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Oh For a Decent Night's Sleep!
Written by Lew Johnson, pharmacist
July 2014

In our practice we get a huge amount of requests for advice on possible treatments for sleeping disorders.

Many people have tried various treatments including medical prescription medications from their GP.

Some of the hypnotics prescribed medically such as Zopiclone, tend to work very effectively, but there is a risk of tolerance developing, where the body requires a higher dose to achieve the same effect. Unless there is a requirement to use these medications for severe or disabling insomnia it is always a good idea to get some advice on a more holistic approach to improving sleep quality in the inital stages.

I always look at the patients overall lifestyle first, because many sleep problems occur due to a stressful and hectic lifestyle. I always like to first concentrate on the Adrenals which are heavily involved in our daily lifestyle today and treatment suggestions here are for this particular form of insomnia. The Adrenals are responsible for hormone production and regulation. One of the main hormones produced by the Adrenals is Cortisol. This is an essential hormone to the body and is useful as an anti-inflammatory, and is also released in stress situations where more glucose is released into the bloodstream. It is also useful to the body for fat , protein and carbohydrate metabolism. However in a stress situation, more cortisol is produced than is immediately required by the body, and this may have an influence on sleep quality.

I do often recommend that patients undertake a saliva test to measure the night-time hormone levels. This test is best done at 2am to measure melatonin levels and cortisol levels.

At this time of the day the cortisol levels should be low and melatonin levels should be high.( During the day, the cortisol should be elevated and melatonin decreased). If the level of this 2 am saliva test indicates an elevated cortisol reading and low melatonin level, I would definitely look at the Adrenals.

I would look initially at reducing the night-time cortisol and I often recommend Phosphatidyl Serine which would be taken 2 hours before bed.(200-400mg) This has been trialled as being beneficial for breaking down that excess cortisol. (This product is also useful for improving brain activity, with particularly good results being reported for memory improvement-which is a bonus)

Other preparations I recommend for this adrenal induced insomnia.

Melatonin: This used to be available for purchase but has been made a prescription medication. I consider this as being much safer than Zopiclone, without the dependency and tolerance dangers. This is naturally produced in the body by the pineal gland, but the amount produced tends to decrease with age. This has a huge role to play in the sleep cycle. There are fast release and time release forms of this available with prescription, and your GP would decide which form or dose is best for you.

Magnesium Citrate: This very valuable mineral is very useful to induce muscular and nervous system relaxation,at a dose of 200mg to 400mg before bed.

Pantothenic Acid: This is very beneficial for the adrenals. This is a member of the B group vitamins, and is present in many B-Complex preparations.You need to look at a complex preparation with a higher level of this vitamin (B5).This needs to be taken in the morning.

5-HTP: Hydroxytryptophan has an influence on the serotonin levels in the brain and can be used at night to induce relaxation. If you are on anti-depressant prescription meds,you need to talk to a Pharmacist about compatability, as it is not recommended for those on MAO inhibitors or SSRI drugs.

Withania (Ashwaganda): This is an adaptogenic herb with many uses.It is particularly beneficial for stress induced insomnia and can be taken as a twice daily supplement in the morning and the evening.

L-Tyrosine: This is an amino acid useful for adrenal activity and neurotransmitter activity in the body and supports brain function.it is useful in stressful situations.

Vitamin C: Vitamin C levels in the body tend to decrease with stress, so it is a valuable supplement to be taken on a daily basis at a level of 500mg to 1200mg to restore body levels.

There are many causes of insomnia including pain and disease, but the most common form we encounter is stress induced insomnia due to the highly active lives people lead now.

Sleep is a routine procedure and you need to take steps to prepare your body for sleep.

(1)Regular daily exercise is recommended,but it is not a good idea to exercise vigorously in the evening as this may promote cortisol production and excite the body.

(2) Make sure that you get out in the sun periodically during he day, as sunlight through the eyes promotes production of melatonin

(3) Avoid caffeine products such as coffee in the evening. It is better to have a relaxing herbal tea such as chamomile.

(4) Try not to have your main evening meal close to bedtime.

(5) A hot shower or bath before bed may help to relax muscles prior to sleep.

(6) Don't go to bed worrying about a problem....many therapists recommend that you write down any problems with suggested solutions before going to bed.

(7) Stretching then relaxing while lying in bed helps to loosen muscles.

(8) darkness stimulates melatonin production, so make sure that your bedroom is dark at night with no light sneaking in.

(9) Avoid stimulation with computer screens,TV,cellphones etc before bed and relax by reading or doing some other relaxing activity before bed.

There are many other herbs which may be beneficial to help with sleep such as Valerian, Passion flower, Hops,Chamomile,Tart Cherry,Zizyphus,Skullcap and combination products such as sleep drops or rescue sleep.

Recommended products:


Magnificent Magnesium
Written by Lew Johnson, pharmacist
June 2014

Today we are going to discuss the hugely beneficial effects of magnesium supplementation.

We are going to look at groups where I feel magnesium supplementation could make a huge difference to their daily lives.

It is well known that magnesium is utilised by the body for over 300 enzyme reactions and is a critical mineral for health. it is utilised by almost every organ in the body and especially the heart muscles ,lungs and kidneys.

It is a fact that average magnesium intake in New Zealand is well below the recommended daily intake, perhaps due to the fact that our soils are generally deficient in this mineral and this deficiency is repeated consistently within the food chain.

Some of the factors that can lower the magnesium in the body include:

  • Exercise: strenuous exercise may contribute to magnesium deficiency due to an increased excretion of magnesium in the sweat and urine. This may require an increased magnesium intake of 10 to 20%.

  • Stress: Anxiety and stress may elevate catecholamine levels leading to increased urinary magnesium excretion and a decreased blood level of magnesium.

  • Aging: Deficiency of magnesium in the elderly may be due to a deficient diet. Also the elderly tend to have a higher excretion of magnesium and reduced intestinal absorption

A deficiency of magnesium may lead to fatigue, abnormal heart rhythms, muscle weakness and muscle spasms, loss of appetite and potassium depletion.

Asthmatics:
Trials have indicated that magnesium levels are often very low in asthmatics and it has been found that an increased magnesium intake produces a better lung function in both capacity and airway flow. The use of magnesium may also help to reduce bronchial constriction, and therefore reduce bronchial spasms .

Did you know that IV Magnesium is used in hospitals for treatment of severe asthma that is non- responsive to medication.

It stands to reason that supplementation with magnesium may help to prevent asthma attacks at a recommended daily dose of 200 to 400mg for adults.

Migraine:
It has been established that people who suffer from migraines have been found to have lower blood and brain levels of Magnesium.

Preliminary research has indicated that supplementation with 200mg of magnesium per day reduced the frequency of migraine attacks by 80% in those who were treated , and some double blind trials have indicated that supplementation with magnesium was significantly more effective than placebo.

Magnesium is often combined with riboflavin (VitaminB2) when given as a treatment for migraine as some clinical trials have also suggested that vitamin B2 is also very effective at reducing migraine frequency.

Leg Cramps:
Clinical trials using Magnesium citrate have indicated a substantial decrease in the frequency of nocturnal leg cramps.

In this trial Magnesium Citrate was used at a dose of 300mg of elemental magnesium per day.

This could also apply to athletes who lose salts through excretion to supplement with Magnesium citrate to help reduce muscle cramping and soreness.

Kidney stones:
Supplementation of Magnesium citrate along with potassium citrate decreases the formation of kidney stones due to a decrease in Calcium Oxalate saturation due to chelation (Binding) of calcium with the citrate in the magnesium citrate supplement.Magnesium citrate also has a beneficial effect on uric acid accumulation.

Those who have had or are prone to kidney stones would definitely benefit from a magnesium citrate supplement.

Medication:
Certain medication has the effect of depleting magnesium from the body.

Those on proton pump inhibitors (losec,omeprazole,pantoprazole,solox) are recommended to take a daily dose of Magnesium due to the fact that these drugs deplete body reserves of magnesium with long term use.

Those on asthma medication would also benefit from a magnesium supplement to help reduce the symptoms of asthma and improve lung functionality.

Not all magnesium supplements are the same as absorption can vary between different magnesium salts.

Magnesium citrate,magnesium aspartate,magnesium amino acid chelate are ,the best absorbed, where magnesium phosphate and magnesium oxide have low absorption.

Foods high in Magnesium:
Foods that are high in magnesium include :

leafy greens (79mg per 100g), nuts and seeds (534mg per 100g), fish( 97mg per 100g), beans and lentils( 86mg per 100g), whole grains eg quinoa (44mg per 100g), avocado (29mg per 100g), dark chocolate (327mg per 100g).

The amount of magnesium may vary hugely according to soil type and environmental conditions.

Conclusion:
Magnesium citrate is my favourite magnesium because it is very well absorbed and it also renders an alkaline environment to the body, which is very beneficial for the body.

It is well known that many serious conditions such as some cancers, thrive in acid environments.

I think that everyone would benefit from a magnesium supplement due to deficiencies that occur in our diet and the huge requirements for magnesium by our bodies for a multitude of enzyme reactions.

It is considered to be a safe addition to the diet with minimal side effects so give Magnesium a go!

An excess of magnesium in the body will cause looseness in the bowel motions, which gives you an indication to lower magnesium supplementation.

Recommended magnesium supplements are:


Let's Talk About Stress Part 2
Written by Robyn Dickson BHSc Comp.Med
April 2014

In the last blog we looked at the 1st phase of Hans Selye's General Adaptation Syndrome, "fight or flight"

This involved mainly the inner part of the adrenal glands (situated on top of the kidneys) which release Adrenaline and Nor-adrenaline.

This week we are looking at the next 2 phases Resistance and Exhaustion. These phases involves mainly the Adrenal cortex (the outer part of the Adrenals) which releases cortisol and other corticosteroids.

Remember that as we are all individuals, we all react differently. Some people thrive on stress while others just lose the plot! We all develop our own coping patterns which can be negative (addictions to drugs, food, spending, television. Blame, anger, outbursts etc ) or positive (relaxation techniques, exercise, diet, herbs, supplements, seeking appropriate help, changing attitudes that aren't working!).

(2) RESISTANCE REACTION

This phase allows the body to continue on it's increased physical abilities by making sure there is enough glucose available to supply the muscles with energy. The adrenal cortex is mainly targeted, via ACTH released from the pituitary gland, to release corticosteroids (Mineralocorticoids, mainly aldosterone. Glucocorticoids, mainly cortisol). More glucose is made by converting stores of protein and fat, a process called gluconeogenesis. Sodium is increased to retain water and increase blood volume. This all combines to keep blood pressure up so as to deliver nutrients to the muscles and brain to continue fighting the stressor. There are decreases in potassium and immunity.

Causes

Ongoing stressors can be such things as continued financial hardship, busy high pressured work, family disharmony, multiple births or hectic family life, imprisonment, unhappy relationships, sexual or physical abuse, mental or emotional abuse, multiple bereavements, serious or permanent illness, frequent exams and assignments, war and terrorism.

An over-committed lifestyle is very common now days!

Signs and Symptoms

These can be a bit of all 3 phases and can include fatigue, recurrent headaches, neck, shoulder and back ache, insomnia, loss of appetite or compulsive eating, anorexia, indigestion, dizziness, sexual problems, hypertension, anxiety, depression, obsessive-compulsive behaviour, loss of concentration, increased colds and infections. Prolongation of the resistance phase increases the risk of diseases such as diabetes (type 2), high blood pressure and heart disease, increased infection and cancer.

Prolonged Resistance eventually results in Exhaustion as our body's adaptation mechanisms become depleted.

(3) EXHAUSTION

May be a total collapse of body function or specific organ collapse due to loss of potassium ions and depletion of adrenal glucocorticoids (eg cortisone), resulting in lowered blood glucose levels causing hypoglycaemia. Prolonged stress puts a tremendous load om many organ systems, especially the heart, blood vessels, adrenals and the immune system, increasing the risk for associated diseases. Also damage to nerve cells in tissues and organs.

Also known as burnout, overload, adrenal fatigue and maladaption, there is an inability to manage and cope with stress leading to mental, emotional and physical exhaustion.

Signs & Symtoms

Apathy and the feeling of helplessness, hopelessness can occur. Depression, no energy, emotional detached, excessive doubt, preoccupied with worries, fears, details and order. Thinking and memory become impaired. Escapism and addictions occur in an attempt to ignore or shut out troubles.

Muscle weakness, coldness, poor circulation and a weak pulse. Eating and digestive disorders. Insomnia and tired all the time. Prone to extremes of ill health. Heart disease, immune deficiencies, blood sugar imbalances, diabetes can occur.

Remember that this varies according to environmental and genetic factors.

If you get to this stage, all is NOT lost. Your current lifestyle is not working for you so change what you can change. Seek the support you can from friends, family, health groups. The body is a working piece of art that has the ability to correct itself and bring back balance (homoeostasis).

Treatments

Herbal adaptogens can help the improve the physiological action of the adrenals. They are particularly useful in the Resistance phase to avoid the Exhausted phase!! A lot also stimulate immunity and reduce anxiety and depression.

Panax (Korean) ginseng works directly on the adrenal cortex by increasing the production of cortisol, thereby increasing energy and stamina. This is strongly recommended for any one in the Exhausted phase. It also stimulates the immune system, protects the liver and is a heart and adrenal tonic.

Recommended supplements:

Licorice inhibits the breakdown of cortisol so extends its life. It also inhibits adrenal atrophy. Note: Licorice can raise the BP by retaining sodium.

Siberian ginseng is better suited to the Alarm and Resistance phase as it is gentler.

Withania (Indian Ginseng or Ashwagandha) is great for weak, sickly people

Schisandra is recommended for tonifying the adrenals as well as calming the nervous system.

Brahmi (Bacopa) aids memory, concentration and retention and is great for calming the nervous system (as is Rhodiola), especially where there is nervous exhaustion/breakdown. NOTE Gotu kola is also known as Brahmi and is an adrenal stimulant, but is a different herb!

There are a lot of good Adrenal support formulas available ranging from gentle to strong doses.

Supplements to look out for that are essential for the nutritional biochemistry to manufacture the adrenal hormones as well as supporting and maintaining the health of the adrenals are;

Vitamin C, Pantothenic acid (B5), B6, Magnesium (low in NZ soil and high depression / suicide rates, are these related...i think so!!!), L-Tyrosine and Phosphatidylcholine.

Some of these are already added to the adrenal formulas!

Other important supplements include Potassium, zinc, B1, B12, Inositol, L-Glutamine. GABA and DHEA supplements can be hard to source in NZ and you need to be sure they are suited to you.

St John's Wort it a fantastic herb for Anxiety and Depression, it is also anti-viral and an hepatic. Caution is required as it interferes with Anti-depressants eg SSRIs and shortens the half life of some meds through it's liver action of increasing cytochrome P450 to break down and eliminate.

So with these tools at the ready, combined with positive coping mechanisms like yoga, exercise, meditation, relaxation, going to your happy place and breathing techniques...you can start your de-stress program!

Keep replenishing those adrenals, taking your ginsengs, B vits, Vit C, Magnesium and Potassium at the alarm and resistance stage before you exhaust yourselves.

Good Luck!

Click here to read more about Stress in our Learning Centre


Let's Talk About Stress Part 1
Written by Robyn Dickson BHSc Comp.Med
April 2014

We all suffer from it from time to time....or all the time!
Stress can be EXTERNAL (Environmental, life experiences, dietary factors) or INTERNAL (Genetic predisposition, age, sex)

What are our stressors and how does our body respond to them?

Causes

The causes are various and may be a single or combination of factors. The cause affects the severity and the length of the suffering. Short-term (acute) stress can be caused by a change in environmental or personal circumstances. This may be sudden or unusual, such a change or loss of job, changing schools, moving home, building a house, getting married, divorce, an unsuccessful relationship, an argument, pregnancy, childbirth, financial worries, Christmas, an accident, injury or illness of one's self or loved ones.

Here is a table of stressors that impact our lives. Do the calculations to see how much you have been exposed to in the last year. https://www.roadtowellbeing.ca/questionnaires/life-stressors.html

Now lets look at how your body responds to stress!

When we are faced with a stressful situation, our nervous system comes into play setting off all sorts of hormonal triggers and feedbacks that affect many of our body's systems.

There are 3 phases to stress

(1) ALARM REACTION (fight or flight)
The Sympathetic Nervous System stimulates the release of the hormones Adrenaline and Nor-adrenaline from the Adrenal medulla to increase our energy requirements to escape danger by......

Dilating our pupils to see better, dilated bronchioles to breathe better, increased heart rate and blood pressure, increased blood glucose levels to supply our muscles with extra energy to fight or run with increased alertness. Other non-essential activities such as digestion and urine output are reduced. This phase is normally short-lived.

Nowadays we normally do not have to fight or flee a situation so we end up with adrenaline pumping around! Exercise is a good way of burning off all this pent up energy. Yoga and meditation are excellent ways to calm the nerves.

Supplements and Herbs (nervines) such as Oats, Hops, Valerian, Passionflower, Gentian, Chamomile and Skullcap as well as Vit C, B vitamins, Potassium and Magnesium will help nourish and restore the nervous system.

Recommended supplements:

Signs and Symptoms

A stressed person can be nervous and jumpy, ready to escape the fear or concerns that follow them. They may show a worried look, pale skin (as blood is shunted away from the skin to the muscles and brain), a tense, rigid posture with sweaty hands and feet, dry mouth, restless behaviour and dilated pupils.

They may suffer from hypertension, palpitations, tachycardia, panic attacks, irritability, loss of concentration, fear and startled nervous reactions.

The duration of stress factors depends on your individual strength and stability, and the level of support from family, friends and the community. Including informative, helpful websites www.healthchemist.co.nz

How well nourished you are depends on how well you can cope with stress.

A diet high in whole grains, quinoa, legumes (high in B vitamins), cauliflower, salmon, liver, kumura and tomatoes (B 5 pantothenic acid) is recommended. Fruit and veg high in Vitamin C. Avoiding stimulants such as tobacco and coffee! Coconut water is a good source of Calcium, Magnesium, Potassium and Sodium) New Zealanders have no Magnesium in our soil so supplements are often necessary!!!

Recommended supplements:

In our next Blog we will look at Phase 2 and 3 of Stress. So stay tuned as this affects all of us.

To be continued...

Click here to read more about Stress in our Learning Centre


Do You Love Your Liver ?
Written by Robyn Dickson BHSc Comp.Med.
February 2014

February is here already! Well into the New Year and the start of the Chinese New Year of the Wood Horse. This is a time to enjoy the sunshine, beaches, holidays, celebrations and gatherings. It is also the month to love....….........Your Liver! Especially after a little over-indulgence.

Did you know that your liver is the largest gland in your body and the 2nd largest organ (2nd to skin) and weighs about 1.4kg. It has 10 functions which include; digestion, bile production, metabolism of carbohydrates, fats and protein, stores essential nutrients (eg vitamins D,E,K,A), immunity, production of clotting factors, degrades excess hormones and helps in synthesising some hormones, detoxification of drugs, chemicals, alcohol and other ingested toxins.

So lets treat this precious organ with the respect it deserves (at least once or twice a year) and detoxify. Particularly if you suffer from; Tiredness, bloating, indigestion, constipation, diarrhoea, weight gain, bad menopausal symptoms, waking between 2-4am, headaches and grumpiness. Doing something is better than doing nothing, it's your journey so do what is achievable for you. The liver has the ability to rejuvenate and replenish itself given the right conditions. You can help it along with regenerating healthy new liver cells with St Mary's thistle (aka Milk thistle) and Globe artichoke.

Detoxify with St Mary's thistle, St Johns wort, Globe artichoke, Dandelion, Boldo, Vit C, B vits, Methionine, Taurine and Glycine Improve bile production, fat metabolism, digestion and lower cholesterol with; lecithin, B vits, vit C and fibrous green leafy veges (kale, spinach, broccoli, artichokes, beets, mesculin, rocket) and African mango.

Kick start your day with a glass of water with 1/2 a lemon squeezed in. 20 mins later do your juice; carrots, apples, parsley, celery and beetroot. You can include your Barley grass, Chlorella, Wheat grass or Spirilina powder. Your liver will love you for it Avoid sugar, coffee,alcohol, preservatives, additives, refined (white) grains and high fat meats for optimum results. Drink plenty of water!

Simply type in "liver", "detox" or "liver cleanse" in the search bar to look at your options

OR Click here to browse our LIVER SUPPORT products

Worried about drug/herb interactions? Message us on facebook or email us at service@healthchemist.co.nz and one of our Naturopaths or Pharmacists will advise you.

Click here to read more about Liver in our Learning Centre

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