the cause of my 3AM-5AM insomnia

I have this typical insomnia:

  1. fall asleep easily
  2. wake up at 3AM
  3. lie awake for about two hours, being wide awake, very alert

Upon examination there are a few characteristics to consider:

  • I wake up sweaty, with a heated body. I can’t go back to sleep unless I cool down. This points towards some sort of stress reaction my body is having, causing me to wake up.
  • The mental alertness is ridiculously high. It’s like I have a pinball machine in my head. It’s not anxiety, it’s more a superability and -willingness to solve a problem. This is a dopamine excess.
  • The 3AM is not 3AM. The insomnia occurs pretty much precisely 4,5 hours after I fall asleep.

These three things: stress reaction; dopamine excess and 4,5 hours interval have now led me to the cause of my insomnia. It has to do when the internal workings of the machine trigger the neural wiring which reacts violently.

A small intestinal problem triggers my overexitable neurotransmitters.

It takes 4,5 hours for food to traverse the small intestines. It then enters the colon. There, in my case, it remains. It doens’t travel up the ascending colon because it cannot make the curve near the liver (there’s probably an air bubble blocking the way). Food keeps being piled on and the right vertical part of my colon expands, causing stress, waking me up. Since the enzyme that’s supposed to break down stress hormones is broken in me, the MAO A enzyme, my levels of noradrenaline (=norepinephrine) and dopamine are getting very high. Causing me to lie awake for 1,5 to 2 hours, frantically  writing speeches on Important Subjects. During this time my cortisol is depleted and my growth hormone doesn’t get the time of day (I’m robbed of a significant portion of REM sleep). This is a large tax on the body and leaves me with diminished capacity for getting out of bed the following day and healing properties, especially now that I’m over 25 and my endo-glands can no longer make up for such a plundering.

There we have it. A simple blockage leads to a build up in the right colon which makes my body cry out. Triggering the release of too many excitable neurotransmitters.

Again it’s the imbalance between Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS), which both have so much to do with the perifere location: the gut.

My balance is skewed in favour of the SNS due to a homozygous mutation of the MAO A  gene and a life time of training to be in Fight or Flight. I can unlearn the latter. I can only influence and work around the former.

Gut motility is mostly governed by PNS. It’s the modus of Rest & Digest in opposition of SNS’s Fight or Flight. Looking at particular neurotransmitters I’ve now learned that as soon as dopamine rises the stomach is reluctant to release its content. This is why a dopamine-antagonist (Domperidone) is prescribed to people with nausea and vomiting (Dutch link). And this is why I have to go lie down about an hour after I have ingested food. The stomach takes 45 minutes to break down the first bites I took and is now ready to release it. I need to make room for PNS to do its thing and the only way I know how to at the moment is to lie down and relax. As soon as I do so my upper GI tract starts gurgling. If I don’t lie down I’ll grow weary and moody as the day progresses and I’ll be devilish in the evening and have hellish insomnia at night.

Motility in the small intestine is dependent upon having enough of the PSN neurotransmitter Acetylcholine and by activating lots of serotonine receptors. Having bad MAO A is a good thing here, serotonine is soaring and there should be one for every receptor. As soon as I lie down at night the small intestine starts happily motoring things along. In 4,5 hours it has emptied all it had into the next portion of the gut via the one way ileocecal valve into the colon. Luckily I have no problems there. For some this valve flutters and lets stuff and bacteria creep back into the small intestine.

We’ve all seen the picture of how the colon lies in the belly:

The colon rises up, all the way to the liver, then bends to the left, traversing in front of the stomach exit to the spleen area. There’s another bend downwards and then it ends in the temporary holding station called Sigmoid Colon.

Which is true for only about 5% of humanity. In most of us the colon is going wherever it wants. Diagonally to the spleen. Bending backwards. Bulging inwards into small intestine territory. So don’t take anything for granted, these idealistic pictures are just theory.
This colon is more likely:
 pic by Glitzy queen00, radiographer in the UK

I don’t know the route my colon lies. I can feel contents at certain places so I have some idea. But I suspect at the Traverse Colon things are iffy. Interfering with the stomach exit and the duodenum, where also the major PNS nerve is located, the Nerves Vagus.

At the right bend, the Hepatic Flexure, its location is probably irritating the liver. I often have a heavy feeling there, bordering on pain. And now I know that something is hindering process in the night. My GP suggested a mechanical issue: an air bubble is trapped in the Hepatic Flexure, preventing passage. He made the analogy with a bottle with air trapped in it: you can’t pour the liquid in a smooth motion.

I can work with mechanical problems. The solution is to lie on the right side. The air travels upwards, into the Traverse Colon. I’m using breathing as a motion device, the expanding and contracting lungs are the main mechanical force on organs, making them move and shift. It’s a natural thing. A good thing.

When I had an echo done of the liver I had to breathe out and hold my breath. The lungs forced the liver to peek out from under the ribcage and the technician could scan it.  It looked so beautiful! Things were moving and fluids were flowing and we saw all kinds of channels. It was such a marvel. Movement through breathing is very good for the internal organs.

After 5 to 20 minutes I turn on my back. I now lift my pelvis to the roof, resting on my feet and shoulderblades. This is a trick I learned when I went in for a pap smear and the cervix was not there. Somehow the uterus had shifted or folded back and hidden the cervix out of sight. I was asked to do these gymnastics so it may shift to another position. Mechanics. Everything shifts in there, nothing’s stationary. Organs are lying next to each other and are all able to shift and move.

There’s an excellent system in pace to allow for these movements. It both secures the internal organs to the scaffolding (the skeleton) and it lubricates the surfaces so there’s no chafing. It’s the Mesentry, a thin layer of epithelial cells surrounding all organ parts, like pieces of clingfoil taped to the back wall at various points:

 pic by blumdesign.com

The architectural structure of the mesentries is amazing, with small gutters transporting the fluid all around. Breathing and moving and muscular movements aid this system. Go check out non-profit educational site The Radiology Assistent for excellent images and explanations of many internal organs and structures.

I’m still on my bed, pelvic to the sky. I’m again using my breath to move things along. When breathing out I can manually manipulate the downwards colon on the left side a bit, trying to help it transport the air bubble to the exit. After just a few minutes I’ll feel the need to pass some gas. It’s only a little bit and I cannot believe that this is actually the bubble that was stuck at the Hepatic Flexure. But I have a result and I’m glad with it.

I now do this in the evening, before I go to bed. And during the day, when I take my hour rest. And at night, should I wake up. My insomnia is less severe because of this, there’s less dopamine produced. I still lie awake but now I’m a docile book, not a screeching video game. I have reduced the stress reaction. But I have not eliminated it yet.

 pic by amazon

I’m looking into a better motility of the colon. It’s not only air in the Hepatic Flexure, I’ve also noticed slow transit in the Traverse Colon. Then there’s considerable build up in the Sigmoid Colon to examine. And there’s a lack of neural signalling that I need to go, either #1 or #2.

Then there’s the food I eat that influences bulk, consistency, roughage and gas production. I already know to stay away from onions, beans and whole grains. Also carbohydrates make for a more severe insomnia, especially potato products. Which lead my GP and me to assume glycemic problems almost 15 years ago when I entertainingly mentioned how a potato dinner would keep me more wide awake at night than other dinners. Having been down the whole blood sugar route I can now say this is not an issue. But experiencing an insuline peak during the day does trigger the SNS for which I pay during the night. So sugar is still bad, but for a different -and far more serious- reason. Insulin is a potent poison, it should be engaged very prudently.

There, I’m done for today. There’s a lot to be sorted. Especially learning how/which neurotransmitters dampen the motility. Looking at you, dopamine. How to enhance the numbers for Acetylcholine? There’s a loop into the Methylation Cycle there that complicates things. There are probiotics that can help with signaling for defeacation. And how I can give PNS more time of day? I’m already grumbling that I have to lie down for an hour trice a day. But I gotta keep that pinball machine chilled if I ever want to sleep through the night and reap the benefits of both cortisol and growth hormone the following day.

A few more things to park here for future pick up:

1. Strengthening the gut muscles is a separate avenue to travel. One that works well for a lot of people, including a lot with Irritable Bowl Syndrome (IBS) (this is a link with the best instructional video for swinging a kettlebell). I’ve started kettlebelling which is a fun thing to do. I keep mine in the kitchen and kettle the bell a few times while I wait for the tea water to boil. Nothing on a schedule, no counting, . Keeping it fun. I already notice that there’s a certain pleasure in keeping your body upright using the core muscles, instead of stacking all your organs on top of each other and leaning on them. Sitting upstraight on a chair, like I was a woman from a 100 years ago, is pleasurable. Standing straight too. I’m stacking vertebrae instead of organs.

2. The stretching in the ascending colon activates trigger points causing sympoms. They are the reflex zones of the colon:

reflexzones dikke darm

The symptoms that occur at night in my insomniatic period are all noted in the reflex zones of the ascending colon: irritated and stuffed nose; oversensitive sense of hearing (fear triggering); strained eyes; soar throat and tonsils; extra pain in my right shoulder impingement. I have no issues with the other organs noted in this picture, apart from bladder and uterus which are at the sigmoid end.

These symptoms, especially of the allergy kind in tonsils, throat and nose, have thrown me off scent for the longest time. I kept thinking it was dry air or dust mites that kept me awake at night. But it’s the other way around: only if I wake at night dry air and dust mites become a problem. If I sleep through the night they don’t bother me.

3. pH in gastro tract.

4. osteopatic views on movement in and amongst internal structures. Link in Dutch.

5. the various types of motility in the intestines. one link and link to Flash card notes.

6. duodenic colic reflex makes you want to go #2 when the stomach fills up.

7. MAO A influencing when it’s already bust. Progesteron; B2; Ginko Biloba. Progesteron!

and to be perfectly clear: for years I’ve researched all the usual suspects for insomnia. Blood sugar; glycogen; sleep hygiene; circadian rhythm; melatonin; dual sleep; Chinese organ clock; you name it I’ve looked into it. It has done nothing. I could have guessed since I’ve had this sleeping pattern all my life, through every stage of health and constitution.

This now is the first approach that ticks all the boxes, explains everything and gives positive preliminary results when I tweak the dials that are involved.

For other people experiencing this type of insomnia I suggest assuming your body too is experiencing some stress reaction and figuring out what causes yours. I doubt it’s the same colonic issue I have but it might be. Especially if your MAO A gene is faulty you’ll recognize the alertness of your insomnia. This is separate from what causes the stress reaction. But if you are homozygous for MAO A then your dopamine is too high and interfering with stomach emptying and colon motility.

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Managing Adrenal Insufficiency

So, now that my ME is under control by applying the things I learned from Reverse Therapy (RT) there remains the adrenal issue.

The ME is gone, I’m in recovery. The past three months I no longer had the Wired & Tired and general “I’m so dead why am I still breathing?” feelings that go with ME.
But I did have the consistent nausea, especially in the evenings, and I did have to pace myself severely. I even had an adrenal slip up on March the 5th. When I was in a new surroundings, was too cold, had been upright for 5 hours on end and was too stressed.
I started crying uncontrollably which is an alarm signal from my body that I need to make it safe asap or otherwise an adrenal crisis is in the works. It’s a scary route.

I cried. Took my pills. Took a long lie down in the car. Then drove home and went to bed. Took three days of rest.

Me resting in my car. I was wearing my hand felted princess dress and handknit socks. You should always be warm. And being wrapped in wool gives you a feeling of safety.

I’m not too good in the RT thing yet, I have to practice over and over again to relax, feel safe, and calm down the nervous system. But I’m well enough now to address the adrenal thing.

That’s why I had a battery of blood tests done, talked to my GP and had a consultancy with Adrenal expert Dusty Hardman from AddisonsSupport.com.

Dusty is not a doctor and will not make any decisions for you. But to the educated patient she’s a welcome sparring partner with lots of experience and knowledge. She herself has Addison’s and runs marathons -even wild ones, which lasts days and days- and researches Addisons’ medical info.

The blood tests were: hormones, electrolytes and more hormones.
My primary goal was, for both GP and Dusty, to find out whether I was wrecking things the way I’ve been supplying Hydrocortison until now. Secondary was to learn how to improve my protocol.

The risks of long term corticosteroid use involve loss of bone density; getting too high eye ball pressure and some other scary things. There’s also suppression of residue adrenal function, if you take too much.
When your adrenals cannot produce cortisol when you need it, say in an emergency like a trauma or dehydration, you run the risk of death. Quite quickly too.

As Pathology Personified illustrates it:

when vomiting twice, call the emergency services. Addisonian crisis is life threatening.

When vomiting twice, call the emergency services. Addisonian crisis is life threatening.

Addisonian Crisis: Medical emergency
14. Severe vomitting
15. Severe chest, abdominal pains
16. Back pain
17. Severe diarrhea
18. Syncope, fainting

Refs: 1-13 Merck Manual 18th Ed (2006); 1-4 Souhami & Moxham ‘Textbook of Medicine’ 4th ed (2002); 1,2,8,13 Goodman & Snyder ‘Differential Diagnosis for Physical Therapists’ 4th Ed (2007); 1-15, 12 Gray & Toghill ‘Symptoms & Signs of Clinical Medicine’ (2001); 1-3,7,14,15,18 Ballinger & Patchett ‘Saunders Pocket Essentials of Clinical Medicine’ 3rd Ed (2004)

But I haven’t had an Addisonian crisis yet. I’m still in the process of determining how my system is doing.

The electrolytes showed that calcium-magnesium was ok-ish but low on magnesium. Natrium-kalium was perfect. My kidneys are troopers!
I’m having a bone density scan done soon (DEXA) to tell me more about the bone density. In the mean time I have started to do weight bearing exercises. It’s the only thing left to do at my age.

Don’t go taking calcium enriched supplements!
You’ll only put your bone-cells into overdrive and exhaust them before you’re old. Have you never wondered why the country that drinks the most milk, the Netherlands, has the highest portion of osteoporosis? Calcium from dairy is bad for you. Lies:

This is all lies!
Don’t eat so much calcium. At least fill up on Magnesium if you do take some calcium. It’s such an easy and unlogical assumption to think that because your bone is brittle and it’s made from calcium you need to take more calcium.

My GP taught me about a complicating factor: that the bone cells needs vit D receptors and these decline with age. You should have maximum receptors at age 30 because after that they dwindle and cannot help your brittle ass enough.
I asked whether I was perhaps lowering my amount of vit D receptors with the large amount of vit D I take. Just like you lower the amount of Progesteron receptors when readily supplementing. He found it an intelligent question.

The eye-thing has been checked by an optometrist and the eyeball pressure will be checked in two weeks by an opthmologist.

The hormone ACTH is the hormone the brain releases to get the adrenals to produce cortisol. My value is 19 in a reference scale running from 0 to 50.
With my supplementation of 20 mg of Hydrocortison my brain is still asking my adrenals to put out more cortisol. Hence: my brain has not shut down my adrenals. And: my adrenals/supplementation do not provide my body with enough cortisol.

Not enough cortisol also explains my residu symptoms:
– nausea (not enough stomach acidity. Not enough HCL in the world to help with this)
– not able to make choices. See last posts. Who’d knew this was a symptom?!
– crying inappropriately
– dropping blood pressure
– losing words when tired. I especially lose my Dutch nouns and verbs. English ones pop up instead.
These are all adrenal symptoms.

My blood work showed I don’t supplement cortisol enough. There seems to be no damage with the supplementing I’ve done so far.

Talking to Dusty and reading everything on her site has given me a new look towards Addison’s. Doctors still know very little about it. And what they know they haven’t thought through very well it seems. They are so scared of suppressing adrenal function that they rather have people on too low a dose, causing them to have a poor quality of life.
Whenever someone needs an acute higher dose they linger to give it to them, wrecking their body unneccessarily.

I have educated myself and have started a trial of higher cortisol replacement. I’ve upped my dose, with blessing from my GP. And boy, do I feel alive!

pic by St.Mattox

Suddenly the quality of my life has shot up. I’m nowhere where a healthy person is, who runs after the children or doesn’t think twice about getting some groceries before cooking dinner.
But I can take a shower when I feel like it. Not make it the one thing I do on a day.
I’ve just been outside, puttering about in the garden. It’s a gorgeous Spring day out there! I came inside and sat down to write this post, I didn’t have to lie down first.

I’m now on 25 mg HC per day. And I’m going to up it to 30 mc because over the past few days I needed to stress dose each and every day because one day we were taking a drive of 1.5 hours. The next day the optometrist was about to put painful drops in my eyes which would annoy my body for three days. The day after I had stomach pains. And today I worked in the garden.

These are all activities/events that require a little bit of cortisol extra.

Yesterday I was hormonal. I was cranky, weepy and aggressive. Looking at the calendar I saw it was ovulation day. I never have these symptoms on this day. At best I can muster up a little bit of arousal but overal I’m a very tame woman.

With the upped HC I am pouring extra hormones into the adrenal hormone cascade. Less of my Progesteron is needed to make cortisol and it’s probable that it flows into Estrogen and Testosteron production. (Test. was low in the blood test btw)

I took extra Progesteron to counter it. Problem solved.

This HRT is all a delicate dance. Luckily I supplement physiological doses so anything I overdo or underdo leaves the system within a day. And I’ve danced with my Progesteron and Estrogen for a few years now, all the HRT things I learned from that I get to apply to cortisol replacement.

Lots of things happening, in just these 5 days since my trial started. For example I also noticed that my thyroid is picking up. I had it tested too and it is within range but not optimal. Which explain the residu thyroid symptoms I had:
– poor digestion
– poor intestines motility
– hair loss

With only a few days of extra cortisol my thyroid is feeling more comfortable: no hair loss and a more warm body. No more cold from the bones!
I do need to take my Iodium/Kelp supplement every day though.

Kelp by Donna Adenine

Adrenals and Thyroids are the battery and the gas pedal of the body. I’m revving and going through my minerals and co-factors faster.
I now take diligently daily: Zinc, Magnesium, Selenium, Kelp, vit D and Q10. If I forget any of these the system bucks.

I also take Lithium (the mineral, not the drug) and Progesteron (and Zinc to keep an even brain chemistry.

The action plan I wrote out with Dusty:
1. take two weeks to figure out correct HC dosage.
2. in two weeks test to see if Florinef is needed. This helps blood pressure. The test to take is: Renin, at 8 in the morning, sober without breakfast and without having gobbled salt the previous day.
3. in two months test Thyroid values. They should be better than they are now. If not supplement.
4. around that time: test sex hormones. They should be ideal. If not I should supplement. We’re talking DHEAs, Estrogen, Progesteron and Testosteron. Testosteron for females should be a 0.2% solution.
5. in 6 months time retest the whole shebang as these are the values I need to monitor my supplementing and my well being. DHEAs, Renin, electrolytes, FREE T3, FREE T4, Total and Free Testosterone, Progesterone. All of these things need to be supplemented if deficient.
6. Repeat this monitoring battery of tests every 6 months.

Also. Now that I’m probably on full replacement of the adrenal cortisol, I’m now in danger of my life should anything happen to me. Addisonian crisis.
Because of this I will ask my GP for an emergency injection kit for 100 ml of Solu-Cortef. It’s a cortisol you inject into a muscle in case of adrenal crisis. It’s pretty much like an epi-pen and it will save my life in the same fashion an epi-pen saves someone with sever allergies..

I’ve also ordered two wristband tags that state my needs. I hope, should I ever end up unconscious or wounded, a smart bystander will find me, read the tag and do what’s needed.
In my case: reach into my bra and feed me the pills you find there. Then call the emergency services.
Or give me the shot.

OMG feeling alive again is serious business.

by Mark Aplet

two more things to tell you:

  1. the court case about the manure plant was lost. Don’t know how that happened, I had such solid and scientific arguments. I guess we lost to political agenda and biases. I will now learn to live with a manure plant next to my cabin. But I did manage to write three engineer rapports last year, when I was still ill from ME and adrenal issues. That’s something to be proud of.
  2. I still wake up after 5 hours of sleep. I can’t find a consistent factor. But the stress system is involved, that I know. I’m now looking into problems with the intestines, specifically the Ileocecal valve, which lies between the small and large intestine. This bit hurts, at night. And I have circled towards a dietary habit that is THE diet for problems with the valve. Two coincidences that prompt me to look into this ileocecal valve.

How come I end up talking poo to you again? Twice!

PMS from hell gone.

The past few months I got really bad PMS. PMS from hell.
PMDD. Weeks that I could not live alone because it was not safe. Because I was desperate and suicidal.

I knew it was all brain chemistry and not a chronic depression. As soon as my period started the cloud lifted and I was my happy normal self. But only for three days, the last two months. Three days after my period the cloud would descend again.

But knowing something has a chemical cause and dealing with the feelings/thoughts it generates are two different things. In the end it got too hard to manage the feelings and thoughts.

The weird thing was that my usual PMS can be managed by taking micronized Progesteron and/or Progesteron cream. I’m versed in that. I know how to work it.
I’ve had one bout of suicidal depression that was caused by a vit D shortage.
But neither one of those supplements helped this time. I was stumped.

Of course I did research and found the term PMDD, meaning PMS-from-hell. Including the suicidal tendencies. This rang true.
I looked up other people who have this and what works for them. One thing is that anti-depressants work instantly. Instead of the few weeks it takes to affect a chronic depression. With PMDD anti-depressants work instantly and you only need to take them a few days in the month.

The other suggestions I got were supplementing GABA, Lithium, St John’s worth, black bear spray, bh4 and 5htp.

I went to the doctor to get anti-depressants. This is tricky because I have a homozygous mutation for MAO A which means I already have an inborn MAO A inhibitor. Anything extra that blocks my noradrenaline receptors will have me bouncing off the walls for hours. Because I already have that tendency.

The doctor was very good!
He suggested that what I’ve been lacking these past few months is Dopamine:
neurotransmitter werkings

You all read Dutch right? The title is Function depending on Neurotransmitter.

Dopamine = attention; motivation; enjoyment; rewards.

Noradrenaline = alertness & energy

Serotonine = obessions & compulsion.

The three words in the middle read: interest; mood and fear.

The doctor must be right. There must be some sort of system where prolonged stress interacts with sex hormones (in their neuro transmitter role!) and depletes Dopamine in my head. An interesting thing to go look at.

Normally I have a healthy mix of the three. Although my Noradrenaline sticks around for too long because it’s destroyer MAO A isn’t very good. But otherwise I have a natural high Dopamine level.

He then talked me through the various anti-depressants that exist and on what neurotransmitter they have effect:
antidepressants overview

We chose an anti-depressant that affects Dopamine level, the best there is: Bupropion (this also is the only one that won’t affect libido)
It also inhibits noradrenaline but we agreed I should try it, in a low dose, to see how bouncy it makes me.

Dr. also suggested I use my sensitivity to assert if a pill was going to help me. Or even just carry it on my person instead of ingesting it.
Can you believe such a suggestion coming from a certified GP? That’s tailormade medicine right there. Fabulous!
I’d never thought of it but it is indeed something that works for me. I can sense whether something (a food) is good for me. Why not a pill?

He also mentioned the three things that improve mood:

  1. Zinc
  2. Krill oil
  3. Taurine

So that’s what I started taking. Taurine also soothes the liver which is a strained organ in my body. But it also contains sulphur which my body cannot handle very well (MTHFR/MTRR mutation)
The Zinc did it.

Whenever the dark cloud reared its head I just took Zinc and it went away again. It was amazing.
I hate when this happens, when a singular thing influences my mind so much and when it repeatedly proves it does and when I could have avoided suffering just by taking it earlier. And I hate the tiredness afterwards, when my body sighs in relief and needs time to recuperate. I hate when I wasn’t smart enough, resourceful enough, to stop this earlier.
I know I should be proud that I solved it and that I don’t feel so awful anymore. But the frustration is bigger at the moment.

So: no mental PMS/PMDD symptoms this month. I did not need to take any anti-depressant (but boy, am I glad I have them in my pantry. A good back-up whose presence eases the mind).

I’ve now had my period and we’re in day 4 of my new cycle.
Unhappiness is here again. But it’s very mild. I don’t think it’s related to the things above at all. The Zinc doesn’t attack it unfortunately.
It IS chemical though. I’m lacking something. Or have eaten something that poisons my brain. Could be the shrimp kroepoek? Or is the the stress of prolonged staying the city? The lack of chicken soup?

Either way I’m back on eating a clean diet again. No exceptions. With a brain chemistry as sensitive as mine, that’s the best thing to do.
I’m drinking a lot of (salted) water and taking enough hydrocortisone to keep my body out of stress.

And I’m re-affirming my body all the time that there is no reason to stress. We are safe. We are good. Relax. We are fluid and we are walking in the sunshine. Life is good. No worries.

(this is a solid approach to ease my Autonomic Nervous System which is at the core of my illness. More about that later.)

PS I stopped Valerian and also Progesteron pills the last week of the last cycle. Both might be energizing my system too much.

I took a Prog pill the other evening and laid awake again. Without it I sleep through the night. I do need the Prog cream for the current unhappiness though. This has always worked neurological for me so we’re back again at neurotransmitters and brain chemistry.

When feelings are lies.

I came out of a dangerous depression. Which was caused by a lack of vitamine D, that all important hormone.

Even though I knew the depression had a chemical cause it did not hurt me any less. My ratio was no match for the powerful feelings.
It even went so far that I was not to be trusted to be by myself any more. The restrains on suicide had been eroded. And I am an efficient person.

The depression had been building from the start of January. By the start of February it was bad. I was like a caged animal. I knew something was wrong but I could not figure out what. I changed everything around: my stress levels, my diet, the methylation, the HRT, the place I slept. Nothing worked.

By the end of February it was becoming dangerous.
Just two days before I was to have myself committed or killed (yes) I thought of the vitamin D. Just gave it a shot.

I took one extra pill of 25 mcg, on top of the one I take every morning.
45 minutes later the depression lifted.

I was shocked.
Flummoxed.
Relieved.
And then outraged.

Later in the day the depression doomed over me again. Another 15 mcg of vit D took care of that.
This happened the next day too. But each time the depression lifted.
Within a few days I got rid of the depression all together.

I am still very angry. Because these kind of emotional rollercoasters take their toll, both physical and mental. Not to mention how much being depressed hurts, all those days of struggle, all those individual minutes of misery. And the dangerous level this one got to was really scary! I had left that level years in the past, it is not good for moral to have it resurface.
How it could have been avoided altogether. If I had just thought about it.

In October my doctor had told me to half the dose of vit D because my blood levels were now perfect: 85 where 60 to 80 is desired. Over the Summer I had brought it up from 52 by supplementing 50 mcg per day.
So I tapered down to 25 mcg and this is what I took all Winter.
Forgetting Winter eats vit D. As does the methylation I started. And forgetting I got the initial low level of 52 while supplementing 25mcg every day for months.

If I only had thought about vit D sooner.
But I was so fixed on those blood levels. They say too much vit D will show the same symptoms as not enough…

Now I know: MS people gladly aim for blood levels of 100.
Me, with various cell processes siphoning away the hormone and at least one receptor out of commission, should probably not go by blood levels at all but by cell functioning.

Anyway. It’s been two weeks. It was Monday the 3rd of March that I took the first extra vitamine D and had my lightbulb 45 minutes later.
Since then I’ve topped up and the depression has been gone for a solid 13 days now.

pic by Julien Osotimehin

I’ve found my optimistic self again. (it’s weird, being enraged and happy at the same time)
And in those two weeks I’ve also put in two days of solid work: research and writing.

I’m still working on a technical report to be used in the court case to stop the manure plant from being build in the field next to my cabin.
I’ve put in a solid six hour day of working at my desk. Twice.

This bids well for the future. If I can work one day a week I can do something I love: work on paper. Perhaps write my fairy tale musing. Or illustrate.

I also allocated other hours fairly well and kept stress and worries out of it.
But I have not found the time yet to sit and do that thinking exercise I wrote about in the previous post. Still having to set priorities and still not doing that too well (choosing hours of surfing over a walk or constructive thinking)(still: should’t beat myself op over things)(shouldn’t)

In the mean time it also has become Spring and my senses enjoy the sounds and smells of that. The warmth of the air. The colours. The call of the Lapwing.
My emotions run high, pulsed by the birds in my patch of woods and the way my cat jumps and runs through the grass.

I do not know what to do with these feelings. They are strong. And they evoke memories. Of Norway. Of dreams I had. Plans. Strong emotions again.

Probably nothing, there’s probably nothing one has to do with these feelings.

Last night a sense of urgency arose. That I need to get writing/illustrating soon. Because my life is flashing by. I’m already older than many (all) people who have careers.

I know this is rubbish. Nonsense. I suspect there’s a chemical in play here too.
But still, my ratio is no match for feelings.
So on my new search I go, looking for the element that causes urgency and a feeling of midlife crisis. I suspect Lithium (which shortage makes me feel a useless human being) or the Vanillin in some cream puffs I had yesterday (which excess makes me wired and sensed of doom).

I know for sure that thése kind of feelings are not the right kind of feelings. They are not the ones I get from Spring, love, beauty or shocking news. Those are real. But these, these are chemical feelings. They are not genuine. They are not me.

(in other news: I just slept two days through the night. After eating raw steak for dinner. This might not be a coincidence…)

pic by Makio Kusahara

PS
let me say that in no way I think that depression is caused by lack of vitamins, hormones or sun light. Depression is a serious thing, not something that is easily cured.
It’s just that in this case, my case and this particular depression, I knew it was chemical. I felt it. I knew it in my bones. But wether it was from hightened stress levels (due to court case manure plant) or something I was wrecking with the methylation or sleep deprivation I could not tell.
This depression, of me, in this time frame, had a chemical cause. This says nothing of depression in other people.

It is a horrible thing to suffer from depression. Or feel suicidal. Hang in there. Just busy yourself with living through the next 30 minutes. That’s all you need to do. Just the next 30 minutes. That’s something you can do.
After that: survive another 30 minutes. No more. No less.

Thinking myself to sleep. Research notes.

I have a specific sleep pattern that is of no good. I sleep for 5 hours straight and then I wake up. I am wide awake. This lasts for about an hour, maybe two. Then I get back to a light sleep for another hour or two. I have had this all my life. Every night.

This is a specific pattern of insomnia. It is not cured by sleep hygiene. It wrecks havoc on the body. My current fascination is to get to the bottom of it and FIX it.

Here now follow my research notes. I need a place to keep track of my thoughts. I’m not sure this of interest to any of you… I apologize.

SLEEP is IMPORTANT.
dr. Gominak, a neurologists, found that all her patients improve when their sleep is restored. No matter what their neurological symptoms are. She thinks this has to do with specific healing that takes place in Deep Sleep and in REM sleep. For this healing Human Growth Hormone (HGH) is released and the body needs to be in perfect partial paralysis. Too much paralysis and you get sleep apneu (and rise from your deep sleep, preventing healing). Not enough paralysis and you sleep talk or get up to pee. Both patterns are not good because they prevent right paralysis and healing by HGH.

I get those first five hours of sleep. I typically wake up at 3 ‘o clock and lie awake till 5. I do get some Deep Sleep. This means I will not die from this insomnia. I know this because I have not died before. I have slept like this all my life, even as a child. But my adrenals have given out on this pattern.

MY THEORY: IT’S A CORTISOL PEAK
When I wake after five hours I experience a specific status. My mind is clear and wide awake (if not racing). My body is hot, too hot. I feel this is a cortisol peak. Cortisol has a half time of 1 hour or two. The time it takes me to settle down, cool down and get back into a slumber.

The problem is I needed this cortisol to get me out of bed in the morning, for the Awakening Response. For years my adrenals have gone the extra mile and given me a nightly cortisol peak and a secondary in the morning. Until they gave out. First partially in 2008. Now totally in 2013.
This is what makes this sleeping pattern so dangerously. Apart from the not proper healing in your sleep bit.

CLUES ABOUT THIS PARTICULAR SLEEPING PATTERN

  • My mother has this pattern too, albeit more mild. She wakes up with a soar throat. An ionisator has helped her. This machine makes dust particles in the air settle down.
  • My brother has it, as severe as I have. His adrenals seem to cope, he is nearly 40 and healthy. As long as he doesn’t hold a job that requires getting up before 8 ‘o clock.
  • I’ve found a few others on RisingPhoenix.me who have the same pattern. These people have fatigue. They knock themselves out with anti-histamines and they sleep (somewhat).
  • a few years ago I started to sleep through the night once and again. Co-factors are: destressing, clean bed sheets, valerian, anti-dustmite, earplugs, no cat shananigans in the night, no drinking after 7 o clock in the evening, enough progesterone, no insuline or cortisol peak during the day, no gluten, no cheese, woolen bed and blankets, keeping throat warm, feeling safe. But these give no guarantees whatsoever, it’s a tombola every night.
  • things that didn’t work were: eating before bed, camomille tea, dark room, whale sounds, different bed times, segmented sleep, no tv/screen, use room for only sleep, melatonine, age, location

THEORY: SOMETHING UPSETS THE SYSTEM AFTER FIVE HOURS OF SLEEP. ENOUGH TO MAKE IT PRODUCE CORTISOL, THE ANTI-STRESSHORMONE.

What causes the system to freak out? Can I prevent it?

ALLERGY
Since anti-histamines and dustmites came up I’m wrapping my brain around this first. Here now follows the research I already did. It’s my thought process, it may not be very interesting for anyone else… In cursive are quotes from Wikipedia. In bold thoughts I want to park and get back to at a later time.

ANTIHISTAMINE
A histamine antagonist (commonly called an antihistamine) is a pharmaceutical drug that inhibits the action of histamine by either blocking its attachment to histamine receptors, or inhibiting the enzymatic activity of histidine decarboxylase; catalyzing the transformation of histidine into histamine (atypical antihistaminics). It is commonly used for the relief of allergies caused by intolerance of proteins.

Antihistamine mainly blocks the mucus reaction that cells give, which reaction leads to the annoying allergy symptoms of sneezing and loosing water from all sides of the head.
This is a symptom-approach. I’m more interested in the cause of the allergic reaction and dampening that response.

What now if you don’t produce mucus and sneezing but do reach the stage right before that, where you do get the freaking but not the sneezing? That would make a body make cortisol, I’d think. So: how does the arousal of the allergy initiate?

Key: intolerance of certain proteins. (intolerance to other things too? Dustparticles? )

There are four kinds of Histamine-receptors, see Wiki. They have various functions some of which are interesting to someone looking for sleep.
H1 for example also modulates circadian rythm (!)
And H2 is a system-activator, just like cortisol.

Btw H1 couples via its G mechanism to Vassopressin, het gotta-pee-repressing hormone.

HOW DO RECEPTORS WORK ANYWAY?
A receptor sits in the cel membrane. With its head outside and its feet dangling on the inside of the cel. A primary messenger bonks into the head, this usually is a hormone. This makes the lights go on in a parking garage called G protein that’s located at the feet of the receptor molecule, on the inside of the cell. One of the cars gets a tank full GTP, the alfa no less! This car leaves the parking garage and drives along the inside of the membrane until it bonks into the soft belly of a protein, the primary effector.
It’s this protein that starts to produce molecules that will influence the cells functioning: the secondary messengers.

This system is called the Second Messenger System and it shows exactly where the various G proteins are that various anti-histamine medicines target.

Secondary messengers can influence the cell insides directly or first activate a secondary effector in the cell membrane.
The alfa-car, a little enzyme in itself, has used up its petrol. All GTP is decreased into GDP. It drifts back to a parking garage at the feet of a receptor cell.

Sometimes this system doesn’t work. The head, the feet, the Parking garage, the car, all and any can malfunction.

pic by Erik Hutters

MALFUNCTION OF THE RECEPTOR/G-protein CELL
“Malfunction of GPCR [G Protein-Coupled Receptor] signaling pathways are involved in many diseases, such as diabetes, blindness, allergies, depression, cardiovascular defects, and certain forms of cancer. It is estimated that about 30% of the modern drugs’ cellular targets are GPCRs.”

The human genome encodes roughly 800 G protein-coupled receptors, which detect photons (light), hormones, growth factors, drugs, and other endogenous ligands. Approximately 150 of the GPCRs found in the human genome have unknown functions.

There are about 800 kind of receptors. They use all kinds of things to bonk themselves with in the head (neurotransmitters, hormones, food additives, cocaine, GABA, Calcium ions). Things going wrong leads to all kinds of system wide illnesses such as diabetes, allergies, depression, cancer.

HORMONES ARE NEUROTRANSMITTERS
The hormone ACTH is the neurotransmitter that floods the whole body and is picked up specifically by the receptors in the adrenal cells. Through the Second Messenger System mentioned above, it activates these cells to produce cortisol. http://en.wikipedia.org/wiki/CAMP-dependent_pathway
Another hormone, Glucagon, is picked up by receptors in the liver and activates glycogen breakdown
Another hormone, ADH vassopressin, makes blood vessels contract, ignoring your pee pressure. (Supposed to be high during the night. If you wake up to pee it isn’t)(perhaps it’s high all day in me?)

So Hormone Replace Therapy (HRT) is basically neurotransmitter therapy. Bonking around the heads of 800 kind of receptors in your body. Better be careful what kind of neurotransmitters you put in there.

This includes vitD3 which is a hormone and not a vitamin. All hormones are made from cholesterol so does supplementing leave you with high cholesterol?

LAYING AWAKE BECAUSE OF CORTISOL
ACTH is produced, adrenal cells make cortisol, I wake up. Because the system downstream gives the right results I can assume the adrenal cels work properly (the receptor receives ACTH, the alfa car drives, the cortisol is made). Looking in that place for a cause of my cortisol peak seems not logical right now.
The production of cortisol by a cell could be inhibited my crippling the G protein with a particular anti histamine however. Effective. But not solving the cause.

LOOKING AT ACTH PRODUCTION.
It’s the anterior pituitary gland in my head that produces the hormone ACTH. I can therefor conclude I have not primaire Addison’s. The gland functions.
The pituitary gland does so in response to the hormone corticotropin-releasing hormone (CRH) released by the hypothalamus, another piece of brain.
Gaat pituitary gland op eigen houtje aan de acth produktie of is het i o v de hypothalamus?

There’s a lot involved in regulating the levels of ACTH. There are feedback loops coming from the adrenals themselves, for instance. These feedback come in fast loops and in slow loops.

In order to regulate the secretion of ACTH, many substances secreted within this axis exhibit slow/intermediate and fast feedback-loop activity. Glucocorticoids secreted from the adrenal cortex work to inhibit CRH secretion by the hypothalamus, which in turn decreases anterior pituitary secretion of ACTH. Glucocorticoids may also inhibit the rates of POMC gene transcription and peptide synthesis. The latter is an example of a slow feedback loop, which works on the order of hours to days, whereas the former works on the order of minutes.
(The half-life of ACTH in human blood is about ten minutes.)

“Hours to days”!?
Might these slow loop feedbacks be connected in any way to the circadian rythme or sleep cycles? Can there be something awry in the slow loop feed back making me release cortisol in the middle of the night?

There are ACTH receptors outside of the adrenal glands. They are in the bone producing cells.
Also: ACTH is a cleavage product of the pro-hormone, proopiomelanocortin, which also produces other hormones including melatonin.

Can inappropiately timed ACTH rob the body of the pro-hormone needed to make the sleep hormone melatonin?

Of course, a real elevated production of ACTH is the illness Cushing. I don’t have that. But the knowledge about Cushing disease might shed a light on these nightly cortisol peaks.
Also, the ACTH producing enzyme in the pituitary may be of the same sort as my busted MRT: a brake that slips. The gene to check for mutations might be POMC.

pic by andre leme

HYPOTHALAMUS AND ITS CRH
Pituitary gland takes its cue from the Hypothalamus. The hypothalamus is the grand concert director in your head. It oversees all kinds of information coming in, both from the inside and the outside of the body. It sends out all kinds of signals to make various body parts do things.

Because of the hypothalamus people can influence and calm their adrenals by practizing mental zen and active destressing and behavourial therapy and (re)training the Central Nervous System.
But the hypothalamus also reacts to:
– Neurally transmitted information arising in particular from the heart, the stomach, and the reproductive tract
– Autonomic inputs
– Blood-borne stimuli, including leptin, ghrelin, angiotensin, insulin, pituitary hormones, cytokines, plasma concentrations of glucose and osmolarity etc.

Is it one of these that triggers my system after 5 hours of sleep?

Well, this concludes the thinking I’ve done when lying awake last night and two hours of reading this morning. I will look into the bold sections.

The main question still is: WHAT CAUSES THE SYSTEM TO FREAK OUT AFTER FIVE HOURS OF SLEEP?
Other questions to ask about this are:
What happens to the body in those 5 hours? Do the glucose reserves in the liver get depleted? Have all the toxins build up during sleep healing and not find a way out (due to genetic mutations)? Has our food digested by that time and is energy not properly stored away, causing blood sugar to spike? Has all the progesterone gone, crippling basis processes?

 pic by John Evans