: Sleep, regular exercise and good nutrition are the biggest components of health.

Dec
03
2016

Electronics In The Bedroom

There is new research showing that electronics in the bedroom can interfere with a normal sleep pattern. Dr. Ben Carter is the lead author and a senior lecturer in biostatistics at King’s College London. He just completed a study involving 125,198 children with an average age of 14½ years. There were about equal amounts of males and females. Both sexes had the same problem. When they were allowed to use electronic media, this interfered with their sleep time. What electronic devices are we talking about? Watching TV, using the computer, the cell phone, tablets and computer games. The study was originally published at JAMA Pediatrics.

Result of the study on electronics in the bedroom

  1. When media bedtime use was allowed, there was a 2.17-fold higher risk of not getting enough sleep quantity. This was compared to kids who did not use media devices in the bedroom.
  2. There was a 1.46-fold risk of having poor sleep quality.
  3. There was a 2.72-fold risk of excessive daytime sleepiness.
  4. Even children who had access to media use, but did not use it at night had similar findings. They had a risk of 1.79-fold to get inadequate sleep quantity. There was a 1.53-fold risk of poor sleep quality. And excessive daytime sleepiness was present with a 2.27-fold risk.

Melatonin level influenced by electronics in the bedroom

Physicians researched the diurnal hormone rhythm and sleep pattern for decades. Essentially two hormones work together.

In the morning when you open your eyes, light enters our eyes and is registered in the hypothalamus. There are also links from the hypothalamus to the pineal gland, where melatonin is synthesized and stored. The light signal stops the secretion of melatonin from the pineal gland, although it is still being produced during the day in the pineal gland, but stored there until the evening hours set in. You may have noticed that you start yawning when the light dims in the evening. That’s when melatonin is released into your system to let you know it’s time to slow down and go to sleep.

Balance of melatonin and cortisol

Of course, we have electrical light and can turn night into day if we choose to! This works for a limited time, but eventually tiredness sets in, and melatonin wins the upper hand. Melatonin is the master hormone of the circadian rhythm.

It is interesting to note that cortisol does exactly the opposite. Cortisol is the adrenal gland hormone that helps us cope with stress. When we are fully awake, we need cortisol to cope with the various stress situations of the day. Melatonin inhibits cortisol secretion and cortisol inhibits melatonin secretion, and they are natural opponents working together for your common good. This is part of the circadian rhythm. We can measure these hormones, and this is how researchers have found out how these two hormones work together.

What light stimulation does to your hormones

Too much exposure of children or adults to electronic devices overstimulates the brain and sends signals to the adrenal glands to produce more cortisol. In between the hypothalamus and the adrenal glands a cascade of hormones regulates this. The hypothalamus sends CRH, the corticotropin-releasing hormone to the pituitary, which stimulates in turn the release of the messenger hormone ACTH to produce more cortisol in the adrenal glands. It is the extra cortisol that keeps kids awake. The same applies to adults who invite electronics into their bedroom. All the excitement from watching the various media gadgets leads to extra cortisol. And we just learnt that cortisol counteracts melatonin. 

What can parents do about electronics in the bedroom?

First of all, parents need to be firm with their kids. They need to explain to them that electronics are staying out of the bedroom. There needs to be a cooling down period one hour before bedtime where they do not watch TV, use the cell phone or other electronic gadgets. They may rebel against this first, but when they sleep better, they likely will be more agreeable. Here is a list that contributes to better sleep habits and better sleep quality:

List for better sleep habits

  • Ensure that the bedroom is dark, soundproof, and comfortable with the room temperature being not too warm. It is important to develop a “sleep hygiene”. This means going to sleep around the same time each night, to have some down time of 1 hour or so before going to bed and get up after the average time of sleep (for most people between 7 to 9 hours). Sleeping in is not a solution, and an alarm clock will help also to develop a sleep routine.
  • Caffeine drinks, alcohol, nicotine and recreational drugs must be avoided. Smokers should butt out no later 7PM, as nicotine is a stimulant.
  • Getting into a regular exercise program, either at home or at a gym is beneficial.
  • Avoid a heavy meal late at night. A light snack including some warm milk would be OK.

More points for the better sleep habit list

  • It is not a sensible idea to use the bedroom as an office, reading place or media center. It paves the way to the stimulus of the cortisol effect that keeps us awake. The bedroom is a place of rest and should be comfortable and relaxing.
  • Some sleepers wake up at night, and they are wide-awake! Leaving the bedroom and relaxing in the living room for a while can help. It goes without saying that playing video games will not help! An alternative is to take 3 mg of melatonin, which will helps to fall asleep faster, but melatonin will wear off after about 4 hours.
  • A self-hypnosis recording is a useful adjunct to a sleep routine. Listening to it before going to sleep helps to focus on relaxation and to stop ruminating about the day and its events. Keep the volume low.

Some thoughts about sleep aids after electronics in the bedroom are removed

Sometimes an adolescent will have trouble falling asleep. Here is the solution of what to do: at the time the youngster is having problems sleeping, there is too much cortisol on board, which prevents the pineal gland to release melatonin. What is missing is melatonin.

The first step is to take 3mg of melatonin at bedtime. It takes 20 to 30 minutes for melatonin to take effect. If the youth does not fall asleep within that time frame he or she is likely thinking too much. If that were the case, I would recommend taking 1 or 2 capsules of valerian root (500 mg strength) from the health food store. This combined with the melatonin should help in more than 80%-90% of insomnia cases. If the child still cannot sleep, see your physician. The adolescent may need sleep studies done or may have problems with the thyroid (hypo- or hyperthyroidism), which may need to be checked. Physicians need to check out other medical problems, including depression. Melatonin and valerian are safe. Other sleeping pills have multiple side effects including memory problems.

Electronics In The Bedroom

Electronics In The Bedroom

Conclusion

A new study has shown that electronics in the bedroom will often keep children awake. It has become a huge problem in schools where students fall asleep or have problems paying attention. There are simple rules regarding a quiet bedroom without electronics that will go a long way of rehabilitating a child who has sleeping problems because of electronics. There are natural ways to help nature along, if the simple measures don’t work. Melatonin and valerian root help to calm the mind and help catching some healthy sleep. If the problem were persisting, an appointment with the family physician would be in order.

Even though this article deals with children and adolescents and the use of electronics in the bedroom, the same applies to adults. They are not immune to the stressors that disrupt sleep. They are just as likely to feel tired and sluggish after a restless sleep, and their performance at the workplace will suffer. Sleep hygiene is as important for adults as it is for adolescents.

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Nov
05
2016

Health Risks Of Night Shifts

One of the news stories in 2016 was about health risks of night shifts. The Bureau of Labor Statistics reported in 2000 that 15 million workers (16.8 % of the working population) were doing alternative shifts (night shift work mixed with daytime shifts). In 2016 they reported 14.8% were working alternate shifts. Among blacks, Asians and Latino Americans the percentage of working alternative shifts was higher, namely 20.8%, 15.7% and 16%, respectively.

Shift work is more common in certain industries, such as protective services like the police force, food services, health services and transportation.

Evidence of health risks of night shifts

1.There are several publications that showed evidence of health risks of night shift workers. Here is a random selection to illustrate the health risks of night shifts.A study from 2015 examined the sleep patterns of 315 shift nurses and health care workers in Iranian teaching hospitals. They found that 83.2% suffered from poor sleep and half of them had moderate to excessive sleepiness when they were awake.

2.This South Korean study examined 244 male workers, aged 20 to 39 in a manufacturing plant. Researchers compared blood tests from daytime workers to blood tests from night shift workers. They also obtained inflammatory markers like the C-reactive protein and leukocyte counts. Night shift workers had significantly higher values. The investigators concluded that shift workers have increased inflammatory markers. This is a sign of a higher risk of developing cardiovascular disease in the future.

Higher mortality and higher cancer risk in nighttime workers

3. A Swedish study found that white-collar shift workers had a 2.6-fold higher mortality over a control group of daytime white-collar workers.

4. Another study compared night workers in the age group of 45 to 54 with daytime workers and found a 1.47-fold higher mortality rate in the night shift workers.

5.In a study from China 25,377 participants were included in a study that investigated cancer risk in males with more than 20 years of night shift work. They had a 2.03-fold increased risk to develop cancer compared to males working day shifts. Women with night shift work in this study showed no effect with regard to cancer development.

BMI and estrogen levels higher in women nighttime workers

6.A Polish study examined hormones and the body mass index (BMI) among 263 women who worked night shifts and 269 women who worked day shifts. When night shift workers had worked more than 15 years at nights, their estrogen levels, particularly in postmenopausal women were elevated compared to the daytime workers who served as controls. The BMI was also increased in the nighttime workers.

Risk for chronic lymphocytic leukemia higher in nighttime workers

7.Chronic lymphocytic leukemia (CLL): a study in Spain showed that working for more than 20 years in rotating night shifts was associated with a 1.77-fold higher risk of developing CLL. The authors noted that melatonin levels in that group were much lower than in controls that worked only day shifts. Working in straight night shifts did not show higher risks of CLL compared to daytime workers.

8. In a Korean study from Seoul 100 female medical technologist who worked nighttime had their melatonin levels tested, which were compared to daytime workers.  They measured 1.84 pg/mL of melatonin for the nighttime workers compared to 4.04 pg/mL of melatonin in the daytime workers. The authors felt that this is proof that the diurnal hormone system has been disrupted. Altering the melatonin level also changes the circadian hormone rhythm.

Flatter cortisol curves at night in nighttime workers, also increased diabetes risk

9.A group of 168 female hospital employees doing rotating nightshift work in Southern Ontario hospitals were compared to 160 day workers. Cortisol production was assessed. Cortisol production in day workers and in shift workers on their day shift was similar. However, shift workers on their night shift had flatter cortisol curves and produced less cortisol. The authors felt that this disruption of cortisol production would explain why rotating night shift workers have a higher risk of cardiovascular diseases.

10.A Danish study with female nurses followed 28,731 nurses between 1993 and 2015. Researchers measured the incidence of diabetes in rotating nighttime nurses in comparison to the data from daytime nurses. Night shift workers had a risk between 1.58-fold to 1.99-fold when compared to daytime workers to develop diabetes. The risk for evening shift workers was less (between 1.29-fold and 1.59-fold).

Diurnal hormone rhythm behind health risks of night shifts

Your body has its own rules. It rewards you, if you sleep 7 to 8 hours during the night, but it will penalize you severely, if you turn it upside down. The reason is our built-in diurnal hormone rhythm. A peak of melatonin regulates sleep during the night. Melatonin is released by the pineal gland (on the base of the skull) when it gets dark outside. Daytime wakefulness regulates the release of the stress hormone cortisol from the adrenal glands. These two hormones inhibit each other, cortisol inhibits melatonin and melatonin inhibits cortisol. All the other hormones are also regulated according to the diurnal rhythm: testosterone is highest in the morning, human growth hormone is highest between midnight and 3 AM etc.

Adjustment of the diurnal hormone system

When you work daytime shifts, your diurnal hormone rhythm works just fine. But if you work nighttime shifts, your hormones have to adapt. This is very similar to traveling east or west where you cross several time zones. Your internal diurnal hormone system has to adjust to these changes. Typically it takes 1 day to adjust to a 1-hour time zone difference.

Rotating shift workers have the highest risk of getting sick

In people who work permanent night shifts, the hormone changes stay adjusted and there is no further switching. But most employers want to be “fair” to everybody, so they introduced the rotating night shifts. The publications above show that this is the worst thing you can do. It messes with your diurnal hormone rhythm, and some people never switch completely to the new hours worked. They don’t get enough daytime sleep because the kids are loud during the day etc. The rotating shift workers are running the highest risk of getting sick. The get cancer, diabetes, cardiovascular diseases, obesity, cancer, leukemia, and they have low levels of melatonin.

Health Risks Of Night Shifts

Health Risks Of Night Shifts

Conclusion

Shift workers working constant night shifts is less stressful than the more common rotating shift work. This is where you work night shifts for a period of time. Then the schedule switches to day shift, and you keep on rotating. The least health risks occur with regular daytime work. People exposed to rotating night shifts suffer from poor sleep. They have a higher risk of gaining weight, getting obese and acquiring diabetes in time. They are at a higher risk for heart attacks, strokes and cancer. All-cause mortality is about twofold higher than for workers who work day shifts.

The underlying problem seems to be a disturbance of the diurnal hormone rhythm. Normally this regulates our waking/sleeping rhythm and keeps us healthy. But with nighttime work melatonin production weakens, there is less cortisol production and hormone rejuvenation during rest periods suffers greatly. This weakens the immune system, allows cancer to develop and leads to chronic inflammation causing cardiovascular disease and diabetes. The remedy to prevent this from happening is to catch little naps whenever you can during the day. And, if at all possible, work daytime shifts permanently.

Jul
30
2016

LED Streetlights Can Be Harmful

The American Medical Association (AMA) has just released a new policy recommendation and statement that LED streetlights can be harmful. After meticulous reviews of the research on the effect of white LED streetlights and their effect on health the AMA decided that it needed to publish its recommendations so that city fathers have some guidelines for illuminating their cities.

Cost and energy savings from white streetlights

Many cities in the US have already switched from the yellowish traditional streetlights to the high-intensity LED lighting. The cities did this unilaterally without consulting health professionals or the public. The cities wanted to save money by using white LED lights. But as we will discover below there are serious health consequences to this.

Historic lighting solutions

We did not always have streetlights. Physicists use Kelvin units (K) to measure the intensity of light. The term“color temperature” (CT) is in us to describe color composition. Before Benjamin Franklin and Thomas Edison invented electricity we burnt candles and wood at night. This produced a light of 1800 K, which was yellow and red with hardly any blue. Next came incandescent light bulbs. They have a color temperature of 2400 K, which contains less blue and more yellow and red. The new light source is the LED light, which contains a lot more blue color and appears to us as white light. The color temperature is around 4000 K to 5000 K.

LED streetlights can be harmful to your health

Who would have thought that switching streetlights could have anything to do with your health? The newest LED street lights are emitting large amounts of blue light. Our eyes perceive this as white light, but it also creates nighttime glare, much more so than conventional lighting. Eye discomfort from blue-rich LED lighting can interfere with visual acuity and cause road hazards. The blue-rich LED streetlights happen to operate at the wavelength that suppresses melatonin during the night. Researchers believe that the white LED lamps cause interference with the important circadian sleep rhythm. This effect is much stronger with the white LED lights in comparison to the conventional streetlights. The interference with the sleep rhythm means that there is less sleep time. The sleep subjects reported that their sleep quality was unsatisfactory. There is daytime sleepiness and impaired daytime functioning. White light LED lights can even cause obesity.

Effect of white LED light on animals

Animals can also react to white LED light. The bright outdoor LED lights disturb many species that need a dark environment. Poorly designed LED lighting disorients some birds. Researchers detected that insects, turtles and certain fish species also experience disturbance in their habitat by white LED lights. US national parks have adopted lighting designs that reduce the effects of light pollution on wildlife. So far nobody has shown any concern, what light pollution does to humans!

AMA guidelines to reduce impact of white LED lights

The AMA has come out with new guidelines to help reduce the impact of white LED light. Instead of high-intensity white streetlights the AMA recommends to communities to use the lowest emission of blue light possible to reduce glare. The AMA has recommended a color temperature of no more than 3000 K. This type of light has more of a mix of blue, green, yellow and red in it and very little white. In contrast the CT of bright LED streetlights have 4000 K to 5000 K. This contains a lot of blue light, which appears as white to the eye. Seattle and New York belong to the cities that recently had their streetlights retrofitted to the white LED streetlights.

American Medical Association (AMA) recommendation

According to the AMA guidelines these lights should now be refitted again. The AMA also recommends that the lights should be shielded to minimize glare and the detrimental effect on humans and the environment. There should also be a possibility of dimming the lights in off-peak periods.

Evidence from medical literature that LED streetlights can be harmful

Here I am reviewing what has been found in the medical literature about white LED lighting that is now preferably used in street lighting.

Cataracts caused by high color temperature

A Chinese lab tested epithelial cell lines derived from human lenses under a variety of light sources. The lab had previously established that oxidative stress on epithelial cells from human lenses was the most important factor for developing cataracts in humans. Human epithelial cells were cultured in the presence of different LED light frequencies. A high color temperature of 7378 K caused damage to the epithelium while controls of lower color temperatures of 2954 K and 5624 K LED lights did not. The authors concluded that white LED light with a high color temperature could cause significant photobiological damage to human lens epithelial cells. This in turn can cause cataracts and legal blindness.

Human retinal cell cultures damaged by white LED light

Another research group studied human epithelial pigment retinal cells in tissue culture. They exposed the tissue cultures to various light frequencies, namely white, blue, green or red LED light. Reactive oxygen and DNA damage were assessed. The white light showed the highest amount of damage to the human retinal cell in culture.

Intermittent exposure to white LED light in long-term care residents

In a trial on senior long-term care home residents researchers found that intermittent exposure to bright light (versus red light) showed positive cognitive effects on the seniors. It is not clear why with respect to cognitive function there is a positive finding using white LED lights, while the other tests mentioned above showed negative effects on the lens and the retina of the eyes.

Blue light filters for night shift workers

In another investigation blue light filters were employed in night shift workers and the investigators detected beneficial health effects. In animal experiments the same results were found.

Normally in shift workers cancer, heart disease, metabolic disturbances, depression, anxiety disorders and reproductive problems are found.

 

LED Streetlights Can Be Harmful

LED Streetlights Can Be Harmful

Conclusion

Despite the evidence in the medical literature showing that yellow lights are better than the newer white LED lights, cities have been converting the yellow streetlights to white LED streetlights. It makes economic sense, but harms people. The American Medical Association is attempting to convince authorities to use common sense. The AMA wrote guidelines and hopes that city fathers will reconsider their decisions. If you are concerned, voice your opinion by talking to your political representative.

Apr
16
2016

Sleeping Habits

When you are a child or a youngster sleeping habits are rarely a problem. But as people age, they tend to have problems falling asleep and sleeping through the night. Older people may also have certain hormone deficiencies, which can contribute to a change in sleeping habits.

Some basics regarding sleeping habits

There are a couple of facts that everybody should know about sleep, so you work with nature, not against it.

Need of 7 to 8 hours of sleep

The way our bodies are hardwired, we need 7 to 8 hours of sleep and we need to fall asleep between 10PM and 11PM.

Diurnal hormone rhythm

The reason for the relative rigid sleeping schedule time wise is the diurnal hormone rhythm. This is also known as the circadian clock that is dictated by the light of the sun (24 hour cycle). Light going into our eyes in the morning inactivates melatonin. But in the evening the pineal gland releases melatonin after sunset. This is what keeps the internal clock on time. We all know how we derail when we fly east or west. There are differences. I find that I am more affected when I fly west than east. The readjustment for me often takes one or two weeks for a 9-hour time zone difference.

Melatonin production is age-sensitive

Melatonin is gradually produced less as we age. The highest melatonin production occurs around 10 years of age. From then on melatonin production declines. This likely is the reason why older people more often have insomnia problems.

Melatonin rules at night, cortisol rules during the day

There is interplay between melatonin and cortisol. These two hormones complement each other. When you sleep melatonin governs and resets the hormones to be ready in the morning. This involves an early testosterone peak for the male and cortisol, which has to be ready the moment you wake up. It is cortisol coming from the adrenal glands that rules during the day and is giving us energy. Thyroid hormones also gives you energy during the day. As I will explain below, human growth hormone is an energy-giving hormone as well that also clears your mind.

Human growth hormone

What is not as much known is that human growth hormone (GH) provides energy for us. Growth hormone is released as a spurt between midnight and 3 AM, when you’re deep asleep. The purpose of that is to get you ready with regard to energy for the next day. If you drink alcohol after 5PM the afternoon before, you will miss most of that GH spurt during the night and have a hangover (lack of energy the following day).  At the 23 rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about GH and said that even one drink during the evening before you go to sleep will cancel 75% of the GH spurt causing a lack of energy the following day.

Regular alcoholic drinks can interfere with growth hormone production

When you have alcoholic drinks evening after evening as many people do, you interfere with your deepest sleep, creating a fitful sleep and you can develop GH deficiency, which can be measured with blood and urine tests. GH deficiency leads to premature signs of aging, such as wrinkles, musculoskeletal problems, muscle weakness and dementia. Many people in their 80’s look “old”. In fact they may be growth hormone deficient and could be treated with human GH, if GH deficiency were confirmed by tests. Part of the aged appearance is reversible in cases of growth hormone deficiency by treating with daily GH injections.

Less melatonin as we age

As we age, we produce less melatonin and less growth hormone. All of these hormone levels can be determined. If they are low, they should be replaced with small amounts of whatever hormone is missing.

Other hormones that are important

There are other hormones that are important for energy: cortisol from the adrenal glands, thyroid hormones and DHEA from the adrenal glands. When people get older there is a problem with melatonin production and an evening dose of melatonin supplement of 3mg is advisable. People beyond the age of menopause (females) and andropause (males) need bioidentical sex hormone replacement. Once they have sufficient hormone levels, they will also have more energy. It is advisable to get all of these hormones tested using a saliva hormone test.

How to assess growth hormone deficiency

Growth hormone is a bit more difficult to assess, but IGF-1 levels give a first indication what your growth hormone levels are doing. The newest test is a 24-hour urine collection or an overnight urine sample looking for growth hormone metabolites. If levels are found to be low, daily replacement of growth hormone using a pen similar to insulin injections in diabetics can be given, using pure human growth hormone. You would need to seek the advice of a knowledgeable naturopath.

What does insomnia do to you?

From a psychological point of view performance is slower, there is a slower reaction time and there is a risk of developing anxiety or depression. The immune system gets weakened, high blood pressure can develop and there is a risk of developing heart disease, diabetes and cancer. It is common to gain weight becoming overweight or obese. Even your telomeres, the caps of chromosomes in every cell get shortened from too much stress and too little sleep. Shortened telomeres mean a shortened life span.

How to improve sleeping habits

Set your alarm clock for 8 hours later when you go to sleep. Make sure your bedroom is dark, but wake up to the alarm clock after 7 to 8 hours of sleep. Don’t sleep longer than 8 hours per night. Your internal diurnal hormone rhythm will thank you for regulating your sleep/wake rhythm by giving you the energy you want. I enjoy mine.

Sleeping habits include problems falling asleep or sleeping through

Falling asleep: As we mostly have a lack of melatonin, the first step is to take 3mg to 5mg of melatonin at bedtime. But it should be taken during the window of opportunity fitting into the diurnal hormone rhythm as mentioned above: between 10PM and 11PM. It takes 20 to 30 minutes for melatonin to take effect. If you do not fall asleep within that time frame, you are likely thinking too much. If that were the case, I would recommend taking 1 or 2 capsules of valerian (500 mg strength) from the health food store. This combined with melatonin should help in more than 80%-90% of insomnia cases.

Not sleeping through: Some of you, particularly if you are elderly, may wake up at 3 or 4 AM and have a hard time falling asleep again. At that time it would be safe to take another 3mg of melatonin and if this does not work within 20 minutes add another 500mg valerian capsule.

If you continue to have insomnia problems, see your physician. You may need sleep studies done or you may have problems with your thyroid gland (hypo- or hyperthyroidism), which needs to be checked. The doctor needs to be aware of other medical problems including depression. Melatonin and valerian are safe. Other sleeping pills have multiple side effects including memory problems.

Part of good sleeping habits is to provide a quiet, comfortable bedroom

The following points are good checklist for a comfortable sleep environment (Ref.1).

  • Ensure your bedroom is dark, soundproof, and comfortable with the room temperature being not too warm, and you develop a “sleep hygiene”. This means you get to sleep around the same time each night, have some down time 1 hour or so before going to bed and get up after your average time of sleep (for most people between 7 to 9 hours). Do not sleep in, but use an alarm clock to help you get into your sleep routine.
  • Avoid caffeine drinks, alcohol, nicotine and recreational drugs. If you must smoke, don’t smoke later than 7PM.
  • Get into a regular exercise program, either at home or at a gym.
  • Avoid a heavy meal late at night. A light snack including some warm milk would be OK.
  • Do not use your bedroom as an office, reading place or media center. This would condition you to be awake.  Reserve your bedroom use only for intimacy and sleeping.
  • If you wake up at night and you are wide awake, leave the bedroom and sit in the living room doing something until you feel tired and then return to bed.
  • A self-hypnosis recording is a useful adjunct to a sleep routine. Listen to it when you go to bed to give you something to focus on (low volume) and you will find it easier to stop thinking.
Sleeping Habits

Sleeping Habits

Conclusion

We need to be aware how important a proper hormone balance is when it comes to a healthy sleep pattern. Thyroid hormones and sex hormones are easy to measure. Bioidentical hormone replacement is necessary, if one of the hormones is low. To check GH levels, the doctor orders an IGF-1 level and/or metabolites of GH in a 24-hour urine sample as explained above. Older people need to replace melatonin deficiency the way I summarized above. With these measures sleeping habits improve, and you will get your 7 to 8 hours of restoring sleep. Forget the notion of the past that older people would not need as much sleep. Especially for an aging individual it is important to have a good night’s sleep in order to feel well and energized every day.

References

Ref.1: Jean Gray, editor: “Therapeutic choices”, 5th edition, Chapter 8 by Jonathan A.E. Fleming, MB, FRCPC: Insomnia, © 2008, Canadian Pharmacists Association.

Feb
06
2016

Effects Of Hormones On The Heart

Since February is heart month, this is a good time to discuss the effects of hormones on the heart. I believe that this is a timely topic to understand how we can protect ourselves from heart disease. During the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 11-13, 2015 in Las Vegas Dr. Ron Rothenberg gave a talk entitled ”Hormones And The Heart”. He stated that he wanted to give an overview of the effects on the endocrine system and on the cardiovascular system, in particular the effect of testosterone and estrogen. Also discussed were the effects of thyroid hormones, growth hormone, vitamin D and melatonin. In the following I will summarize what he explained in detail.

Testosterone treatment in men

He stated that there has been some confusion about the protective effect of testosterone on the heart in men. But Dr. Sharma and colleagues who investigated 83,010 male veterans with documented low testosterone levels clarified this confusion with this large study.

One group received testosterone replacement therapy, another did not receive replacement therapy and one group received replacement with testosterone, but the testosterone levels did not normalize.

Mortality reduction with testosterone replacement

The observation time for the various groups was between 4.6 years and 6.2 years. The results were impressive. A comparison between the results of men on testosterone replacement and the results of men without testosterone replacement, showed that there was a 56% reduction in overall mortality. Furthermore, there was a reduction of heart attacks by 24% and a reduction of strokes by 36%. There was no difference between the control group without testosterone replacement and the partial testosterone replacement group where the testosterone levels did not come up. It is clear from this that with proper testosterone replacement where the physician monitors testosterone levels and corrects the levels, significant reductions in strokes and heart attacks can be achieved. The explanation for these findings is simple: both, brain cells and heart cells in males, have testosterone hormone receptors that need to be stimulated for full function.

Hormone replacement in women

This topic was confusing for many years because of the insistence of the medical profession to use horse estrogen extracts from pregnant mares (Premarin) and synthetic Provera (instead of bioidentical progesterone). These artificial hormone-like substances were used in the much-discussed Women’s Health Initiative (WHI).

Dr. Rothenberg said about this study that investigators used the wrong estrogen, the wrong progesterone, the wrong route of administration of estrogen (oral estrogen causes inflammation), and the wrong women at age 63 who already had cardiovascular disease and breast cancer.

Revisiting the Women’s Health Initiative

One important aspect that was learnt by re-interpreting the WHI was that when estrogen replacement was initiated right away when menopause started, the heart attack risk went down by 34%. Estrogen and Provera together reduced the risk only by 28% (Provera being the wrong hormone). Again, the explanation for this findings is simple: women have both estrogen and progesterone receptors in heart and brain cells, which want to be stimulated with the natural hormones. When estrogen is missing, women need bioidentical replacement of what is missing with estradiol transdermal creams. When a woman is progesterone-deficient, she needs replacement with bioidentical progesterone transdermal cream or with micronized progesterone orally.

Estrogen

KEEPS study

With regard to estrogen replacement the KEEPS study has shed a new light on what is going on with hormone replacement in women.

700 women in early menopause participated in this study. Treatment consisted of 0.45 mg of Premarin (still the wrong hormone) or 50 micrograms of transdermal estradiol (the right active human estrogen). Women also received 200 mg of micronized progesterone (Prometrium, the real human progesterone) for 12 days each month. After 4 years of observation there was no case of breast cancer, uterine cancer, heart attack, transient ischemic attack, stroke, or blood clots in veins between the three groups. Both Premarin and transdermal estrogen had slightly reduced coronary artery calcifications on CT scans compared to the placebo group without hormones. The Premarin group increased the triglyceride and the CRP (a measure of inflammation) levels while the transdermal human estrogen did not do that.

It is a disadvantage to the woman, if she does not receive bioidentical hormone replacement after menopause 

Another study showed that due to the WHI study with the wrong synthetic hormones many women were fearful of starting estrogen replacement. The lack of hormone replacement with nature-identical hormones is responsible for the death of many women, who did not have the beneficial effects. They died of cancer and heart disease.

Dr. Rothenberg explained that this study and others have shown the following
  1. Bioidentical hormone replacement must be started immediately at or before menopause to have the best results in terms of cardiovascular and neuroprotective (Alzheimer’s) prevention.
  2. Oral estrogen induces inflammation, which causes heart attacks, strokes and venous thromboembolism (blood clots). To prevent this, estradiol must be given as a transdermal cream. This will avoid the first pass effect through the liver, which is the cause for inflammation. Transdermal estradiol does not have the first pass effect. Inflammatory cytokines are implicated in autoimmune processes, initiation of cardiovascular disease, osteoporosis and Alzheimer’s disease.
  3. If estrogen replacement is not done right away with the start of menopause, the estrogen receptor may get damaged, which means that when estrogen replacement is started at a later date, it is no longer effective.

Progesterone

Progesterone is the other female hormone that physicians often overlook. It balances the effects of estrogens, but the body can also metabolize it into estrogen or testosterone. Tiny amounts of testosterone are necessary for normal libido. In premenopause the ovaries already reduced progesterone production. She should receive progesterone replacement by transdermal bioidentical progesterone cream in premenopause.

Estrogen dominance needs to be treated with transdermal progesterone (or micronized oral progesterone). Both estrogen and progesterone can be accurately determined using a saliva hormone test. Blood tests are accurate for estrogen levels, but not for progesterone levels.

Thyroid replacement

Not infrequently thyroid tests are low (hypothyroidism) and cholesterol levels rise. This can lead to heart attacks and strokes. For instance, a slightly elevated TSH of 5.5 is associated with a total cholesterol level of 209 mg/dL, and a TSH level of 7.0 is associated with a cholesterol level of 270 mg/dL (normal less than 180 mg/dL). It is very important to detect hypothyroidism early and to treat it effectively to prevent cardiovascular disease. The active thyroid hormone is T3. Thyroid replacement has a stabilizing effect on the heart rhythm. It works together with testosterone in men and estrogen in women to stabilize metabolism of all cells, but in particular the heart muscle cells and brain cells. Hypothyroid patients are often depressed, but thyroid replacement lifts the depression. Cognitive deficits in patients with hypothyroidism are also remedied with thyroid treatment.

Growth hormone replacement

Growth hormone (GH) is important in childhood for bone growth and growth of all the organs. But GH still has an important function later in life. GH improves cardiac performance; it does so by thickening the wall of the left heart chamber, the main pump of the heart muscle. GH improves the contractility of the heart muscle, reduces the stress on the heart muscle wall and decreases vascular resistance. In animal experiments GH plays an important role in remodeling the heart after a heart attack.

GH deficiency occurs with aging; it leads to high LDL (bad) cholesterol and high triglycerides in the blood and increased fibrinogen, which causes blood clots. All of this increases the risk for heart attacks and strokes.

Age-related GH production declining

When people age, they lose GH production, which puts them at a considerable risk to get heart attacks and strokes, but they are also at a higher risk of serious falls due to muscle weakness and balance problems. When the doctor detects low IGF-1 levels in the blood and confirms low GH metabolites in a 24-hour urine sample, the time has come to do daily GH injections with human GH. You achieve this using a similar pen that is in use for insulin injections. The dosage is only between 0.1 mg and 0.3 mg per day before bedtime. This is remarkably effective not only for heart attack and stroke prevention, but also to treat muscle weakness, lack of mental clarity and general well being. Patients report that their joint and muscle aches disappear and they can engage in physical activities again.

Melatonin replacement

Most people think of melatonin as the “sleeping hormone”. The pineal gland releases melatonin. It rules overnight giving you a refreshing sleep. In the morning and during the day the light that enters your eyes inactivates it.

Melatonin is a powerful antioxidant, stabilizes the heart’s rhythm (anti-arrhythmic activity), is anti-inflammatory, anti-hypertensive and protects against heart attacks and strokes. People who have heart disease often have very low blood melatonin levels. Physicians can use melatonin intravenously in patients who have heart attacks. This will reduce the amount of damage to the tissue and stabilize the heart rhythm.

Age-related decline of melatonin production

Like with GH, the production of melatonin deteriorates significantly beyond the age of 40. Blood levels of melatonin can be easily ordered, and replacement is easy to do. 3 mg of melatonin taken at bedtime will be a sufficient dose for most people. You can take another 3 mg, if you wake up in the middle of the night. It will wear off within 3 to 4 hours.

Vitamin D replacement

The history of vitamin D3 is interesting. Vitamin D3, the active form of vitamin D has many actions: it stimulates the immune system and reduces the risk of infection, it reduces blood pressure, it reduces inflammation by reducing circulating cytokines, and it increases insulin sensitivity making insulin receptors more responsive.

Vitamin D3 binds to the vitamin D receptor, which is contained on all cells.

Many middle-aged and older people are deficient for vitamin D.  A lack of it leads to higher mortality. Vitamin D helps to restore circulation in patients with ischemic heart disease. Vitamin D insufficiency causes high blood pressure, diabetes and metabolic syndrome. In addition, vitamin D deficiency also causes enlargement and thickening of the wall of your heart’s main pumping chamber, heart failure and chronic vascular inflammation.

More on the effect of vitamin D3 preventing mortality

A prospective 7.3-year study looked at the hazard ratios of the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality files with lower 25-hydroxyvitamin D levels. There were 33,994 persons part of the survey, of whom 1,493 died.

Below 10 ng/ml of 25-hydroxyvitamin D level the mortality was 2.5 fold for all causes and 3.08-fold for cardiovascular causes compared to those with levels of 100 ng/ml or higher.

The recommendation presently is to maintain serum levels at 60-80 ng/ml of 25-hydroxyvitamin D to prevent cardiovascular disease.

Effects Of Hormones On The Heart

Effects Of Hormones On The Heart

Conclusion

The following is important to remember regarding prevention of heart disease.

  1. Never smoke or if you do, quit smoking.
  2. Have your thyroid hormones checked. Thyroid hormones are important as an energy source for your heart muscle, and they lower LDL cholesterol levels.
  3. Your sex hormones matter: in men it is testosterone, in women estrogen and progesterone that support your heart.

Other effects on the heart

  1. Vitamin D is not only important when we grow bones as youngsters, but it continues to be important when we are older. It supports our heart and other body functions. It is an essential team player, as it prevents premature deaths. Blood levels of vitamin D are easy to measure.
  2. Two hormones leave us rapidly as we age: melatonin and human growth hormone. However, the physician can measure the levels of both hormones and if low he can replace what is missing.
  3. There are only two more things you need to do: eat a Mediterranean type diet and exercise on a regular basis. This will ensure your heart is still healthy in years to come.

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Nov
05
2014

How To Cope With Time Switches

This review is about how to cope with time switches. In Europe daylight saving time begins on the last Sunday in March and wintertime starts on the last Sunday of October. Here in North America we start daylight saving time on the second Sunday of March and end it on the first Sunday of November each year.

With the time switch just last weekend I thought it would be worthwhile to comment in a blog how our bodies, particularly our hormones suffer from this.

You may have heard about the circadian rhythm with respect to hormones. The changes of the sun causing the day/night cycle have profound influences on our hormones, called the diurnal hormone changes or the circadian rhythm.

How do circadian rhythms work?

In the morning when you open your eyes, light enters our eyes and the hypothalamus registers this in the suprachiasmatic nuclei (see Ref.1). There are also links from the hypothalamus to the pineal gland, where melatonin is synthetized and stored. The light signal stops the secretion of melatonin from the pineal gland, although it is still being produced during the day in the pineal gland, but stored there until the evening hours set in. You may have noticed that you start yawning when the light dims in the evening. That’s when melatonin is released into your system to let you know its time to go to sleep.

Of course, we have electrical light and can turn night into day if we choose to! This works for a limited time, but eventually tiredness sets in, and melatonin wins the upper hand. Melatonin is the master hormone of the circadian rhythm.

Cortisol and melatonin are natural opposites

It is interesting to note that cortisol does exactly the opposite. Cortisol is the adrenal gland hormone that helps us cope with stress. When we are fully awake, we need cortisol to cope with stress. Melatonin inhibits cortisol secretion and cortisol inhibits melatonin secretion, so they are natural opponents working together for your common good. This is part of the circadian rhythm. We can measure these hormones and this is how researchers have found out how this works.

How To Cope With Time Switches

How To Cope With Time Switches

Time switches affect the circadian rhythm

When we switched time back by one hour on our wristwatch and clocks, the internal time in our body did not accept that right away. The body needs to gradually adjust to this by reading the external signals: when are we opening our eyes? What is the light intensity when we get up, what is the light intensity when we go to sleep?  Some people find it easy to adjust; others find it very difficult to adjust. Some individuals breeze through the adjustment process in a day or two. For others it can as much as 1 or 2 weeks before the hormonal adjustment is completed.

Symptoms of problems adjusting the circadian rhythm

Symptoms due to time switch are a feeling of hangover on the first one to two days after the switch. This is despite you having gotten enough sleep, but the quality of sleep was not the same as before the time switch. Your head feels heavy, you are irritable, and you may feel mildly depressed. You also may find it more difficult to concentrate on one thing and you experience fatigue. Some experience insomnia. What is behind this is a disturbance of your cortisol levels. Your cortisol level is normally highest in the early morning hours, just before you wake up. As a male your testosterone level is also highest when you wake up thanks to the circadian rhythm. Both cortisol and testosterone recover their hormone storage during your deepest sleep.

Our hormones are linked to the internal diurnal clock

In women the ovarian hormones have not only a monthly rhythm, but also a 24-hour diurnal rhythm, based on the internal 24-hour clock. The hypothalamus and the pituitary gland have an intimate involvement in both sexes regarding this diurnal rhythm. They are in communication with the pineal gland that produces melatonin to regulate all of the major hormone systems. So, when we switch our watch back by one hour in the fall or forward by one hour in the spring, our body clock is out of sync with the new time that rules the world. This state of being out of sync may last for a few days. We still get tired according to the old time and we still wake up according to the old time until our internal clock has readjusted. People have genetic differences on how quickly they readjust.

Jet lag

When we travel eastward or westward through time zones a phenomenon of being “out of sync” occurs as well, very similar to what happens with time switches. It is the same re-adjusting process of the internal circadian rhythm that our bodies have to come to terms with. Some people are affected more when they travel west though time zones, and it may take them longer to adjust to it compared to traveling east. But other people complain that for them it is just the opposite, and traveling east is the problem for them. North-south travel does not cause jet lag as the internal time and the external time remain synchronized. A very similar phenomenon is happening with the spring and fall time switches. Some people find it nervier when in spring the clock is advanced by one hour and others complain that fall is their difficult time when the time is switched back by one hour. There are genetic differences of how we adjust with our internal clocks.

Shift workers

Shift workers experience problems with the circadian rhythm as well. The switch between working day shifts and night shifts leads to a condition called “shift-work sleep disorder” (Ref.3). Similar to jet lag this is due to the fact that there is a disruption of the synchronization between the body’s inner clock and external cues. The work rules do not allow enough time for recovery. It would be much more cost effective, if unions and employers allowed those who are naturally born to cope with night time shift to work those shifts and allow those who are sensitive to shift-work sleep disorder to work only day shifts. We live in an age of political correctness, but we tend to overlook how our bodies work.

What you can do to ease yourself into the time switch

1. As there is a lack of deep sleep with the time switch, it is not a bad idea to take a short nap when you feel tired during the day. Catch a nap on the weekend or on a day, when you are off work! It’s good for you! This will build up your adrenal gland hormones and give you the extra surge of energy you are craving for.

2. At the end of the day though, you need to go to bed according to the new time to train your pineal gland and your entire hormone system about the new time situation. Your body needs the cues from you, when you start and end your day, so that it can sync your internal clock with the outside time.

Melatonin restores the circadian rhythm

3. A simple remedy that fits right into your hormone rhythm is to take a melatonin tablet (about 3 mg for an adult), available at your health food store or drugstore 30 minutes before bedtime. Ref. 2 states that melatonin “restores the circadian rhythm “. This helps your circadian hormone rhythm by giving it an evening boost of melatonin. This tells your system it is time to go to sleep. At that time when you close your eyes the signals  through the optic nerve shut down. This gives the circadian rhythm yet another signal about what time it is. In just a few days (for very sensitive people in 1 to 2 weeks) your entire hormone system including the circadian 24-hour undulations will be reset. Now your internal clock has been reset and is in sync until the next time switch.

More about hormones: http://nethealthbook.com/hormones/introduction-hormones/

References

1. Melmed: “Control of Hormone Secretion” in: Williams Textbook of Endocrinology, 12th ed.Copyright 2011 Saunders, An Imprint of Elsevier

2. Rakel: Integrative Medicine, 3rd ed. Copyright 2012 Saunders, An Imprint of Elsevier

3. Daroff: Bradley’s Neurology in Clinical Practice, 6th ed. Copyright 2012 Saunders, An Imprint of Elsevier

Feb
15
2014

Melatonin More Than A Sleeping Aid

Melatonin has been available to the public in the US since 1992. It is usually used as a sleeping aid or for jet lag related sleeping problems. However, in the last decade much more data about melatonin has come out that has proven that melatonin is a major hormone. The pineal gland contains another brain hormone, serotonin, which is converted into melatonin within that gland. Melatonin is a key hormone that regulates the sleep/wake cycle. It works in concert with cortisol, which has the highest level in the morning while melatonin has its highest level in the evening and during the night. Melatonin also regulates the menstrual cycle and determines when women get into menopause.

Lately new information has come to the forefront showing that there are connections to Alzheimer’s disease, Parkinson’s disease, stroke size and recovery from strokes. Even traumatic brain injury can be minimized when enough melatonin is present. In addition melatonin is an important anti-oxidant.

Finally, there is evidence that melatonin helps to determine how well we age.

In the following I like to review some of the evidence for all of these claims.

1. Melatonin as a hormone

Melatonin levels were found to be very low in breast cancer and prostate cancer patients. It has been determined that the immune cells have melatonin hormone receptors and need melatonin for stimulation. Because of the immune stimulatory effect of melatonin, it is often given as a cancer adjuvant treatment to other cancer treating modalities. Ref. 1 describes that melatonin regulates the female hormones (LH, FSH), which then determine when a woman has her menstrual period and also when she eventually enters menopause. The pineal gland is the master gland for the diurnal hormone rhythms.

Melatonin More Than A Sleeping Aid

Melatonin More Than A Sleeping Aid

2. Melatonin levels decline with age

Melatonin levels in both men and women decline as we age. This figure shows that the highest melatonin levels are reached by the age of 10; by the age of 40 only 15% of the youthful levels remain while by the age of 55 only 5% or less of the original youthful levels are left. This explains why older people are more prone to infections (missing immune stimulation) and why the sleep pattern in older people is changed (shorter periods of sleep, less restful sleep). Ref. 1 points out that with insulin resistance (from diabetes or due to excessive sugar and starch consumption) cortisol levels are chronically elevated, which in turn inhibits melatonin production.

3. Melatonin protects from neurodegenerative diseases

A newer application of melatonin is as a preventative in the neurological field, particularly in the area of Alzheimer’s disease, Parkinson’s disease and the prevention of strokes. With respect to Alzheimer’s disease studies have shown that patients with Alzheimer’s have much lower melatonin blood levels when compared to age matched normal controls. In ischemic stroke patients it was found that stroke patients had much lower melatonin levels when compared to normal age-matched controls. Other studies have shown that pineal gland calcification was associated with low melatonin levels and a high risk for ischemic stroke. This risk was even higher when the patients had high blood pressure, diabetes and high cholesterol/triglycerides. When a stroke has occurred, it is important that the free radicals are removed as quickly as possible, which is where the antioxidant properties of melatonin fit into a rehabilitative program. The presence of melatonin enhances brain plasticity. However instead of using melatonin after a stroke, it is much better to use melatonin regularly before a possible stroke, as this gives a better chance reducing the size of the stroke. This in turn will lead to a faster and more complete recovery after a stroke.

Another important disease of the elderly is Parkinson’s disease. Melatonin helps to prevent oxidative damage to the dopamine producing cells in the basal ganglia thus preventing Parkinson’s disease. As with Alzheimer’s disease, there is a correlation of low melatonin levels and this neurodegenerative disease, which goes beyond the age-related reduction of melatonin levels. In experimental Parkinson’s disease models in mice melatonin was highly effective in preventing deterioration of Parkinson’s disease.

4. Melatonin may extend life

The combination of being a free radical scavenger, an immunostimulant and an integral key hormone allow melatonin to have beneficial effects in the aging process. When melatonin supplements are given, the stimulation of the immune system can cut down infection rates in the elderly, prevent and mitigate degenerative diseases of the brain (Alzheimer’s, Parkinson’s), re-establish sleep/waking rhythms and help reduce arthritis.

Conclusion

Melatonin is a widely used sleep aid. As it is practically absent in people beyond the age of 55, it makes sense to supplement with melatonin in that patient group. However, there are side effects particularly in people on blood thinners as coumadin competes with melatonin in getting eliminated through the cytochrome P450 liver enzyme system. This will result in longer bleeding times in patients on blood thinners who also take melatonin supplements. It is important that patients discuss this with their doctors. However, given all of the benefits described above, for the vast majority of the baby boomers melatonin supplementation would be very beneficial. Doses as a sleep aid vary between 1mg and 5mg at bedtime for most people. Cancer patients require higher doses (10 to 20 mg per day).

More information on melatonin, which is at the center of the circadian hormone rhythm as the key hormone switching from day to night and welcoming the day by switching its secretion from the pineal gland off in the morning: https://www.askdrray.com/how-to-cope-with-time-switches/

Reference

1. Datis Kharrazian: “Why isn’t my brain working?” Copyright 2013, Elephant Press, Carlsbad, CA, USA (pages 306-310).

Last edited Nov. 7, 2014

Oct
26
2013

Being SAD in Fall (Seasonal Affective Disorders)

Any general practitioner knows that fall and winter are the time when patients come in with a variety of complaints like a lack of energy, problems sleeping, inability to cope with stress, but often there may be non-specific pains like muscle spasm in the back, the shoulders, or indigestion. These symptoms can all be part of seasonal affective disorders (SAD) like depression, the winter blues, often coupled with anxiety.

Emotional health does not fit easily into our health care model. The receptionist will warn the doctor that this is going to be a “difficult” patient. If the doctor has only time for a 5 or 10-minute visit, where only one or two problems can be dealt with, then this does not fit when a patient with SAD has a problem concentrating, falling asleep, and presents with a long list of other complaints. Even 20 minutes or 30 minutes may not be enough to deal with this patient adequately. It is easier to send the patient for tests and to prescribe an antidepressant and a sleeping pill and reschedule for a follow-up appointment. But this likely will result in normal blood tests and investigations, added health care costs, but no solution to the patient’s problem when he  or she simply states “doctor, I feel so sick”.

I thought it would be interesting to review how our emotions can get out of balance and review an integrative approach to SAD.

Definition of SAD

Seasonal depression (also called seasonal affective disorder) occurs during fall (autumn) and winter, but this alternates with no depressive episodes during spring and summer. A person defined to suffer from SAD would have suffered from two major depressive episodes during the past 2 years with no depressive episodes in the intervening seasons of spring and summer (Ref.1). Alternative names for SAD are winter depression and wintertime blues. Typically SAD lasts about 5 months.

Brain hormone disbalance

Around 2002 it was detected that in mice there was a second light sensitive pathway from ganglion cells in the retina that were responsible for circadian hormone rhythms. This was later confirmed to be true also in humans, where photosensitive retinal ganglion cells buried deep in the retina and containing the pigment melanopsin absorb blue light in the visible light spectrum. The electrical signals are sent along the retinohypothalamic tract, so that light from the retina regulates the hormone circadian rhythm (daily hormone fluctuations including the sleep/wake cycle) in the hypothalamus. The hypothalamus is one of the major hormone centers in the center of the brain. As this publication shows there are minor genetic sequence changes for the retinal photopigment, melanopsin in patients with SAD. This affects about 1 to 2% of the American population. Many more have probably partial defects in the function of this pigment.

Being SAD in Fall (Seasonal Affective Disorders)

Being SAD in Fall (Seasonal Affective Disorders)

Many hormones in our brain experience a circadian rhythm.

When the sun goes down, melatonin is produced making us sleepy. In the morning serotonin production goes up and stays up all day, which normally prevents depression. There are other hormones that cycle during the course of the day. Cortisol is highest in the morning and low in the evening and at night. Growth hormone and prolactin are highest during sleep.

There is a lack of serotonin in the brains of patients with SAD and depression.

Symptoms of SAD

A person affected by SAD or any other patient with ordinary depression will present with symptoms of lack of energy, with tearfulness, negative thought patterns, sleep disturbances, lack of appetite and weight loss and possible suicidal thoughts. On the other hand symptoms may be more atypical presenting with irritability and overindulging in food with weight gain. Some patients somaticize as already mentioned in the beginning of this review experiencing a multitude of functional symptoms without any demonstrable underlying disease. It is estimated that up to 30 to 40% of patients attending a general practitioner’s office have some form of depression and in the fall and winter season a large percentage of them are due to SAD.

Treatment approaches to SAD

There are several natural approaches to SAD. However, before deciding to go this route, a psychiatrist should assess the patient to determine the risk for suicide. When a patient is not suicidal, light therapy can be utilized.

1. Light therapy: According to Ref. 2 a light box from Sun Box or Northern Light Technologies should be used for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often takes up to 4 weeks to reach its full benefit (Ref.2).

2. Exercise reduces the amount of depression. The more exercise is done the less depression remains. A regular gym workout, dancing, walking, aerobics and involvement in sports are all useful.

3. Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid is recommended. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.3). Folate and vitamin B12 are methyl donors for several brain neuropeptides.

4. Vitamin D3 supplementation: A large Dutch study showed that a high percentage of depressed patients above the age of 65 were deficient for vitamin D3. Supplementation with vitamin D3 is recommended. (Ref.3). Take 3000 to 4000 IU per day, particularly during the winter time.

5. St. John’s Wort (Hypericum perforatum) has been found useful for minor to moderate depression. It is superior in terms of having fewer side effects than standard antidepressant therapy (Ref.3).

6. Standard antidepressants (bupropion, fluoxetine, sertraline and paroxetine) are the treatment of choice by psychiatrists and treating physicians when a faster onset of the antidepressant effect is needed (Ref.3).

7. Electro acupuncture has been shown in many studies to be effective in ameliorating the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.4).

8. A balanced nutrition (Mediterranean type diet) including multiple vitamins and supplements (particularly the vitamin B group and omega-3 fatty acids) also stabilize a person’s mood (Ref.3). Pay particular attention to hidden sugar intake, as sugar consumption is responsible for a lot of depression found in the general population.

9. Restore sleep deprivation by adding melatonin 3 to 6 mg at bedtime. This helps also to restore the circadian hormone rhythm.

Conclusion

Seasonal affective disorder is triggered by a lack of light exposure in a sensitive subpopulation. An integrative approach as described can reduce the amount of antidepressants that would have been used in the past in treating this condition. This will reduce the amount of side effects. The use of a light box can reduce the symptoms of this type of depression within a few days. But the addition of electro acupuncture and St. John’s Wort may be all that is required for treatment of many SAD cases. Regular exercise and a balanced nutrition (with no sugar) and including vitamin supplements complete this treatment. If the depression gets worse, seek the advice of a psychiatrist and make sure your doctor has ordered thyroid tests and hormone tests to rule out other causes where depression is merely a secondary symptom.

More information on depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

References

  1. Ferri: Ferri’s Clinical Advisor 2014, 1st ed. © 2013 Mosby.
  2. Cleveland Clinic: Current Clinical Medicine, 2nd ed. © 2010 Saunders.
  3. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders.
  4. George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

Last edited Nov. 7, 2014