Everyone should routinely measure their 25-hydroxyvitamin D status and use sun exposure or vitamin D3 supplementation to attain a level around 40 ng/ml.
This is especially important for those whose occupations keep them out of the sun. Night workers, especially, may have difficulty manufacturing sufficient vitamin D.
In my last post on the amazing and unnatural fragility of Red Sox players’ bones, I didn’t discuss vitamin D – a crucial nutrient for bone health, and health generally – because I thought that baseball players must get a great deal of sun exposure.
But on second thought, that may not be the case.
The Red Sox Are Night Workers
Most games start in the evening, around 7:05 pm. Games typically last between three and four hours. Players often eat a post-game meal at midnight, and may not sleep until 2 or 3 am. On road stands, every third game is followed by travel, so that players arrive in the new city early in the morning. As it is often difficult to sleep on planes, it’s reasonable to guess that many players sleep during daylight hours.
Night Workers Are At High Risk for Fractures
The Nurses’ Health Study found that night workers generally had a 37% higher risk of bone fractures. But slender night workers – those with a BMI below 24 – had a 136% higher risk of fractures. [1]
Jacoby Ellsbury, with the most fragile bones on the Red Sox, is one of the more slender players, and might be particularly vulnerable to the night work effect. At 6’1”, 185 pounds, his BMI is 24.4.
Vitamin D Is Crucial for Bone Health
Bone mineralization is optimized at serum 25-hydroxyvitamin D levels near 40 ng/ml. [2] Randomized controlled trials have found substantial reductions in fracture rates with vitamin D supplementation, for instance a 58% reduction in non-vertebral fractures and a 37% reduction in hip fractures. [2]
Even slight deficiencies can weaken bones. In mild vitamin D deficiency, serum PTH becomes elevated in order to increase conversion of 25(OH)D to the more active form of 1,25(OH)D to compensate for the insufficiency of 25(OH)D; however, elevation in PTH increases bone resorption, leading to additional bone loss. [3]
Vitamin D Optimization Improves Athletic Performance
In addition to its effects on bones, Vitamin D is also critical for muscle function and coordination. [3] Prolonged vitamin D deficiency is associated with severe muscle weakness which improves within several weeks of vitamin D supplementation. [4] In another study, quickness of movement was proportional to serum 25-hydroxyvitamin D levels. As the 25(OH)D level rose from 9.0 to 37.6 ng/mL, time to perform an 8-foot mobility test decreased by 0.67 seconds. [5] In another study, vitamin D supplementation reduced the rate of falls by 49%. [2]
For elite athletes, optimizing vitamin D can make a significant difference. After noticing that athletic performance was consistently better in summer than winter, the East German and Soviet athletic machines began programs of vitamin D supplementation. These programs coincided with the rise of these nations to the top of the Olympic medal lists. [6]
Melatonin Is Also Important
Melatonin, the “hormone of darkness,” is released during sleep, but only under conditions of quiet and darkness. Even a small amount of light can disrupt melatonin production.
Melatonin has both direct and indirect effects on bone. [7] It directly affects bone mineralization and activity of osteoclasts and osteoblasts – the two cell types responsible for bone remodeling and healing – and indirectly affects bone through its effects on other hormones such as cortisol. Melatonin levels tend to decline with age, and this may be responsible in part for the higher rates of osteoporosis in the elderly. In rats, melatonin co-participates in bone loss in a model of osteoporosis. [8]
Melatonin may also help athletic performance. In rats, 4 weeks of melatonin supplementation just before sleep led to reduced lactate levels during exercise, delayed exhaustion, and increased glycogen reserves. [9, 10]
Conclusions
Everyone, but especially professional athletes who work at night, should monitor serum 25-hydroxyvitamin D levels and get sun exposure or D3 supplements at mid-day to achieve 40 ng/ml.
Everyone, but especially professional athletes who work at night, should sleep in rooms with totally opaque drapes, so that the room remains completely dark after the sun rises, until natural waking. Artificial light sources should be eliminated, for instance by turning LCD clocks face down. Melatonin supplementation may also be worth consideration, especially in the elderly or those suffering from chronic infections; time-release melatonin at bed-time is optimal.
These steps will help optimize status of two hormones crucial for bone health and, possibly, athletic performance.
Maintaining optimal vitamin D and melatonin status is tricky for night workers. It should be a priority for the Red Sox. Have they done it?
References
[1] Feskanich D et al. Nightshift work and fracture risk: the Nurses’ Health Study. Osteoporos Int. 2009 Apr;20(4):537-42. http://pmid.us/18766292.
[2] Bischoff-Ferrari HA et al. Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med. 2004 May 1;116(9):634-9. http://pmid.us/15093761.
[3] Lane NE. Vitamin D and systemic lupus erythematosus: bones, muscles, and joints. Curr Rheumatol Rep. 2010 Aug;12(4):259-63. http://pmid.us/20429045.
[4] Prabhala A et al. Severe myopathy associated with vitamin D deficiency in western New York. Arch Intern Med. 2000 Apr 24;160(8):1199-203. http://pmid.us/10789615.
[5] Bischoff-Ferrari HA et al. Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr. 2004 Sep;80(3):752-8. http://pmid.us/15321818.
[6] Cannell JJ et al. Athletic performance and vitamin D. Med Sci Sports Exerc. 2009 May;41(5):1102-10. http://pmid.us/19346976.
[7] Cardinali DP et al. Melatonin effects on bone: experimental facts and clinical perspectives. J Pineal Res. 2003 Mar;34(2):81-7. http://pmid.us/12562498.
[8] Ostrowska Z et al. Assessment of the relationship between dynamic pattern of nighttime levels of melatonin and chosen biochemical markers of bone metabolism in a rat model of postmenopausal osteoporosis. Neuro Endocrinol Lett. 2001;22:129–136. http://pmid.us/11335889.
[9] Kaya O et al. Melatonin supplementation to rats subjected to acute swimming exercise: Its effect on plasma lactate levels and relation with zinc. Neuro Endocrinol Lett. 2006 Feb-Apr;27(1-2):263-6. http://pmid.us/16648794.
[10] Kaya O et al. Effect of melatonin supplementation on plasma glucose and liver glycogen levels in rats subjected to acute swimming exercise. Pak J Pharm Sci. 2010 Jul;23(3):241-4. http://pmid.us/20566433.
via this link:
If its not possible to completely darken the room can i also use a sleeping mask?
Yes. Aren’t those uncomfortable?
Hi Paul,
Enjoying the e-book and this blog. Thanks for the excellent responses to readers’ comments.
I think you already have plenty to keep you busy, but does the blog program you use support a facility to notify the posting person when a comment has been made to an older post? I hope that made sense.
Hi Jim – There is an RSS feed for comments which will give you all comments to all posts. I don’t know of a way to get comments to a specific post.
i didnt know about the melatonin connection to bone….just sleep. thats interesting.
about the dark room stuff… its impossible to get a dark room where i live, on a street with lights. i have curtains AND blankets over my curtains and it’s still not dark. i tried the mask thing over my eyes but umm hahah it felt like there was something over my eyes all night
any ideas??
Try room darkening or blackout drapes, e.g.:
http://www.bedbathandbeyond.com/product.asp?SKU=117957
http://www.bedbathandbeyond.com/product.asp?SKU=110337
Hi Paul,
I haven’t read much about sleep, so forgive my ignorance, but I’m curious why just closing our eyes isn’t enough to create adequate darkness for sleep (assuming there’s nothing especially bright in the room). Also, this example may be a bit too literal, but wouldn’t our ancestors have evolved sleeping near the light of a fire (albeit not blazing all night) and/or under the light of moon/stars, as compared to total darkness?
One more question (if I may!) – you don’t mention it in your book (at least not that I recall), but do you have any thoughts on time-release melatonin as a regular supplement for anyone (beyond the examples you gave above) – perhaps those who cannot obtain total darkness at night? Any drawbacks to using melatonin at night?
Thanks for any comments!
Mark
Jim,
Individual post comments as RSS can be obtained via the following URL format;
http://perfecthealthdiet.com/?p=731&feed=comments-rss2
Hi Mark,
Eyelids aren’t opaque, they let some light through.
I think it’s very unlikely that Paleo peoples kept fires going through the night. It’s very costly to gather all that wood and there’s no need for it.
They probably sought dark places to sleep — in the shadow of trees and bushes, if not in caves or tents/dwellings. I believe most primates avoid sleeping in the open.
I’m not sure why we evolved such sensitivity to light — maybe to make sure we’d wake up early at dawn, when predators would have an easy time seeing us.
Melatonin is safe if taken immediately before bed. There have been no reports of toxicity even at very high doses.
Thanks, Winalot! That’s cool, I’ll have to remember that.
So would you recommend melatonin to improve athletic performance? I am wondering if it would be helpful on days where I could not get enough sleep, or even on days that I could?
Also, any other recommendations for athletic performance?
Hi Abby,
Well, our whole diet is good for athletic performance. Eat a lot of saturated/monounsaturated fat, eat toward the high end of our carb range with “safe starches” (say 500 calories), and get a lot of micronutrients. Follow the book’s supplement recommendations.
A few other tips: The ketogenic & branched-chain amino acids are good for athletes — you can have a scoop of whey protein isolate each day for those. Also, intermittent fasting is good for athleticism, autophagy cleans up cellular junk and makes mitochondria work better. Fast, but never be hungry. Coconut oil is good too. Some cold exposure.
Melatonin – as a young person I don’t think you need it, just sleep in total darkness. It’s usually older people and people with infections who have difficulty making it. However, if you have difficulty sleeping then I would give it a try.
http://www.amazon.com/Tempur-Pedic-Sleep-Mask/dp/B0027OUUFW/ref=sr_1_2?ie=UTF8&s=hpc&qid=1287085729&sr=1-2
It seems like a ridiculous price. I hope I didn’t pay that much!
I own this mask and use it. It’s very comfortable.
Hi Paul,
“Melatonin, the “hormone of darkness,” is released during sleep, but only under conditions of quiet and darkness. Even a small amount of light can disrupt melatonin production.”
Would even a small amount of noise also disrupt melatonin production? I’ve always been a poor sleeper, and use a mechanical white-noise generator (basically a motor/fan in a box – see marpac.com/soundscreen.asp for anyone who’s interested). Is this something that you think could be consequential?
Hi Sam,
I don’t think all noises necessarily disrupt melatonin production, but I have no idea what the effect of those products is.
Why not try a melatonin supplement and see if your sleep improves? E.g. http://www.amazon.com/Natrol-Melatonin-TR-5mg-100-Tablets/dp/B001HCM7AQ/
You might find that if you take the melatonin you won’t need the white-noise generator.
I keep reading this in different articles and it makes no sense. People feel more alert when it gets dark and want to go out and party, and we sleep the most soundly between the hours of dawn and noon. If these findings were real, bars would open and people would go out and party in mid-afternoon, but we don’t.
And evolutionarily it makes no sense. A lot of predators are nocturnal, and night is the most dangerous time for a lot of reasons. A species that was designed to be unconscious during the hours when predators were on the prowl and most difficult to detect would have been lunch millions of years ago. This is why children are so frequently afraid of the dark and can’t sleep without a nightlight. And they get night terrors, not “day terrors”. It’s because their bodies know that when their parents put them to bed the minute the sun goes down, they’re basically feeding them to leopards.
We’ve had electric light for over a century, it’s high time we dispensed with this agricultural-era forced diurnal lifestyle.
Hi Jane, Not everyone sleeps most soundly between dawn and noon! I’m doubtful that the college student lifestyle was the evolutionarily selected one.
Humans are terrified of darkness because we’re not adapted to it … suggesting that we didn’t try to accomplish much at night, but rather slept.
Thanks Paul,
I’ll try to wean myself off the noise-machine with the help of melatonin, though I’ve gotta admit, I’m nervous about letting go of what’s been a very effective crutch! I’ll report back sometime in the future.
Sam, if the noise machine works for you, use it. I wasn’t trying to persuade you to quit – only to try melatonin, since lack of it is often a cause of poor sleep.
If we were adapted to be out and about at night on a regular basis, wouldn’t we have better night vision than we do?
Hi Paul,
I should think that the Red Sox would do well to also check their RBC Magnesium status and supplement as necessary to reach mid-range levels.
Best, KKC
Hi KKC,
Yes! They should follow all of our supplement recommendations in fact.
Best, Paul
Yes Paul, no doubt they should!
The following is very off-topic, but I didn’t know where else to post it. Feel free to move as you see fit.
Would you be so kind as to tell me what you think of my most recent thyroid panel?
Tests run w/ LabCorp, 12 hour fast:
TSH 3.510 uIU/mL (Reference Interval 0.450 – 4.500)
Free T3 2.2 pg/mL (RI 2.0 – 4.4)
Free T4(Direct) 0.96ng/dL (RI 0.82 – 1.77)
No antibodies present.
I take 7-8 g. Brazil nuts daily and supplement with 200mcg methylselenocysteine every other day. Was taking 1/2 an Iodoral daily, switched recently to Iosol, one drop providing 1.8mg iodine daily. 500 mg tyrosine 2 x day.
(I also supplement with the others you recommend, and have for some time: D3, K2 as both MK-4 and MK-7, Mg, zinc + copper, ascorbate C. Many other$ as well, sigh.)
Not sure what my next move ought to be to get the thyroid numbers more in line. By the way, my oral temp is consistently ~96.5 in the a.m. after puttering around a bit. It rises steadily to ~98.4 just after lunch, falls steadily in the evening, so that I’m back to 96+ at bedtime.
Any thoughts? I’m wondering If I’ve made myself hypo from too much iodine (took Iodoral daily for close to a year).
Thanks in advance for your time and knowledge. I’m enjoying your e-book immensely, although I can’t quite get myself to add back fruit and/or safe starch to my diet – yet. Diet is 2/3 – 70% fat by calorie, same amount plant matter by volume. 80-100g high-quality protein daily. I’m female, in my forties, 5’10, 110lbs. No meds nor other health concerns. Got overzealous with the D3 and supplemented up to 82 25(OH)D. Gradually reducing now.
Best wishes, KKC
Hi KKC,
Well, you’re doing a lot right.
My number one recommendation would be restore safe starches and fruits. Eat a banana and a sweet potato or yam each day at a minimum. As we say in the book, there are 2 million glycoproteins in the human body, they have a tremendous number of functions, and you don’t want to starve yourself of glucose.
Although your 320-400 calories protein is plenty on a glucose-sufficient diet, if you are zero-carb you may be starving yourself of glucose / gluconeogenic substrates. Stefansson in the Bellevue All-Meat Trial needed 550 calories protein, and we estimate protein+carb needs at 600 calories/day. Since vegetables supply negligible glucose, you are de facto zero carb. I think this glucose starvation is bound to cause trouble.
I would also add coconut oil, which relieves glucose deficiency by substituting ketones and also increases metabolic rate.
Do you have evidence that the iodine induced your hypothyroidism? Was your TSH lower before starting iodine? It can happen but there are many other possible causes. Is your thyroid gland enlarged?
I might drop the Brazil nuts and use the supplement every day just to have better control on selenium intake.
I would also consider asking the doctor for a T3-containing natural thyroid extract while you are sorting this out. Normalizing T3 levels may help the thyroid recover.
I do think it’s good to reduce D supplements, you are probably inducing vitamin D resistance. I would also try to get regular mid-day sunshine, it’s best not to rely totally on supplements.
Make sure your fats are low in PUFA, high in saturated and monounsaturated. PUFA can cause hypothyroidism and low metabolism. Beef, lamb, salmon, other seafood are good foods; butter, coconut oil, beef tallow are good fats/oils.
I would expect that if you add starches back to your diet, and return to a normal level of D, then you should have a good chance of seeing things heal over a 6 month timeframe.
Best, Paul
It’s my understanding that taking a thyroid test fasting will make the scores look worse.
That is, the scores will look more hypo.
Thanks for the quick response! And to Michelle, too.
Yes, I know I *should* add back some fruit/starch. Oh my! I’m getting used to the idea. I even bought some fingerling potatoes and frozen berries. I’ve been “green” veg only for quite some time. (My late mother was insulin-dependent at the end, and I became quite the Bernstein devotee – although I don’t limit non-starch veg. as he recommends. I would exist on wood chips only if necessary to avoid diabetes.)
Yes, TSH was lower, <2, before Iodoral. Still high-ish, though. My T3 and T4 have been remarkably consistent all along.
Thyroid is not enlarged.
I adore Brazil nuts; I have to control myself to limit them to 2 or 3. I can do the coconut oil, in fact I have some Nutiva on hand.
Fats are pastured butter, ghee, heavy cream from grass-fed cows, EVOO, macadamia and avocado oils. I track my intake using CRON-o-meter and the ratios are in good shape: slightly higher in SAT than MONO, quite low in PUFA especially the n-6. i do supplement with fish oil, currently 500mg DHA/200 mg EPA daily, wild salmon usually once weekly. I know you recommend against the supps, but I'm going to use them up.
Starch and fruit… Well, I'll give it a go. What do I have to lose but my cold hands?
Thanks again, Be well. KKC
Hi Paul,
One of the things I wrangle with is having to take yet more and more supplements to reach optimum health.
I used to be a pill popping fiend but over the past couple of years only take Vit. D and Fish Oil (as well as prescribed SSRI’s for depression).
We talk of insomnia; take melatonin, we talk of stress; take magnesium, we talk of alzheimers; take selenium and so on adfinitum. Where does it stop for things that should come naturally?
At one time I looked into 5HTP or St. Johns Wort as alternatives to my prescribed medications as they’re “natural”, but £30 for a months supply of 5HTP vs £7.20 prescription (UK NHS) for a months cipramil just doesn’t compete.
I suppose I’m wondering when you ever stop? Will I need to consume all this coconut oil forever to stave off suicide and depression? Will I need my Vit. D every day as I’m a computer geek and work indoors? I sleep poorly so should I stock up on melatonin?
I’d sure love the real food I consume to fully meet my needs but I guess it can’t in this modern era?
WP
Oh, I meant to add:
DirectLabs.com is offering the 25(OH)D test as one of its October monthly specials – only $39.00. Once ordered it can be used any time in the next 6 months. Directlabs is affiliated with LabCorp, which I understand is more reliable than Quest for this test. [I am in no way affiliated with Directlabs or Labcorp (or Quest, for that matter), just wanted to pass along the info.]
KKC
Hi Winalot,
We have a section in the book on why malnutrition is a risk even if you eat right.
We recommend 5-9 daily supplements: a multivitamin, D only if you don’t get sunshine, K2, C, magnesium, copper if you don’t eat beef liver, selenium if you don’t get enough from food, iodine if you don’t get enough from seaweed and seafood, and chromium. Melatonin is a pharmacological supplement for certain conditions.
It is possible to construct a lifestyle and diet that eliminates the need for supplements. We suggest the pill approach because on practical lifestyles of busy working people, it’s easier to take half a dozen pills than to get mid-day sun and large quantities of food that needs to be fresh-bought (leafy green vegetables) or prepared at home (bone marrow).
As for the coconut oil, I think you should take it until your depression is cured. If your depression is due to a brain infection, as I think it commonly is, then you need to supply the neurons with an alternative energy source that bacteria can’t steal. Eradicate the bacteria, and you would no longer need the coconut oil. Unfortunately this is easier said than done, but that is the goal.
” I wasn’t trying to persuade you to quit – only to try melatonin, since lack of it is often a cause of poor sleep.”
Thanks for this, Paul. It’s what I meant as well – I’m going to supplement with melatonin to see if it improves my sleep, and I’ll experiment to see if the white-noise machine then becomes unnecessary.
Hi Paul,
can low vit D status be linked to scoliosis in children?
My seven years old has mild scoliosis that impacts on her leg muscles, where she gets cramps, we only found out when she was taken to a chiropractor recently. I have been giving her 1000 units of vit D for about two years, maybe less, during the long winter (Ireland) I’m wandering can it be reversed or can we avoid progression and the complications that appear later on?
We haven’t done any blood tests yet.
She is eating some wheat regularly as well.
Hi Simona,
I believe so, although the literature is surprisingly quiet about the link. Children with scoliosis do have low bone density and osteopenia, and genetic alleles that affect vitamin d status promote scoliosis (http://pmid.us/20361340).
I believe all of the bone nutrients — C, D, K2, magnesium especially — are important, as is elimination of grains and balancing of omega-6 and omega-3 at a low level. She should get a serum 25OHD test, and eat vitamin A rich foods like liver and egg yolks and colorful vegetables (but don’t supplement vitamin A).
Wheat should be eliminated, since an autoimmune reaction to wheat can cause scoliosis, as in a case here: http://pmid.us/15515214.
Simona & Paul,
This is interesting and supports my contention that my teenage niece’s back problems might be due to nutrition/Vit D deficiencies/gluten issues. According to her mother, her tentative diagnosis was spondylolisthesis with mild scoliosis after being examined for chronic back pain during the older grade school years. She changed sports from soccer to cross country running, as well as some other behavior modifications, but otherwise AFAIK hasn’t had any medical treatment, nor a lot of followup. The doctor said it “ran in families”, but of course, no one in our extended family has these conditions to our knowledge. I can only push so hard and so far.
However, via Enterolab genetic testing, I know I carry two HLA genes that predispose to gluten sensitivity (not necessarily celiac & GI symptoms), so I know both my parents carry a gene, so my sisters likely do, too. No one in the family wants to pursue the gluten testing to really find out. Ok.
At my urging, though, after her mother’s Vit D came back at 9 ng/mL, the girl was given a blood test by her pediatrician for gluten and it was negative (end of story), and her Vit D level was tested and was found to under 20 ng/mL (so was her sister’s). The pediatrician was shocked, btw, as the girl drinks a lot of skimmed milk fortified with D. Sheesh. She supplemented for a while but AFAIK hasn’t retested or been consistent about supplementing. Sigh.
Their mother (my slightly younger sister) was diagnosed with hyperlipidemia not long after this second daughter’s birth (I suspect post-natal hypothyroidism, but that wasn’t investigated or diagnosed) and was sucked into the vortex of statins/low fat/high carb/AHA nonsense for many years along with the older generations of the family, and also had to give up breastfeeding her younger daughter at 3 mos of age because of the statin. Until fairly recently this girl was a pasta & cheese, cold cereal & skim milk, soft bread with no butter kind of girl. She’s as skinny as her mother and I were as a child and young woman. Despite the formula feeding and SAD type diet of refined starches and processed foods, this girl is seriously quite brilliant, which is great. But I’m so concerned for her long-term health and well-being with this spinal issue and continuing to eat the way she does. I was glad to see after a 3 week visit with us this past summer that she has branched out into a more diverse diet as she matures and she was interested in *some* of the food ideas that I have. It was a bit of a tightrope walk to demonstrate our eating style without preaching or ruffling feathers back home. Except for the huge amount of butter (& the raw dairy) we consume compared to her family, she was surprised at how “not weird” our food really was ;-).
Hi Anna,
It’s great that your niece liked your food! Maybe there’s hope.
I really believe that vitamin D and thyroid status should be routinely tested for everyone — but especially pregnant women and anyone with chronic health problems. It’s amazing that doctors don’t know they ought to do this.
I have a number of aunts and uncles with cancer, heart disease, statins, etc. I’m hoping our book will persuade them to switch diets. It’s not easy to change.
Thank you both,
I was hoping that she has not inherited the genes in the family that made two aunts on my husband’s side of the family (the Irish one) coeliac. My son had a bit of eczema as a toddler and serous otitis media, and I have been trying to convince my husband to avoid wheat and gluten altogether, unsuccessfully, he sees it as extreme and unnecessary caution. They have been breastfed for at least 7 months, we never used veg oils and they’ve taken omega 3 supps since they were babies, a multivitamin too, they have eggs or scrambled eggs with salmon every day for breakfast, organic butter on everything, raw cheese for lunch, rarely cakes and rarely pasta, never pizza or other fast foods. The only thing that could be changed besides introducing liver is eliminating the sourdough bread sandwich for lunch.(and obviously focusing on gluten-free cakes) Easier said than done.
Maybe a blood test for coeliac, vit D and borrelia antibodies all in one would be a good idea (they have been biten by ticks in Romania during the holidays)
Dear simona,
The tests seem like a good idea. I hope you find the cause. Six months without wheat would be a good experiment.
Best, Paul
somewhat off topic, but curious if you have any opinions on white noise machines for sleep? we found our baby girl slept much better using one from birth, but my wife has continued this now for years and is convinced it is helpful. any thoughts? thanks in advance.
Hi steve,
We had a discussion of white noise machines earlier in this thread, Sam brought it up here: http://perfecthealthdiet.com/?p=731#comment-3220.
I don’t have a strong opinion about it, if they work for you great. I don’t think there’s much research on how effective they are.
I would encourage total darkening of the room and similar natural sleep enhancing steps first. If that is not enough, then I would encourage experimentation with melatonin supplementation; this can narrow down the cause of poor sleep and have diagnostic value, even if you don’t wish to supplement continually. Devices like white noise machines wouldn’t be something I would recommend trying early. But the key is whether they work, and personal self-experiments are the best way to find out.
Best, Paul
Dear Paul,
I ordered the “PHD” book a few days ago but until I receive it, am already trying to get informed by means of your excellent blog.
I started low carbing in January 2010 and at first it seemed to work rather well. However, it appears that it is doing “nasty things” to my thyroid, producing antibodies. So I hope your book will help me to make better decisions.
My question may make many people laugh (yourself included), but the problem in my case is real: what do you recommend to a grown-up woman like me, who is afraid in the dark and cannot bring herself to go to sleep in a pitchdark room?
I honestly need the tiny bit of reassurance that I get by leaving the door to the hallway open, so that a bit of (orange) light from the street comes in.
I have had this silly fear my entire life. When I was little, there was the fear of “monsters”. Later in life that was “adapted” to something more realistic: burglars (in spite of the house being quite safe).
I went to a very good (but sadly enough also very expensive) anti-aging doctor who prescribed Melatonin (2 mg daily – time released). It helps tremendously and I saw my melatonin 24h (urine) figure skyrocket from 4,3µg/24h to >200 in 3 months time. Not sure though if that is good. I read that too much melatonin can cause depression.
The fact is however that I sleep very well at the moment. I try to go to bed before midnight (don’t always succeed) and have to be up at 6:30. On the weekends I catch up and sometimes manage to sleep until 8:30 or even 9:30.
I have installed the f.lux utility to “mellow down” the colours of my monitor, as I sit at my computer for a substantial time of the day as well as the evening.
I cannot go to the expensive doctor anymore, since I simply cannot afford her. I am going to see another doctor soon and hope that she will understand the problem. I have a long list of other (relatively minor) ailments as well, for most of which I am already supplementing with vitamins and minerals.
Would it be alright to continue taking the melatonin? Do I need to be worried about the >200 figure?
A week or two ago I tried two nights in a row to do without the melatonin. It took me ages to get to sleep. I repeated the “experiment” a week later with the same result.
Sorry for the length of the question. I am renowned for making any short story a long one ,-)
Many thanks on beforehand for your kind advice.
Tarragon
Dear Tarragon,
Shou-Ching had a similar problem when she was younger. She found that meditation helped. Calm yourself, relax, breath deeply and slowly, think happy thoughts. Gradually her fears disappeared.
I think you’re doing the right thing by taking the melatonin and cutting blue light from your monitor. Good sleep is important. Melatonin is sold over the counter so you don’t need a prescription (at least in the US).
The presence of melatonin in your urine, plus your sound sleep, indicates that 2 mg is enough for you. I wouldn’t worry about excreted melatonin. That’s your body managing levels. You might experiment with 1 mg or 1.5 mg to see if either is sufficient.
Best, Paul
Many thanks!
Since I dislike medication and I consider melatonin exactly that, I will try to find out what 1,5 g does to me. My regular vitamin and mineral (US) supplier sells melatonin and so I will order it there when my supply is at its end.
The fear is less when my boyfriend is with me. It’s reassuring having someone in the house. But he’s usually only there in the weekends and we have to wait another 2 years before any change can be expected as far as that is concerned.
I have never tried to do any kind of meditation, I admit, and not sure if I “believe” in it. But I suppose it cannot hurt. On the contrary, it may help in many respects since I have a few years of extreme stress past me.
I have been informing myself the past year about food and health. I will just inform myself about meditation in the same way.
Kind Regards,
Tarragon
I hope you’ll find this way down here:
Harvard School of Public Health (HSPH) is hosting a live webcast next week on the IOM vit D recommendations. BOOSTING VITAMIN D: Not enough or too much?
Presented in Collaboration with Reuters
Tuesday, March 29, 2011
1 p.m. to 2 p.m. ET
The Forum at Harvard School of Public Health
Second in The Andelot Series on Current Science Controversies
You can submit questions at the link website.
Ivan Oransky of Reuters (The Retraction Watch blog about science research), Walter Willett, Joanne Manson, Patsy Brannon, and
Bess Dawson-Hughes, Senior Scientist and Director, Bone Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University; Professor, Tufts University School of Medicine; and Past President and Trustee, National Osteoporosis Foundation will be presenting.
Best-
aek
Thanks, aek.
I’m sure many readers may want to watch. Sounds fascinating.
A further follow up regarding melatonin –
in the years since this thread was started, have you had any further insights on melatonin as related to hormone (specifically thyroid) normalization and weight loss? Are you at all familiar with Walter PierPaoli and his theories http://thyroid.about.com/od/Vitamins-and-Supplements/fl/Melatonin-Your-Thyroid-and-Hormones.htm
The T4-to-T3 conversion seems important, as well as the “anti-aging” claims. He also shares your passion for circadian rhythm entraining 🙂
As an active 50 year old woman with no thyroid (removed 2011 for goiter & cancer), 5’6″ and 235lbs who is trying desperately to lose weight and regain health, I’ve been losing and gaining the same 3 lbs for the last 4 weeks on your eating plan. No wheat for 8 years, finally have the energy for walking and weight training @ 30/min daily 6 days per week. I’m on all the recommended suppliments. Will be getting as many levels tested as I can afford next week. Should I add melatonin at 3mg daily? Thanks you two for all your amazing work!