Archives for October 2017 | Integrative functional medicine blog

"Any fool can Know. The point is to understand" - Albert Einstein

Tips to keep your circadian rhythm (sleep cycle) in tip top shape

The 2017 Nobel Prize in Physiology or Medicine was awarded to researchers for their discoveries of molecular mechanisms that control circadian rhythm, our biological “clock.” This sleep-wake cycle helps us move between sleepiness and alertness at regular intervals, and regulates important functions such as:

  • Behavior
  • Sleep
  • Mood
  • Immunity
  • Brain function
  • Hormone levels
  • Metabolism

Although we’ve long known the circadian rhythm exists, the Nobel awardees isolated the gene that controls it and identified the proteins that govern its cyclical function.

The importance of healthy circadian rhythm
Humans are similar to other animals in that our internal clocks are set to the rising and setting of the sun. A healthy sleep-wake cycle is critical for many aspects of our health. Circadian rhythm imbalances increase risk for heart disease, obesity, mood disturbances such as depression and anxiety, diabetes, cancer, dementia, and Alzheimer’s, and other neurodegenerative diseases.

Despite the circadian rhythm’s intuitive design, our modern lives tend to sabotage its critical balance. Some disruptive factors can’t be avoided while others can, but for most of those things we have the tools and knowledge to minimize the negative effects. We just need to do it.

Daylight savings wrecks the biological clock each year

Daylight savings time changes throw a kink in our daily rhythm. The time change is minimal, but studies show rates of driving fatalities, workplace injuries, suicides, and heart attacks rise after the spring-forward change. And night owls take the longest to recover. It will also have a big effect on those that work night shifts.

Prepare for daylight savings time by shifting your bedtime and waking time a bit every day the week before.

Traveling across time zones
Everyone laments how jet lag can wipe you out. Jet lag occurs when the time of day doesn’t line up with your body’s clock. Crossing two time zones should take you about a day of readjustment; however, crossing six time zones can easily take three days or more to recover. So if you are going in vacation somewhere far, just about the time you are recovering from jet lag of getting there its time to go home just to repeat the process all over.

My recommendation is that the farther you are traveling and more time zones you are crossing the longer you should stay, giving your body more time to recover. Plus you get the added benefit of a longer vacation under the guise of it being better for your health.

You can also try taking some melatonin to help trigger your sleep cycle and stay asleep longer. There are also other sleep aids that can be helpful such as valerian root, chamomile, and hops. I have included some links that you can check out.

Beware; chronic time zone jumping can lead to a suppressed immune system,
chronic fatigue, and memory issues.

Here are some other tips to help you when traveling to lessen the effect of jet lag.
Plan ahead by moving your body’s time clock toward the destination time zone during the week before.

Hydrate before and during the trip.

Choose a flight that gets to your destination in early evening and stay up only until 10 p.m. local time. If you arrive early and are exhausted, take a two-hour nap but no longer.

Once at your destination, expose yourself to the sun’s rays to help your body sync up with the new time zone. This one is actually really simple and one of the most effective things to do.

Poor sleep habits
Twenty percent of the population is estimated to sleep too little (less than 6 hours a night); this can lead to changes in genes that regulate stress, our immune system, sleep-wake cycles, inflammation, and aging. Chronic sleep deprivation is linked to heart disease, diabetes, obesity, stress, inflammation, dementia, and depression. 7-8 hours is really the best amount and some people may even need more.

Let’s talk electronics!
The CDC says insufficient sleep is a public health epidemic and research has established that the constant exposure to blue light from electronic devices is a major culprit.

Blue light and screen time
Changes in the levels of the hormone melatonin in your body are what make you fall asleep. During a normal day, morning light stimulates the body to decrease your melatonin level, promoting wakefulness, then as the day darkens, melatonin increases to encourage sleep.

However, adults and children disrupt this cycle by using smart phones and tablets late into the night. This can cause chronic insomnia because the blue light these devices emits is perceived by our brains as daytime light, which suppresses melatonin and keeps us awake.

Some tips to reducing the melatonin disrupting effect of blue light

Minimize blue screen time. Read a book instead. Turn off all screens (phone included) two hours before bed. If you can’t do that, get a pair of orange safety glasses. Side note: Turn you phone to airplane mode before you go to bed. That wi-fi is damaging.

Also, change the settings on your phone to what is called “night-shift” or “day-shift.” The phone will automatically shift the light type based on the time of day.

Improper daytime and nighttime light exposure
Proper patterns of light exposure during the day are a major factor affecting how well we sleep.

Start each day with as much bright light as possible. Eat breakfast with as many lights on as possible to stimulate serotonin production, which helps melatonin production later in the day. Serotonin converts to melatonin. You can also add a sun light.

Get light during the day at home and work. Open the shades; turn on all the lights (try full-spectrum); sit by a windowand look out often; take a walk outside during your breaks.

Minimize light in the evening by dimming or turning off unnecessary lights. Put orange bulbs in lamps you use at night, especially next to your bed and for reading. This helps to jump start melatonin production in preparation for sleep.

Lack of sunlight
Patterns of light during the day aren’t the only way light affects our circadian rhythm; exposure to actual sunlight is key for healthy function of the body and brain.

Research shows the average person spends less than an hour a day outside. Shift workers spend even less time outdoors. Lack of exposure to sunlight inhibits production of melatonin, affecting sleep and potentially affecting our ability to produce Vitamin D, key for bone health, mood regulation, and immune function.

Get direct sunlight every day. If you can’t get outside, use a quality light box early in the day.

Go sunglasses-free even for just 10–15 minutes, to provide beneficial sunlight exposure to your eyes and brain.

Respecting our body’s natural rhythm
Your body’s innate sleep cycle is largely controlled by the amount and pattern of light and dark you are exposed to each day. By managing the lifestyle factors that disrupt your circadian rhythm, you will support your body’s ability to function well and stay healthy. For help with sleep issues, please contact my office.

I have included a bunch of links at the bottom of this post for some products that can help improve your quality AND quantity of sleep.

And for those that like to save some more money check out my
link HERE to a page on my website where you can buy supplements direct and in many cases 10-15% cheaper than on amazon.

I primarily use Physician only brands such as
Xymogen and Designs for health, which if you are a patient, you can order directly from them or in my office. Another great option is Healthwave, also known as Fullscript. This is were I recommend patients get the rest of their supplements if they aren’t able to make it into my office. We buy in bulk and don’t charge extra sales tax so you get it cheaper, but these websites are great alternatives.

I’m Dr. Craig Mortensen
Be healthy, be happy.

Recommended Products:
Sleep aids:

Melatonin -.5-1mg should be plenty
Valerian root
Kava - also a natural anti-anxiety supplement
Gaba - See my post on testing for leaky gut with gaba
Lemon balm

Products to help circadian rhythm (or not impair it)
Light therapy box
Blue blocking glasses/orange glasses
Full spectrum lights

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Are those mysterious unexplained symptoms really an autoimmune disease?

Do you have mysterious health symptoms — such as fatigue, pain, brain fog, or unexplained weight gain?

These issues can often rob you of your quality of life.
Are traditional lab tests and doctors saying nothing is wrong with you? Or maybe doctors tell you your chronic symptoms are depression and you need an antidepressant. Maybe you’ve even been accused of complaining too much.

It’s very sad, but I cannot tell you how many times I have heard a patient tell me that a doctor told them…
”it’s all in your head.” Are you kidding me?!!! That is terrible!

Most people know when something is wrong with them, even if lab tests come back normal and doctors say you’re fine. They just might not know whats wrong with them.

This is because the standard health care model does not screen for autoimmunity — a disorder than occurs when your immune system attacks and destroys your own tissue. You can suffer from symptoms of undiagnosed autoimmunity for years or even decades before it is severe enough to be diagnosed and treated in the conventional medical model.

You have probably heard me say this before, but I will say it again. I have patients that are told by doctors all the time to wait until their symptoms get bad enough and then they will do something about it. This is when patients lab tests results are in what we call the “suboptimal” or “subclinical” range.

An easy example is with anemia. A common % transferrin saturation range is from 15 - 50. So if a women gets her iron levels tested and it comes back at a 16 or 17 they say you are normal. But what if you were normally at a 25, 35 or 45 and now you are at a 17? You could be labeled “normal” at 17 but possibly be at literally 1/2 of what you used to be. This is what we mean by subclinical/suboptimal.

Fortunately, in functional medicine we can screen for autoimmunity against multiple tissues in the body at once. Knowing an autoimmune reaction is causing your symptoms can remove the mystery and bring significant peace of mind. It is confirmation your health symptoms are real and proof you are not a whiner or hypochondriac.

We identify autoimmunity by testing for antibodies in the blood against a particular tissue. For instance, we can screen for Hashimoto’s, an autoimmune thyroid disease that causes hypothyroidism, by testing for immune antibodies against thyroid peroxidase (TPO) and thyroglobulin (TGB). Positive results mean autoimmunity is causing your hypothyroid symptoms of weight gain, depression, fatigue, constipation, cold hands and feet, and hair loss.

What is my favorite and really the only test you should use to screen for autoimmunity you ask. It is a lab test by Cyrex labs. They really are the only ones that do this type of testing, at least one that is any good.

Cyrex Labs tests for 24 different types of autoimmunity at once. The specific panel is called Array 5 Multiple Autoimmune Reactivity Screen. It is more cost effective than testing for each autoimmunity individually, and Cyrex Labs tests are highly sensitive.

To do the test, simply ask us for the kit, take it to an approved blood draw center, and vioala, we will find out if you are having an autoimmune reaction.

If your test results are “positive” or “equivocal,” it means your immune system is attacking that tissue. You may not even have symptoms yet. This is a best-case scenario because managing your health with functional medicine can prevent the autoimmunity from progressing.

The old saying “an ounce of prevention is worth a pound of cure”
is very true in the case of autoimmune.

Array 5 screens for the following autoimmunities:

  • Parietal cell and ATPase instrinsic factor: Stomach autoimmunity
  • ASCA, ANCA, and tropomyosin: Intestinal autoimmunity
  • Thyroglobulin and thyroid peroxidase: Thyroid autoimmunity
  • 21 hydroxylase (adrenal cortex): Adrenal autoimmunity
  • Myocardial peptide, alpha-myosin: Cardiac autoimmunity
  • Phospholipid platelet glycoprotein: Phospholipid autoimmunity
  • Ovary/Testes: Reproductive organ autoimmunity
  • Fibulin, collagen complex, arthritic peptide: Joint autoimmunity
  • Osteocyte: Bone autoimmunity
  • Cytochrome P450 (hepatocyte): Liver autoimmunity
  • Insulin, islet cell, glutamic acid decarboxylase (GAD): Pancreatic autoimmunity
  • GAD, myelin basic protein, asialoganglioside, alpha and beta tubulin, cerebellar, synapsin: Neurological autoimmunity

If you have no symptoms but a positive result, then you may be able to prevent the autoimmunity from expressing itself completely. If you have symptoms that correspond with a positive test result, other testing may help you track your condition. For instance, if you test positive for Hashimoto’s hypothyroidism, follow up with thyroid testing will track the severity.

Knowing you have an autoimmune reaction means you can halt its progression and prevent it from worsening. This can mean preventing or even reversing devastating and debilitating symptoms.

Remember…”an ounce of prevention…” you finish the sentence!

I’m Dr. Craig Mortensen
Be healthy, be happy.

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Stress and hormone balance, Pregnenolone Steal

It’s not easy being female.

About 60-70% of all my patients are women. It’s not that men don’t need functional medicine, it’s that they think they don’t or they are too tough to need it.

Women suffer from the hormonal ups and downs each month and through puberty and then through menopause. These can range from mildly irritating to downright debilitating. Although many, if not most women suffer from some degree of premenstrual syndrome (PMS), the extreme health and mood imbalances associated with PMS and menopause are a sign your system is out of whack, often due to stress, among other issues.

Hormone balance is very sensitive to stress, inflammation, toxins, poor diet, sleep deprivation, lack of exercise, too little sunlight, and other common factors of modern life. Because the reproductive hormones play an important role in brain health, mood, and brain inflammation, when they’re imbalanced, brain function and mood suffer.

In women, imbalances are characterized by excess estrogen, insufficient progesterone, or too much testosterone. Both stress and blood sugar that is either too low (hypoglycemia) or too high (insulin resistance) are the most common culprits of PMS symptoms and a miserable menopause transition.

Symptoms of hormonal imbalances in women include:

  • Frequent or irregular menstruation
  • Mood instability
  • Depression
  • Problems sleeping
  • Changes in weight or appetite
  • Cry easily
  • Irritable
  • Poor concentration
  • Anxiety
  • Fatigue
  • Low libido
  • Migraines

Low pregnenolone/progesterone from chronic stress

One of the more common reasons for hormonal imbalance is low progesterone caused by chronic stress. This is a mechanism called “pregnenolone steal,” when chronic stress robs the compounds needed to make progesterone to make stress hormones instead. This leads to PMS and sets the stage for a miserable menopause transition.

When it comes to stress, the brain does not know whether you are angry at traffic, soaring and crashing after consuming a glazed donut and triple-shot caramel latte, or narrowly escaping being trampled by a bison, or chased by a lion. All it knows is to prepare for fight or flight and that reproduction hormones can wait until things have settled down. But for many sleep-deprived, over-stressed Americans fueled on caffeine and sugar, settling down rarely happens. This leads to an over production of cortisol and a decrease in pregnenolone and/or progesterone leading to a decrease in hormones.

The fix isn’t necessarily in a tub of progesterone cream; first address the sources of stress. A primary stress-buster is stabilizing blood sugar. People either eat too infrequently and too sparingly, or they overeat and eat too much sugar. Both are stressful for the body.

Here are some other common causes of chronic stress that lead to miserable PMS and menopause:

  • Sugar, sweeteners, starchy foods (rice, pasta, bread, etc.), too much caffeine
  • Food sensitivities (gluten, dairy, eggs, soy, corn, nuts, grains, etc.)
  • Leaky gut and gut inflammation symptoms — gas, bloating, indigestion, heartburn, diarrhea, constipation, stomach pain, irritable bowel
  • Sleep deprivation
  • Pain and inflammation — joint and muscle pain, skin rashes, respiratory issues, brain fog, fatigue, depression
  • Autoimmune diseases such as Hashimoto’s hypothyroidism
  • Overdoing it, over exercising, not taking time for yourself
  • Bad diet of junk foods, fast foods, processed foods

Restoring hormonal balance naturally

Ideas to halt pregnenolone steal include an anti-inflammatory diet, stabilizing blood sugar (SUPER IMPORTANT), restoring gut health, dampening pain and inflammation, and managing autoimmunity.

These are functional medicine basics. Make sure you are eating the right amounts and kinds of essential fatty acids. Additionally, certain botanicals are effective in supporting female hormone health and the body’s stress handling systems. I have included some links to some of the more common hormone balancing supplements we use in my office.

Go take a chill pill

I’m Dr. Craig Mortensen
Be healthy, be happy.

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