Obstructive Sleep Apnea (OSA) is a prevalent and serious health condition affecting millions of Americans. Characterized by repeated interruptions in breathing during sleep, OSA can lead to significant health complications if left untreated. According to the American Academy of Sleep Medicine, approximately 25 million adults in the United States suffer from OSA [1]. These interruptions, or apneas, can last from ten seconds to one minute and occur multiple times per night, severely disrupting sleep quality and overall health.

OSA is associated with a range of adverse health outcomes, including cardiovascular disease, diabetes, stroke, and increased mortality risk [2]. The condition also contributes to daytime fatigue, cognitive impairment, and reduced quality of life, highlighting the importance of effective diagnosis and treatment [3].

Treatment Modalities for Obstructive Sleep Apnea

Various treatment options are available for OSA, each with its own benefits and drawbacks. The choice of treatment often depends on the severity of the condition, patient preference, and specific anatomical considerations.

Continuous Positive Airway Pressure (CPAP) Machines

The most commonly prescribed treatment for OSA is the Continuous Positive Airway Pressure (CPAP) machine. CPAP devices deliver a steady stream of air through a mask, keeping the airway open during sleep. This prevents apneas and ensures a continuous supply of oxygen to the body.

Benefits of CPAP:

• Effectiveness: CPAP is highly effective in reducing or eliminating apneas, improving sleep quality and reducing associated health risks [4].
• Symptom Relief: Many patients experience immediate relief from symptoms such as snoring and daytime fatigue.
• Long-Term Health Benefits: Consistent use of CPAP can significantly reduce the risk of cardiovascular events and improve overall health outcomes [5].

Drawbacks of CPAP:

• Comfort and Compliance: Many patients find the CPAP mask uncomfortable, leading to issues with compliance. The noise of the machine and the feeling of claustrophobia are common complaints [6].
• Side Effects: Potential side effects include nasal congestion, dry mouth, and skin irritation from the mask.

Mandibular Advancement Devices (MAD)

Mandibular Advancement Devices (MAD) are another treatment option, particularly for patients with mild to moderate OSA. These dental appliances are designed to reposition the lower jaw (mandible) forward, enlarging the airway and preventing collapse during sleep.

Benefits of MAD:

• Non-Invasive: Unlike CPAP, MADs do not require a machine or mask, making them more comfortable and less obtrusive.
• Ease of Use: MADs are portable, quiet, and do not require electricity, making them convenient for travel.
• Compliance: Studies suggest that patients are more likely to adhere to MAD therapy compared to CPAP due to increased comfort and simplicity [7].

Drawbacks of MAD:

• Variable Effectiveness: MADs are generally less effective than CPAP, particularly in severe cases of OSA [8].
• Jaw Discomfort: Some patients experience discomfort or pain in the jaw, teeth, or gums.
• Potential for Dental Changes: Long-term use can lead to changes in bite and tooth alignment [9].

The Herbst Sleep Appliance: A Focused Review

Among the various MADs available, the Herbst Sleep Appliance stands out for its design and efficacy. The Herbst Sleep Appliance is a custom-made dental device that positions the lower jaw forward, similar to other MADs, but with some distinct features.

Design and Functionality:

• Adjustable Mechanism: The Herbst appliance includes an adjustable mechanism that allows for incremental advancement of the lower jaw, providing a customized fit and optimal airway management [10].
• Durability: Made from durable materials, the Herbst appliance is designed to withstand long-term use without significant wear and tear.

Benefits of the Herbst Sleep Appliance:

• Effective for Severe OSA: Clinical studies have shown that the Herbst appliance can be effective even in patients with severe OSA, offering an alternative to CPAP for those who cannot tolerate it [11].
• Improved Compliance: The adjustable nature of the device allows for gradual acclimatization, improving patient comfort and compliance rates [12].
• Versatility: The Herbst appliance can be used in conjunction with other treatments, such as weight loss and positional therapy, to enhance overall effectiveness.

Drawbacks of the Herbst Sleep Appliance:

• Cost: As a custom-made device, the Herbst appliance can be more expensive than other MADs.
• Adjustment Period: Patients may require an adjustment period to get used to the device, during which they may experience temporary discomfort or increased salivation.
• Regular Monitoring: Regular dental check-ups are necessary to ensure the device remains effective and to make any necessary adjustments.

Conclusion

Obstructive Sleep Apnea is a significant health issue in the United States, impacting millions of individuals and contributing to a host of adverse health outcomes. Effective management of OSA is crucial for improving quality of life and reducing the risk of serious health complications.

Continuous Positive Airway Pressure (CPAP) machines and Mandibular Advancement Devices (MAD) are the primary treatments for OSA, each with unique benefits and drawbacks. CPAP machines are highly effective but may have issues with patient compliance due to discomfort. MADs, including the Herbst Sleep Appliance, offer a comfortable and portable alternative, though they may be less effective in severe cases.

The Herbst Sleep Appliance, with its adjustable mechanism and custom fit, represents a significant advancement in MAD therapy, providing a viable option for many patients. As research continues to evolve, the combination of patient preference, severity of OSA, and specific anatomical considerations will guide the choice of the most appropriate and effective treatment.

References:

1. American Academy of Sleep Medicine. (n.d.). Obstructive Sleep Apnea. Retrieved from AASM
2. Peppard, P. E., Young, T., Palta, M., & Skatrud, J. (2000). Prospective study of the association between sleep-disordered breathing and hypertension. New England Journal of Medicine, 342(19), 1378-1384.
3. Punjabi, N. M. (2008). The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society, 5(2), 136-143.
4. Sullivan, C. E., Issa, F. G., Berthon-Jones, M., & Eves, L. (1981). Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. The Lancet, 317(8225), 862-865.
5. Weaver, T. E., & Grunstein, R. R. (2008). Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proceedings of the American Thoracic Society, 5(2), 173-178.
6. Aloia, M. S., Smith, K., & Arnedt, J. T. (2007). Examining the impact of untreated sleep apnea in CPAP nonadherers: a randomized controlled trial. Behavioral Sleep Medicine, 5(1), 1-14.
7. Hoffstein, V., & Deegan, P. (2003). Comparison of the efficacy of continuous positive airway pressure and oral mandibular advancement device in patients with severe obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 168(2), 239-247.
8. Ferguson, K. A., Cartwright, R., Rogers, R., & Schmidt-Nowara, W. (2006). Oral appliances for snoring and obstructive sleep apnea: a review. Sleep, 29(2), 244-262.
9. Riley, R., & Powell, N. (1990). Treatment of obstructive sleep apnea with a mandibular repositioning device. The Journal of Oral and Maxillofacial Surgery, 48(8), 792-797.
10. Mehta, A., Qian, J., Petocz, P., Darendeliler, M. A., & Cistulli, P. A. (2001). A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 163(6), 1457-1461.
11. Marklund, M., Verbraecken, J., & Randerath, W. (2012). Non-CPAP therapies in obstructive sleep apnoea: mandibular advancement device therapy. European Respiratory Journal, 39(5), 1241-1247.

The post Understanding Obstructive Sleep Apnea: Prevalence, Treatments, and Innovations appeared first on Total Health Magazine.

A strong link between physical health and stress was established more than a quarter century ago when researchers noted that exacerbation of tumor growth in rats occurred following acute exposure to uncontrollable shock but not to controllable shock. It was postulated that stress influenced neurochemical, hormonal and immunological changes that, in turn, effected the tumor growth¹.

More recent research focused on the physiology of emotional response to psychosocial stimuli added to the understanding of how neurochemical, hormonal and immunological changes occur and contribute to physical and neurological dysfunction. The responses were characterized as the “defense, fight or flight” and “defeat or give up” behaviors. These limbic-hypothalamic patterns of response serve to protect a person from adverse stimuli². Under normal circumstances a person can manage their stress but when demands exceed coping abilities, a cascade of physical and psychological events take place and illness and disease can occur, especially if left unchecked over a long period of time^3,4.

Stress and Physical Illness

It is known that stress contributes to or exacerbates certain physical diseases such as diabetes, rheumatoid arthritis, peptic ulcer disease, and cardiac disease. Newer information supports the idea that not only does physical illness cause stress, but stress may bring on or worsen symptoms and disorders. Some examples are increased blood pressure and pulse rate, diarrhea, headache, chest pain, backache, depression, schizophrenia, bipolar disorder, panic disorder, post-traumatic stress disorder^5,6.

Chronic medical conditions (CMC) can be caused, exacerbated and supported by stress and are a major cost-driver in developed countries. In the US, for example, the cost of treating chronic conditions constitutes 83% of total Medicaid and 96% of the total Medicare expenditures⁷. In some countries, healthcare costs on a person with one CMC is double that of health care costs on someone without a CMC. According to the World Health Organization (WHO) there are more than 2 billion patients with CMC worldwide and in the United States, chronic conditions account for over $1.2 trillion in health care costs annually^8,9.

Patients with CMC usually have physicians who help them manage their illness. However, doctors are very limited in their ability to assess and monitor the stress and physical or symptomatic changes their patients might experience. They must rely on patients’ memory and how accurately they record, recall or communicate events. Often, the physical changes in a disease state are too subtle to even be noted by patients. Furthermore, patients with CMC are not aware of the things that trigger stress and cause their symptoms to flare.

Assessments can determine the current status of an individual’s stress as well as what activities make symptoms worse or better. Biofeedback is a process whereby a person trains their physiology and thereby self-manages their symptoms. Thus, a stress assessment and a biofeedback (SAB) system can become critically important tools for self-management of stress and ease of symptoms associated with CMC.

The majority of computer, tablet, and smart phone applications available today that are designed to improve general health do so by tracking physical activities and monitoring metrics such as heart rate, calorie consumption, weight, blood pressure and BMI. Unfortunately, these apps have a low to medium sophistication levels in terms accuracy, range of functionality, use of physiological measurements, integration of medical services and linkage to existing medical databases. The apps lack systems to track and quantify the effects of exercise, food, alcohol, sleep, and stress have on the mind and body. Most importantly, the current apps lack systems to aid use of biofeedback to manage and improve negative symptoms.

Broad use of an appropriate SAB systems will revolutionize health care. The system must be accurate, affordable and employ a convenient wearable device that measures and monitors the impact of stress on chronic conditions and symptoms in real time. By doing so, it can significantly improve the management of chronic diseases, improve clinical outcomes, increase patient/physician communication and increase quality interventions. It will collect data to trend and convert into understandable charts and graphs that give patients and their doctors methods to easily and constantly monitor how they are individually managing stress and responding to treatment. It will work with Apps that continuously monitor stress data and enable patients to log other data such as any recognized triggering events, the severity of symptoms, diet, medications, etc. Patients will be able to wear a comfortable sensor that sends ubiquitous streams of quantitative data to be transmitted, stored, analyzed, and compared with previous tests and normative data such as age and gender, then the results will be reported in forms appropriate to the user.

The SAB system should be based upon a physiological variable considered the gold standard in stress measurement: heart rate variability or HRV. This is a reliable, scientifically documented method of assessing an individual’s stress. HRV measurements quantify beat-to-beat fluctuations in heart rate and is considered an index of cardiac parasympathetic nervous system activity ^10,11,12,13. In the general populations, reduced HRV has been associated with increased risk of coronary heart disease cardiac mortality¹⁴, diabetes¹⁵, depression¹⁶, and all-cause mortality¹⁷.

Two methods to measure HRV are currently commercially available. One is based upon electrocardiography (ECG) and the other is photoplethesmography (PPG) or light technology. The validity of ECG and PPG in measuring HRV variables has been compared in studies with correlations between the two reported between 90 and 97 percent depending on the condition^18,19. PPG has been an important technological development because it less inexpensive than ECG to produce, less intrusive, does not require additional disposable products to capture the signal, and can be embedded into an ear clip, finger clip, clothing, or a watch.

Biofeedback training for stress management involves syncing respiration with heart rate and producing a condition referred to as respiratory sinus arrhythmia (RSA), that is known to facilitate a decrease in stress while strengthening the peripheral nervous system. To accomplish RSA a patient follows a breath-pacer set at a prescribed pace changing their HRV. Subsequently, the PNS will improve and symptoms decrease. Positive changes at increasing percentages are rewarded. The process continues until the person can achieve a high level and maintain it for increasing amounts of time. A training report is recorded and trended. Doctors can use a system like this to quickly test patients during office visits and to monitor patients with chronic conditions. Patients may use it at home as often as they want and share their measurements with the doctor. Patients can also do personalized biofeedback sharing these results as well.

In summary, it is now possible to assess stress and apply mobile-accessed biofeedback to improve symptoms and improve health. Consumers should look for a SAB system that delivers quick and frequent stress assessments using scientifically tested HRV analysis. The system should have the capability to assist individuals in learning and practicing biofeedback techniques that improve their HRV and cardiorespiratory functioning so they can prevent untoward stress and thereby ameliorate chronic illness symptoms.

References:

1. Sklar, L. S. & Anisman, H. Stress and Tumor Growth. Psychological Bulletin. 1981: 89(3); 369-406.
2. Folkov, B. Stress, hypothalamic function and neuroendocrine consequences. Acta Med Scand Suppl. 1988: 723; 61-69.
3. McKewen BS. Biol Psychiatry, 2003 54(3):200-207.
4. Kudielka, B. M. & Kirscbaum, C. Biological basis of the stress response. In al’Abasi, M. (Ed.) Stress and Addiction: Biological and Psychological mechanism. 2007; (pp. 3-18) Elsivier LTD.
5. Hjemdahl, P. Stress and the metabolic syndrome. Circulation. 2002:106;2634-2636.
6. Source: Does Stress Cause Psychiatric Illness? Progress in Psychiatry Carolyn M. Mazure (Ed.) American Psychiatric Publishing, Inc.; 1st ed edition (May 1995) 304 pages.
7. The Mayo Clinic. Stress Management: Retrieved from internet source https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/hlv-20049495 on December 25, 2019.
8. Centers for Disease Control and Prevention. Chronic Disease statistics. Retrieved from internet source: https://www.cdc.gov/datastatistics/index.html on November 17, 2019.
9. The World Health Organization. Non-communicative diseases and their Risk Factors. Retrieved from Internet Source https://www.who.int/ncds/surveillance/en/ on November 17, 2019.
10. Acharya UR, Joseph KP, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Medical and Biological Engineering and Computing 2006; 44:1031-1051. PMID: 17111118 2.
11. Routledge HC, Chowdhary S, Townend JN. Heart rate variability-a therapeutic target? Journal of Clinical Pharmacy and Therapeutics 2002; 27:85-92. 3.
12. Task Force of the European Society of Cardiology the North American Society of Pacing Electrophysiology. Heart Rate Variability: Standards of Measurement, Physiological Interpretation, and Clinical Use. Circulation 1996; 93:1043-1065. PMID: 8598068 4.
13. Shaffer F and Ginsberg JP. An Overview of Heart Rate Variability Metrics and Norms. Front. Public Health 2017; 5:258. doi: 10.3389/fpubh.2017.00258
14. Liao D, Cai J, Rosamond WD, Barnes RW, Hutchinson RG, Whitsel EA, et al. Cardiac autonomic function and incident coronary heart disease: a population-based case-cohort study. The ARIC study. American Journal of Epidemiology 1997; 145:696-706. PMID: 9125996 5.
15. de Bruyne MC, Kors JA, Hoes AW, Klootwijk P, Dekker JM, Hofman A, et al. Both decreased and increased heart rate variability on the standard 10-second electrocardiogram predict cardiac mortality in the elderly The Rotterdam Study. American Heart Journal 1999; 150:1282-1288. 6.
16. Dekker JM, Schouten EG, Klootwijk P, Pool J, Swenne CA, Kromhout D. Heart rate variability from short electrocardiographic recordings predicts mortality from all causes in middle-aged and elderly men. The Zutphen Study. American Journal of Epidemiology 1997; 145:899-908. PMID: 9149661 7.
17. Billman GE. Heart rate variability-a historical perspective. Frontiers in Physiology 2011; 2:1-13.
18. Russoniello, C. V. (2010). A measurement of electrocardiography and photoplethesmography in obese children. Applied Psychophysiology and Biofeedback, 35, 257-259.
19. Russoniello, C. V. (2013). Heart Rate Variability and Biological Age: Implications for Health and Gaming. Cyberpsychology, Behavior, and Social Networking, 16 (4), 302-308.

The post Mobile Stress Assessments and Biofeedback: Modern Tools for Managing Health appeared first on Total Health Magazine.

It turns out that our DNA is exquisitely sensitive to even the minutest amount of non-ionizing (non-heating) electromagnetic radiation from wireless technology. Our bodies respond to this type of radiation in a number of ways including the secretion of heat shock proteins—around 20 to be exact—with a corresponding elevation of cortisol.

Out of control cortisol levels and non-stop stress can send your health into a downward spiral resulting in a series of negative consequences besides stockpiling on tummy fat. Practically every single disease known to man is due to unmanaged stress. Your brain can actually shrink; the happy hormone serotonin can take a nosedive, your bone density and strength can diminish, and mental illness can set in.

The two hormones that are most impacted by various types of stress are the ultimate fat promoting cortisol and insulin. Remember, the stress hormones, more than any other hormones, will inhibit your ability to lose weight even if you are on the best diet and exercise program!

STRESS HORMONE # 1 – CORTISOL

This fat storage stress hormone is blocked by omega-3 rich oils:

• Walnuts and walnut oil
• Camelina (wild flax) oil
• Fish and fish oil

When cortisol—your main stress hormone—is behaving itself, it truly is your BFF hormone. It gives you that “get up and go” and provides you with just the right surge of energy in emergency situations whether you are emotionally upset or physically challenged or suffering from low blood sugar. But when you can no longer hit the pause or refresh button, and that cortisol surge won’t quit, then you run the risk of some very unpleasant side effects—including weight gain.

The human brain contains more than 60 percent fat. It also happens to need more omega-3 fatty acids than any other organ or system in the body. The EPA and DHA (docosahexaenoic acid) fats are major players in regulating emotions, mood and warding off depression. These Smart Fats can help to reduce aggression and hostility in a number of clinical studies. They can help to fortify your system so you can mentally handle and cope with stress more efficiently to minimize the damage created by elevated levels of cortisol.

OMEGA-3 FATS EASE STRESS
According to the National Institute of Health, omega-3s help to balance stress hormone levels and provide direct weight loss benefits. They can be supplied by ALA-rich walnut and walnut oil, Camelina oil, as well as fatty fish and fish oil.

Walnuts and walnut oil contain high levels of the omega-3 plant-based ALA, which have many added benefits besides their ability to regulate stress hormones. Camelina oil is also a rich source of ALA, but contains an amazingly high amount of stable monounsaturated fatty acids (omega-7s), as well as vitamin E, which makes it a very beneficial oil for medium-heat cooking. Due to its high antioxidant content, it’s known as the “better” flax. Of course, an even more direct source of the omega-3 fatty acids is fatty fish like wild caught salmon, sardines, anchovies and mackerel.

Walnuts, however, unlike fish or fish oils, are rich in trace minerals like zinc, selenium, calcium, copper, and manganese. Walnuts and walnut oil also pack a serious dose of vitamins B1, B2, B3 and vitamin E— all notably worthy vitamin stress relievers that soothe the nervous system. Walnuts are also one of the richest natural sources of melatonin—second only to tart cherries. Melatonin is the hormone that regulates your body’s sleep-wake cycle. It ensures that you get the sleep you need for restorative rest that also prompts weight control.

Omega-3 rich foods right before bed—like a couple of walnuts or walnut oil in a smoothie—will come in very handy when you consider that just one night of poor sleep can raise cortisol by 45 percent.

As it turns out, sleep and cortisol are intimately entwined. Chronically high cortisol levels disturb sleep, and lack of sleep can make you fat.

SLEEP: THE SECRET WEIGHT LOSS AID
Sleep deprivation has reached epidemic proportions here in the US. Approximately 7 out of 10 Americans report sleep-related problems. Lab tests show that cortisol levels are much higher in sleep-deprived people. A landmark study in 2000 by the University of Chicago’s Department of Medicine revealed that not only does sleep deprivation affect tiredness and immunity, but too little sleep impairs the way your body actually handles food, creating impaired glucose tolerance. This can result in insulin resistance and obesity.

And it’s not just cortisol and insulin that become out of whack without proper rest. A lack of quality sleep also impedes surges of growth hormone, resulting in increased fat tissue and reduced muscle mass—just what you don’t need. Growth hormone is released while you sleep, raising gradually from about 10 PM and peaking at about 2 AM. It also prompts your body to burn fat in order to repair the tiny tears in your muscles caused by exercise. This gives you a higher muscle-to-fat ratio, which boosts your metabolism, helping you to lose weight and keep it off.

In order to boost growth hormone, even more, eat a light cortisol-containing snack of walnuts or a smoothie with walnut oil or even an omega-3 deviled egg—providing your gallbladder can tolerate eggs—just before you retire.

CORTISOL AS FAT MAKER
Cortisol is such a primary fat storage hormone because it activates enzymes to store fat when it comes into contact with any and all fat cells. Abdominal fat has four times the amount of cortisol receptors than any other fat cells and so is a telltale sign of cortisol imbalances that your body can’t hide.

High cortisol levels over a long period of time have huge consequences, such as chronically high blood pressure, memory changes, depression, insomnia, slow wound healing and diabesity (diabetes + obesity, a term coined by my buddy, the late, great Dr. Atkins).

Elevated cortisol levels also depress thyroid function, interfere with progesterone (your body’s natural anti-depressant), raise blood sugar and cause your body to break down muscle tissue to be used for energy—a big setback for weight loss since muscle is a natural calorie burner. The less lean muscle mass you have, the lower your metabolism and the easier you gain weight.

In contrast, extremely low cortisol levels are associated with thinning skin, brittle bones and fibromyalgia—probably due to burned out adrenals. Maintaining balanced cortisol levels that are not too high and not too low is truly a lifetime balancing act and one I find my most challenging!

Cortisol has a nasty habit of making you wake up in the middle of the night. Intermittent frequent awakenings—especially at 3 AM or 4 AM in the morning are often related to cortisol surges, which should be lower to allow you to sleep through the night. When melatonin levels naturally rise, cortisol should be lower. Taking melatonin before bed or drinking several ounces of diluted tart cherry juice may help neutralize excess cortisol and prevent it from keeping you up at night—when you need to be stacking ZZZs and snooze to lose.

FLOWER POWER FOR EMOTIONAL STRESS CONTROL
Repressed emotions can trigger over-eating and bingeing as many of us know. Also, this can impede our best weight loss efforts unless we can learn to cope with emotional issues. Impatience, discouragement, bitterness, frustration, and anger are often common triggers. Granted for many psychotherapy may a viable solution. For those that want to either augment this therapy or find a natural alternative, I would recommend the Bach Flower Remedies. They are a kind of energy medicine similar to homeopathy that offsets emotional turbulence that can be at the root of physical disorders. Developed in the 1930s by Dr. Edward Bach, an English immunologist, the most renowned formula, Rescue Remedy is a five-flower extract combo that is used to help alleviate trauma, whether emotional, physical or psychological.

COMMUNITY CALMS CORTISOL
Women, in particular, benefit from the support of others in being able to handle all aspects of life including stress. A landmark study from UCLA proves something that many of us have already suspected: a unique bond forms between women. A circle of friends makes life brighter and the tough times easier.

The researchers at UCLA demonstrated that women that were under stress produced brain chemicals that opened them up to making and maintaining friendships with other women.

It was generally assumed that when a person experiences stress, the hormonal release creates the typical “fight or flight” response. Women have a very distinct response to stress, as opposed to men. In women, the hormone oxycotin is released which acts as a buffer to cortisol and encourages females to gather with their girlfriends. Men do not have this response because of the high amounts of testosterone they produce. So, when men are stressed they tend to go off by themselves, and when women are stressed they gather others around them.

SMART TIPS: CORTISOL

Here are some smart tips to balance cortisol levels and tame the stress hormone monster so it can’t scare away your best weight loss efforts:

1. Eat walnuts and enjoy walnut oil. This omega-rich nut can be popped into salads and side dishes. The oil—when roasted—is absolutely delicious (one of the tastiest oils I have ever used) and packs serious health benefits. Roasted walnut oil will lift an ordinary salad to the sublime with a basic mix of Romaine lettuce, chopped green onion, cilantro, celery and Celtic sea salt. Serve one tablespoon of roasted walnut oil per salad.
2. Count on Camelina! Camelina is also an excellent oil for those with heart issues—because of its high vitamin E content, it works wonders for blood clots! It’s a tasty salad dressing and can be used in medium-heat sauteing.
3. Eat fatty fish and take fish oil supplements. Try to consume some wild caught fish at least twice per week and also supplement with fish oil on a daily basis to help manage stress better. Just make sure that the fish oil you buy is molecularly distilled and free of heavy metals. Do be aware, however, that fish oil is a natural blood thinner so caution should be taken if you are also taking blood-thinning meds. Choose the newer orange and lemon flavored fish oil liquids or softgels, which seem to be better tolerated.
4. Shake MORE salt. Yes, you heard that right. Most of us are sodium deficient and the right type of salt (I like Celtic sea salt) can support adrenal function and help your body better cope with stress. It may then indirectly balance elevated or depleted cortisol levels. I would recommend at least 1/4 teaspoon in warm water first thing in the morning. Gargle with this and then swallow, as the salt is anti-bacterial to your mucous membranes.
   For an extra boost, try my Adrenal Cocktail. I have used this for years for my over-stressed and overworked clients. It’s best taken mid-morning and/or mid-afternoon. Mix four ounces fresh squeezed orange juice, 1/4 teaspoon cream of tartar and 1/4 teaspoon Celtic sea salt. Take a blood test to actually measure your serum sodium so you can better take care of your body’s sodium needs. Without sodium, muscles become stiff and hardened. Sodium relaxes soft tissue and is incredibly important when you are under stress.
5. Lights out! Let’s talk sleep—a key underlying cause for stress fat. Do try to be in bed by 10 PM when your cortisol levels diminish to their lowest levels (three hours after sunset), and to give muscle-building growth hormone a fighting chance to properly release. Ideally, your body will start to lower cortisol between midnight and 4 AM. If this important cycle is interrupted at all, you can kiss the prospect of ever melting that belly fat goodbye!
6. So, by all means, shut off lights and start to dim them after dark to prepare your body for sound sleep and melatonin activation. Unplug all electronics and keep digital gadgets out of the bedroom to reduce invisible EMF stress. Disable wireless routers before bed and put your cell phone on airplane mode. Aim for seven to nine hours of peaceful, restorative rest.
7. Eschew the blue—at night that is. On the light spectrum, blue light is great for helping you stay alert. One reason: studies show it suppresses melatonin production. As you get ready for sleep, it becomes increasingly important to filter out blue light to keep melatonin production at its peak. That’s why dimming lights before bed may be so helpful to protect melatonin so it can do its job. And, that also means that you should avoid the blue light emitted from computer screens, iPads and your smartphone at night—especially in the hour or two before bedtime.
8. Go barefoot. Going barefoot on your lawn or on the beach for at least 15 minutes a day can help your body get grounded. When you are grounded you discharge chaotic electromagnetic energies and absorb healing electrons from the earth through the body. These healing electrons can start to repair stress damage from elevated cortisol and curtail inflammation and pain by quelling free radicals.
9. Curb the caffeine. Caffeine is an underestimated cortisol spiker that gives you instant energy in the short term but will come back to haunt you later. It also makes you lose key minerals like calming magnesium and calcium due to its dehydrating effects. It is a known blood sugar disruptor and contributes to anxiety and sleepless nights. While a tablespoon of high MCT oil like coconut can help regulate coffee’s blood sugar peaks and valleys, it is even better to opt for a decaffeinated green tea or dandelion root tea, both of which will help give you energy without the crash and fall effect. If you MUST drink your Morning Joe, however, along with that coconut oil, you can spike your coffee with vanilla whey protein powder for a dose of Smart Fats and healthy protein to prevent cortisol spikes.
10. Axe the alcohol. It can raise cortisol and dial down metabolism by greater than 70 percent. You may hate me for this, but alcohol (yup, even wine) makes it difficult for your liver to keep up with its other metabolic duties so it’s not able to balance the rest of your hormones properly.
11. Walk, don’t run AWAY stress. If you are a fitness buff, then you know that intensity, not duration, is the current exercise hot button. Yet, any type of daily movement with deep breathing is a terrific combo to beat stress. Think yoga, Pilates or Tai Chi. But, DO give up that long-distance running. It elevates cortisol—as will any continuous exercise over a two-hour stretch. Burst running is a different story though, so mix it up. As far as I am concerned, I prefer brisk walking or jumping on my mini-trampoline to get my lymph flowing and thoughts in order. At least 20 minutes a day—and 40 minutes is even better—of consistent movement and frequent breaks from sitting at the computer are in order here. Exercise can help you cope with stress more effectively while you rev your metabolism, increase lean muscle mass, burn off belly fat, improve bone mineral density and reduce insulin resistance. You can’t afford NOT to move.
12. Take supplements to relieve tension. In this regard, the very best dietary supplement of all, which controls over 350 bodily processes, is magnesium. It literally acts like a tranquilizer in a bottle. You can take an Epsom Salt Bath (two cups to a tubful of water) to relax your muscles, or consider an easily absorbable magnesium supplement. I am especially a fan of magnesium formulas, which contain a mix of the best co-factors for absorption like the glycinate, malate, taurinate and orotate forms that target blood sugar, muscles, cardiovascular health and ATP energy. I am also a fan of adrenal tissue glandulars and pair this with the highest quality Rhodiola (an adaptogenic herb from Siberia), ideally taken at 7 AM, 11 AM and 3 PM —the times when blood sugar can be at a low ebb, creating physiological stress.

Some of my clients also swear by phosphorylated serine—taken at least four hours before bed—to dampen cortisol surges that disturb peaceful sleep.

The post How Smart Fats Reset Stress Hormones appeared first on Total Health Magazine.

As the healing arts grows, it is important to remember that there are four key domains in healing:

1. Biochemistry. This includes herbals, nutrition and medications.
2. Structural. Including areas such as manipulation, surgery, breathing, exercise, and ergonomics.
3. Biophysics. For example, Acupuncture, Chakra work, Yoga, and NAET.
4. Mind-Body-Spirit. Understanding how the body is a metaphor for what is occurring at a deeper level. For most illnesses, including anxiety and even cancer, complete healing is unlikely to occur unless this is also attended to.

You will find that healing occurs best when all four of these areas are addressed. No individual healer is likely to have complete expertise in all of these areas. As our new healthcare system evolves, and the current one heads to extinction, it is good to see health practitioners from diverse backgrounds communicating and working together more.

So let’s look at how a Comprehensive Medicine approach works when addressing anxiety and stress. I will focus predominantly on mind-body and biochemical aspects, as these are where my expertise is.

Treating Mind-Body Issues
Stress is not inherently good or bad. In fact, stress can be used to force flowers to bloom, and this analogy applies to people as well. The problem is when stress becomes chronic, and is no longer enjoyable. This then contributes to chronic elevation of the stress hormone cortisol, directly triggering anxiety. As the excessive stress becomes chronic, cortisol levels then go too low—ironically also triggering anxiety by causing recurrent bouts of low blood sugar.

A simple way to tell if stress is healthy? Simply check in to see how it feels. If it feels good, it is healthy. What is enjoyable can vary markedly from person to person. For example I enjoyed the stress of skydiving, while for my wife it would feel awful.

A Novel Treatment
The key stress antidote? Check in to see how things feel. This is so important, that I am being purposely redundant. Learn to say NO to things that feel bad. Leave your brain out of it. Our brain is the product of our societal and family training. It simply feeds back to us what we were taught that we should do to make others happy. Our feelings, on the other hand, tap into our own personal authenticity. So choose to focus on, and do, those things that feel good. Once you’ve determined what feels good, then your mind can figure out how to make it happen.

And yes, it is OK to simply choose to focus on what feels good in life, without being in constant battle mode against things you don’t like. Like food choices at a buffet, we don’t have to protest for the removal of those foods we don’t choose to eat. Simply ignore them and pick those things you like. You will find that the rest will soon stop appearing in your life. This is part of how I suspect “free will” works. Our focus is like the remote control on our TV. What we focus on keeps showing up on our screen. This is why our constant “Wars on…” just seem to create more of what we are attacking.

Is it truly OK to do what feels good? Some will make the argument that “Heroin feels good, and perhaps also smacking that person who makes me angry over the head with a two-by-four.” This is why we add two caveats:

1. Don’t hurt others.
2. Ask yourself “How is that working out for me?”

Doing this, people will find their anxiety is often coming from their choosing what they think they should do over what feels good (i.e. doing what others want, instead of what is authentic to them). Notice if you are constantly feeling, “I should do this, or I should do that.” This is euphemistically called “Shoulding on yourself.” I invite you to change that toxic behavior.

If hyperventilation is present, one will usually have buried feelings that are bubbling to the surface during periods of relative calm. Counseling to help them learn to feel their feelings helps over time. Also, as panic attacks often leave people feeling like they are going to die, understanding that the symptoms are not dangerous helps. Simply being told this may not be enough to reassure you though. You can confirm hyperventilation is the cause by breathing rapidly for up to 30–60 seconds and seeing how it amplifies your symptoms. Unfortunately, this can also precipitate a full-blown panic attack, so be forewarned, and pick a safe time and place to do this test!

My e-book, “Three Steps to Happiness—Healing through Joy,” can help guide you through the mind-body healing process.

Balance The Biochemistry
Begin with ruling out and treating overt issues, including:

1. Overactive thyroid. Consider this if your Free T4 thyroid test is even in the upper 20th percentile of the normal range.
2. Low progesterone (women). Progesterone is like our body’s natural Valium. Consider this if anxiety is worse around menses and ovulation.
3. Low testosterone (men). Consider if testosterone levels are in the lower quarter of the normal range.
4. Adrenal fatigue—caused by drops in blood sugar. A key tip-off? Irritability and anxiety that triggers sugar cravings and improves after eating.

Also optimize nutrient status, especially magnesium and B vitamins. Instead of blood testing, which is of questionable value here, I simply recommend (for most people—whether or not they have anxiety) a high potency multi powder called the Energy Revitalization System (by Enzymatic Therapy). With this, one drink replaces well over 35 pills, optimizing levels of most nutrients. Also have the person decrease sugar and caffeine intake to see if this helps.

Herbals can also be very helpful. For example, there is a unique extract, which can be as effective as Xanax, but is very safe. This special extract stimulates one of the most abundant neuroreceptors in the body, the cannabinoid receptors. Many of you may recognize this as the marijuana receptor, and in fact many people use cannabis to self-medicate for their anxiety. But what if you could get the benefits without the sedation and side effects?

The good news is that now you can. Recent research showed that a special extract of the roots of the narrow leafed coneflower (Echinacea angustifoliae) was more effective than the tranquilizer Librium, with none of the side effects. It also worked quickly, with effects building with continued use. This is not the same component used for immune enhancement, and isn’t found at needed levels in standard Echinacea. It is available though as AnxioCalm (by EuroPharma—20 mg per tablet).

Let’s look at a few studies of this unique extract.
A study published in the March 2012 issue of Phytotherapy Research included 33 volunteers. All experienced anxiety, assessed using the validated State-Trait Anxiety Inventory (STAI). The extract decreased STAI scores within three days, an effect that remained stable for the duration of the treatment (seven days) and for the two weeks that followed treatment. There were no dropouts and no side effects.

Another study looked at higher dosages (40 mg 2 x day) in a multi-center, placebo-controlled, double-blind Phase II study involving 26 volunteers diagnosed with generalized anxiety disorder (GAD). Over a three week period, the number of severely anxious patients (HADS-A scores larger than 11) decreased from 11 to zero!

So I begin with two tablets of AnxioCalm 2x day for severe anxiety. After three weeks, the dose can often be dropped to one 20 mg tablet twice a day. It can also simply be used as needed, and serves as an excellent sleep aid.

Other helpful herbals include valerian, passion flower, hops, theanine, and lemon balm. These can be found in a combination called the “Revitalizing Sleep Formula,” which helps anxiety during the day and sleep at night. I personally use both AnxioCalm and the Revitalizing Sleep Formula at night to ensure 8–9 hours of deep sleep.

The smell of lavender oil is also calming, and a small drop on the upper lip, or even having a lavender bouquet in one’s room, can be helpful.

Structural And Biophysics
Simply going for regular walks in the sunshine, and doing yoga, tai chi, and meditation can be very helpful. A technique called centering can help people feel that they are in the calm “eye of the cyclone” when panic attacks hit. In addition, it is helpful to explore a technique called Butyko breathing, which can be very helpful for anxiety and hyperventilation.

For PTSD or old emotional traumas, a technique called EFT (Emotional Freedom Technique) can give near miraculous benefits in as little as 20 minutes (see EFT.Mercola.com). It may seem odd, but try it and you’ll be amazed. Releasing old traumas through a simple “trembling” technique is also helpful, and the person can do it on their own. It is easy and simple instructions can be found in the book Waking the Tiger.

By having the entire healing arts toolkit available, and not just using the “medical hammer,” anxiety can now be effectively treated!

The post A Practical Guide to Treating Stress and Anxiety appeared first on Total Health Magazine.

• Preventing themselves from becoming stressed (44 percent)
• Managing or reducing stress once experienced (39 percent)
• Recovering fully or recharging after they’ve been stressed (31 percent)

The ramifications of chronic stress include increases in illness, including headaches, heart disease, immune deficiencies and digestive problems. To a large extent, this appears to be due to an increased production of stress hormones and decreased immune function.²

So what can be done to help control stress and reduce its ill effects? The answer is really multifaceted and may include a program of diet, exercise, stress-management techniques such as yoga, and even psychological counseling. In addition, when stress rears its ugly head, nature’s chill pill, L-theanine may be able to help.

L-THEANINE’S MECHANISM OF ACTION
Asian cultures have often used teas for relaxation effects. The relaxing effect is, at least in part, caused by the presence of a neurologically active amino acid, L-theanine (gamma-ethyl-amino- L-glutamic acid). Tea has the reputation of having less caffeine than coffee but it is the L-theanine in the tea that lessens the stimulant effect of caffeine on the human nervous system. In the brain, L-theanine increases both serotonin and dopamine production³, and possibly GABA as well.⁴

Evidence from human electroencephalograph (EEG) studies show that it also significantly increases brain activity in the alpha frequency band which indicates that it relaxes the mind without inducing drowsiness. Alpha activity is also known to play an important role in critical aspects of attention. Research indicates that L-theanine has a significant effect on improving mental alertness while promoting relaxation.⁵

L-THEANINE AND RELAXATION
According to Mason, two small human studies⁶ showed that within 30–40 minutes of consuming 50 or 200 mg of L-theanine there is an increase of alpha wave activity/electrical signals produced by the brain. The perceived relaxation effect in the subjects coincided with the detection of alpha waves. This shows that L-theanine fosters a state of alert relaxation, which is consistent with the fact that anxious people have fewer or smaller alpha waves.

The journal Human Psychopharmacology Clinical and Experimental published a double-blind placebo-controlled study⁷ in which sixteen healthy volunteers received 200 mg L-theanine, a pharmaceutical anxiolytic or placebo. The results showed that L-theanine induced feelings of tranquility in the volunteers.

L-THEANINE, STRESS AND ANXIETY
The journal Biological Psychology published a double-blind, placebo-controlled study⁸ in which twelve participants underwent four separate trials: one in which they took L-theanine at the start of an experimental, stress-inducing procedure, one in which they took L-theanine midway, and two control trials in which they either took a placebo or nothing. The results showed that L-theanine intake resulted in a reduction in some physiological indicators of stress within 15 minutes, compared to the placebo or control condition. Moreover, analyses of heart rate variability indicated that reductions in heart rate were likely attributable to a reduction of sympathetic nervous activation, suggesting that L-theanine had anti-stress effects via the inhibition of cortical neuron excitation.

Similarly, a placebo-controlled study⁹ conducted with pharmacy students found that L-theanine (200 mg, twice a day, after breakfast and lunch) was effective at suppressing the initial stress response of students.

The Journal of Physiological Anthropology published a placebo-controlled study¹⁰ in which 14 participants took either L-theanine + placebo, caffeine + placebo, or placebo only (L-theanine 200 mg, caffeine 100 mg) while performing mental tasks and physiological activities under conditions of physical or psychological stress. The results showed that L-theanine significantly reduced anxiety and reduced the blood-pressure increase in high-stress-response adults. Caffeine tended to have a similar but smaller inhibition of the blood-pressure increases caused by the mental tasks.

The Journal of Functional Foods published a double-blind, placebo-controlled study¹¹ in which 18 normal healthy subjects were divided into two groups referred to as high anxiety propensity group and the minimal anxiety propensity group. Both groups received 200 mg L-theanine and placebo (at different times)(200 mg/100 ml water) and placebo (100 ml water) in a double-blind repeated measurement design protocol. When tested at 15–60 minutes after consumption, results showed significantly enhanced activity of alpha bands, descending heart rate, elevated visual attentional performance, and improved reaction time response among high anxiety propensity subjects compared to a placebo. However, no significant differences were noticed among subjects with a minimal anxiety propensity.

L-THEANINE AND MENTAL FOCUS
The journal Neuropharmacology published a double-blind, randomized, cross-over study¹² in which 27 participants received 100 mg L-theanine, 50 mg caffeine, a combination of the two, or a placebo. The results were that L-theanine and caffeine each significantly reduced error rates during a sustained attention task. It was noted that the combination of L-theanine and caffeine did not confer any additional benefits over either compound alone.

Another study¹³ examined “sensory gating.” Sensory gating describes the processes of filtering out redundant or unnecessary stimuli in the brain from all possible environmental stimuli. Being able to do this is obviously beneficial when you’re trying to focus on a mental task. In the study, L-theanine was given to 14 healthy subjects, and tests were conducted 90 minutes later. The results were that 200 mg and 400 mg significantly improved sensory gating.

CONCLUSION
Research shows that L-theanine is effective at helping to promote relaxation while reducing feelings of stress and anxiety. Furthermore, this amino acid is even helpful in promoting mental focus. Truly, L-theanine is nature’s chill pill.

References

1. American Psychological Association. Stress in America™: Our Health at Risk. Released January 11, 2012. 78 pgs.
2. Head KA, Kelly GS. Nutrients and botanicals for treatment of stress: adrenal fatigue, neurotransmitter imbalance, anxiety, and restless sleep. Altern Med Rev. 2009 Jun;14(2):114–40.
3. L-Theanine monograph. Alternative Medicine Review 2005;10(2):136-8.
4. Lu K, Gray MA, Oliver C, et al. The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans. Hum Psychopharmacol Clin Exp 2004;19:457–65.
5. Nobre AC, Rao A, Owen GN. L-theanine, a natural constituent in tea, and its effect on mental state. Asia Pac J Clin Nutr 2008;17 Suppl 1:167–8.
6. Mason,R. 200 mg of Zen. Alternative & Complementary Therapies 2001; 7(2):91–95.
7. Ibid. Lu K, Gray MA, Oliver C, et al.
8. Kimura K, Ozeki M, Juneja LR, Ohira H. L-Theanine reduces psychological and physiological stress responses. Biol Psychol 2007;74(1):39–45
9. Unno K, Tanida N, Ishii N, et al. Anti-stress effect of theanine on students during pharmacy practice: positive correlation among salivary á-amylase activity, trait anxiety and subjective stress. Pharmacol Biochem Behav. 2013 Oct;111:128–35.
10. Yoto A, Motoki M, Murao S, Yokogoshi H. Effects of L-theanine or caffeine intake on changes in blood pressure under physical and psychological stresses. J Physiol Anthropol. 2012 Oct 29;31:28.
11. Higashyama A, Htay HH, Ozeki M, Juneja LR, Kapoor MP. Effects of l-theanine on attention and reaction time response. Journal of Functional Foods. 2011;3(3):171–8.
12. Foxe JJ, Morie KP, Laud PJ, Rowson MJ, de Bruin EA, Kelly SP. Assessing the effects of caffeine and theanine on the maintenance of vigilance during a sustained attention task. Neuropharmacology. 2012 Jun;62(7):2320–7.
13. Ota M, Wakabayashi C, Matsuo J, et al. Effect of L-theanine on sensorimotor gating in healthy human subjects. Psychiatry Clin Neurosci. 2014 May;68(5):337–43.

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THE ROLES OF TRYPTOPHAN
Although tryptophan is one of the least abundant essential amino acids, it is one of the most critical. It serves as a precursor for the production of the neurotransmitter serotonin and the neurohormone melatonin. The positive effects of this process are proven to promote good mood, relaxation, deep sleep, healthy sleep-wake patterns, emotional stability, dreaming, and creative imagination. Tryptophan can also be diverted to produce niacin (vitamin B3), with all it’s vital functions, which we discuss later.

SEROTONIN
Serotonin is considered the “mood neurotransmitter” a chemical messenger in the brain that keeps us emotionally and socially stable. Women often have more problems than men in maintaining their moods since their cycling hormones affect serotonin levels. This would explain the emotional shifts in premenstrual syndrome and, during menopause, when many women experience increased moodiness, irritability, and sensitivity to pain.

Women who are low in serotonin are likelier to express their anger inwardly, with depression and even suicidal behavior. In contrast, research shows men who are low in serotonin are often violent and may even engage in dangerous criminal behavior. Alcohol and drug abusers also are often low in serotonin. The good news is we can successfully correct these imbalances by supplying supplements that raise serotonin.

MELATONIN
Melatonin is a molecule made from serotonin. It has a significant influence on our hormonal, immune, and nervous systems. Melatonin helps to set and control the internal clock that governs the natural “circadian” rhythm (day and night cycles) of the body, through its sensitivity to light, keeping us “in sync” with the rhythms of nature. Each night the pineal gland produces melatonin, which helps us fall asleep. Then, with morning light, melatonin levels dip, and we awaken refreshed.

Melatonin also has anti-inflammatory effects that can be useful in treating osteoarthritis. Since it both helps improve sleep patterns and relieve pain, melatonin is an ideal supplement for chronic fatigue syndrome and fibromyalgia.

NIACIN
Niacin or vitamin B3 is an essential nutrient in protein, and fat metabolism. It is also needed in the production of serotonin from tryptophan. In the 1950s, Drs. Abram Hoffer and Humphrey Osmond discovered that large doses of niacin were able to reverse acute schizophrenic episodes, and treat seriously ill patients. In fact, it is likely these patients were suffering from pellagra, or niacin deficiency disease, and were showing one if not all of its typical 3 D’s: dementia, dermatitis (eczema) and diarrhea. The mental illness, though, was often the first sign. They treated patients with as much as 3 gm twice daily with excellent results. See Dr. Hoffer’s Adventures in Psychiatry: The Scientific Memoirs of Dr. Abram Hoffer.

Dr. Hoffer also discovered that niacin had a cholesterol-lowering effect. This nutritional approach is to this day among the most effective treatments for an unhealthy cholesterol profile.

Elevated cholesterol has been identified as a contributing factor to cardiovascular heart disease, the leading cause of death in America. Niacin is unique in that it plays the dual role of reducing LDL the “bad” cholesterol, and increasing HDL the ”good” cholesterol, improving heart health and longevity. The dose is 500 mg—1 gm twice daily. A harmless side effect is flushing that stops after 30 minutes or so. Another more serious (but uncommon) side effect is liver toxicity especially with the sustained release form of niacin. Many common drugs have liver toxicity as well, so simply exercise caution here. You can substitute non-flush niacin (inositol hexanicotinate), or niacinamide forms of niacin, but they are slightly less effective.

TRYPTOPHAN THE NATURAL PATH
Tryptophan is essential for the production of key neurotransmitters. Many depressed patients have low levels of tryptophan. Researchers have found that when they take depressed patients who have improved and then deprive them of tryptophan, their depression returns. This was demonstrated in a double-blind study at Oxford University’s Department of Psychiatry. Young women with a history of depression were divided into two groups and given a diet either excluding or including tryptophan. Neither the subjects nor the researchers knew who received which diet. At the end of the experiment, 10 out of 15 women on the tryptophan-free diet were significantly depressed, while none on the tryptophan diet were. When the participants in the deprived group were then given a diet containing tryptophan, their depression lifted. I have certainly seen this same response in my own practice, as well.

An adequate supply of tryptophan, combined with B vitamins, is also critical to the chemistry of social interaction. We have seen how tryptophan deficiency leads to depression, impulsivity, and aggressiveness, while tryptophan supplementation is an effective antidepressant. In addition, a recent study showed that healthy volunteers given one gram of tryptophan three times daily for 12 days showed an increase in their self-confidence and sociability and a decrease in quarrelsomeness. Meanwhile, the placebo group showed no such effect. However, once they were given tryptophan, they showed the same positive change.

Tryptophan has also been shown to be effective in treating manic depression and depression associated with menopause. Tryptophan is also a useful and safe pain reliever, in such cases as dental pain, headaches (migraines in particular), and cancer pain. It appears to work by increasing the pain threshold. Other potential uses for tryptophan include in Parkinson’s disease, epilepsy, and schizophrenia, (as discovered by Dr Abram Hoffer).

TRYPTOPHAN VS. SSRIs
A substance natural to the body, tryptophan is considerably safer than the antidepressant prescription drugs referred to as selective serotonin re-uptake inhibitors (SSRIs). The predominant brand names are Zoloft, Paxil, Prozac, Celexa, and Lexapro. With total sales exceeding $20 billion annually, the SSRIs are used to treat depression, anxiety, and some personality disorders. While useful for certain patient populations, as with all drugs, they have significant side effects, leading to many individuals abandoning their prescriptions. Certain drugs in the SSRI category are required by the Food and Drug Administration (FDA) to display a “black box” warning, regarding possible suicidal behavior stemming from their use.

While both SSRIs and tryptophan enhance serotonin activity in the brain, their actions differ. By inhibiting the breakdown of the serotonin, the drugs are misdirecting the brain into thinking there is more serotonin, while giving the amino acid is actually restoring needed levels. For more details, see my book, Natural Highs. Why use a drug with its serious side effects when a natural (and much cheaper) product is available, one that solves the problem at its root cause? I certainly follow this principle in my psychiatric practice.

SLEEP STUDY
A recently completed clinical pilot study using Tryptopure™, a very pure brand of tryptophan from Japan, revealed the following benefits. Participants reported significant decreases in the time needed to fall asleep and showed substantial increases in actual sleep time during the night. Participants also reported a significant lowering of the number of times they woke up during the night. Most importantly, the participants of the tryptophan study showed a marked improvement in the ability to function during the day.

Recommended Dosage: For depression or insomnia take 1,000–3,000 mg daily of L-tryptophan, in divided doses, or all at once at bedtime, depending on your response. It is best absorbed away from protein, and with a carbohydrate snack, such as a piece of fruit or fruit juice, plus B vitamins, which are required to convert it to serotonin. A multivitamin should be able to supply the required amount, and can be taken with meals some time that day.

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There is a lot out there about how competitive athletes can up their energy. Although the approach we’ll discuss below is also excellent for athletes, it was developed, and is outstanding, for the rest of us. Whether you are a mom trying to juggle a fast paced hectic life, a student on a fast food diet, or just trying to optimize your day to day energy, here’s how to get from being fatigued to feeling fantastic!

Having spent the last 30 plus years specializing in treating chronic fatigue and chronic pain, we have learned about the keys to energy production. As an unexpected fringe benefit, these treatments have also offered enormous benefits to those suffering from heart disease.

Optimize energy production with the “SHINE Protocol” Ribose (and our overall approach to treating fatigue) has been highlighted by Dr. Oz, “America’s Doctor” on Oprah, in his wonderful new book YOU: Being Beautiful—The Owner’s Manual to Inner and Outer Beauty.

In addition, our research has shown that severely fatigued people with Chronic Fatigue Syndrome (CFS) and Fibromyalgia can increase their energy by an average of 90 percent (see the published study at www.Vitality101.com) by treating with “SHINE”: Sleep, Hormonal support, Infections, Nutrition and Exercise. For mild fatigue, the physical keys to optimizing energy are Nutrition, Sleep and Exercise, while the emotional key is to start paying attention to what feels good—while letting go of things that don’t.

How Do I Start?
Given my hectic schedule as an educator and physician, people often ask me what I do to keep my energy turbo charged. I like to keep it simple, so here is what I do personally. All of the vitamins, minerals and other essential nutrients are important to health, and the American diet is so highly processed that people have widespread deficiencies. Because of this, I like to use vitamins that make supplementation simple.

Why Ribose—And What Is Ribose?
Ribose, also called D-Ribose, is the key to your body’s energy production. Ribose is a special, five-carbon sugar (known as a pentose by biochemists) that is found naturally in our bodies. But ribose is not like any other sugar. Sugars we are all familiar with, such as table sugar (sucrose), corn sugar (glucose), milk sugar (lactose), honey (predominantly fructose), and others are used by the body as fuel. These sugars are consumed and, with the help of the oxygen we breathe, are “burned” by the body to recycle energy. Because they are used excessively, they become toxic— acting as energy loan sharks.

Ribose, on the other hand, is special. When we consume ribose, the body recognizes it is different from other sugars and preserves it for the vital work of actually making the special “energy molecules” (called ATP, NADH, and FADH) that power our hearts, muscles, brains, and every other tissue in the body. These represent the energy currency in your body, and are like the paper that money is printed on. You can have all the fuel you want, but if it cannot be converted to these molecules, it is useless. For years, I talked about the importance of B vitamins, which are a key component of these molecules. These helped improve energy to a degree, but it was clear that a key component was missing. In looking at the biochemistry of these energy molecules, they are also made of two other key components-adenine and ribose. Adenine is plentiful in the body and supplementing with adenine did not help energy production. We then turned our attention to Ribose.

Ribose is made in your body in a slow, laborious process and cannot be found in food. We knew that severe fatigue and stress causes your body to dump other key energy molecules like acetyl-L-carnitine. We then found that the body did the same with Ribose, making it hard to get your energy furnaces working again even after the other problems were treated.

This was one of those “Eureka!” moments where things came together. Not having Ribose would be like trying to build a fire without kindling—nothing would happen. We wondered if giving Ribose to people with fatigue and even CFS would jump-start their energy furnaces. The answer was a resounding yes! Our recently published study (see the study abstract at www. Vitality101.com) showed an average 44.7 percent increase in energy after only three weeks (improvement began at 12 days) and an average overall improvement in quality of life of 30 percent. Two-thirds of the study patients felt they had improved. Usually a 10 percent improvement for a single nutrient is considered excellent. A 44.7 percent increase left us amazed, and I am now recommending Ribose for all of my chronic fatigue, chronic pain and fibromyalgia patients, for athletes, and for any one with fatigue or heart problems. Ribose recently became available (over the counter) to physicians, and is one of the few natural products actually starting with physicians and then moving out into supplement companies and health food stores. It is critical to use the proper dose for the first three weeks, which is five grams (5000 mg) three times a day. It can then be dropped to twice a day (and often even once a day in the morning with the vitamin powder to maintain optimized energy for those that are otherwise healthy).

Normal, healthy heart and muscle tissue has the capacity to make the ribose it needs. But when we are chronically stressed by life or illness, it helps to have extra ribose to help boost energy production.

The Scientific Link Between Ribose, Energy, And Fatigue
Clinical and scientific research has repeatedly shown giving ribose to energy deficient hearts and muscles stimulates energy recovery. Research in Ribose and fatigue began with a case study that was published in the prestigious journal Pharmacotherapy in 2004. This case study told the story of a veterinary surgeon diagnosed with fibromyalgia. For months, this dedicated doctor found herself becoming more and more fatigued, with pain becoming so profound she was finally unable to stand during surgery. As a result, she was forced to all but give up the practice she loved.Upon hearing that a clinical study on ribose in congestive heart failure was underway in the university where she worked, she asked if she could try the ribose to see if it might help her overcome the mind-numbing fatigue she experienced from her disease. After three weeks of ribose therapy she was back in the operating room, practicing normally with no muscle pain or stiffness, and without the fatigue that had kept her bedridden for many months. Being a doctor, she was skeptical, not believing that a simple sugar could have such a dramatic effect on her condition. Within two weeks of stopping the ribose therapy, however, she was out of the operating room and back in bed. So, to again test the theory, she began ribose therapy a second time. The result was similar to her first experience, and she was back doing surgery in days. After yet

a third round of stopping (with the return of symptoms) and starting (with the reduction of symptoms) the ribose therapy, she was convinced, and has been on ribose therapy since that time. I found this report intriguing and decided to design a larger study in patients with fibromyalgia or chronic fatigue syndrome which I began to discuss earlier. Our study included 41 patients with a diagnosis of fibromyalgia or chronic fatigue syndrome who were given ribose at a dose of five grams three times per day for three weeks. We found the ribose treatment led to significant improvement in energy levels, sleep patterns, mental clarity, pain intensity, and well being. Of the patients participating in the study, 65.7 percent experienced significant improvement while on ribose, with an average increase in energy of 44.7 percent and overall well being of 30 percent- remarkable results from a single nutrient! The only significant side effects were two people felt too energized and hyper/anxious on the ribose. This is simply dealt with by lowering the dose and/or taking it with food.

The good news is that we now have a wonderful tool to increase energy naturally. Take five grams of ribose three times per day for three weeks, then twice a day (can be mixed with any liquid or food) for two to three weeks, and then one to two times per day to see what it will do for you. You’ll be amazed!

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