A note about supplements and botanicals: herbs are powerful medicines that hardly ever have just one function. On the contrary, herbs and nutraceuticals have various actions that act synergistically. Please check with your clinician who is knowledgeable in these areas before initiating a new product as it carries the risk of interfering with other medications.
In the beautiful and vast world of botanical medicine, there are well-known, tried-and-true herbs for insomnia. The classic insomnia herbs, and some with published research include skullcap, valerian, lemon balm, kava, hops, passion flower and chamomile. Other great herbs that may help relax the body and brain for sleep include lavender, oatsraw, and even poppy. Ashwaghanda has been studied for its sleep-inducing effects over time and may help establish a healthy sleep cycle with regular use.
The herbs mentioned above come in a variety of forms- alcohol/water based tinctures, non-alcohol based tinctures, capsules, tablets, loose leaf teas or powdered root. They’re available as single-herb products or are combined with multiple herbs and/or nutrients for a stronger effect. At many naturopathic clinics, doctors can even create a customized combination of herbs that are specific to your unique needs; this is called an herbal formulation. Tea blends are also a great option, but could potentially interrupt sleep if it ultimately causes you to wake in the night to urinate!
Soothing scents like lavender, chamomile or rose can switch our brains into nighttime mode. These oils vaporize well in an essential oil diffuser. You can also take a warm Epsom salt bath with a few drops of oil sprinkled in… with a candle burning nearby. Some soothing, relaxing music playing softly in the bathroom won’t hurt either! Are you getting sleepy yet?
DIY- To make a lavender hydrosol spray at home, add 10 drops of lavender oil into a spray bottle full of water. Spray this mixture in the air, on your skin or even in your bedroom for maximum aromatherapy effect.
While browsing the aisles at our local health foods store, there is no shortage of products to help us sleep. The art of the medicine lies in selecting the correct one for the type of insomnia you have. Examples of products on the market for insomnia include 5-HTP, L-tryptophan, melatonin, magnesium, l-theanine, GABA, phenibut…. and there are many more. Each of these products boasts a different mechanism for shifting our body into sleep mode. The most effective way to know which one works for you is to have a comprehensive intake with your doctor who will take a careful and informed health history. There are also situations where underlying causes need testing such as thyroid, glucose, cortisol, melatonin, and neurotransmitters. Many times, we encourage our patients to use a product regularly for a few weeks before we determine its effectiveness .
Over the counter pharmaceutical and prescription-only drugs for sleep are our last resort as naturopathic physicians. These are necessary in some situations; however our goal is short term use while we work on other aspects of your overall health. There are various types of medications for insomnia- some have a risk for dependence and can cause unpleasant side effects. For these reasons, they are best discussed at your doctor’s office.
Up next: PART 3- Investigating Insomnia: when treatments aren’t helping
Image courtesy of www.theinsomniaclinic.co.uk
Although it may be an obvious fact, it must be said; sleep is an integral part of our lives. A good night’s sleep allows the body and brain to rest.
While we sleep, our immune system goes on high alert and scans the body for infection. Our brain converts short term memories into long term storage, a process called consolidation. And lastly, our conscious brain temporarily takes the back seat while our subconscious runs loose.
When sleep quality starts to diminish, consequences are felt immediately and their detrimental effects accumulate over time. Studies suggest that poor sleep (or less than 7 hours per night) increases one’s chances of heart disease, obesity, depression and even diabetes. Yikes!
“OK you’ve scared me enough Dr. Manning- what am I going to do to start sleeping better??”
While often a challenging chronic health issue, insomnia is one of the most responsive conditions to naturopathic treatment modalities. The solution for you could be an easy switch or it may require a comprehensive evaluation and plan- always check with your doctor before initiating any treatments listed in this article.
Below you will find an overview of naturopathic approaches to insomnia- split into three parts:
- Insomnia Basics: finding the root cause and lifestyle interventions
- Botanical and nutraceutical treatments for insomnia
- Investigating insomnia: when treatments aren’t helping
Insomnia Basics: finding the root cause and lifestyle interventions
Treatment for insomnia should never be “one size fits all.” As always in naturopathic medicine, identifying and addressing the root cause of why you can’t sleep is paramount to treatment success and long term cure.
So… Why can’t I sleep?
Looking deeply and with depth at your problem can help you identify the reason why sleep is not a satisfying, refreshing experience. Your doctor may ask the following questions:
- Do you have trouble falling asleep?
- Do you have trouble staying asleep?
- Do you wake often throughout the night?
- How much time do you spend in bed? Sleeping? Doing other activities in bed like reading, watching TV, eating?
- What is your work/school/home schedule like?
Some causes of insomnia are obvious while others may take a little digging (e.g .nutrition, pain, medications, anxiety) and maybe testing for a thyroid disorder, a blood sugar problem or cortisol dysregulation among others.
Food, News and Booze
Do you eat large meals shortly before bedtime? Do you watch headline news at night? Do you engage in a liquor, beer or wine night cap most evenings? These all have the potential to significantly interfere with your body’s “winding down” process, either by causing a spike in your blood sugar or even worse- a spike in your body’s stress hormone, cortisol.
Experiment this week by replacing your evening TV time with a relaxing book, a warm bath or gentle stretches before bed. Save the headline news for the following morning or afternoon.
Aim to eat your last meal for the day at least 60-90 minutes before you hit the hay, that way your body will be finished digesting food once it’s time to sleep. If you find yourself hungry before bedtime, eat a light protein-focused snack like veggie sticks, nut butter, hummus, hardboiled egg or a small piece of cheese.
Aim to limit your exposure to inflammatory or stimulating social media, television or music if you’re the sensitive type. Often, these images, words and/or articles linger in our subconscious mind long afterward and inhibit truly restful sleep.
Ready… Set… Sleep! Establishing a Bedtime Routine
The body responds surprisingly well to routine. If you regularly repeat a similar sequence events leading up to bedtime your body will begin to learn that these activities equal sleep- and over time it will become easier to fall asleep. There is a practice called sleep hygiene that outlines several practices for attaining satisfying sleep. More info regarding this can be found here.
Try brushing your teeth, changing into your PJ’s, dimming the lights, etc. in the exact same order every night for a week. Notice if your body begins to relax and prepare for sleep as soon as you start that routine. Often, preparing our bag, supplies, outfits, etc. for the following day can make us feel less stressed and more clear-minded as we drift off to sleep.
Other lifestyle tips for sleep
Meditation offers a multitude of benefits for sleep. Try mindfulness meditation, progressive muscle relaxation, loving kindness or mantra meditations. Meditation can be self-guided or guided by a podcast, audio recording or book. Stretching, yoga and tai chi are also great ways to enhance your sleep if you prefer movement meditation. Journaling our day, our thoughts or even our concerns can help free more of our mental space for rest, sleep and rejuvenation.
Napping is a great way to recover from a poor night’s sleep, however it can interfere with the following night’s sleep. If you must nap, limit to 30 minutes only and avoid napping too late in the evening.
Exercise is the one of the most underrated, untold secrets in medicine. The benefits of regular exercise (150 minutes per week, to be exact) are immense. Regular exercise not only helps us sleep better at night, it improves almost every aspect of our health. Start small: a few minutes per day or a few days per week. Increase your amount/intensity slowly and ask for guidance if you run into difficulties or develop pain in your joints.
Image courtesy of www.theinsomniaclinic.co.uk
Coming up next: Botanical and nutraceutical approaches to insomnia.
– “Sleep and Chronic Disease,” www.CDC.gov
By Erin Conlon, ND, MS
As we go through life we experience various and sundry joys of fluctuating hormones. For many women, teen years bring forth a roller coaster of emotions and physical changes as we experience new and evolving levels of hormones. The modification of hormones in pregnancy can further alter bodies and impact emotions. Finally, the culminating change in hormones, known as menopause, influences the body in entirely new ways, as hormone production declines.
The menopausal change in hormone levels may present with an assortment of symptoms that includes flushing with waves of internally generated heat, mood lability, vaginal dryness, and mental cloudiness. Symptoms of hot flashes, mood swings, and brain fog often bring a woman into her doctor’s office, as these are commonly discussed topics. But all too often, symptoms of vaginal dryness or pain with vaginal penetration are left untreated due to associated social stigmatization. It should be noted that roughly 50% of postmenopausal women experience vaginal dryness between the ages of 50 and 70, a number that increases to over 70% after age of 70. Unfortunately, only about 25% of affected women seek medical treatment for this condition.
Vaginal dryness is often accompanied by sensations of itching and burning, increased incidence of urinary tract and vaginal infections, and urinary leakage. Furthermore, vaginal dryness can contribute to pain with penetrative vaginal activity and an associated decreased libido. This constellation of symptoms may all be attributed to a condition call atrophic vaginitis. This atrophy/thinning, also affects a decline in pelvic floor/vaginal tone, urinary incontinence, and changes in the vaginal and bladder ecology such that vaginal and bladder infections can become more common.
Atrophic vaginitis is the change in vaginal tissue and lower urinary tract following the loss of estrogen, which may occur with natural, surgical, or chemical menopause. Current standard-of-care treatment for atrophic vaginitis is local vaginal estrogen. The hormone can be delivered to the vagina through a variety of methods, including creams, suppositories, vaginal tablets or ring. Creams, tablets and suppositories are generally used nightly for two weeks and then twice a week thereafter. Rings are used continuously. The purpose of this long-term therapy is to help preserve the ecology, pH, and tissue of the vagina. While the majority of the hormone is delivered directly to the vaginal tissue, some studies have shown that vaginal estrogen may contribute to elevations in systemic estrogen. The potential for vaginal estrogen therapy to alter body-wide hormone levels, albeit very minimally, makes the treatment less than ideal for some women.
Fortunately, there are other options to treat atrophic vaginitis! DHEA, also known as dehydroepiandrosterone, is a precursor hormone that when in the presence of necessary enzymes, can be converted to testosterone and eventually estrogen. In November 2016, the U.S. Food and Drug Administration approved DHEA to be used vaginally to treat atrophic vaginitis and associated symptoms. Research regarding DHEA has demonstrated the ability for the compound to improve symptoms of vaginal dryness and pain with sexual activity. In the future we may find that DHEA improves libido. Presently, however, data are limited and more research is needed to truly elucidate the impact of DHEA on libido. Additionally, daily use of DHEA appears to keep systemic hormones within the same ranges demonstrated in menopausal women not using hormone therapy. However, small increases in systemic estrogen have been noted with daily DHEA use, thereby potentially ruling it out as a treatment option in certain populations of women. Finally, it is of note that DHEA must be used daily in order to remain effective.
Discussed here are just two potential treatment options for atrophic vaginitis. Primary care doctors and women’s health providers have a variety of treatment options for this condition. Talk to your doctor about any menopause associated vaginal symptoms that you may be experiencing so you can get a tailored treatment that is best for you!
Building Your Winter Blues Toolbox
Valeria Manning, ND
Seasonal Affective Disorder, better known as S.A.D., affects approximately 3-6% of the general population. The incidence is higher in northern latitudes and among women of reproductive age. Typical presentations of S.A.D. overlap significantly with major depressive disorder, however S.A.D. occurs in a more cyclical nature during the autumn and winter months.
Fatigue is the most common complaint doctors see in their office. The causes of low energy are numerous, and often there isn’t a single culprit. However, in women of reproductive age, low iron can be a common cause of or contributing factor to low energy. Many of my patients have been told to supplement iron in the past, but they haven’t been told why or for how long. Let’s explore the subject.
When considering any nutrient in the body, we have to think about 3 factors: how much of it are we taking in (diet or supplement), how much of it is getting absorbed in our digestive system, and how much are we losing.
One of the major challenges in my practice is relaying information about single nucleotide polymorphisms (SNPs) in a way that’s accessible and empowering for my patients. The acronyms alone make it daunting to approach: MTHFR, COMT, MAO, VDR, UGH (okay, that last one was mine). Genomic medicine can be a powerful tool for improving and optimizing health, so with that in mind, let’s try to decode the alphabet soup.
In Chinese medicine, spring is an excellent time to cleanse and renew. Much like the buds sprouting on plants outside, the body is energized and ready to emerge from its winter dormancy. The buzzword “detox” can evoke thoughts of deprivation with a dash of lemon-cayenne water, but there are many avenues for resetting your health. Below are some gentle ideas. (more…)
Sometimes I catch patients off guard by mentioning perimenopause as a potential underlying cause of their symptoms. In some cases, this is because the woman didn’t realize the menopause transition could cause more than hot flashes and night sweats. At other times, it’s because the person doesn’t realize that perimenopause can occur at their age. (more…)
Melanoma is the most common cancer in women ages 25 to 29 years and the second most common cancer in women ages 30-35 years. Due to ozone depletion, incidence has doubled every 10 years. Therefore, it is important that women be educated on the risk factors and signs of melanoma in order to identify a potential malignancy and monitor skin changes. Similar to self breast exams, women should become familiar with their skin and monitor for changes monthly. (more…)
Varicose veins are a common concern for women as they age. They range from being an unsightly nuisance to being painful and debilitating. Surgical treatment is becoming increasingly sophisticated, but there are many lifestyle and nutritional steps that can be taken to help prevent them in the first place. (more…)