ARE YOU WAKING UP DURING THE NIGHT IN A SWEAT?
It's no fun, and trying to fall back asleep when your bedclothes, sheets, and pillowcase are wet can be a challenge. The good news? Night sweats are optional. More good news? When you treat their underlying causes, you're going to feel much better overall!
There Are Four Key Causes Of Night Sweats:
- Deficiencies of reproductive hormones such as estrogen, progesterone, and testosterone
- Infections, such as Candida
- Drops in blood sugar from inadequate adrenal function
- Nighttime acid reflux
This four-part series will take a look at all of these and how to address them. Don't be surprised if more than one underlying process is contributing.
A helpful tip for all of these? Sweating is controlled by our hypothalamic autonomic control center. This can be stabilized using a special herb called Black Cohosh. Research has shown that the only brand that is effective is Remifemin (by Enzymatic Therapy). Take two twice a day and give it two months to work, so you can sleep dry and comfortably. It also helps the daytime sweats. Then the dose can often be lowered.
In this first article, let's look at reproductive hormone deficiencies.
Optimizing Reproductive Hormones IN WOMEN
Ever wonder what each of these hormones does?
- Inadequate estrogen will result in poor sleep, sweats, brain fog, vaginal dryness and depression.
- Inadequate progesterone will result in anxiety and poor sleep.
- Inadequate testosterone, even in women, will result in weakness, loss of libido, and pain.
The problem? Most doctors will not diagnose estrogen or progesterone deficiency until your menses stop, or the blood tests become overtly abnormal. Unfortunately, estrogen and progesterone deficiency have already been present for 5–12 years before these occur.
Have you had a hysterectomy or tubal ligation? Hysterectomy can trigger estrogen and progesterone deficiency about 1–2 years afterward. Even if you're only 20 years old! Most doctors are not familiar with this old research by Philip Sarrel, emeritus professor in the Yale Departments of Obstetrics, Gynecology & Reproductive Sciences and presume that if the ovaries are left then there is no problem.
This is simply not the case. Especially in younger women, where suddenly being thrown into menopause can trigger major problems, including fibromyalgia. Sadly, I find hysterectomies to be more frequent in young women with a childhood history of sexual abuse. It seems almost as if the psyche is trying to do a "clean sweep." Other techniques to deal with the trauma such as EFT (Emotional Freedom Technique) can be very helpful.
How To Tell If You Need Bioidentical Estrogen Support
Instead of relying on the blood tests I find one single question to be most helpful. "Are your sleep or fibromyalgia symptoms worse the week around your menses?" If the sleep, brain fog, pain, and fatigue are worse around your menses, when your estrogen and progesterone are at their lowest, this suggests that deficiencies of these hormones are contributing to your symptoms and a trial of bioidentical estrogen and progesterone are warranted. This can be used just around your menses, or even throughout the month depending on which leaves you feeling the best. If you simply are having irritability around your menses (at any age), this suggests low progesterone, and I will give the prescription Prometrium 100 mg, one capsule once or twice daily (although I will go higher if needed) around the menses, adjusting the dose as feels the best. Alternatively, a compounded progesterone cream can be used, with 30– 60 mg a day being optimal for most women. This can do wonders for PMS, anxiety, and sleep, and a low dose may be used through the rest of the month as well.
For a woman suffering refractory migraines mostly during ovulation and around the menses, this is often being triggered by shifts in estrogen and progesterone. In these cases, I will use just the estrogen patches plus Prometrium during these periods to prevent migraines. Some doctors will not give progesterone to women who had a hysterectomy, because they think the progesterone is only needed to prevent uterine cancer from estrogen treatment. This simply is not so. Progesterone is a critical hormone for sleep and maintaining a calm mood. So I do recommend it as part of hormone replacement even if a woman has had a hysterectomy.
If testosterone levels are in the lowest one-third of the normal range, adding testosterone can be very helpful. Over 70 percent of women with fibromyalgia, as well as those in menopause, are in the lowest 30th percentile for testosterone. Using bioidentical testosterone by prescription (one-half – 5 mg daily) has been shown to not only improve function, but also will decrease fibromyalgia pain. This was shown in a study on women with fibromyalgia done by Prof. Hilary White at Dartmouth University. It can also help improve libido. In one study we did, when we asked women with fibromyalgia how the libido was, the answer 73 percent of the time was, "what libido?"
For treatment, I only use bioidentical hormones and not the synthetics. The bioidenticals are very healthy and the synthetics are quite toxic. Most often I will use the compounded mixes that contain BiEst, progesterone, and testosterone. These will need to be prescribed by a holistic physician. Alternatively, the standard estrogen patches (0.1 mg) and Prometrium (100–200 mg daily) are both bioidentical and can be obtained at a regular pharmacy (often insurance covered). Unfortunately, this does not supply the testosterone. The overall research is suggesting that these bioidentical hormones are very healthy, actually being associated with a lower risk of breast cancer. It was the toxic synthetics that caused the problems.
In women who prefer not to use hormones, eating a handful of edamame each day around their menses can also be helpful, as can the Black Cohosh. As mentioned earlier use only the Remifemin, brand. This is the only form shown to be effective in research studies.
Treating Testosterone Deficiency IN MEN
Inadequate testosterone levels in men, even if the blood levels are "normal" simply means that you are not in the lowest two percent of the population, often including 80 year old men, which is an absurd way to define the normal range for a younger man. Low testosterone often causes night sweats. It also can trigger erectile dysfunction, low libido, diabetes with high blood pressure and elevated cholesterol (called metabolic syndrome), weight gain with a "spare tire" around your middle, and a generalized poor mood and a decrease in motivation.
Studies show that using bioidentical testosterone (not to be confused with the toxic chemicals bodybuilders sometimes use) helps bring down blood sugar, blood pressure, and cholesterol while helping many of the other symptoms. It also seems to be associated with improved overall health and longer life.
I do not recommend testosterone shots or synthetic testosterone. Instead, in men over 55 who are no longer looking to have more children, I use compounded testosterone cream, switching over to the subcutaneous pellets if convenient and if they feel better on it. The cream should be put on different locations each day or the skin may him stop absorbing the cream over time.
In men under 55, I preferred to begin by giving the prescription medicine clomiphene, which stimulates the body's own production of testosterone. I have them take half of a 50 mg tablet each night, and repeat the testosterone level the morning after the seventh dose. If it is over 550 ng/dl, then the clomiphene by itself is often adequate and I will leave them on one-half tablet a night or every Monday, Wednesday, and Friday night.
For those with difficulty with elevated blood sugars, a wonderful new herb called Hintonia latiflora (sold as Sucontral D) can be very helpful, lowering average glycosylated hemoglobin's by almost one percent. I am so impressed with it, I wrote a book on it!
Please be aware that medicine is complex and without actually being your attending physician we cannot give medical advice. Any information given is to be used as a teaching tool for you and your physician to work with therefore we cannot take any legal responsibility for its use. Please check with your personal physician before applying any recommendations.
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Jacob E Teitelbaum, MD
Jacob Teitelbaum, MD, is a board certified internist and Medical Director of the national Fibromyalgia and Fatigue Centers and Chronicity. He is author of the popular free iPhone application "Cures A-Z," and author of the best-selling books
- The Fatigue and Fibromyalgia Solution: The Essential Guide to Overcoming Chronic Fatigue and Fibromyalgia
- From Fatigued to Fantastic!
- Pain Free 1-2-3
- Three Steps to Happiness: Healing Through Joy
- The Complete Guide to Beating Sugar Addiction
- Beat Sugar Addiction Now! Cookbook
- Real Cause, Real Cure: The 9 root causes of the most common health problems and how to solve them
Dr. Teitelbaum knows CFS/fibromyalgia as an insider — he contracted CFS when he was in medical school and had to drop out for a year to recover. In the ensuing 25 years, he has dedicated his career to finding effective treatments.