In last week’s column we discussed my favourite options for improving sleep by treating the adrenal glands. We discussed how a low-functioning adrenal gland can make it difficult to fall asleep or stay asleep because of poor production of stress hormones. The signs of the adrenals being involved in the sleep difficulty include difficulty sleeping after stressful days and waking recurrently through the night especially after a stressful day. In this week’s column, we will review hormone therapies that may be helpful in treating poor sleep due to adrenal gland dysfunction.
Hormone replacement therapy is becoming more and more prominent in the healthcare system. In fact, many physicians are focusing their practices on this area of work. HRT is like most therapies in that it has its pros when used appropriately and its cons when it’s abused. I offer hormone replacement therapies as part of my practice because they can provide support in many situations that other therapies can’t offer. HRT can also be part of an overall holistic treatment plan that is designed to fix the problem and not just temporarily treat the symptoms.
I find that HRT can help improve sleep in people who are having difficulty sleeping due to imbalances of sex and stress hormones. In particular, this seems to be most useful for women in the peri-menopausal to menopausal years. This is especially highlighted if the adrenal glands are functioning sub-optimally. The reason for this is that as a woman progresses towards peri-menopause and menopause, the ovaries begin to produce less and less sex hormones like estrogens, progesterone, and testosterone. The adrenal glands then have to pick up some of this slack by increasing their production of sex hormones. Eventually, when a woman enters menopause, her ovaries cease to produce sex hormones and the body becomes largely dependent on the adrenal glands for sex hormone production.
The transition of peri-menopause to menopause typically occurs in the mid 40’s to mid 50’s for most women. However, women who’ve had hysterectomies, other surgeries, or family history of early menopause may experience this transition earlier in life. For many of my patients, their sleep problems significantly worsened during this type of hormonal transitioning and treating sleep with basic sleep medications rarely helps completely resolve the majority of symptoms they experience. The typical symptom picture includes difficulty falling asleep, waking frequently, night sweats, hot flashes, waking unrefreshed yet unable to sleep longer, fatigue during the day, and mid abdominal fat accumulation.
The treatment of poor sleep due to these types of hormonal imbalances largely depends on the stage of peri-menopause or menopause the patient is in, the symptom picture they present with, and the results of hormone testing. There is a wide variety of HRT options that we can prescribe but we always want to make these prescriptions in a targeted way with a short-term, intermediate-term, and long-term plan. Unfortunately, I meet many patients who started some form of HRT without a future plan in place. Often, the initial prescription was well targeted but due to lack of follow up the plan becomes less effective.
If you feel that your sleep difficulties may be a result of hormonal imbalances I highly recommend you seek advice from a physician (MD or ND) who is well versed in therapies designed to address hormonal imbalances. This should include not just HRT but also botanicals, vitamins, minerals, amino acids, glandulars, nutrition, and other holistic therapies. Make sure your not just being treated for the symptom of poor sleep but the treatment is focused on the causes of poor sleep. Don’t immediately jump into hormone prescriptions without a thorough evaluation including some form of hormone testing. As I mentioned in an earlier article in this sleep series, I feel a multi-day saliva hormone testing panel is the most effective at capturing a more accurate representation of hormone levels vs. urine or blood testing.
If you have any questions about treatments for poor sleep you can contact Dr. Barlow via email at [email protected]
or call his office at 250-448-5610.
In last week’s column
we investigated the options for testing the function of the adrenal glands. We discussed how the adrenal glands are the body’s primary producer of stress hormones. We also discussed the consequences of a fatigued adrenal gland when its ability to produce stress hormones precisely when they are required is compromised. That end result is typically fatigue during the day and poor sleep at night. In this week’s column we will discuss my favourite ways to improve sleep by supporting the adrenal glands.
Hopefully, it goes without saying that treating the adrenal glands only helps sleep when the adrenal glands are contributing to the sleep problem. Also, although the remainder of the article is dedicated to my favourite adrenal treatments, this information is not intended as a one size fits all protocol. Treating the adrenals successfully requires choosing the right treatments at the right dose at the right times of the day. What really makes a treatment the most effective is selecting the right option for each individual patient.
The adrenal glands are highly metabolically active organs, especially when they are working overtime. In the earlier stages of adrenal fatigue, the adrenal glands are often able to produce stress hormones on command but may have a difficult time winding down at night. This often causes difficulty falling asleep because they’ve been running “hot” all day. Vitamin C and the B complex vitamins are wonderful for fuelling the adrenal glands in times of higher need. I never look at these vitamins as overly restorative but instead look at them as high octane fuel that helps prevent further damage. These vitamins work well orally but can be administered in high doses intravenously to boost the adrenals through many situations.
An adrenal glandular is a product that contains the raw materials for the adrenal glands to rebuild themselves. They are typically sourced from cattle but contain no actuall hormones. I use adrenal glandular supplements regularly in order to help regenerate the capacity of the adrenal glands. As the adrenals get stronger, they become more capable of producing stress hormones precisely when needed. This often translates into increased daily energy and better sleep at night.
There are more than a dozen botanical remedies that have the ability to in some way improve the function of the adrenal glands. My favourite botanicals include rodeola, withania, sissandra, licorice root, and reishi mushroom. These botanicals help to improve the efficiency of the adrenal glands and when dosed at the appropriate times in the day can help to restore a healthy daily circadian rhythm. I use botanicals for almost every patient suffering from some form of adrenal fatigue because they usually play such a crucial role in recovery the adrenal glands.
There are a number of hormones and prescription options that can be used to treat the adrenal glands. Due to the amount of information I will save this until next week and leave it as the focus of next week’s column.
When I’m trying to help improve someone’s sleep I feel it’s critical to assess the function of their adrenal glands. Poorly functioning adrenal glands can cause people to have difficulty falling asleep at night, promote waking throughout the night, leave people waking un-refreshed in the morning, and create various forms of physical and mental fatigue during the day. Typically, as the adrenals become stronger, a person’s daily energy improves and their sleep quality improves as well.
In last week’s article
we discussed the idea of adrenal fatigue causing poor sleep. We talked about how the adrenal glands are largely responsible for producing our stress hormones. We talked about how we need to produce stress hormones precisely when they are needed in order to feel energized and capable. We also discussed the ramifications of burning out the adrenal gland system and what it feels like to not be able to produce stress hormones in high enough levels at the exact times they are needed. In this week’s article we will look at the methods to test the adrenal glands.
In my opinion, the best way to test the adrenal glands is via saliva testing, a close second option is testing through urine, and blood testing is a distant third best option. First, however, your doctor must understand and appreciate the tasks the adrenal glands take on and the potential signs and symptoms of adrenal fatigue. Difficulty falling and/or staying asleep are two key potential signs of adrenal fatigue. If your adrenal glands are producing inappropriately low or high amounts of cortisol compared to your momentary need, you will likely experience fatigue at times of high need and sleeplessness at times of low stress hormone need. Identifying the patterns and the depth of the problem is where testing methods can really come in handy.
The saliva hormone panel I typically run involves a 3 day collection of saliva samples to measure several stress hormones and sex hormones. It’s important to run samples on various days in order to get a sense of the possible variability a person might experience. By getting enough samples you’re able to see the bigger picture. Cortisol production is measured at 4 different points in the day, which gives you a very good idea of how capable the adrenal glands are on a given day. These samples are usually taken at home, work, or wherever you normally would be so they reflect your typical day. They are collected by the patient, who spits into a tube when they wake up in the morning, and then at 3 other points in the day roughly 4-5 hours apart. This collection is then repeated on 2 other days.
When the results of saliva testing return from the lab we use them in conjunction with a patient’s symptoms, other lab testing, and medical history in order to make an accurate diagnosis. The reason this is so important is because you want to be as specific as possible with supporting the adrenal gland in the right way at the times the gland needs support. For example, if you stimulate the adrenals when they are over stimulated you will only worsen the problem.
DHEA is a hormone best known as the mother hormone because it has the potential to be turned into any stress hormone or sex hormone. Saliva testing is a great way to assess DHEA levels over the course of several days. The accurate treatment of adrenal fatigue really needs to have DHEA accounted for because it reflects the raw materials a person has for their stress hormone and sex hormone production. If DHEA levels are low it is likely a person’s adrenal glands are heading downward. If the DHEA levels are high it’s a sign of a more superficial problem.
In next week’s article we will look at the various options for improving sleep by providing treatment to the adrenals.
In last week’s article we discussed three nutrients that can help people having difficulty getting to sleep. We learned that L-theanine, magnesium, and skull cap each can be used differently to help you wind down for the night. In this week’s article we will discuss the use of adrenal supportive nutrients for the purpose of getting to sleep.
The ongoing disclaimer in this series of articles on sleep is that treating the causes of poor sleep is always much better than trying to sedate the body and push it towards sleep. The subject of this week’s article can be the cause of some peoples inability to fall asleep. Lets now take a brief look at what the adrenal glands do.
The primary job of the adrenal glands is to produce stress hormones on command when you need them to cope with any type of stressor. This could be emotional stress like in an argument, physical stress like exercise, or physiological stress like getting out of bed and starting your day. The better your ability is to make stress hormones precisely when you need them the more energetic you will feel. For those of us who don’t handle stressors as well as we should there is often a toll taken on the adrenal glands over the course of many years and decades. The toll is that they become less able to produce stress hormones exactly when you need them. This starts to show up as fatigue in various forms. Another sign of adrenal fatigue is difficulty getting to sleep. This is because the adrenal glands have difficulty winding down after being pushed beyond their capacity during the day.
My favourite analogy for the adrenal glands compares a 4 cylinder 30 year old car vs. an 8 cylinder 2 year old truck. If you were to drive both of these vehicles up a steep mountain pass like the Coquihalla you would see several differences. The most obvious difference would be in the 8 cylinder's superior ability to pull the load at high speeds without much of a struggle. However, another difference is what happens to the vehicles when they reach the top of the pass. The 8 cylinder’s temperature will be normal and the 4 cylinder’s will be hot. It will also take a lot longer for the 4 cylinder to cool down.
Ideally, you want your body and adrenal glands to be the 8 cylinder engine in this analogy. Many people who have difficulty getting to sleep do so because in some part their adrenal glands are fatigued to the point of measurable dysfunction. One of the most important treatments I offer to sleep is regenerating the function of the adrenal glands for patients with adrenal fatigue.
In next week’s article, we will look at the signs symptoms of adrenal fatigue and the testing and treatment options.