Sleep Too, Early Waking

Some people fall asleep fine but cannot stay asleep. Like other sleep pathology this can be due to a complex interplay of underlying reasons. Often the 24H cortisol circadium rhythm has become dysregulated and the early morning peak is coming earlier than it should, waking people up at 3, 4 or 5am. What can be done? There are some prescription sleep medications that can be helpful, and global stress management skill building is also important. Underlying anxiety disorder may need to be treated and substance use disorders are also major players in sleep-wake disorders.

Alcohol is an obvious player in the 3am waking game. For people who drink regularly, depending on what time one goes to bed and therefore stops drinking, at some point the alcohol with start to wear off and the withdrawal will start bringing agitation, heart palpitations, sweating, and headache. This can cause early morning waking between 3-5am. Chinese medicine correlates each organ to a 24H clock, and this time of day is the Liver time. Ironic, yes? Accurate, yes? Decreasing evening alcohol can certainly result in better sleep. Alcohol free evenings may take some time to produce better sleep but after about 7 days of abstinence the sleep cycle will begin to regulate. If full abstinence is not desired, start by at least assessing the effect of alcohol and considering your own motivations for changing drinking patterns as they do certainly effect sleep negatively. Having some protein closer to bed time can be stabilizing to blood sugar and alcohol metabolism overnight.

This is true for diabetics as well as for people using alcohol. This is not my area of expertise, but diabetes is related to increased cortisol levels due to the connection between fasting blood glucose, blood sugar, and the liver and pancreas control of blood sugar during the overnight fasting period. There are several studies on sleep disorders in people with diabetes which have evidenced that there are clinical correlations. If you have diabetes and poor sleep, I recommend working with your PCP or Diabetes specialist to make sure your blood sugar issues are not the root cause before moving into more behavioral or psychiatric sleep medications and sleep medicine studies.

The first botanical medicine I turn to when faced with early waking is a version of several different formulations using standardized botanical extracts of magnolia. The first agent that was trademarked was called Relora and was a Canadian product. This standardized extract regulates disorderde circadiuan rhythms. Whan taken at night it helps smooth out early morning cortisol spikes, decreasing early morning waking related to stress and anxiety. It also has some evidence to decrease stress related eating, and improve subjective mood and wellbeing.

Relora vs placebo effects

A similar American product is Cortisol Manager by Integrative Therapeutics. This product also uses the honokiol standardized extract with magnalol rather than berberine. This product is combined with ashwaganda (Withania somniferol). Ashwaganda also has evidence that it adjusts dysregulated cortisol circadian rhythms for improved early morning waking. There are many sleep formulations available that contain Ashwaganda. Gaia brand “Sleep Thru” formulation is another similar product for use when early waking is the issue rather than difficulty falling asleep.

These botanical formulas are generally safe for people without significant health conditions. If you are taking more than 5 medications, have kidney disease CKL3 or greater, or are on immunosuppressive drugs for transplants, autoimmune disease or any other indication, supplements should not be taken randomly without supervision by a licensed Naturopathic doctor or trained herbalist as there could be real drug-herb interactions.

 Finally, as mentioned at the beginning, emotional stimuli do go thru hypothalamic-pituitary-adrenal axis to effect cortisol secretion. Lifestyle modifications are necessary in every case to at least consider the underlying causes of the stress. A pill alone cannot regulate a deeply engrained habit or pattern. Most health care providers would like to hear about what is keeping you up at night, in order to troubleshoot with you ways to improve coping and reduce suffering. These plant based medicines are allies in your journey towards improved health and are only part of the team based approach that real change towards health entails.

lDeshpande A, Irani N, Balkrishnan R, Benny IR. A randomized, double-blind, placebo-controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults. Sleep Med. August 2020;72:28-36.

Talbott, S.M., Talbott, J.A. & Pugh, M. Effect of Magnolia officinalis and Phellodendron amurense (Relora®) on cortisol and psychological mood state in moderately stressed subjects. J Int Soc Sports Nutr 10, 37 (2013). https://doi.org/10.1186/1550-2783-10-37

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Anyone else a Type O?

BLOOD TYPE O

SUMMARIZED FROM DR. D’ADAMO’S BOOK

EAT RIGHT FOR YOUR BLOODTYPE

FOODS THAT WILL HELP YOU GAIN WEIGHT

corn wheat navy beans
KIDNEY BEANS LENTILS CABBAGE
BRUSSEL SPROUTS CAUILFLOWER MUSTARD GREENS
     

FOODS THAT WILL HELP YOU GET THINNER

KELP SEAFOOD SALT
LIVER RED MEAT KALE
SPINACH BROCCOLI  

BENEFICIAL FOODS:

FLAX SEEDS PUMPKIN SEEDS WALNUTS
ADUKI BEANS PINTO BEANS EZEKIAL BREAD
ONIONS KALE SWEET POTATO
FIGS PLUMS PRUNES
PINEAPPLE JUICE CAROB PARSLEY
TUMERIC BUBBLY WATER  

FOODS TO AVOID:

BACON OCTAPUS, LOX
ALL CHEESE PEANUT OIL AVOCADO
MUSHROOMS OLIVES POTATOES
MELON STRAWBERRIES ORANGES
COCONUT APPLEJUICE CINNAMON
VINEGARS KETCHUP CAFFEINE
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A Pandemic Wasn’t the Plan: Pt 1 – Food/Meditation 03/19/2020

When I went to San Francisco for holiday, the plan was not to get caught in a COVID19 community spread hotspot during my intern year in Internal Medicine. The plan was to get some heavy mist, ocean waves, redwood love and friend time. I got 2 out of the 4. What I received instead was some insight into my core values of medicine, health and healing and an increased horror of capitalism.

Having gone through a childhood living in a holistic health center outside of mainstream America, then Canada, then college and Naturopathic/ Acupuncture medical school in Canada I have a very left of center foundation of health and healing. And Yet I am an Internal Medicine doctor and successfully completed a fairly traditional, rural medicine based allopathic medical training. I rarely bring any of my foundational knowledge into my daily practice of medicine as we know it – even when I witness its applicability.

I consider myself at the bottom of the pyramid of medical training – a lowly intern- and always endeavor to learn and practice evidence based hospital based medical standards of care. There is so much I have to learn and I am truly a convert to the Church of Pharmacy. Yes, i prescribe vaccines and statins and birth control and antihypertensives with assurance and pride.


But in this situation, where there is no medicine other than the possible monoclonal antibody being engineered by Regeneron, I fall back on my original pillars of nutrition, botanical medicine and even prayer as medicines worth bowing to.

Ive been talking about the food parts alot lately on this blog. See Food Sensitivities as well as other Food as Medicine posts. I have been triggered and upset by the food hoarding and money spending on food that has been happening over the past two weeks as people collectively buy out shelves of food to stock their fridges. I mean, I love a full fridge and meal planning and I have love for the folks taking the time to cook vegetables and eat fruits and make special meals for themselves and family. I am sadenned by the scarcity mentality that has erupted like Pompeii and concerned about both restrictive food mentality and binge eating with or without purging in these uncontrollable times. Not to mention alcohol and pot and other substance use skyrocketing without the structures of work outside the house and mouting social and familial pressures…..

What is the medicine for this in these times? I do think its prayer and mindfulness. Cleaning house. Feng Shui. Emptying our skeletons from closets with literal and metaphorical help from therapists and friends and family across the globe using the internet. My daily quarantine schedule includes:

  • 20 minutes of mindfullness meditation with the Insight App timer or guided visualization
  • 20 minutes of stretching or calisthenics *(or more)
  • 60 minutes of housework to beautify the space for work
  • at least 4 hours of academic work including reading, study
  • 30 minutes of fresh air
  • time online with friends

‘I unexpectedly went to the Stella Maris church in San Fran 3 days in a row. It was in the neighborhood I stayed in, and had a welcoming open door I passed by often. I was drawn to the Marys, lightening candles and saying Hail Marys not only for myself, my lover and my friends but also the world. This is a global issues, not a first world only or American drama. There are decades (generations) of evidence for the power of prayer for long distance healing and miracles. I dont have the energy to research this right now to provide evidence based links; find them for yourself. In this time, more than ever, I believe in the power of prayer to lift us up from our selfishness and anxieties, our fears and projections, and to offer both solace and hopelessness in this wold wide moment we are sharing.

Stella Maris Prayers and Votives

Pema Chodron says it best in her audiobook When Things Fall Apart which I could not recommend highly enough. Having a consciousness that we as healthy or strong humans can hold strength for those who are weaker or less privileged only in this very moment is a position of empowerment and capability that builds on itself. Prayer builds capability out of nothing. There is nothing to lose, and it does not need to be structured within a religion, a god or goddess, or a building. There is no wrong way to connect.

The other thing I have relied on heavily for prevention in these contagions viral times is herbal medicine. I have some knowledge of chinese herbs and some of western herbs. More to follow on pandemic herbal medicine in Part 2

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We Are All Related

Adam DreamHealer’s Message of March 12, 2011: Damaged Japanese Nuclear Reactors

As you are aware, Japan has suffered a major earthquake and the nuclear reactors there have been damaged. We can all focus our energies on a safe resolution of this issue. Your participation in this visualization is your way of helping to create a safe outcome.

Use your positive intentions and this visualization to see their nuclear system cooling safely.

1: Visualize water being pumped into the reactor.
2: See the rods in the reactor totally submerged in water.
3. Know that cooling is happening in an enclosed system.

Please forward this to those you know who will want to be active participants in this global awareness issue.

Thanks for your participation.

The visualization can be found on Youtube.

http://www.youtube.com/watch?v=sTVDCYhTclw

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And in the Beginning, There was Nothing

The absence of sound, a quiet rock on a still afternoon. Sunshine. This is todays first entry. This is the quietness before the first beginning; the dark hour while babies wait to be born and everything seems its most terrible, or wonderful.

I look forward to what this will become, beyond its naming.Thank you for joining me here – See you in the sweetness of what is to come.

Masina

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