The Health and Healing Implications of Circadian Imbalance
by Dr. Susan Tanner, MD, and Eric Hosford, RN
What does the phrase “circadian imbalance” indicate to you? Disrupted sleep-wake cycles? This is certainly a huge component, but the health implications of not falling asleep, staying asleep, getting enough quality sleep, or having a productive and energized wake cycle are more numerous and widespread than many people realize. Additionally, several facets of immunity may factor into either the causes or the complications of a dysfunctional sleep-wake routine. Research has shown that cognitive ability, psychiatric disorders, infection resistance, fatigue/energy levels, control of body weight, and even cancer susceptibility can correlate with the activity of one’s biological clock. In other words, a circadian clock that keeps good, consistent time is reliable and helpful to the body’s systems and function, while one that is imbalanced and stops occasionally or skips ahead causes confusion, stress, and discord to the body. In this article, we intend to examine some of the factors that influence circadian rhythm and to introduce a few ideas to improve balance, if needed.
Cause and Effect
Pathogenic sources of circadian disruption are not uncommon, becoming a particular problem when they result in a chronic condition, whether an active infection is present or not. Epstein-Barr virus, for instance, may “reactivate” in response to stress, leading to an immune response capable of manifesting in multiple places throughout the body. Or alternately, mycotoxins from a current mold infection can begin to affect not only the GI tract but neural and endocrine structures as well.
Cortisol, an adrenal hormone, helps to metabolize glucose and limit the release of inflammatory substances in the body. It typically follows a daily cycle based on one’s regular patterns but will increase during a stress response. Similarly, the thyroid’s secretions have a direct influence on metabolic rate and energy use. Supposing a toxin or inflammatory response begins to damage the hypothalamus or pituitary gland, the entire endocrine system can be affected, most often resulting in a diminished glandular activity. This places significant value on preventing or stopping hyperimmune activity, be it related to infection by microbes or exposure to the body’s sensitivities. It is also one of the reasons that metabolic changes often coincide with imbalanced circadian rhythm, resulting in food cravings and weight gain or loss.
Sometimes, for varied reasons, the adrenal cortices or thyroid become hypoactive. If needed, both supplemental and prescription-based therapies are available for use on a temporary or permanent basis under regular supervision by a medical professional. Sometimes just these small changes can make all the difference. Conversely, should either of the aforementioned glands begin to over-perform for any reason, restorative sleep will become much more difficult to achieve due to heightened alertness and increased heart rate. If necessary, certain procedures targeting the glands themselves may help to restore balance by reducing their activity.
Sleep: There’s No Replacement
No amount of caffeine, meditation, or nutrition can work as a fully effective stand-in for a proper night’s rest. Sleep hygiene is only one of several factors relating to optimal slumber, but it’s definitely important. From this perspective, aside from exposure to light or stimulation from display screens, exercise can be an unexpected detriment if utilized improperly. This is not to say that physical activity is a bad thing; quite contrarily, its effects on mental and physical wellbeing are well documented. A common misconception, however, is the idea of exercising shortly before bedtime to tire oneself out in the hopes of a more rapid entry to dreamland. What exercising too close to bedtime actually does is tell the body that energy is required to fuel the increased physical output, moving it away from relaxation mode and into stimulation/work mode. So while the exertion will make you more physically tired, it still delays your ability to get sleepy. Please continue to schedule any exercise you’ve had planned, but don’t train your body in this fashion; do your exercise earlier in the day whenever possible.
A pituitary secretion that seems to be associated with sleep rhythm is melanocyte-stimulating hormone (MSH). MSH is very commonly suppressed in the face of mycotoxin exposure, and likely other chronic chemical exposures as well. Levels can be tested through blood and should be addressed if low. Of course, removal of the offending toxin is the first order of business for healing, but overall body detoxification seems to help as well in getting levels back where they need to be, including the use of binders for biotoxins. Additionally, it has been suggested in some cases that the use of the essential oil myrrh may be helpful in improving MSH levels. As this oil is fairly sticky, I have had patients simply put a small amount on a cotton swab and apply it intranasally before bedtime. At the very least, it smells nice and can be relaxing to the senses.
Our actual body clock is more closely governed by the pineal gland, a tiny gland at the base of the brain. The pineal gland is heavily influenced by melatonin, and the production of this is actually what helps develop the true circadian rhythm. As mentioned previously, the pineal gland is directly affected by light, especially blue light from cell phones, tablets, computers, and televisions. It takes only moments to disrupt pineal regulation, so avoidance of these triggers before bed and during periods of nighttime wakefulness is important. Because melatonin has such a direct impact on immune function and natural killer cell activity, its secretion and regulation are imperative for good health and recovery.
Supplements are Great…Within Reason
Another personal habit that may affect sleep is nutritional supplementation. Even though nutraceuticals are not prescription-only, they’ve still been designed to affect biological activity, and there is definitely such a thing as overuse in this area. The body is a complex blend of synergistic chemical processes, not a bag to be filled as full as possible. Electrolyte imbalance, for example, is one of the more common causes of restless leg syndrome, meaning this sleep disorder is often the result of improper hydration or mineral overload. This is why supplements, while not always necessarily dangerous, should generally be approached with care and not excess.
On the subject of supplements, there are some available that may help improve sleep (in both achieving and retaining it throughout the night). As mentioned earlier, disordered sleep is often a symptom of a larger issue, and while the goal of addressing these chronic concerns should remain at the forefront, finding a better night’s rest in the meanwhile is still a relief. Just keep in mind that mileage may vary from person to person and from product to product.
Melatonin in pill or liquid form is a common go-to supplement for sleep and calmness, as are l-theanine, GABA, and magnesium. Chamomile has also been known to demonstrate relaxing properties, but individuals with a ragweed allergy likely ought to avoid it as the two plants are in the same family and therefore often cross-react.
Addressing cortisol–your waking hormone may be as important for some patients as melatonin. When your adrenal glands have been strained from things like mycotoxins, chronic illness, infection, physical or emotional stress, using nutraceutical support may be helpful. Adrenal Boost by Micro Balance Health Products offers a blend of botanicals, adrenal concentrate, and micronutrients to support the adrenal glands, as well as the body’s ability to respond to and counter-act the negative effects of stress. When stress is managed by the body in a balanced way, sleep also comes easier and is more restorative.
The regulation and metabolism of growth hormone are also highly correlated with sleep and circadian rhythmicity. While not a supplement, CellTropin is a homeopathic remedy designed by Dr. Dennis after studying the pituitary damage incurred by inhaled mycotoxins in his mold patients. When the pituitary gland is not functioning properly, all hormones are impacted, especially growth hormone. CellTropin provides the signal that the body needs to stimulate proper pituitary function for some patients. There are patients for whom a homeopathic treatment is not enough and will require growth hormone supplementation, but for many who are out of the mold exposure, it is enough for healing to begin.
Sleep apnea is another thing that needs to be considered in some cases of a circadian disorder. Sleep apnea is a situation in which an individual stops breathing for more than 20 seconds at a time, resulting in a loss of oxygen in the bloodstream. Some people have many episodes of apnea in a single night. Some snore loudly while others do not, but if daytime somnolence or unexplainable fatigue is present, sleep apnea needs to be considered by a proper sleep specialist. If appropriate, a sleep study can be very telling. The causes of sleep apnea can be obstructive—when the sinuses, tongue, or throat impede airflow—or neurogenic—in which the brain does not properly signal respiration as an autonomic nervous system function. Treatments may range from devices, such as C-PAP or mouthpieces, to surgery, depending upon the cause. For some, stimulant medications used during the day can help to reset neurogenic apnea. In any case, this is a possible consequence of brain injury, which can be from physical trauma or chemical assault, including severe cases of mycotoxicosis.
Circadian imbalance can be a symptom of larger health issues or a barrier toward resolving them. What’s reassuring is that there are options and opportunities to understand the causes of these concerns. While pinpointing the root of the matter may take time, working under the guidance of a medical professional may prove fruitful and possibly even uncover more deeply buried chronic health concerns, informing a more effective treatment plan going forward.
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About the Authors: Susan Tanner has practiced medicine for over 33 years, concentrating primarily on chronic illness and its impacts on the individual, the family, and the community. Her formal education was completed at Emory University in Atlanta, the Dominican Republic, Brooklyn, NY, and Atlantic City, NJ. After starting her family practice, a driving curiosity into why people are made ill caused her to pursue education in Environmental Medicine, completing coursework, exams, and necessary practice years to earn board certification in this area in 2009. Her own struggles with mold-related illness drove her desire to teach those similarly affected. While in clinical practice, Dr. Tanner wrote and contributed to a number of publications on environmental health, prepared narratives for understanding legal matters, and researched new techniques for modulating the body’s ability to clear toxins and infections. Now, Dr. Tanner continues to research and learn. She now has a fitness and health website www.thebodynexus.com, where she writes articles and shares education on utilizing the various body systems to improve overall health.
Eric Hosford is the son of Susan Tanner, MD. A theater major at FSU, he found that the healing path held a special pull for him, leading him to complete his RN degree at Emory University in December. He has observed and experienced many interventions for mold-related illness and shares his mother’s passion for finding the root causes of illnesses.