Wednesday, August 22, 2012

Stress and Insomnia (aka 3am hell!)

Compared with good sleepers, people with insomnia secrete more cortisol in the evening before bedtime and in the first half of their sleep; they also have more fast brain-wave activity in non-rapid eye movement (NREM) sleep, both indicators of arousal. Stress is the principal cause of the insomnia that plagues so many millions of Americans.

How does stress cause insomnia? To understand that, we must first know a little bit about the physical processes that occur when we fall asleep. Falling asleep is a natural process that involves a distinct sequence of events in the body. As we approach sleep, there is a gradual lowering of metabolism. Our heart rate slows and our blood pressure declines. Our breathing becomes more regular, and we consume less oxygen. At the same time, there are changes in the processing activity of the brain. The activity of neurons in the cerebral cortex becomes first slower, and then more synchronized, indicating a shift away from the complex, activated patterns of waking consciousness and toward a homogenous, deactivated state. As a result, we cease to process the sensory messages coming in from the outside world, and we slip into quiet sleep.

The adrenal hormone cortisol is a trigger of the stress response. That's not cortisol's only job, however. In addition to the sharp transitory peaks of cortisol secretion that characterize the stress response, there is also a daily, cyclical rise and fall of cortisol levels that govern our level of wakefulness throughout the day and night. Cortisol is excitatory; it arouses us and wakes us up. Blood levels of cortisol have been shown to increase between 50 and 160 percent within thirty minutes of waking; that produces the powerful jolt of arousal needed to wake us up and get us moving in the morning. Then, cortisol levels should decline as the day wears on and reach their lowest point in the evening, allowing us to rest, relax, and sleep.

But, as we know, cortisol levels can also be affected by the conditions of our daily existence. Dangerous, demanding, or threatening events--stressors--cause us to temporarily secrete higher levels of cortisol. That's a good thing, because we need to be aroused in order to answer the challenges that arise in the course of our lives. But when, as a result of prolonged or unremitting stress, whether real or perceived, our cortisol levels get stuck at a chronically higher level, that's bad news for our bodies and minds, and especially bad news for our ability to sleep and rest. Chronic over-secretion of cortisol leaves us chronically hyperaroused. Numerous studies indicate that insomnia is accompanied by excessive activation of the stress-response system not only during waking hours but during sleep as well. Furthermore, chronically elevated levels of cortisol and its precursor, adrenocorticotropic hormone (ACTH), can make sleep shallow, fragmented, and unrestful; delay the onset of sleep; and produce more frequent nocturnal awakenings.

Stress is the principal cause of insomnia. Stress hormones are excitatory. When stress becomes chronic, we become chronically excited, or hyperaroused. When we're chronically hyperaroused, we can't sleep, and the sleep we do get is not as restful.

Tuesday, July 3, 2012

Why antacids are really bad idea.

Beginning in their mid-thirties, most people begin secreting less stomach acid.  Stomach acid secretion then continues to decrease year-by-year.  People who chronically use acid reducers, have hypothyroidism, have low blood sugar, and who have or have had an H. Pylori infection (the bacteria associated with ulcers) are at a greater risk of developing hypochlorhydria.  More than 50% of the world's population harbors H. Pylori in their upper gastrointestinal tract.

Adequate stomach acid is critical to digesting proteins.  Stomach acid begins the protein digestion process and is required to produce a digestive enzyme called pepsin which further breaks down proteins. Fat and carbohydrate digestion and absorption rely on stomach acid as well. Stomach acid triggers the pancreas to produce enzymes that digest fat (lipase), protein (protease), and carbohydrates (amylase).

Additionally, stomach acid aids in keeping the stomach a sterile environment, preventing the overgrowth of bacteria and yeast. Low stomach acid can lead to bacterial or yeast overgrowth, also known as dysbiosis. Stomach acid is also needed to properly absorb micronutrients including calcium, iron, and vitamin b-12 to name a few.

The condition of having low stomach acid is called hypochlorhydria (hi po klor hid ria).  Symptoms of hypochlorhydria include belching, burping, bloating or gas immediately following a meal, bad breath, constipation, poorly formed stool, and undigested foods found in the stool.  Many cases of irritable bowel syndrome are directly related to low stomach acid. Anemia is also common in people with hypochlorhydria.

My next post will deal with correcting/managing hypochlorhydria.

Yours in Health,
Dr. James Turnbull D.C., C.C.S.T., F.I.A.M.A.

Tuesday, October 4, 2011

Your Car Can't Run Without Gas and Neither Can You

A simple sugar called glucose is the primary fuel for every cell in your body. Carbohydrates that you eat break down into glucose that is then delivered to all of your cells via the blood stream. Without adequate levels of glucose in your blood your cells can not perform their functions normally. Your brain, although only about 1-2% of your body mass, uses about 25% of available glucose. Not surprisingly, many symptoms of hypoglycemia (lower than normal blood sugar) are your brain telling your body that it is in desperate need of glucose such as: craving sweets, mood swings, migraine headaches, dizziness, irritability, shaking, being jittery, blurred vision, agitation, light-headedness, and forgetfulness.  It is my clinical experience that hypoglycemia is an underlying mechanism in over 50% of cases of migraine headaches.

Functional hypoglycemia has reached epidemic proportions in this county in the past two decades due primarily to, what I like to call, the SAD SAL—the Standard American Diet, consisting of ever increasing amounts of refined carbohydrates (soda, sugary snacks, breakfast cereals, many coffee drinks) and the Standard American Lifestyle of skipping breakfast, grabbing unhealthy food on the run, high amounts of caffeine, too much alcohol, high stress and not enough sleep.

Hypoglycemia also has devastating effects on the gastrointestinal system, typically by causing low stomach acid and therefore poor digestion, and on the entire endocrine system—all of the glands in your body such as the pituitary, thyroid, gonads, and adrenal glands, that regulate many bodily functions. Many hypoglycemics have significantly suppressed adrenal function leading to symptoms of: sleep disturbance/insomnia, morning sluggishness  afternoon fatigue, dizziness when standing up quickly, salt cravings and weak nails.

Supporting Hypoglycemia--What You Can Do

Diet & Lifestyle

There are many books and websites with information about hypoglycemia. These supportive recommendations are by no means exhaustive, but are a concise summary of necessary diet and lifestyle changes to support hypoglycemia.
  1. You must have breakfast every morning within 30-45 minutes of waking. Breakfast must not be heavy on carbohydrates and have both a good fat and protein source. Breakfast could look something like one or two hard boiled eggs and some low-fat yogurt or a protein shake blended with almond milk and some fruit.
  2. You must have a small snack 2 to 2 ½ hours after breakfast and after lunch. Your snack should be fat amd protein based such as a small handful of raw almonds, cashews or sunflower seeds or a stalk of celery with some almond butter.
  3. Lunch and dinner should include fiber, veggies, and a lean protein. A mixed green salad with steamed veggies and a piece of grilled chicken, fish or lean red meat would be a good option.
  4. You need to establish routines around meals and snacks so that none are ever missed or pushed back an hour or two. Appropriate snacks like trail mix, nuts, seeds or well balanced protein bars must be kept handy in your vehicle and at work.
  5. You must establish good bedtime and wake-up routines. Go to bed and, most importantly, get up at the same time every day. Get at least 6 ½ hours of sleep nightly.
To support all of physiological mechanisms associated with hypoglycemia we suggest supplementing with a broad spectrum of vitamins, minerals, and glandulars to improve nutritive and biological conditions and support healthy blood sugar levels. Antioxidants are also important to support cells during high oxidative stress especially when caused by oxidized blood glucose. Key factors include: thiamin, riboflavin, niacin, B6, Folate, B12, and pantothenate, manganese, chromium, inositol, and l-carnitine, omega-3 fatty acids, and adaptogenic herbs. I often recommend two products from Apex Energetics called Proglyco-SP and Adaptocrine to support functional hypoglycemia both of which have produced outstanding results.  A high quality omega-3 supplement containing EPA and DHA is also of great benefit.  

To find out if hypoglycemia is an underlying cause of your dis-ease, fill-out the free survey at Help Me Be Well will give you a thorough, free report about your potential health pitfalls.

Fuel your system well.

Yours in Health,
Dr. James Turnbull D.C., C.C.S.T., F.I.A.M.A.

Wednesday, September 21, 2011

The Whole Truth about Whole Grains

Inflammation is the fire that burns inside us damaging our cells, our cardiovascular systems, our brains, and our immune systems.  Inflammation is a necessary evil pruning dead or dying cells, fighting infections, and healing wounds.  Gone unchecked, however, inflammation is associated with almost every disease and condition known to man including chronic pain, arthritis, fibromyalgia, chronic fatigue syndrome, sinusitis, allergies, acne, asthma, autoimmune diseases, digestive disorders, dysmenorrhea, endometriosis, alzheimer’s disease, Parkinson’s disease, multiple sclerosis, cancer, heart disease, osteoporosis, hypertension, depression, insulin resistance/metabolic syndrome (pre-diabetes), diabetes and stroke.

Diet is the leading culprit when it comes to inflammation. It is discouraging to discover that so many foods are pro-inflammatory, leaving you wondering what to eat. More discouraging is suffering from many of the numerous diseases and conditions associated with inflammation discussed above.  We need to be careful about consuming pro-inflammatory foods and not take for granted what appears to be current good health. The fewer inflammatory foods we eat, the less inflammation we will have. With every bite, we either increase or reduce inflammation. The problem is most inflammatory diseases develop slowly and without symptoms until it is too late.

Today, let’s talk about grains.  Consider the fact that grains have been consumed for a short period of man’s time on earth. The use of grain products for food has existed for only a (relatively) brief 10,000 years out of the 2 million years in the history of early and modern man. Grains, refined sugar, partially hydrogenated fats, vegetable & seed oils were not consumed for nearly 2 million years.  Humans are genetically adapted to eat fruit, vegetables, nuts, fish, fowl and meat; foods not related to any chronic disease.
Our genetic code is not that different from our predecessors' but our food chain most definitely is. After grains were adopted as a staple food that replaced animal proteins a number of negative health outcomes occurred including the following: 

• Increased infant mortality
• Reduced lifespan
• Increases in infectious
• Increase in iron deficiency
• Increased number of
   dental cavities and
   enamel defects
• Increased osteoporosis
   and other bone mineral disorders

GLUTEN - Many different biochemical components make grains inflammatory. The most notorious is a protein called gluten, which is found in wheat, rye, barley, barley malt, semolina, spelt, kamut, cous cous and possibly oats (thought there is some debate about this). Gluten may cause many symptoms and conditions ranging from Celiac Disease to more common conditions such as headaches. In a 1992 study published in the journal Gut, researchers randomly selected 200 “disease-free” individuals to assess gluten antibody levels. 15% of the subjects were severely affected by gluten and suffered from headaches, chronic fatigue, regular digestive complaints, anemic changes and showed no signs of having celiac disease.  I find this approximate number to be true in my clinical practice as well. Brought to the current population of the United States, 46,000,000 people experience negative effects associated with gluten.

LECTIN - all grains and legumes (beans, lentils, soy) contain sugar proteins known as lectins that can cause digestive system inflammation.  While details are not known, researchers from the Journal of Nutritional Medicine state that, “there is now abundant evidence that lectins can cause disease in man and animals,” such as arthritis, kidney disease, psoriasis, multiple sclerosis, cataracts, congenital malformations, infertility, allergies and autoimmune problems.

OTHER PROBLEMS WITH GRAINS - Grains contain phytic acid which is known to reduce the absorption of calcium, magnesium, iron and zinc. Grains also promote the pH of our body to become more acidic, which is known to be inflammatory. Finally, grains contain higher amounts of omega-6 fatty acids which cause inflammation. This is in contrast to the anti-inflammatory omega-3 fatty acids which are prevalent in fish and green vegetables.

So why are grains so heavily promoted as good for us? First, whole grains do contain nutrients and fiber which are healthy and anti-inflammatory. Unfortunately, these benefits most likely do not outweigh the problems with grains previously discussed. We can obtain the nutrients and fiber required by eating good meats, fruits, vegetables, nuts and using supplements wisely. Second, from an economic standpoint, grains are inexpensive and profitable to store and manufacture. This is why they are found everywhere in fast foods, snacks, easy to prepare meals, packaged foods, etc.

Everything you put in your mouth matters.  Choose wisely.

Yours in Health,
Dr. James Turnbull D.C., C.C.S.T., F.I.A.M.A.

Wednesday, February 16, 2011

What have you done for your brain lately?

Everything you have ever experienced, felt or conducted in life is due to brain function.  The ability to enjoy, perceive, sense, and experience life is dictated by the firing rate and health of your brain.  It is impossible for a person to become healthy mentally or physiologically without a healthy brain.

This very poignant quote from my colleague, Datis Kharrazian, D.C., D.H.Sc. is the subject of this and several upcoming posts about brain function, its relationship to health and physiological functions, and what you can do to preserve and optimize your brain.

Our brain determines who we are, what we do, and what we get out of our lives.  We all know that our brain is vitally important to our existence, so let me ask you a very simple question:  What have you done for your brain lately?

Why do some people’s brains age gracefully, while others struggle for decades with symptoms of brain deterioration?  You and I both know someone in her nineties who is as sharp as a tack—just as mentally agile as she was when she was forty.  Unfortunately, we also know someone who is sixty and struggles with forgetting appointments, remembering names and places, and has difficulty recalling words.  Brain degeneration is a reality for all of us.  It is a normal part of ageing—the brain looses neurons and shrinks as we get older.  So, if it is just a normal part of ageing, why such a disparity?

On top of the normal loss of neurons and brain shrinkage that comes with ageing, our brains are constantly being assaulted by stress, stress hormones, inflammation, dietary sensitivities, poor blood sugar regulation, immune activation, detoxification deficiencies and lack of stimulation.  For the most part this is completely overlooked.

In our traditional healthcare system doctors are not taught to identify early and subtle changes in brain function—only to identify major disease once it has developed and then treat the symptoms.  By the time major symptoms have developed IT IS ALREADY TOO LATE.  Subtle changes in brain function  may be expressed by hypertension, poor digestion, constipation, sexual dysfunction, hormonal imbalances, incontinence, insomnia, depression, abnormal pain perception, and poor balance and coordination—just to name a few.  By the time doctors identify dementia, Parkinsonian tremors, or any other problems the brain has experienced accelerated degeneration for decades and the best that can be done is to manage the disorder.

This approach makes no sense and is not good enough for me.  I don’t want to develop dementia, have my career and family life suffer, lose all enjoyment in life to then just be managed.  Do you?

Here is what I do for my brain on a daily basis:
1.     Manage stress
a.       Vigorous exercise 5-6 times per week
b.      Manage physiological stress with adaptogenic herbs (Adaptocrine K-2) and phosphatidylserine (Adrenacalm K-16)
2.    Support detoxification (also known as methylation) with sublingual B-12/methylcobalamin (K-34)
3.    Antioxidants—the most important one to the brain is glutathione (Super Oxicell K-23)
4.     Reduce inflammation with the essential fatty acid EPA (Omega Co3 K-7)
5.     Support the structure of the brain with the essential fatty acid DHA (Omega Co3 K-7)
6.     Increase oxygenation and manage blood sugar levels with  vigorous exercise 5-6 times per week

The above is a good program for overall brain support and brain wellness, attacking many avenues of brain degeneration including stress, oxidation, detoxification, inflammation, and oxygenation.
Is this the right program for you?  The answer is maybe.  It certainly can’t hurt and will definitely help many people. But, is there a more tailored program for you?  You can start by filling out the Neurotransmitter Assessment Form (NTAF) on our website.  Look at your form—did you circle many 2s and 3s?  Perhaps you should be concerned.

The NTAF, coupled with a physical exam and a comprehensive blood chemistry (the Opti-Cardio test) will help us determine an individualized approach in treating and supporting your brain—helping you to be all that you can be (thanks,  Army).

Yours in Health,
Dr. James Turnbull D.C., C.C.S.T., F.I.A.M.A.