Hi, Neil! Long time, no talk!

I haven't bought the book yet, but plan to. I skimmed through all the pages of the thread, but couldn't find an answer to my question.

I'm 51 and starting the ravages of menopause. I'm on a bio-identical estrogen from a compounding pharmacist, but not on the cycles advocated by your wife.

The thing is, I'd love to sleep more, but simply can't. I go to bed between 8:00 and 9:00 every night, since I have to get up at 4:00 in the morning. Trouble is, I wake up almost every night sometime between 1:00 and 2:00 and can't get back to sleep again ... that is, until about 30 minutes before I have to get up. Then I zonk out and wake up very sleepy. I know I'm not getting the restorative sleep I need.

Someone mentioned melatonin. What is the recommendation on this? Is it something I could use for a short time to back into a more natural sleep rhythm? Anything else I could try?

By the way, I fall asleep quickly, but always wake up again -- wide awake -- in the middle of the night.

THANKS!!!

That is happening to me too. :\

I did the 4-times-a-day saliva test for cortisol and adrenals (since this is a common symptom of those things), and I did have low readings on the morning and noon tests. I'm taking licorice root and a bunch of other supplements geared toward helping out in these areas. Hasn't worked yet, and I've been on them around 3 weeks now.

I hate that - sleep problems - I've been up since 3:30.

Susie says take 500mcg of melatonin for each hour after sundown you lay down. Use the chewable kind only, but DO NOT chew it, let it dissolve slowly under your tongue. This will put you to sleep. Take Tylenol PM to stay asleep. Once you reset your clock over a month or so, you can start to wean off the meds.

However, if you're taking a flat dose of estradiol (same every day) and no progesterone, this probably won't help you anyway. And if you were given Trieste (estradiol, estrone and estrace) flush it down the toilet.

-NR

Careful with the supplements. All supplements work across hormone receptors and they all have interactions. I suspect that most practitioners who prescribe them have no idea about this. In fact, I doubt that they could even describe a receptor, much less how they operate. They work on the "beaker" theory - shove some stuff down your throat to solve problems one-on-one.

Thanks, Neil. I'm taking progesterone, not estrodial or the other stuff you mentioned. Details are in my journal. I do think I'm starting to feel better, but who knows. And it's strange, but I'm not really overly tired during the day.

I go to bed around sundown, maybe 8:00 to 9:00 now. I don't have any trouble at all FALLING asleep. I've tried Tylenol PM and it does nothing to keep me asleep.

Someone over in my journal suggested I try some other supplement. Not sure what it's called, but the details are in my journal.

I'll try again tonight!

Bawdy, if you find something that works, let me know.

I tried Ambien but same thing. Fall asleep fine but wake up at 3-4 am wide awake.

Nancy, and you do the same for me. I just posted a new thread on the general LC forum about menopause weight gain. So far, 6 people have stopped to look, but no one has responded. I'm crossing my fingers.

You say in your signature that you're out of estrogen, but you're taking progesterone. Does that make sense?

Try the Tylenol PM with the melatonin (try two tabs to start, but let them dissolve, the dishestive tract chews it up otherwise). You may be falling asleep, but not really cycling - the melatonin will help that. Is the room dark? No noise, blinking lights, etc.? If you wake up, don't look at a clock, just go back to sleep. Try to avoid sequential thinking or problem-solving, conversation, etc. Think about walking on the beach or something like that.

My signature? It's a joke!

The room is totally dark, no light on the alarm clock even. I know I can't sleep with any light on at all, even if the light at the bottom of the stairs is on, I can't sleep. So, totally dar,. No noise. We do use a fan at night, both to keep cool and for the ambient sound. I find I have trouble sleeping anymore if there's no fan, like if I'm in a hotel room or at a friend's house.

I do try to clear my mind. I never wake up thinking about anything, nor do I problem-solve after waking. I try to clear my mind and just relax.

I'll try the melatonin and Tylenol PM. Thanks for the advice!

Well, I am not real excited about how they said the fruit/grain carbs are still in alcohol. I do not believe that part.

Here's an interesting article about light spectrum and sleep quality: http://sciencenews.org/articles/20060527/bob9.asp

OK, here are the answers. She embedded some abstracts in here, so it's sort of long.

1) First question: are we sure the cheesecake isn’t sweetened with saccharine? It doesn’t really matter, the answer is that a “mixed” meal…fat, protein and sugar (artificial or otherwise) slows the glycemic response and insulin output. Reactive hypoglycemic response happens when the portal vein provokes a huge, fast insulin rush that slams down (disperses) your blood sugar. The fat slows this process, so no misery.

2) GENERIC NAME: SORBITOL - ORAL

USES: This medication is used as a laxative to treat occasional episodes of constipation.

HOW TO USE: This medication is usually taken by mouth. Do not use for longer than one week and do not take with additional laxatives or stool softeners unless directed by your doctor. Laxatives should only be used temporarily until normal bowel habits return. Prolonged use can lead to laxative dependence. This medication may also be used rectally as an enema after properly mixing. Consult your doctor or pharmacist for more information.

SIDE EFFECTS: Nausea, gas, diarrhea, stomach cramps or anal irritation may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Tell your doctor immediately if any of these serious side effects occur: rectal bleeding, vomiting, weakness, dizziness, persistent urge to empty the bowel. Tell your doctor immediately if the following highly unlikely but very serious side effect occurs: black, tarry stools. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: undiagnosed stomach pain, nausea/vomiting, rectal bleeding, a sudden change in bowel habits lasting over 2 weeks. Before using this medication, tell your doctor or pharmacist your medical history, especially of: any allergies. Contact your doctor promptly if your constipation is not relieved after using this medication for one week. Caution is advised when using this drug in the elderly because they may be more sensitive to its effects. Caution is advised when using this drug in children because they may be more sensitive to its effects. This medication is not recommended during pregnancy. Consult your doctor if you are pregnant. It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: other laxatives, sodium polystyrene sulfonate, stool softeners. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: stomach cramps, diarrhea.

NOTES: Do not share this medication with others. Consult your doctor for a plan that is right for you to prevent constipation. The plan may include drinking more fluids, increasing bulk or fiber in your diet, and regular exercise.

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE: Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

3) Four cups a day (the Starbucks Effect) remodulates cortisol to allow insulin a restoration of pulsitility.








Coffee and Diabetes - Can it help?





Coffee and Diabetes. Type 2 diabetes is one of the most rapidly accelerating diseases today in terms of number of people afflicted. Theories abound as to why this is the case; however, scientists are now looking at new ways to improve the overall health of those both at risk for and suffering from this disease.

Many of these scientists have found that drinking coffee can significantly reduce the risk and effects of the disease.

Recently a study concerning the relationship between Coffee and Diabetes was conducted at Harvard Medical School along with Brigham and Women's Hospital in Boston. Researchers explored the link between long-term coffee consumption and Type 2 db.



This Coffee and Diabetes study followed over 120,000 men and women for eighteen years. The researchers found that long-term coffee consumption actually reduced insulin resistance, which is the key factor in Type 2. They were able to conclude that long-term coffee consumption significantly reduces the risk for Type 2 in both men and women and therefore benefits the health of the coffee drinker.

The results of this Coffee and Diabetes study were affirmed Karolinska Institute in Stockholm, Sweden. Although this study was of a smaller scale (7949 subjects), it found similar results.

If the patient came into the study already suffering from Type 2 or impaired glucose tolerance (also known as insulin resistance or pre-diabetes), drinking at least 5 cups of coffee a day reduced their insulin resistance.

This was particularly true for women, who statistically suffer from a larger risk of insulin resistance than men. The health of those who drank coffee also benefited from enhanced insulin response.

The University of Helsinki in Finland, also did a study of the relationship between Coffee and Diabetes of over 14,000 middle-aged patients. This study was particularly interesting because the Finnish people have the highest coffee consumption in the world. This Coffee and Diabetes study again found that the incidence of Type 2 decreased as coffee consumption increased.

In doing this study, the researchers found that this relationship existed even when the results were statistically adjusted to account for other risk factors, such as age, smoking, weight, alcohol consumption, and filtered/non-filtered coffee.

As mentioned before, for some unknown reason women have a higher incidence of insuling resistance than their male counterparts in Type 2 diabetes. This is probably the reason that a study at a University in Goteborg, Sweden studied women exclusively. Over a period of twenty years with a study of over 1000 women. Women who had no previous occurance of heart disease or diabetes. It was found that women who had a daily consumption of coffee of five or more cups had an approx. reduction of risk for type 2 diabetes than women who consumed three to four cups of coffee daily. Another curious find was that consumption had another beneficial effect, that was a healthier level of cholesterol.

It was also confirmed thru a study at a United Kingdom university that the risk of getting type 2 diabetes was reduced with the consumption of coffee. This study looked at the effects of drinking coffee with regards to the gastrointestinal hormones that help to regulate the secretion of insulin. Another benefit was found to reduce the effects of this type of diabetes. It was found that the absorption rate of glucose from caffeinated coffee consumption was reduced, thereby reducing the negative effects of type 2 diabetes.

In conclusion, these coffee and diabetes studies seem to suggest that the consumption of caffeinated coffee can be beneficial to reducing the overall risk of worsening and/or developing type 2 diabetes.

4) Yes, protein under glyconeogenesis can become glycogen or storage sugar in muscles, brain and liver, but whether or not you undergo glyconeogenesis depends on cortisol and testosterone levels.

5) The carbohydrates make you feel better in a self-medicating mode until they wear off, hence the “bi-polar” effect. Your stress response is lead by high cortisol mobilizing storage sugar driving serotonin into the paranoid, lethargic, misery zone. You’re too reactively hypoglycemic to keep the carbs you eat around long enough to get the same reaction that endogenous stress induced cortisol can produce.

6) Most people who report getting “too much sleep” are really talking about sleeping “in” in the morning, hours after dawn. If you’ve been up in the period of melatonin secretion dusk to midnight, you will re-secrete melatonin the next moring making you feel drugged all day.

7) Light-induced Hormone Surge Points To Benefits Of Light Therapy
A report in the November Cell Metabolism reveals powerful effects of light on the adrenal glands, a finding that might explain the broad benefits of bright light therapy for a variety of conditions, including sleep and depressive disorders, according to researchers. The body's two adrenal glands sit atop each kidney, where they secrete hormones that regulate stress response and metabolism.








--------------------------------------------------------------------------------

The researchers found in mice that light sparks a cascade of gene activity in the adrenal gland through its effects on the suprachiasmatic nucleus (SCN). Located in the brain region called the hypothalamus, the SCN is the seat of the circadian clock, the body's internal clock that regulates the roughly 24-hour cycle of biological processes.

Moreover, the researchers report, the gene expression changes accompany a massive surge of the steroid hormone corticosterone in the animals' blood and brain. That hormonal response increased with light intensity, they found.

Glucocorticoids--including cortisone in humans and corticosterone in mice--play many roles throughout the body, including metabolic response to starvation, antiinflammatory immune response, and the timing of circadian rhythms in peripheral organs. Therefore, light-induced secretion of glucocorticoids may play a key role in physiological changes in the body and the brain evoked by light, reported study author Hitoshi Okamura of Kobe University Graduate School of Medicine in Japan

First introduced in the early 1980s for the treatment of seasonal affective disorder, bright light therapy has been applied to many sleep disorders, including jet lag syndrome and shift work sleep disorder, the reseachers said. Shift work sleep disorder, which affects people who frequently rotate shifts or work at night, is often accompanied by metabolic symptoms, including hypertension, cancer, and diabetes.

"In these patients, light therapy improves not only psychiatric status, but also disordered hormones and metabolisms," Okamura said. "However, effects of light had only been established on melatonin, and the remaining powerful and broad effects of light on body metabolism and hormones remained to be clarified."

The researchers examined the activity of the clock gene Per1 in the organs of living animals. The team found that nighttime light exposure induced Per1 expression in the adrenal gland. Further analysis of the gland revealed numerous changes in the activity of almost 200 genes, followed by the delayed release of corticosterone.

When the researchers severed the SCN, light's effect on the gland was lost, indicating that the phenomenon is closely linked to the circadian clock, they said.

"The surge of blood corticosterone after light exposure indicates that environmental signals are instantly converted to glucocorticoid signals in the blood and cerebrospinal fluid," Okamura reported. "The present light-induced corticosterone release may entrain metabolically peripheral clocks to the environmental light-dark cycle through its prevailing receptors located in virtually all cells in the body."

The findings could prove of great clinical and physiological interest, wrote Ueli Schibler and Steven Brown in an accompanying commentary.

"If a light-induced pathway were also operative in humans, a question that could readily be examined by recording blood cortisone levels after light exposure, it would be tempting to speculate that cortisone-mediated synchronization of peripheral circadian clocks would be one of the beneficial effects light therapy has on patients with seasonal affective disorder," Schibler and Brown said.

"It might also explain why bright light therapy can aid patients with other disorders--such as major depressive disorder and bipolar disorder--not typically associated with the circadian clock," they continued.

###

The researchers include Atsushi Ishida, Tatsushi Mutoh,Tomoko Ueyama,Satoru Masubuchi, and Hitoshi Okamura of the Kobe University Graduate School of Medicine in Kobe, Japan; Hideki Bando of Kobe University Graduate School of Medicine in Kobe and of Kyoto Prefectural University of Medicine in Kyoto, Japan; Daiichiro Nakahara of Hamamatsu University School of Medicine, Hamamatsu, Japan; and Gozoh Tsujimoto of Kyoto University Graduate School of Pharmaceutical Sciences in Kyoto, Japan. This work was supported by Scientific Grants from the Ministryof Health, Welfare, and Labor, The Special Coordination Funds and the Scientific Grants of the 21st Century COE Program from Ministry of Education, Culture, Sports, Science, and Technology of Japan, SRF, and Hyogo Science and Technology Association.

Ishida et al.: "Light activates the adrenal gland: Timing of gene expression and glucocorticoid release." Publishing in Cell Metabolism Volume 2, November 2005, pages 297 - 307. DOI 10.1016/j.cmet.2005.09.0

7)






























--------------------------------------------------------------------------------
\
Well I finished reading the book today.
I had thought I was only half way through till I realized half the book was like references .

I have a gazillion questions, but, for simplicity (and the fact I am too lazy to go get everything I noted) I'll just ask a few that are on my forebrain right now...



1) Artificial sweeteners. Wiley says all except saccharin cause insulin release. If this is true why do I not experience a hypoglycemic reaction from artificially sweetened eggs & cheese (i.e. cheesecake)?
Sometimes I get a "rush" feeling that forebodes blood sugar problems when eating my "sweet egg" type meals. However, my metabolism *always* behaves as if I ate eggs and cheese soon thereafter. I never, ever get a hypoglycemic reaction and am more likely to get one from large quantities of skinny protein and too much caffeine, than I am from sweet cheese and eggs (proper balance of fat, protein, and low carbs).



2) She says sorbitol is "really really bad stuff". Why?



3) Why is coffee okay? I thought that was a little funny. Caffiene does horrible things to my blood sugar. The woman wants us to sleep 9.5 hrs nightly with duct tape over our alarm clocks but a blood sugar spiking, adrenal gland taxing substance like coffee is given the okay?
I guess even she has her vices



4) She claims carbs are the only food that release insulin, but this is not correct as all macronutrients convert to blood sugar in varying degrees (in protein the insulin release is significant as is the blood sugar impact).
Lots of very blood sugar/insulin sensitive people find that we must eat a very high fat diet and watch protein as well in order for an ideal state of being. If I eat a great deal of lean meat it affects me similarly as a smaller amount of carbs.
With that said, does she say this to simply a complex idea (that its carbs causing obesity)... or, does she truly believe that carbs are the only macronutrient to affect insulin, thus, fat storage?




5) The "high serotonin" personality cited around page 92ish of the book does not sound like many obese people I know. Those behaviors/feelings of anxiety and depression tend to (stereotypically) go hand in hand with reduced appetite and thinness.
Yet, she says that a high serotonin state cannot coexist with a normal (low) insulin state. How do I reconcile these statements with what I know of fact?

Example. I know in myself, I get like the "high serotonin stereotype" predominantly when I put myself under physical and emotional stress - NOT from carbs. Carbs do make me emotionally miserable, but, in a different way. I become bi-polar alternating between periods of feeling "okay" and periods of feeling terrible. My energy is low (probably because of malnutrition), but NOT my drive for pleasure and general "desire" for life. Carbs do not make me exhibit signs of anxiety, "rigid" behaviors (ocd), or a lack of desire/motivation for pleasure characteristic of depression in anxiety.

In other words, carbs alone do not cause the kind of psychological/behavioral profile outlined. They definitely do something to my mind but not that. I have not commonly observed this in other obese people, either (implying my experience is common).

On the other hand, I do notice LOTS of thin people with poor appetites like that. In fact the only time I ever became that way was, ironically, when I took my diet too extreme and was underfed and underweight. I reason it had something to do with the stress of it. I have seen this happen in others who go to far with diets as well, and, I've seen people become that way in response to other types of stress too (emotional and physical). An underweight underfed person cannot possibly have high insulin.

THe only way I can reconcile this is if I reason that the high serotonin state created from blood sugar spikes (coexisting with hyperinsulinemia) has a very different physiological effect than a high serotonin state created by pure stress (without hyperinsulinemia). While it is true that any insulin reducing activity (e.g. undereating) will also reduce serotonin, however, it is simply untrue that carbohydrate is always the catalyst for a high serotonin state. So you cannot say "serotonin dominance cannot happen without high insulin". Therefore, it is erroneous to absolutely link metabolic syndrome/hyperinsulinemia/carbs with anxiety and depression... in fact, obesity and weight (drive for pleasure, for food, to eat, hunger and appetite) usually do not jive with anxiety and depression symptomatically speaking.




6) If I oversleep sometimes I feel extremely lethargic all day, as if I didn't sleep much at all. Also, my sense of time perception goes crazy (like it will be 3 pm and I'll have an overwhelming feeling that it's more like 7 or 8). Just a few days ago I got nearly 11 hrs of sleep and this occurred.
When I sleep more "normally" for me (between 7 (low) and 9.5 (high) hours) this never happens. If I get a few days in a row of normal sleep, plus, normal exposure to daylight, my internal rhythms become such that I know exactly what time it is when I wake up.
Do you think the absolute number of hours you sleep is as important as sleeping (and being in the sun) so as to get your "clock" working? I would think that would be a far more reliable guide than trying to "force" sleep.



7) She makes the suggestion that artificial lights are as disruptive of rhythms as natural light; I really strongly disagree. I do think they have an effect but it is NOTHING like noonday sun.
If I sit out in noonday sun more often for a few days in a row all my rhythms are thrown out of wack - everything about my body is affected very strongly by changes in sunlight (especially my sense of time). For example, I've been doing a lot of walking lately under the bright sun. It's 8:37 pm now but I have no sense of this; I feel very stimulated and active and a sense of a new day the way I might feel at noon. I feel "blitzed" if that makes sense.
Number of hours I spend in front of the comp/TV with a big bright light in front of me does not seem to have as strong of an effect. It takes a loooot of hours staying inside holed up on the computer before I start notice any changes in my perception of time and well being (and that very well could be related to isolation and stimulus deprivation as much as the light of the computer ).

Thats it for now

The Independent
London, UK
19 June, 2006

Avoid breast cancer. Sleep in the dark...

... and you could reduce the chances of getting breast cancer. Dramatic new research shows the risks to women of artificial lights at night, in or out of bed
By Geoffrey Lean, Environment Editor


Sleeping with the light on or staying up late could be a cause of breast cancer, authoritative new research suggests.

The research - which is being hailed as a "watershed", providing "the first proof" of a link between artificial light at night and cancer - confirms a mass of the studies suggesting that modern life causes the disease by interfering with natural sleep cycles.

Carried out by the blue-chip National Cancer Institute and National Institute of Environmental Health Sciences in the United States, it offers a solution to the mystery of rising levels of breast cancer in rich countries, which are five times as high as in the developing world. One in 10 women will develop the disease.

Experts believe that half of the cancers are likely to be accounted for by family history, smoking, drinking alcohol, diet, medicines, and such reproductive factors as childlessness and having children late. But evidence has been building up that electric light during the hours of darkness may be responsible for much of the rest.

Repeated studies have shown that night-shift workers - such as nurses or air stewardesses - are up to 60 per cent more likely to get the disease. Another found that women who stayed up late two or three times a week were similarly susceptible. Conversely totally blind women are half as likely to succumb to it.

"If light were a drug, the government would not approve it," says Professor Charles Czeisler of the Harvard Medical School. And Professor George Brainard of Thomas Jefferson University in Philadelphia, adds: "Humans evolved on a planet without electric light over thousands and thousands of generations. The body is designed to be alert and awake during daytime hours and to sleep at night. Now we have a 24-7 society that isn't in harmony with our biological design."

Studies show that light at night interferes with one of the body's greatest natural defences against cancer - melatonin, dubbed "the hormone of darkness". The hormone - which is secreted by the pineal gland at night, and particularly in the early hours of the morning - both impedes the growth of cancers and boosts the immune system.

Light, however, stops its production, making the body think it is daytime.

In the new study, scientists grafted human breast cancer tumours on to rats and infused them with blood taken from women during the day, in the early hours of the morning, and after being exposed to light at night. The blood taken in darkness slowed the growth of the cancers by 80 per cent, but the blood taken after exposure to light accelerated it.

Professor Richard Stevens of the University of Connecticut, who describes it as "a watershed study", says: "Electric light as a driver of the breast-cancer epidemic worldwide - that's a dramatic big thing."

And Dr David Blask, who led the research - and calls it "the first proof that light is indeed a risk factor for cancer" - adds: "Breast tumours are awake during the day, and melatonin puts them to sleep at night." Add artificial light and "cancer cells become insomniacs".

Sleep Safely: What experts recommend

Shut out all light: Sleeping in a dark room aids production of neurotransmitter serotonin, which is crucial in making melatonin.

Get nine hours' sleep: A Finnish study found that women who slept nine hours were one-third as likely to get breast cancer as those who slept seven-eight.

Get a red lightbulb: Place a red lightbulb in one fixture. If you get up in the night, only use this one.

Get outside in the morning: Just 10-15 minutes of morning light will send a strong time-keeping signal to the brain's clock, leaving it less likely to be confused.



http://news.independent.co.uk/uk/he...icle1090208.ece