It’s all Connected: Hormones & Nightowls

Hello. Hello. Welcome. You’re listening to Dr. Martha Reid at Doctors Choice Integrated Medicine in downtown Vancouver, a space where I bring passion, inspiration and nourishment to the conversation of your health.

The other day I had a patient of mine come in, who I’ve been working with for years, and years, and years ( I’m just so grateful for her presence in my practice). And what she brought to my table was fertility. And I don’t think she’s the only woman out there struggling with fertility concerns.

So the thing is, is this particularly young lady, she’s been pregnant before but lost the pregnancy. She had a miscarriage, which is so incredibly tragic for anyone who has ever experienced that. But she’s ready to roll and ready to get pregnant again. And so she said to me, she said, “Dr. Reid, like, what do I do? We have virtually uncovered every stone in balancing my cycle, ensuring that I can get pregnant. We did everything we thought we needed to do so that I could sustain a pregnancy. I don’t know what else is there but I need help because I want to have a baby.”

And I said, Okay, all right. Well, let’s look where we may not have looked then, because you’re right. You tick all the boxes in doing everything right for your body. So then what is it that is blocking your body’s ability to potentially hold a pregnancy? So, let’s see. Let’s make sure that we’ve uncovered everything.

So I said to her, let’s talk about your sleep wake cycle.

And she said, “Well, I’m a night owl.”

And I said, Oh, well, what time do you go to bed?

She’s like, “Well, I’m a night owl, and I get most of my juice and creative activity at night. So I can, like, get really lit up and get so much done at night. And I love it. And so I go to bed at around three or four.”

I went, Oh, well, that (straight out of the gate) is going to have an impact on your hormones and an impact on your body and potentially they may be a contributing factor, (not to the previous miscarriage by any stretch), but potentially in the ability for your body to balance its hormones properly and well, to easily get pregnant again, and then to go through that pregnancy completely solidly; comfortably. I said, so let’s talk about that sleep. I said, I totally get that. You’re a night owl. I’m married to one. But what if you have just normalized the fact that most of your creativity comes at the night time because there’s actually an imbalance in your circadian rhythm, your sleep wake cycle? But because you have most of your creative juice and you feel most lit up at that time, you’ve normalized that for yourself? But what if it in fact is not normal for you?

She said, “but what do you mean? It’s been this way my whole life.”

I said, but yes, it may not, in fact, be normal. I said, because as an animal, as a species, we essentially, in a nutshell, are evolved for thousands of years ago just because we can create light and electronics and activities 24 hours a day, seven days a week, doesn’t mean that our bodies are capable of being up 24 hours a day.

“Well, I still get 8 hours of sleep”, she said.

I said, yes, you do, as you’ve told me, but the 8 hours you get from three or 4 a.m. until ten to 12 noon are not the same in quality from a hormonal perspective as the sleep you would get if you went to bed at 10 or 10:30pm.

Let’s talk about that. So, circadian rhythm: As a human being, our circadian rhythm is controlled and defined by hormones and it means our sleep wake cycle. And think of it as a teeter totter; on one side of the teeter totter is stress hormone cortisol, which is released by the adrenal gland. You have two of them. They’re two tiny little triangular glands that live on the back of your body and a tiny little dot pad above your kidneys. And they are super small. But here’s a little analogy. Anybody that has a toddler in the house, the smallest feet and the smallest body has the loudest voice in the house. So, your adrenal is the same way in your body. It is super teeny tiny, but it has a really loud and raging voice. So it is what keeps you alive against a threat. The production of cortisol and adrenaline from this tiny little gland on the back of your body. But we are not designed for stress. We are designed to be in rest, which is why we have evolved such super teeny tiny stress glands.

But those stress glands are not meant to be doing stress all the time. Their predominant job is our sleep wake cycle, our circadian rhythm. So when the one side of the teeter totter is the production of cortisol (in the context of circadian rhythm), to balance on the other side of the teeter totter is melatonin.

So, if I break down how these two things work: In a nutshell, your cortisol starts its secretion from the adrenal gland at approximately 2:00am in the morning… a tiny little amount “ding” at 2:00am, “ding” again at 230, “ding”, 315am, “ding” 4:00am. And it’s meant to be a super small amount not to wake you up at that time, but to slowly pull you out of the deeper layers of sleep so that by 5 a.m. (when cortisol is at its highest), you are wide awake, bushy tailed, you’ve swept your ancient cave and you are long gone on the savanna (long before sabre tooth or a warring tribe is coming to get you) and you forage along the way for your food. Your cortisol stays high from 5 a.m. until approximately noon, at which point it starts to decline gradually from noon until 8 p.m. So when people’s energy is pitting and falling after lunch hour break, sure, that might be that you’ve eaten the wrong foods and they’re actually draining your energy sources, but it may be that your cortisol pathway is off, right? It’s normal for it to drop, but if it’s really plummeting, and then you’re getting these peaks and valleys and spike again and you need sugar or coffee to pick up that energy, it may be that your circadian rhythm is out of balance.

So, if we go back to what the normal function is: starts at 2am, raises till 5 a.m., high till noon, slowly drops, and by 8 p.m. it’s down in the pits. And I say to my patients, that’s down in the toilet or at six feet under, that’s where your cortisol should be by 8 p.m., at which point the other side of the teeter totter starts to rise. That’s melatonin.

Melatonin starts its rise at about 8 p.m. by 10 p.m. if you are in pure darkness, sound asleep melatonin is at its highest and it has a peak from ten until two, at which point it drops. Cortisol begins its rise “ding”, “ding”, “ding” up at its raging amount by 5am, and on goes the cycle. But if you are not in bed, in pure darkness to get that melatonin secretion to its maximum by 10 p.m., you don’t get the benefits of what melatonin creates in the body for hormone balance and melatonin the way I think of that.

I call it the “lead elf in the cleaning crew”, so to speak. So at 10 p.m., the lead elf comes in to clean up the house and iron the shirts and polish the shoes and grind the beans. So, coffee’s ready in the morning and melatonin comes in and directs all of these other hormones, growth hormones, and then the domino of growth hormone falls. And then you get a whole range of other hormones which include things like leptin and other connections so that your metabolic balance is where it needs to be. Hormonal secretion to support thyroid balance, to support reproductive health. All of these things occur because you got the correct secretion of melatonin to begin with. But if you don’t get that melatonin because you’re not in bed until long after the secretion of that is done, you lost out on all of the regenerative restore creative balancing components that melatonin brings to the body.

So, even though it is completely and totally your normal for you to be up until 3:00am in the morning, it may in fact be a dysfunctional circadian rhythm. You may not be able to fall asleep when you need to earlier to get that melatonin at 10 p.m. and it might be because instead of that cortisol dropping, perhaps your cortisol is rising at night.

So then that begs the question, why does my cortisol spike at night? And what might be going on there is that during the daytime hours when cortisol is at its highest and that’s normal for it to be high between 5 a.m. and noon. But if you have added demands for stress hormone production during that time… think of your little adrenal glands as tiny little stables of horses.

You’ve got two horses per adrenal gland and they are going full tilt from 5 a.m. until noon. But then you’re sitting in the carriage cracking the whip with every little bit of stress that comes along, whether that was too much caffeine, too much sugar, a food sensitivity a perceived threat and extra demand from your boss or your partner, or a true sabre tooth tiger, (some sort of threat that threatened your life, whatever it is), and bam, you with those horses… faster, faster, go, go. And you spike more cortisol on top of their full production. And now they are exhausted. Which sounds interesting that “oh, my God, they’re exhausted and yet I’m releasing too much cortisol at night??”. It’s because they can’t control the amount that they release.

Imagine when you are so overwhelmed (and I don’t know if anyone else has been there. I sure as heck have been) when you’re so overwhelmed, and there’s one more thing tossed on your plate. Normally I would be able to handle that one more thing with grace, calm, courage. Nah. Sometimes I just lose my cookies and the amount of emotional releases far more than I would like. But that’s because I’m overburdened. I’m overwhelmed.

Well, your adrenal glands are like that. So what happens is: when they’re already too beat up during the day and then in the middle of the night at 2 a.m., (for example: let’s say you went to sleep at ten, but you’re waking at two and you’re waking at three.) You’re waking at the times that the cortisol is starting to be your natural body’s alarm clock. And it’s because the adrenal gland is not controlling the amount that it secretes. And that might be because it is exhausted. It’s been beat up all day, the day before and the day before that and the day before that, that it can’t control its emotional release, so to speak.

And so instead of a tiny little release of cortisol at 2am, “bing”, 230am, “bing” and instead it’s going “BING, AGH!”, oh I guess I gotta go pee. And you think you have a small bladder, and off you trot to the bathroom. You go pee and you come back and you fall back asleep, but at 315am, “AGH!”! You’re up, your mind starts to race and you start to get anxious about your day.

So perhaps it has to do with the over demand of stress production from the day before and the fact that your circadian rhythm is actually out of balance secondary to prolonged and chronic stress.

The good news is there are things we can do about that. There’s so many wonderful, amazing adaptogenic herbs, adaptogens are herbs that help your body adapt to the stressors it’s under; the physical pressures, the emotional pressures. There’s a lot of nutrients in terms of vitamins and minerals that you can use to support and nourish these adrenal glands so that they can better hold their boundaries and their grace when stress is given to them.

So in a nutshell, I said to my patient, I said, You know, the one stone we haven’t turned (because we’ve normalized it for you) is the fact that you get your creative juices in the middle of the night. But let’s play with the notion that perhaps this is not normal. Perhaps there’s something out of balance. Let’s work there and she said to me,”Gosh, I had no idea that my sleep was connected to my hormones”. And I said, Yeah, right?! Everything that is happening for you, your sleep, your digestive system, your muscle pain, your nervous system, the little minor anxiety that you get, the acne that pops out on your skin, the menstrual cramps, all of it is happening in one human sitting in front of me.

Therefore, it is all connected.

Thank you so much for spending this time with me and joining this conversation. If any of the things that you’ve heard today have landed with you, moved you, resonated with you, and you’d like to pipe in, I would sure love to hear from you. Some of the best conversations happen right in the medicine house with me and the easiest way to do that.

Pop over to the website www.doctorschoiceintegrative.com. Book a discovery conversation with me. It’s called a discovery call, and it’s a complimentary 15 minute slot where we can explore health together. I’d love to do that with you. Hope to see you there.