Monthly Archives: May 2014
Chronic insomnia is a fairly common problem, but it is often addressed by prescribing a sleep medication instead of finding and addressing the cause of the insomnia. In my opinion, it is imperative to identify and address the cause of sleep disturbances instead of merely patching the symptom. I support the use of sleep medications on a short-term basis during times of insomnia and if other remedies have not been effective, but most of those medications have serious side effects and should only be used when absolutely necessary.
We’re all familiar with transient insomnia caused by excess caffeine consumption, stress, grief, pain, etc. Chronic insomnia is characterized by insomnia that lasts for at least a month but which may stretch on for years. Per the National Institutes of Health, most cases of chronic insomnia are side effects of other health problems which may or may not have been diagnosed and addressed.
There are a wide variety of issues that can cause prolonged bouts of insomnia. The list that follows describes some of the most commonly missed causes of insomnia. When possible, I discuss how to identify these causes and how to address them.
The following causes of insomnia are rarely considered when someone has insomnia:
- Blood Sugar Fluctuations: The body has an amazing desire to maintain stable blood glucose levels. Its desire to maintain normal blood sugars is strong enough that it will not allow someone to fall asleep who has a low or high blood sugar. It is also very normal for people with a low or high blood sugar to wake up and not be able to fall back asleep until their sugar is at a normal level. Eating a snack before bed that contains low glycemic carbohydrates combined with protein can sometimes help avoid overnight blood sugar drops. Those who struggle with high glucose levels should work with your doctor to find the perfect insulin dose and eating style to avoid high or low overnight sugars.
- Hormonal Imbalances: This issue is most commonly experienced by women. Progesterone is a reproductive hormone that is known to induce sleep. The highest levels of progesterone occur in the days immediately preceding menstruation. This is why sleeping more is a normal part of PMS for many women. Women who have a progesterone deficiency or estrogen excess often experience insomnia. Depending on the severity of the deficiency or excess, their insomnia may only occur during specific days of their cycle or may occur every night. The best way to identify this type of imbalance is with a saliva hormone test. My favorite can be purchased online: Hormone Level Saliva Test Kit. After identifying any existing imbalances, steps can be taken to bring hormone levels back into balance. Please work with a trained practitioner to address any imbalance identified.
- Neurotransmitter Imbalances: Neurotransmitters are chemical messengers the brain uses to send signals throughout the body. Imbalances in neurotransmitters can have a broad range of effects, but often include sleep disturbances. Neurotransmitter imbalances can be identified via Neurotransmitter Testing. It is important to work with a trained professional to bring neurotransmitter levels back into balance.
- Adrenal Fatigue: The adrenal glands are the body’s “fight or flight” organs. They spring into action anytime the body is exposed to stress. Stressors can result from external environmental sources or from internal, physical challenges. If the adrenals are exposed to stress over a long period of time, they sometimes become fatigued and stop producing normal levels of adrenal hormones. The adrenals secrete over 400 different hormones, so any deficiency will be felt in a wide variety of ways. The most common symptom of Adrenal Fatigue is extreme fatigue, but insomnia can also be an unfortunate symptom. Although saliva hormone testing can be used to test for deficiencies in some adrenal hormones, there is no definitive test to identify Adrenal Fatigue. The most common method of identifying Adrenal Fatigue is identification of symptoms and ruling out other potential physical issues. Adrenal Fatigue is best addressed via changes in eating style, rest, and herbal supplementation.
- Thyroid Imbalance: Many people know that excessive thyroid activity (hyperthyroidism) interferes with sleep, but many people do not realize that insufficient thyroid activity (hypothyroidism) may also cause insomnia. Unfortunately, hypothyroidism is rarely suspected in cases of insomnia and correct testing is rarely ordered. Please read How to be Your Own Thyroid Advocate for more information on how to identify a thyroid imbalance.
- Prescription and OTC Medications: Many medications cause insomnia. Medications for coronary issues, blood pressure, pain, high cholesterol, antidepressants, allergies, stimulants, steroids, decongestants and products for weight loss may interfere with sleep. if insomnia develops, discuss the medications you are taking with your physician.
Have you suffered from chronic insomnia? What was the cause?
In my next post, I’ll discuss natural ways to address insomnia. Thanks so much for reading!
I’m seeing a huge increase in scabies infestations this year. I’m not sure why so many people are affected, but scabies can be very difficult to get rid of. Scabies are tiny mites that burrow under the skin, where they reproduce and excrete toxins that cause extreme itching. Although it sounds absolutely disgusting, scabies are very common, especially in elementary schools, daycares and other environments where people are in very close contact. Scabies are typically spread via prolonged skin-to-skin contact, such as occurs when children sit in a group or during sexual activity. Scabies cannot be caught via brief contact with someone who is infected.
It is important to note that Scabies cannot be passed to or caught from cats and dogs. The mite that causes mange is a different type of mite which cannot survive for extended periods in the human body. I have wondered if the current problem being called “Scabies” is a new mite, as I know several of my clients found their pets became infested with mites after they became infected. Further testing is needed in that realm.
The itching associated with Scabies usually starts on the hands or stomach and spreads from there. The mites can cause redness, but often very few external signs are visible. If the skin hasn’t been scratched, tiny “trails” may be visible under the surface of the skin. These trails indicate the paths the mites took when traveling. People who are extremely allergic to the mites may experience tiny sores and/or large red welts.
To say the itch from Scabies is intense would be putting it mildly. The itch caused by such tiny mites is intense. Some have said it is worse than the itch caused by poison ivy. The itch usually worsens at night and may interfere with sleep. It is the type of itch that is difficult to ignore. Topical anti-itch creams may help briefly, but the itch will remain until the mites are killed.
Scabies cannot live more than 72 hours without human contact, but it may take several weeks for the itching to subside after the mites are dead. The prolonged itching is due to a continued allergic reaction to the mites and their feces. I usually recommend repeating the treatment every two weeks until complete relief is achieved.
If you or a loved one develop an intense itch, it is important to identify its cause. Do not self treat before seeing a practitioner to confirm the cause of the itch.
My recommendations for eliminating Scabies include:
- Seeing a doctor and using the prescription cream. Most contain permethrin, an insecticide. The OTC product Nix (a lice treatment) is also known to be effective against scabies. With the current outbreak, many people are finding the prescription remedies are not working.
- If you prefer to not use the prescription approach, apply tea tree essential oil directly to the affected areas. It may be necessary to apply it head to toe in order to effectively eliminate the infestation. I recommend applying it at least once daily, but preferably three to five times daily. The tea tree oil is known to kill the mites, soothe the skin and alleviate the itch. I like this tea tree oil: http://amzn.to/1jpdLUT
- Wash bedding, towels and clothing on a daily basis using hot water. This is imperative regardless of which other options you choose. I recommend adding a cup of vinegar to the wash cycle. This will help ensure no mites are living in the fibers of clothing and household goods.
- Make a spray using one cup of 100 proof vodka and one tablespoon tea tree oil. Shake well and spray on furniture to kill any mites lingering there. The mites will die if they don’t find a human host within 72 hours, but spraying the furniture will help ensure they aren’t able to infest anyone before they die.
Have you dealt with Scabies? What approach worked best for you?
Polycystic Ovarian Syndrome (PCOS) is a relatively common condition that can destroy a woman’s physical and emotional health. It is a hormonal disorder, but the hormonal imbalances are not limited to reproductive hormones. Current estimates are that five million women in the US have Polycystic Ovarian Syndrome (PCOS). However, PCOS is not fully understood and is rarely tested for using the correct methods, so the numbers are potentially much higher. Another issue is that the symptoms of PCOS closely mimic several other conditions, so proper testing and diagnosis is essential to correctly addressing the correct condition.
The symptoms of PCOS vary from woman to woman, but are caused by an overproduction of male hormones. Symptoms of PCOS may include but are not limited to:
- Weight gain
- Facial hair or excess hair on the chest, back, stomach, fingers or toes
- Deepening of the voice
- Menstrual irregularity
- Insulin resistance
- Frequent ovarian cysts
- Acne and oily skin
- Sleep apnea (periods where breathing stops for short periods while sleeping)
- Pelvic pain
- Skin tags (small “tags” of skin that are painless but can be embarrassing when they occur on the face or in large quantities)
- Dark patches of dry, tough skin
- Anxiety, depression, or wildly changing moods
Many of the symptoms of PCOS are the result of the fact the woman’s eggs never mature and she therefore does not ovulate. The lack of ovulation creates a deficiency in the hormone progesterone. That, combined with the fact that woman’s ovaries are producing excess male hormones and the woman has excess insulin in her blood stream create a waterfall of different negative symptoms.
Although no one is sure what causes PCOS, recent research suggests that insulin resistance is the cause of PCOS. Genetic predisposition, lack of exercise and exposure to excess androgens in the womb may also play a role, and two recent studies found a link between PCOS and exposure to the plastic Bisphenol A (BPA). The original belief was that PCOS caused insulin resistance, but research has confirmed that insulin resistance typically precedes PCOS and may ultimately cause it. Other symptoms of PCOS, such as weight gain, sleep apnea, acne, anxiety and depression, and skin tags are also associated with insulin resistance. (For more information on insulin resistance, please read Modern Epidemic: Metabolic Syndrome.) The simple fact is that excess insulin in the blood stream leads to lower levels of female hormones and higher levels of androgens, both of which are present in PCOS.
Unfortunately, many doctors are unfamiliar with PCOS and are unsure how to legitimately diagnose it. To correctly diagnose PCOS, the following tests should be run.
- Fasting insulin level: This test is essential, as it will reveal the degree of insulin resistance that exists. Unfortunately, very few doctors order it.
- Hormone levels: Both male and female.
- Full thyroid panel: TSH, FT3, FT4 and TPO at a minimum. Thyroid disorders can mimic the symptoms of PCOS, so it is essential to ensure thyroid function is normal. If your doctor only ordered a TSH, find someone else, as it is impossible to gauge thyroid health solely using that test. (Please read How to be Your Own Thyroid Advocate for more information on correct thyroid testing.)
- Ultrasound and/or pelvic exam to check ovaries for cysts and/or inflammation: Please note that having ovarian cysts does NOT automatically mean you have PCOS. Many women have cystic ovaries at some point in their life.
Perhaps equally important, the following question should be asked:
- When did you stop taking birth control? Many women have false PCOS as a result of stopping birth control. It can take over two years for hormones to regulate after taking birth control, and menstruation may be irregular during that entire phase.
Most doctors use the “Rotterdam criteria” to diagnose PCOS. That criteria stipulates that a diagnosis of PCOS must include high androgen levels, cystic ovaries and a lack of ovulation. Unfortunately, this diagnostic criteria ignores insulin resistance, which is an essential factor in addressing PCOS successfully.
Successfully addressing PCOS requires major changes in eating habits and lifestyle habits. Let me say right now that Metformin is NOT an acceptable “treatment” for PCOS. Metformin improves insulin resistance short term but does nothing to address the cause of insulin resistance, nor does it reverse the issue. To truly address PCOS, the body’s natural sensitivity to insulin must be restored via significant lifestyle and dietary changes. Metformin may be useful very short term while lifestyle changes are being implemented, but is neither effective nor advisable to use as the sole option for rebalancing insulin sensitivity.
After making the necessary dietary and lifestyle changes, hormonal balance may be further restored using a wide variety of techniques and/or supplements. Each of these must be carefully selected based on the woman’s individual needs.
The top three things to do to start the process of reversing PCOS include:
- Following a low-glycemic eating plan and greatly reducing consumption of glycemic carbohydrates
- Exercising daily
- Eliminating all processed foods, chemical cleaners, plastic exposure, etc.
PCOS can be addressed and reversed, but the condition has so many varying factors that it is impossible to use a prescriptive approach. Each person’s case must be considered on an individual basis, with very careful choices made to best address the person’s symptoms and causative factors. I work with many women with PCOS and have helped many restore balance in body, mind and spirit. There is always hope.
Mid-Missouri Reproductive Health and Surgery, PCOS and Insulin Resistance
Janssen OE. High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome. Eur J Endocrin 150(3): 363-369
Fernandez, M, N Bourguignon, V Lux-Lantos and C Libertun. 2010. Neonatal exposure to Bisphenol A and reproductive and endocrine alterations resembling the polycystic ovarian syndrome in adult rats. Environmental Health Perspectives http://dx.doi.org/10.1289/ehp.0901257.
Diamanti-Kandarakis E. P2-395. Presented at: The Endocrine Society 92nd Annual Meeting and Expo; June 19-22, 2010; San Diego.