According to the National Sleep Foundation, “insomnia is defined as repeated difficulty with sleep initiation, maintenance, consolidation, or quality that occurs despite adequate opportunity and circumstances for rest,” and it affects approximately 30-35% of adults. If you’re one of the millions of people struggling to get a good night’s sleep, know that you’re not alone—and there are naturopathic treatments that can help!
One of the best things you can do to improve your sleep is to practice good sleep hygiene. This includes habits like avoiding caffeine in the afternoon and evening, avoiding alcohol before bed, Establishing a regular sleep schedule, and avoiding screens in the bedroom. Creating a relaxing bedtime routine can also be helpful; consider taking a bath or reading a book before climbing into bed.
There are also a number of nutraceuticals—or nutrients that have medicinal properties—that can help improve sleep. Melatonin is a hormone that helps regulate the body’s natural sleep-wake cycle, and supplements can be effective in treating insomnia. 5-HTP is another nutrient that can be helpful in treating sleeplessness; it works by increasing levels of serotonin, a neurotransmitter that plays an important role in regulating sleep. Other nutrients that have been shown to be effective in treating insomnia include gamma-aminobutyric acid (GABA), valerian root, and passionflower.
Traditional Chinese Medicine (TCM) offers another treatment option for those struggling with insomnia. Acupuncture is one of the most well-known TCM treatments; research has shown that it can be effective in treating insomnia by promoting relaxation and improving sleep quality. Herbal medicine is another TCM modality that can be helpful in treating sleeplessness. Traditional Chinese herbs that have been used to treat insomnia include jujube seed, ziziphus seed, longan fruit, tianma root, ginseng root, and magnolia bark.
Cannabis is another treatment option that is gaining popularity for its ability to effectively treat insomnia. THC, the primary psychoactive compound in cannabis, has been shown to increase slow-wave sleep—the deepest stage of sleep—while CBD has been shown to reduce REM sleep density, which may lead to more restful sleep. For those who are interested in trying cannabis for their insomnia but are worried about the potential for addiction or abuse, CBD-only products may be a good option as they do not have any psychoactive effects.
If you’re one of the millions of people affected by insomnia, know that you’re not alone—and there are treatments out there that can help! Sleep hygiene practices like avoiding caffeine and screens before bed can make a big difference, and nutraceuticals like melatonin and 5-HTP can also be effective in treating sleeplessness. Traditional Chinese Medicine modalities like acupuncture and herbal medicine can also offer relief from insomnia; cannabis is another treatment option gaining popularity for its ability to improve sleep quality. Talk to your naturopathic doctor about which treatment option may be right for you!
I have noticed consistently good results using cannabinoids for sleep disorders. I am often asked what are the top indications for cannabis therapy in my practice and insomnia would always be in the top three.
I first started to gain an interest in cannabis and cannabinoids back in 2015. One of the most common reasons that my patients were using cannabis was for various types of insomnia. Most of these patients were having very good results. That really peaked my interest because I too suffered from insomnia for a large part of my life.
I had used various natural sleep aids but needed a change as my current medication was producing some inconvenient side effects. After receiving my medical cannabis prescription I started using a balanced THC:CBD oil which improved my sleep latency and nighttime wakeup’s within a few days. Cannabinoid therapy is now one of my most recommended treatments for various types of insomnia as it is safe, inexpensive, fast acting and effective.
Cannabis can have calming or stimulating effects depending on the preparation, dose and mode of administration. I really wanted to find out what made cannabis effective for sleep and what would be the optimal way to use it for sleep. My research pointed towards a few mechanisms through which cannabinoids likely have sleep promoting effects: GABA, Serotonin and Endocannabinoid modulation.
GABA is an inhibitory neurotransmitter that generally promotes a relaxation response in the central and peripheral nervous system. It is well established that activation of GABA receptors favours sleep and many pharmaceutical drug classes, including benzodiazepines, act on GABA receptors.
Both animal and human studies have demonstrated that cannabidiol (CBD) has a modulatory effect on GABA activity. CBD can both increase and decrease GABA activity depending on neurotransmitter activity levels (if there’s too little it increases, if there is too much it decreases). This makes CBD useful for sleep disorders resulting from too little GABA activity (think of the overactive brain) without the addictive potential of GABA stimulating pharmaceutical preparations.
Serotonin is a neurotransmitter that is involved in mood and sleep/wake responses. Many antidepressant medications specifically target serotonin activity. Research from the early 2000’s by Bambico et al demonstrated that cannabinoid receptor agonists (things that stimulate cannabinoid receptors) have the ability to modulate serotonin activity. Low doses seemingly to raise serotonin activity while high doses have little effect.
Both endogenous cannabinoids (cannabinoids we make ourselves) and phytocannabinoids (THC, CBD etc..) seem to have the ability to modulate serotonin activity via stimulation of our cannabinoid receptors. This may explain some of the physiology involved in the sleep promotion and anti-anxiety effects of cannabis preparations. CBD seems to be particularly useful through its interplay with our endocannabinoid system.
All species, with the exception of insects, have an endocannabinoid system. The endocannabinoid system is our bodies harm reduction system, keeping chemical and electrical singling in balance. Overall, stimulation of the endocannabinoid system has a calming effect and a known modulator of our sleep/wake cycle.
Many chronic diseases that have been linked to disruption in the endocannabinoid system (Fibromyalgia, Migraine, Inflammatory Bowel Disorder) have a sleep disruption comorbidity. This sleep disruption can usually be helped with a prescription of cannabinoids such as CBD. It is certainly plausible and empirical evidence supports the theory that patients with sleep disorders have endocannabinoid disruption. Therefore, phystocannabinoids like CBD can be helpful to restore endocannabinoid tone and subsequently better sleep.
Cannabis is a unique medicine as it cannot be prescribed based on age and weight. Everyone has an individual response to cannabinoids due to the fact that everyone has unique endocannabinoid tone and metabolism.
Cannabinoids like CBD and THC can interact with particular medications and preexisting conditions. Some preparations of cannabis are very different in their effect and duration. Smoked cannabis has a very fast acting effect but a short duration. Edible cannabis can have a slow onset of effect but last for a long time.
Therefore it is highly recommended to have a healthcare professional knowledgeable in cannabinoid therapy work with you for the initial stages of treatment. This will ensure a safe and effective dosing strategy with minimal chance for adverse effects. With that being said cannabis is a very safe medication and when prescribed correctly can make a significant difference in those suffering from sleep disorders. Check out the Cannabis Therapy page for more information.
Pretzsch CM, Freyberg J, Voinescu B, Lythgoe D, Horder J, Mendez MA, Wichers R, Ajram L, Ivin G, Heasman M, Edden RAE, Williams S, Murphy DGM, Daly E, McAlonan GM. Effects of cannabidiol on brain excitation and inhibition systems; a randomised placebo-controlled single dose trial during magnetic resonance spectroscopy in adults with and without autism spectrum disorder. Neuropsychopharmacology. 2019 Jul;44(8):1398-1405. doi: 10.1038/s41386-019-0333-8. Epub 2019 Feb 6. PMID: 30758329; PMCID: PMC6784992. Gottesmann C. GABA mechanisms and sleep. Neuroscience. 2002;111(2):231-9. doi: 10.1016/s0306-4522(02)00034-9. PMID: 11983310. Moreira FA. Serotonin, the prefrontal cortex, and the antidepressant-like effect of cannabinoids. J Neurosci. 2007 Dec 5;27(49):13369-70. doi: 10.1523/JNEUROSCI.4867-07.2007. PMID: 18057193; PMCID: PMC6673093.
Finding an effective treatment for Polycycstic ovarian syndrome (PCOS) is important to me for two distinct reasons. 5-10% of woman are impacted by PCOS in their lifetime making PCOS a common and treatable condition in my Naturopathic practice. The second reason is that it is a condition that my wife has struggled with for many years therefore making it a syndrome that hits close to home.
PCOS is a bit of a misnomer as it is a continuum of symptoms and doesn’t necessarily have to include ovarian cysts. It is however characterized by several common objective findings including irregular periods, infertility, shifts in hormone balance (DHEA, Testosterone, LH, FSH), hirsutism (hair growth on the lip, chin and abdomen), Hair loss (Male pattern head hair loss), acne (typically on the lower jaw), high levels of insulin due to insulin resistance, and unexplained weight gain (especially around the abdomen).
Although we still do not know all the mechanisms involved as to why some women develop PCOS, there does seem to be a genetic component. Environmental toxins such as BPA seem to play a role, and gastrointestinal dysbiosis (unfriendly bacteria in the gut) plays a role as well.
Some of the more common conventional treatments of PCOS include birth control pill (to regulate irregular periods and hormone levels), metformin (a insulin sensitizing drug that helps to control blood sugar levels commonly used in diabetes), and spironolactone (a diuretic that also has the ability to block a type of testosterone formation called DHT). While these treatments can be helpful in the short-term they do not always address the root cause of PCOS and therefore ultimately fail in the long term. Some of these causes include hormone disrupters in the environment and diet, and gastrointestinal dysbiosis (leading to the production of inflammatory compounds that compromise insulin function).
Luckily there are relatively easy and low cost solutions to many of the fundamental causes of PCOS. As a Naturopathic Doctor I have the privilege and ability to take a detailed medical history. Doing so can point me in the direction(s) as to where these foundational imbalances are occurring. For instance if the patient has a history of gastrointestinal concerns, (constipation, diarrhea, gastritis, colitis) that informs me to focus investigation on the gastrointestinal tract. If a patients main concern is infertility and irregular periods I will shift focus into hormone balance. It may also be the case that a patient has several concern at the same time, which is not uncommon in PCOS. Once I know where to focus we can run specialized tests such as comprehensive stool analysis, female hormone panels, nutrient level panels, food sensitivity testing and environmental toxins. This aids in narrowing down where to implement the bulk of the treatment protocol. There are some general recommendations that are sure to aid all women with PCOS such as exercise, reduced carbohydrate diets and lowering exposure to petrochemicals. However, the medical history and specialized testing can be a guide for more specific recommendations.
A nutrients panel test can help determine if there are specific nutritional deficiencies such as low levels of vitamin D, vitamin A and omega-3 fatty acids, which tend to be common in PCOS. A female hormone panel can determine if there are specific imbalances with sex hormones. These imbalances can potentially be corrected with dietary recommendations, bio-identical hormone replacement, and nutraceutical supplements. Evidence of dysbiosis in gut from a stool analysis can be reversed with dietary recommendations that promote colonization of helpful butyrate producing bacteria. Nutraceuticals containing antibiotic herbs can preferentially kill harmful bacteria while protecting good bacteria. Probiotic supplements containing specific strains of bacteria and prebiotic fibre can be very effective. Food sensitivity testing can help confirm if there are specific foods in the diet that are activating an immune response, causing further inflammation in the gut. Environmental toxin analysis would shed light on high levels of exposure to particular toxins, most of which are known hormone disruptors. Even the simple testing of insulin levels and blood sugar can lead to recommendations for easily accessible compounds like inositol, L-carnitine and chromium which can effectively increase insulin sensitivity.
The take home message is that PCOS is an extremely common and often disruptive condition for a significant amount of women worldwide. The conventional treatment of PCOS often does not provide long term solutions and can have significant side effects. Simple and inexpensive solutions through dietary, supplement and lifestyle recommendations can address the root causes of PCOS and bring about significant symptom relief with long-term sustainability. I therefore encourage anyone suffering from PCOS who hasn’t found an effective solution to contact a local Naturopathic Doctor or Functional Medicine Doctor for an assessment. If you would like to contact me, you can do so through the appointment page by clicking the link in the menu bar. The sooner you start to address the root causes the easier and quicker long lasting symptom relief can be achieved. That being said, implementation of a functional medicine approach to PCOS will undoubtably be helpful at any stage and at any age.
A Naturopathic Doctor can play an important role in managing CMT through dietary counseling, specialized testing and by offering relevant integrative therapies.
CMT is a hereditary disorder affecting the motor and sensory nerves. It’s characterized by progressive loss of muscle tissue and sensation in various parts of the body. Currently CMT is incurable and is the most common inherited neurological disorder and affects approximately 1 in 2,500 people.
In terms of managing CMT, by far the most important goal is to maintain movement, muscle strength and flexibility. Often overlooked is the role diet, pain management and antispasmodics can play in CMT. Having a naturopathic doctor familiar with neurological conditions can be a valuable part of a healthcare team.
Sugar
Although sugar is sweet and delicious, at high concentrations it can become a poison for the nervous system. Uncontrolled blood sugar, including diabetes, will exacerbate nerve damage and peripheral neuropathy in CMT. A naturopathic doctor can test blood sugar in order to determine if it poses a risk. Dietary counseling, such as education around glycemic index and glycemic load, can help balance blood sugar levels. There are also effective strategies that can boost insulin sensitivity thus lowering blood sugar. These include; low impact exercise and supplements like chromium, berberine, agaricus mushroom, american ginseng, and vitamin B3.
Diet
A diet rich in antioxidants and anti-inflammatory compounds can greatly improve neuromotor and locomotor performance. Curcumin and vitamin C are two natural compounds that have been and are currently being investigated as potential therapeutic agents for CMT. One study demonstrated a decrease in neuron death and an increase in size and number of nerve sheath cells after administration of curcumin. Intermittent fasting is a diet strategy that promotes a 16 hour fasting period each day and has been shown to improve locomotor functioning in CMT patients after 5-months.
Nerve Pain
Nerve pain and neuropathy can be addressed through a few different approaches. Application of topical counterirritants such as capsaicin and menthol can work by overriding pain signals. Peripheral pain blockers work by re-routing pain signals locally at the source of the pain. Effective peripheral pain blockers include: acupuncture, electro-acupuncture, moxabustion and transcutaneous electrical nerve stimulation (TENS). Central pain blockers block or override pain signals where they are interpreted, in the brain. Central pain blockers include cannabis, wild lettuce and california poppy.
Cramps and Spasms
There are many effective integrative therapies for cramps and muscle spasms. These therapies work by balancing electrical conduction at the muscle and stimulating inhibitory neurotransmitters. Some of the most effective therapies are: magnesium, acupuncture, GABA, valerian, cramp bark, skullcap, passionflower and cannabis.
Nerve-Protection
One of the largest areas a naturopathic doctor can serve as a crucial part of the integrative healthcare team is in offering strategies to prevent further nerve damage, and in some cases reversing existing nerve damage. Neuroprotectants generally belong to two main categories: antioxidants and anti-inflammatories. Neuroprotectant antioxidants include: alpha lipoic acid, glutathione, resveratrol, EGCG, flavonoids, Co-Q10, CBD and THC. Anti-inflammatory strategies include testing for food sensitivities, hormone levels and environmental toxins. Anti-inflammatory supplements include Omega 3 fatty acids, curcumin, boswelia, and CBD.
Garlic (Allium Sativum) is an ancient therapeutic food that has been in use since the dawn of medicine. It is mentioned in the bible and has been used by all the great forefathers of modern medicine such as: Hippocrates, Galen and Dioscorides. Garlic is mentioned several times in the Ebers Papyrus, an ancient Egyptian medical text written circa 1550 B.C. Garlic was used topically and internally to treat ailments of the respiratory tract, digestive tract and for infection. Men and women would consume large quantities of garlic to prevent illness and improve endurance. Garlic bulbs have even been found buried in the tombs of Egyptian royalty, such as King Tutankhamen. Garlic continues to be one of the most powerful remedies in the modern day alternative health care practitioner’s toolbox. Fortunately, it has worked so well for so many thousands of years that a significant amount of funding has gone into researching the particular constituents contained in Garlic that lend it its medicinal properties.
Research has shown that sulfuric compounds in garlic are effective at lowering blood pressure, lowering LDL cholesterol, exploding certain cancer cells, and killing some strains of harmful bacteria. The following is an overview of some of the most compelling research on Garlic as a medicinal supplement over the past few years.
In ancient times Garlic was viewed as a tonic of the respiratory and digestive tract, however; persuasive evidence based research demonstrates that it is also a tonic for the cardiovascular system. In 2010 a double-blinded randomized placebo-controlled trial was performed on 51 coronary heart disease patients to determine the effect of time-released garlic powder tablets on the risk of heart attack and sudden death. It was demonstrated that after 1 year on the garlic supplement, men had a 1.5-fold reduced risk for serious cardiovascular disease and women had a 1.3-fold reduction in risk. The reduced risk was extrapolated through the finding that men had on average a decrease in LDL-cholesterol by 32.9 mg/dl and women had a 27.3 mg/dl decrease on the garlic supplement.
Besides high LDL-cholesterol, another marker of risk for cardiovascular disease is hypertension. A Meta-analysis that looked at 1994 randomized placebo controlled trials using garlic preparations as intervention for hypertension found that garlic was significantly more effective than placebo. In hypertensive patients garlic preparations produced an average of an 8.4 mmHg drop in systolic blood pressure and a 7.3 mmHg drop in diastolic blood pressure. A research article published in 2007 demonstrated that the polysulfuric compounds in garlic are converted into hydrogen sulfide by red blood cells. In turn, hydrogen sulfide has the ability to relax blood vessels, therefore decreasing blood pressure.
Over the past decade there have been numerous studies looking into garlic as a potential anti-cancer medicinal food. Studies, which looked at the correlations between garlic consumption and incidence of cancer, haven’t been extremely convincing in either direction. Some correlations do exist, however, which has spawned further investigation into the anti-carcinogenic properties of Garlic. A 2009 study in the journal of Clinical Cancer Research demonstrated that one of the sulfuric compounds in garlic, diallyl trisulfide, may have a beneficial effect on prostate cancer cells. Just like some breast cancers are sensitive to estrogen, some prostate cancers are sensitive to androgens, like testosterone. Bicalutamide is a drug given to some patients with prostate cancer in order to block the effect of testosterone on cancer cells. The diallyl trisulfide found in garlic has a similar effect to this medication, causing a decrease in androgen receptor protein, leading to a decrease in prostate specific antigen levels (PSA).
One of the most fascinating articles that I came across was an article published in 2008 in the Journal of Biologics: targets and therapy. The study looked at the treatment of childhood Pre-B Acute Lymphoblastic Leukemia (ALL) with preparations of garlic extracts compared to common chemotherapeutic agents used in the treatment of this illness. One of the most concerning side effects in chemotherapy treatment, especially of leukemia, is a decrease in white blood cell count and therefore a susceptibility to infection. While both the chemotherapeutic drugs and the garlic extract caused a destruction of cancerous cells, only the garlic extract was reported to not have any detrimental effect on non-cancerous white blood cells. The authors also comment on the fact that garlic is known to be an effective (around 10% the effectiveness of the antibiotic vancomycin) antimicrobial agent against many hospital acquired infective organisms.
In light of the recent cholera outbreak in Haiti, I decided to include the following study published in 2009 in the journal of Bioscience, Biotechnology and Biochemistry. In this study garlic oil was studied for its diallyl sulfide content and its antimicrobial activity against V. cholerae. The in-vitro study found the oil to have bacteriocidal effect against all tested strains of V. cholerae. It was also demonstrated that the garlic oil had an inhibitory effect on the growth of V. cholerae in contaminated food. In my opinion, it wouldn’t be a bad idea for the Centre for Disease Control and Prevention to add regular consumption of garlic to its cholerae prevention protocol in Haiti.
On a final note, I came a cross an article published in 2009 in the Journal of Agricultural and Food Chemistry that confirms the notion that fresh crushed garlic has a greater therapeutic benefit than processed garlic. This is due to a higher concentration of the sulfuric compounds that have been previously mentioned in fresh garlic. Like all food, garlic is potentially aggravating for some individuals and can cause allergic reaction in individuals with an allergy to the Alliaceae family. Be diligent when consuming garlic, especially when adding garlic to the diet of children. I have used garlic in numerous home remedies for cardiovascular health, and for upper respiratory and gastrointestinal infection. The most common complaint I get is the smell. Since the unpleasant odor of garlic is actually emitted from the inside out, it is very difficult to conceal. I have heard that consuming milk with garlic is the best way to cover it up. Cooking the garlic also helps but this greatly diminishes its therapeutic benefit. I now look at this odor as the odor of a healthy heart, and most likely, the distinguished odor of Egyptian royalty.