Everyone experiences occasional sleeping problems, so how can you tell whether your difficulty is just a minor, passing annoyance or a sign of a more serious sleep disorder or underlying medical condition?
As humans transition from the waking state to drowsiness and into sleep, parasympathetic vagal tone (responsible for downshifting) increases, and sympathetic tone (the go, go, go!) decreases. Many of us experience trouble sleeping at one time or another. Usually, it’s due to stress, travel, illness, or other temporary interruptions to your normal routine. But if sleep problems are a regular occurrence and interfere with your daily life, you may be suffering from a sleep disorder. Here are Dr. J and Evan taking us to another perspective of ways to help better our sleeping patterns.
Since electronics and the bulbs that we have to use artificial lights, some suggestions are the use of blue lights and dimmer lights. It helps lessen or prevent too much cortisol (steroid hormones formed in the adrenal glands) and assist our melatonin is kicking in and put as to sleep. Intake of magnesium, holy basil, and ashwagandha are also useful for bringing the body to a lower gear as well as regular exercise to keep our body in good shape. Watch the full podcast to know more ways to manage your sleep!
Dr. Justin Marchegiani
In this episode, we cover:
2:31 Blue lights, Dimmer lights
09:15 Sleep Mechanism
18:04 Gut Inflammation
25:05 Sleeping Drugs
27:49 Supplements
Dr. Justin Marchegiani: And we are live. It's Dr. J here in the house with Evan Brand, Evan, how are we doing today man?
Evan Brand: I'm doing well. I've got an article here. We're gonna start the show off. This is all about sleep today, issues that affect sleep. How do we mitigate the effect of stress on sleep and gut and all of it. But first, Pepsi, good old Pepsi Co. They're launching its newest beverage, the de stressing and relaxation promoting drift. Well, this is just all about, what's my point of this, that becoming healthier is becoming mainstream. So anyway, they've created a sugar free non carbonated water flavored with a hint of blackberry and lavender with 200 milligrams of L theanine, which you and I've talked about for years and years and years and years and years, DNA being an amino acid that helps to increase GABA comes from green tea. But you can also take it in supplement form. Here's the thing I don't like about this thing, though. Number one, it's seven and a half ounces, I don't really want to drink seven and a half ounces right before I go to sleep, if I'm going to take theming, I would much rather just take a capsule of 200 to 400 milligrams at the end and go to sleep. And then the second thing is there's they're wanting to sell this thing for $18 for a 10 pack that's $1 at a dose basically, versus you and I if we're gonna get a professional grade theanine, we're probably getting what maybe 100 or 200 capsules for 20 bucks.
Dr. Justin Marchegiani: Yeah, it's definitely a little bit more on the expensive side, kind of per dose, but you're definitely paying confer convenience. So like I'm all about if a company can create a product like this without the artificial sweeteners, dyes and colors, and it's using a clean water, you know, reverse osmosis kind of water source, and it has some of these nutrients in there. And it makes it convenient, because it really comes down to can people do it right? If you don't do it, if you don't apply it, you don't get the benefit. So that's a really good first step in the right direction. I mean, I'll still take the supplements, you know, from a raw material standpoint, like you mentioned, but if we can get some non healthy minded people to jump on board that train, that's great.
Evan Brand: Oh, yeah, I mean, imagine if we could get people to switch over from, I don't know, doing a nightly beer. You know, let's say they do beer at night. But instead, they could just do this, you know, themed drink, that'd be a hell of a lot better for their gut and their brain. And you know, theanine has benefits for the brain to it's not just the sleep, they're kind of promoting it as a relaxation drink. But I take theanine daily, and it definitely helps to buffer stress. It's just something that it's not like a sedative. I mean, it's not a chill pill. It's not like a passionflower would do for your sleep. But it, it definitely just kind of settles the mind a little bit.
Dr. Justin Marchegiani: Yeah, I agree. I mean, my nightly routine is typically some magnesium and some vitamin C. And then if I if I'm going to do any alcohol or any like cheating, kind of things, food wise, I'm going to be doing some load of iron ore and acetylcysteine and maybe some charcoal as well. And then if you have any issues ping before bed, just try to drink that an hour or two before bed. And that kind of sets in. And then you know, one of the nice thing people are doing today, a lot of the glasses have a blue light filter. So I have I upgraded my glasses that I typically use when I watch TV to a blue light filter. So nice blue light, really nice. And then, of course, one easy investment we all can make is just get dimmer switches on all your main lights that you're going to have on at nighttime. Just kind of get those dimmers down 80% or so that's going to help a ton. If you were reading glass or a glass for reading or TV, get a blue light filter in there, or just get like one of those nice blue light glasses that you can put over on anyway without a prescription on there. And that's very helpful to kind of get your body in that parasympathetic state that we talked about so much.
Evan Brand: Yeah, I use Iris you can check it out, get Iris if you just search that you'll find it. Iris tech is a company who their competitor to flux it's better because it does have some supposedly has some anti flicker built in so it can help reduce the flicker rate of your screen. So smartphones, Windows computers, Macs, you can use Iris, I'll leave it running 24 seven I have it on right now. So what I'm looking at Justin on the screen here, he's a nice tan golden color to me, which looks good and it definitely reduces eye strain my eyes at the end of the day. You know, we're looking at labs all day. So you know what we do is hard on the eyes and my eyes would just be exhausted. But once I run it at a more warm color, I definitely have less fatigue at the end of the day mentally.
Dr. Justin Marchegiani: Yeah, I'll put the link to some of the things that I do. I use the viewsonic monitors that have a low flicker and low blue light naturally in there. And you can still run an iris in the background as well but I highly recommend I noticed my prescription. The last year two is actually gotten better. It's actually improved my stigmatism which is the shape of the eyes also shifted as well. And I talked about it with my optometrist and he said you know it's possible that just you doing the blue light at night and you shifting over the monitors last year or two could have helped with that so I mean outside of nutrition being stable lutein all of the vitamin A precursors, I think shifting over the monitors if you're someone that's on a computer all day, invest in really good blue light protecting technology and or good blue light monitor. Yeah, well blue light, low flicker very important.
Evan Brand: That's good advice. Yeah. So nighttime we talked about that a little bit. You mentioned dimmer switches, blue light glasses, I'm using just salt lamps at night we have probably six or seven salt lamps. We have some that are just salt lamp night lights that are plugged into the bathrooms. That's pretty convenient. Brush your teeth with just a salt lamp, it's just a nice, pretty warm glow. I haven't actually used a color, you know, like a color device to check if there's blue light coming off of it, but it's a pretty darn warm color. And it's a little like couple watt incandescent bulb incandescence are going to have less blue in them naturally. So we like to use a lot of the Edison bulbs, a lot of the Edison bulbs now I've turned into LEDs though, they'll look like Edison shape with the filament inside, but it's led, which is so annoying. So make sure you're actually getting the true Edison bulb, I use a company called Hudson, Hudson lighting, they make great Edison bulbs, and they're going to be around 2700 Kelvin, which is a really nice amber color. When you get up to the 456 thousand Kelvin. Those are like your fancy car, ah ID headlights that are going to be really really blue kind of whitish, bluish color. That's not what you want at nighttime. It's amazing. You know, I'm rarely out at night. But if we're out on the road, we'll drive past someone's home. And we'll just see, like science lab lights on at nine o'clock at night. It's like, No, those people aren't sleeping good tonight. Some people will argue with me like even my grandparents, I tried to get them off of the TV in the evening or to wear blue blockers. And they'll say, Oh, I sleep fine. And it's like, Yeah, but what's the quality of sleep? You're saying you're waking up three to four times a night to go pee. You're not well rested in the morning when you wake up. So yeah, you may say, quote, you sleep fine. But what's the quality? What's your energy level? Like? What's, you know, are you crashing out by 11am? Because that would tell me your sleep is not so good after all.
Dr. Justin Marchegiani: 100%. Yeah, I 100% agree. So I think it's a good investment where if you wear glasses or contacts, look at getting a night per night glasses to have the blue light filter in there. And some brands don't have a good blue light filter. So you know, you can get a blue light where it tests the actual wavelength going through. I've seen some of these glasses really only filter out the violet, which is interesting. So they're kind of having a marketing ploy on it. So you'd want to go look at some of the reviews online, make sure you find a review where someone actually test those glasses, and sees if the blue light is blocked. But if you can get a significant amount of blue light blocked, you know, even if it's 50% or so. And you get the dimmers on Well, that's a good first step for sure.
Evan Brand: Yeah. And people listening may say, you know, any kind of skeptics listening, which most of those weed themselves out, so most people that listen to us love listening to us. But any skeptics may say, Well, why our ancestors, they didn't have blue light blocking glasses. Yeah, but they didn't have LED lights, they didn't have electricity. In general, there was no artificial light at night. So when the sun goes down, and up, and the moon Yeah, when the sun goes down, and the sky is turning red and orange, the sun, the blue light can't get through, when the sun's at a low angle, the blue light doesn't come through as much. And you naturally have a blue light filter, it's the atmosphere. And so at nighttime, when you have a fire, which is the only source of light you would have had at night, look at a fire. I mean, you may have a tiny bit of blue if you've got a really, really hot fire, but it's nothing. It's it's not going to impair melatonin production at all. And that's the issue here is the artificial light at night is elevating cortisol, which is down regulating melatonin. And of course Melatonin is not just your sleep hormone. It's very important as an antioxidant too, Melatonin is something that's been shown in several studies to have some cancer protective benefits.
Dr. Justin Marchegiani: 100% and I'll put up I'll put a couple of links in here for people that are listening. Regarding my favorite monitors, I use the eye care monitors, and I think those have really been super helpful for me. So I'll put a link down below people can access that. Okay, that's good. We talked about some of the blue light glasses, there's the the Swanwick glasses, there's the true dark glasses. Those are some good ones off the bat, you can jump on Amazon and look for some ones that have good reviews on there. I think those are great. There's some blue light glasses that that go over glasses. So if you wear glasses, you can look for a pair of blue lights that go over that that's on top of that. But if you want extra protection, you'll have that there. That's a good kind of first step in the right direction. Why don't we talk about mechanism? I think this is important. So we talked about like the parasympathetic and sympathetic nervous system. This is important. So the sympathetic nervous system is kind of controlled by the adrenal gland. So the sympathetic is the gas. It's the Go, go, go go go Stress, Stress, Stress, Stress, Stress, and the adrenals kind of are the gateway between the nervous system and the sympathetic response because of the cortisol response and the adrenaline response. So typically, when there's some kind of a stress, adrenaline is the first thing that comes to the table. And then cortisol comes a little bit later. So think of think of adrenaline as the primary it Prime's the pump and then once the engine is going, now cortisol is flooding the zone afterwards. And so when you have a lot of these stress hormones going, you're number one going to be shunting blood flow to the arms and the legs to fight and flee, you're going to be making less enzymes and acids and digestive juices so your digestion won't be as good. So if you're eating healthy, you're more likely to get bloated and gassy and have indigestion. And you're less likely to absorb a lot of those nutrients. So if you're eating lots of good amino acids and minerals, you won't be able to ionize them and absorb them properly. And so we want to do natural strategies that decrease that sympathetic nervous system response which is going to help modulate adrenaline and modulate cortisol. And part of how we do that is we have to stimulate the parasympathetic side. So for instance, this new Pepsi product you mentioned, we don't I'm not supporting Pepsi, but I'm supporting the mechanism. l theanine is a good precursor that Evan mentioned to Gabba, gamma amino butyric acid, and that's a inhibitory neurotransmitter, think of it as the brake, it's the stop the slow down. So think of the sympathetic nervous system response is it's the shifting gear going from first, a second, third to fourth, fourth to fifth, it's going faster, faster, faster, the parasympathetics. And the inhibitory response is down shifting, it's going from 5 to 442-332-2221. And then park in that car. And so things like GABA can be helpful. passionflower, magnesium are excellent things. There's different adaptogens that we use, like holy basil and ashwagandha that really helped decrease and help down shift that stressed out engine and bring it to a lower gear where you can slow down and relax.
Evan Brand: Oh, speaking of ashwagandha This is funny to man, a lot of the things we've been talking about for a very long time are becoming more mainstream. I never have the radio on because I've got streaming radio in the car, so we never have the real radio on. And so the this advertisement comes on, and it's you know, the typical radio announcer voice, it's this lady. And it's this. It's just talking about sleep and stress and all that and the lady's like introducing ashwagandha gummies, an Ayurvedic herb that's been used for thousands of years, it can really help you relax, and I thought, wow, a radio commercial for ashwagandha. This is hilarious times are changing. So it's funny. This is something that you and I use all the time clinically And personally, and it really does help you can take ashwagandha during the day to help blunt stress but you can also use it in the evening, take a dose before bed, Stephen buehner, the herbalist I really love because of his books online, he talks about ashwagandha being very, very helpful in terms of calming down like brain inflammation, which can impair sleep associated with Lyme, so people that have that sleep, or if you're waking up at two or 3am and you're kind of bolting awake or having nightmares. You know, ashwagandha may be something to help. I'm a big fan of Magnolia Magnolia is a bark that can be very helpful. You and I've talked about relora. In the past relora is actually a blend of two different plants. I believe it's two barks that are combined to create the patented relora. That's something clinically shown to help modulate cortisol at night. You mentioned the passion flower, I like to mix passion flower with motherwort, especially if it's a monkey brain situation. motherwort can really help calm the the racing thoughts, the racing mind motherwort, something that Rosemary gladstar and many other famous herbalist, they recommend keeping it in your first aid kit or in the car. So if you get in a car wreck, or if you have a traumatic experience, you could take a dose and mother would never really settle you down, you know, with all the shutdowns and a lot of our clients that are running small businesses and other things that I've had massive amount of reports of stress issues happening over the last six months. And so I really think the time that you and I are putting this out is important. It's always important, but it's more important now. Because once your sleep quality goes out the window, what happens then well, you have a shorter fuse, you are going to be more irritable, you could be more anxious, you could be more depressed, you may have cognitive issues. So you may not be making good decisions as a parent or as a boss or as a CEO. So I mean, this affects every aspect of your life, you really cannot ignore this and just go pound the coffee. First thing in the morning, you can do the coffee, but you've got to be making sure you're doing all the nighttime strategies as well.
Dr. Justin Marchegiani: 100% I love it really, really good points off the bat. Also a couple other strategies I want to highlight is exercising too close to bed. So exercise, it's a stress it does activate the sympathetic nervous system because that's how you get blood flow to the arms and legs into the extremities. And then of course cortisol and immobilize glucose in the muscles and such. And so that is part of the stress response. So you got to make sure the more your parasympathetics are stressed right your rest digest part of the nervous system. The less strenuous the less sympathetic stimulating exercise you should be doing. And of course, you need to allow more buffer time to transition back into the parasympathetics at bedtime. So if you're working out like at six or seven o'clock and then you're trying to wind down At nine or 10, asleep by 11, that may not be enough time. So the more stressed you are you want to look at doing exercise first thing in the morning, and you always want to answer my three questions appropriately. Alright, you want to answer positively to these three things? Number one is do I feel better after the workout than when I started? Number two is, can I emotionally repeat the workout? Do you feel so depleted afterwards? Where you just you couldn't emotionally do it, like, you may like have that high where you're like, Oh, I feel good. And then like, you catch your breath, like 10 minutes, and you're like, Oh, thank God, that's done. You want to feel that sense of like, no, I could do that. Again, like I could do it again, you want to feel that kind of a sense of accomplishment. And then number three is you want to feel not excessively sore or beaten up afterwards. So that next morning, you wake up, you know, barring the fact that you slept good and all that's okay, you didn't drink alcohol, you want to feel not excessively sore with the exception. If you throw in maybe a new exercise you haven't done in a while maybe some lunges or a deadlift, outside of something that's a full body movement, you shouldn't feel overly beaten up.
Evan Brand: Yep, good points, good points. And it's possible, you could use some of those herbs to try to calm down that response. Right? If your work schedule just doesn't allow it and you have to do a six 7pm workout. Like you said, maybe it's not too intense. So you still could settle down, but maybe you, you do take a dose of some type of an adrenal cocktail, after the after the workout, I think that could be really smart. And then let's go into a couple other mechanisms.
Dr. Justin Marchegiani: Just to highlight one thing before we move on topic. So if that's the case, that's the only window there's three major levers with exercise frequency, intensity, duration. So frequency is how often you work out. Is it every day, you taking a day off in between Monday, Wednesday, Friday, Saturday kind of thing. And then of course, that's frequency intensity is how hard Are you working out as well as the rest in between? So like, a compound lift like a a deadlift or a front squat, right? Isn't it be a lot harder than like a bicep curl or military press right, the more you activate, the more joints you activate, the harder it is. So you could shift away from multi joint stuff. Or you do multi joint stuff with less weight, okay, and provide more rest time between sets. And then duration, of course, is going to be how long the workout is right? Instead of a 45 minute workout, you go to a 30 or a 20. So you just keep on frequency, adjust the frequency, how many days intensity kind of workout lifts, you're doing the weight as well as the rest time. And then the duration is the overall length of the workout cutting that down so you can move the lever on those. And I always recommend the easiest first thing is allowing a day off in between to recover. And then keeping the workout shorter, right, Charles poliquin did research on this finding that the cortisol response starts to significantly elevate once you go longer than 45 minutes. So keeping the workout under 45 minutes. And if you're really stressed probably 20 to 30. And just rely on more circuit type of workouts to get the exercise done. So do three movements in a row, upper lower upper or front back front, however you want to pair it. That way you can get a lot more volume and and exercise accomplished in a shorter amount of time.
Evan Brand: Yep, that's good advice. I wanted to talk about the gut. And we could probably mention blood sugar, too. I know that when I had gut infections, my sleep was terrible. Now the mechanism of it. I mean, that's debatable, you and I could try to tease this apart together. I think ultimately the answer is getting rid of gut infections is going to improve sleep in many ways. But I think one of the mechanisms is probably some of the gut bugs possibly affecting blood sugar because the gut bugs are eating and they're feeding on your nutrition. So I definitely had more hypoglycemia issues. And hypoglycemia, if that blood sugar's crashing, blood sugar gets too low, you and I've talked about this, the adrenals have to pinch hit, basically, and try to help out to get that glucose regulated. So if blood sugar is crashing, maybe you're not eating enough with meals, maybe you didn't have enough fat or protein with dinner, or maybe you ate too early. If you ate at five and you're going to bed at 10 that's already five hours and the blood sugar may be dropping to a level that's too low. And then if you compound that with having gut infections, then you really could get into trouble.
Dr. Justin Marchegiani: 100% and like you mentioned earlier, the stress and the inflammation from a gut infection. We see it when we do adrenal cortisol rhythm testing, is we'll start to see a premature elevation of cortisol in the morning. Now what does that mean for you? Well, we have this natural cortisol rather than people watching on video, I'm going to do some demonstrations. But cortisol comes up in the morning, and then it comes up in the morning but it really increases that first hour of waking isn't a double from when you woke up to one hour later. So it starts to here's waking, here's one hour later and then it gently curves, here's bedtime and then as you sleep it's kind of flat and then gently starts to go up like this. So when you have gut infections and inflammation in the gut, and a lot of most infections are on an opposite sleep and wake cycle then we are so the more active they are means more inflammation. More inflammation means Is what more of a cortisol response so that cortisol prematurely starts to rise in the middle of the night. And then that can start to take you out of deeper sleep and cause you to wake up earlier. So, by addressing gut infections, you're naturally supporting that healthy circadian rhythm. And of course, if we can support natural and influence, natural anti inflammatory support, that also takes stress off the adrenals because the adrenals are one of your number one, anti inflammatory mechanisms, right? cortisol, aka cortisone, and then pharmaceutical, prednisone, are all anti inflammatory mediums that conventional medicine uses for topical skin or asthma inhaled are injections in the joints, right for inflammation. So we have our natural anti inflammatories that we want to work on supporting and utilizing.
Evan Brand: Yep, and we've mentioned this, but just to repeat, so the cortisol is downregulating melatonin, that's the mechanism. So people that just go take melatonin, that may help but I would argue that it's not necessarily root cause. And so that's why we're going to be running these panels to look at the hormones, we're going to be running testing to look at the stool, we're going to be running panels to look at the urine and try to confirm what's going on. Just to be clear for people listening or that are not aware, we're clinicians, we deal with this stuff every day all day clinically. And so we have thousands and thousands of, you know, case studies that we can report back from and tell you what's worked and what hasn't worked. If you go to your conventional doctor in you talk about sleep issues, just to quickly compare and contrast. It's going to be something like possibly a Lorazepam if it's an anxiety based sleep issue,
Dr. Justin Marchegiani: -like a benzodiazepine that works on gaba.
Evan Brand: Yeah, exactly. So you're going to get a benzo which are highly, highly addictive and habit forming, or possibly, you're going to get something like an Ambien, which in terms of pharmaceuticals, I will tell you some of the hardest drugs for people to get off of are the benzos and the Ambien, which I don't even know what category Ambien is in, but man, people really, really struggle to get off of that one.
Dr. Justin Marchegiani: 100% so you're going to have Ambien, right, you're going to have Lunesta, you're going to have your benzos They may even be using some SSRIs to increase serotonin, which then increases melatonin. There's, I think it's rozerem rwhich is a gaba kind of in that gaba benzo family. So rozerem. You mentioned I mentioned Lunesta, and Ambien, what else is there, I think there's trazadone is another one that I think is used sometimes for sleep as well. So those are a lot of the common sleep medications. And they don't really address a root cause. And that's the problem. And a lot of the sleep medications, like we mentioned, the Ambien or Lunesta, they don't allow deeper restoration of sleep. So you kind of have like your four phases of sleep, right phase one, phase two, phase three, phase four. And then you go from phase four to three, two ones. This is like once, one cycle is 1234, phase 24321. And you don't really get to go into these deeper three and four levels, where REM sleep and deep restoration happen. So we want to avoid medications that prevent us from getting into deep sleep. So that being said, we want to make sure we sleep. So we want to utilize every natural mechanism possible. So with sleep 10pm to 2am is that deep physical restoration, where you have good physiological repair, and that's where growth hormone increases. That's where we repair structural tissue, and such and bones and joints and ligaments, Hair, Skin nails. And then we have the psychological emotional repair, typically between two and 6am, where a lot of our neurotransmitters and hormones kind of turnover that help us with mood and energy and emotional stuff. And supposedly, a lot of our dreams are us processing a lot of our emotional stress throughout the day, right? So we want to make sure we get to sleep on time, that's really important, right, the hours before midnight are really important. And we want to make sure that we're getting the good time of sleep, we want to make sure that we're decreasing light exposure, which it takes away from our melatonin. And then we want to make sure that we are just having good nutrients on board. So when we're sleeping, we have the raw materials, amino acids and fatty acids to provide the building blocks to assist in the repair process. Yeah, vegetarians, vegans, they have a lot of sleep issues historically. And I would argue it's due to the lack of these amino acids that you need to really help fuel some of these neurotransmitters. So back to the I want to just hit that because you hit something really important. And then when vegetarians and vegans get a lot of the amino acids, they're not really bioavailable. So if you go look at the bioavailability of amino acids in vegetarian vegan foods, they're not very bioavailable. Now, vegans and vegetarians can get by with free form amino acid supplementation, a high quality pea protein, maybe a rice protein, so they can get by with amino acid supplements, but it's very hard from a raw standpoint, meaning you're just relying on Whole Foods to get those amino acids and when you typically do combine them appropriately. You get a ton of carbohydrates. So if you're more insulin sent or resistant or more Carbohydrates sensitive if you don't do well with carbs that could cause more blood sugar issues and more sleep issues with that.
Evan Brand: Yep, yep. So back to the drug. The drug name is zolpidem sold under the brand name Ambien anyway, we talked about alcohol A while ago, we talked about like, some of the date rape drugs and some of the bad stuff that people do. Apparently this GOP. Yeah, apparently this drug actually was used or has been used as a date rape drug as well. And so it is a non benzodiazepine. But guess what, it's a GABA receptor agonist. So it works by increasing GABA binds to the same location as benzos. So tricky little varmints. It's a non bidco but it binds to the same GABA receptor as a benzo. So to me, it's a frickin benzo, you know, not not technically but in terms of the addiction potential and the withdrawal and the adverse effects and the dependency it's it's no good.
Dr. Justin Marchegiani: So yeah, same thing with Lunesta here, I'm looking at some of the the mechanism of action on the nessa same kind of thing. It has a coupling interaction with the GABA receptor sites. So kind of it's coupled with like a benzo. So it's kind of very similar to a benzo and then the rozerem. It works on some of the m two receptor sites, I think some of the same receptor sites that work on melatonin, so I'm pretty sure it's like a melatonin kind of agonist, if you will. And yeah, right here. rosarium is a highly selective melatonin receptor site type one type two agonist. So what does that mean? agonist means it helps the melatonin in those synapses to be it increases it stimulates it with a little bit and kind of gets a little bit more into gear, if you will. Now, my whole I'd much rather be using melatonin as a whole as I rather just provide more of that building block or more of that raw material to help right and gets more natural than just being an agonist and upregulating the receptor sites to it. And of course, even before that, I'd much rather use a lot more of the amino acids like five HTP, and B six, and providing more of the building blocks. So we don't disrupt too many feedback loops, or the herbs just to help regulate the adrenals. And then you stay away from this crap completely. But why is how bad it is. So we kind of always start low and then work our way up. So there's always kind of like a, an algorithm and how we are applying things and even natural we want to do the least invasive to the most invasive if we need it. But of course sleeps is such a huge tenant in our body's ability to heal.
Evan Brand: Yeah. And why is this not on the nightly news? Well, I mean, Big Pharma is highly involved in the media companies, right? So they're, they're not interested in melatonin, which is what maybe a quarter or maybe 50 cents per dose, they want pharmaceuticals, because there's a lot more money involved. And you can't patent it, you and I've discussed this patent issue many, many times. So they can't patent anything.
Dr. Justin Marchegiani: When you just look at the mechanisms, right, like, look what they're doing, like with rozerem, it's just it's an agonist on the receptor site. So what they do is they kind of skate the surf, they kind of tiptoe around it and try to figure out, Okay, this is this mechanism is important, how can we monkey around with the receptor site and adjust that and make it better or over, you know, stimulate the receptor site to be more sensitive. So they're kind of looking at what the the actual mechanism is, and then they try to just skirt the the periphery on it to make it work better, right, which a lot of times have side effects, because that's what typical drugs, do they have side effects? That's right. That's right. So I mentioned the I got into the nutrition piece a little bit talked about kind of the the fat and then just one thing, sorry. And they have to do that. So people thinking, well, I don't understand like, what's the point of that? Well, you can't patent a natural compounds. So when you have things like melatonin or natural amino acid compounds, you can't patent it. So they know these mechanisms are already helpful. So you hire a whole bunch of chemists to go in there and biochem people to go in there and figure out okay, this is the mechanism, what can we do to create a synthetic compound, maybe we just create like an isomer, or something that looks very similar, that buffers or adjusts receptor sites, but is synthetic enough where they can patent it. So that's why they they can't patent natural things. That's why they they look at already known mechanisms, and they try to adjust it and author it just a little bit. So they can patent it. And it never works as good as the natural stuff. And never will because of the fact that you can't. You can't improve upon Mother Nature. You just can't.
Evan Brand: Yep, I know. I love the herbs. I love them. So I hit on the whole, like, not enough fat and protein piece. And I see that a lot. Like I mentioned the vegetarian vegans. I mean, typically these people are depressed, they're anxious and their sleep is crap. Now, the one happy vegan listening, good for you, but talk to me in five years, and I'll be curious to see what happens. But back to the blood sugar piece. So there are some things that you may need to do to help with the blood sugar. That could just be something as simple as eating like a little fat bomb before you go to bed. I mean, it could be like a little piece of some coconut oil or some coconut butter or maybe grass fed butter or maybe I don't know a couple macadamias are pecans are something that can help just kind of throw a little bit of fat on the fire before you go to bed. Now it can do a huge, huge thing.
Dr. Justin Marchegiani: Correct. Some also do better do really good with a little bit of fat and maybe a tiny bit of carbohydrate, whether it's a handful of berries, or a little bit of like, honey. And sometimes that can be helpful because the little bit of glucose can help those with the amino acids cross the blood brain barrier. So if you go so low carb at night, sometimes those amino acids can't cross. And so I kind of go both ways. Try with less sugar. And if you need a little bit of sugar with a little bit of fat and protein, and you can always add a little bit of sugar just to help the amino acids cross that blood brain barrier.
Evan Brand: That's smart. You know, I've tried that like doing a chamomile tea, which is another easy good strategy. I've tried chamomile just by itself, and then chamomile with honey. And I will report with a little bit of honey, delicious, but it does help a little bit with the sleep.
Dr. Justin Marchegiani: Yeah, and just kind of just try it on both sides. Because too much sugar can also create blood sugar swings and cortisol spikes when your blood sugar drops. And that can cause problems. So it's all about finding that right balance. So I always recommend start with none. And then add just a little bit in incrementally.
Evan Brand: Yeah, and we through a lot of people. So where do you start with all this? Well, I think the blue light, the lifestyle stuff, not exercising too close or too intensely before bed. I think all those things are great, getting your bowels regulated, making sure that you're testing yourself for gut infections and getting those things addressed. And then reaching out to a practitioner like Dr. Justin or myself, because we deal with this stuff. Personally, we deal with this stuff clinically. We've done it countless times. And it's incredibly rewarding what we do, because we're showing you on paper, where is this issue coming from? You know, some people blame it on their genetics, like oh, my mother, she never slept good. Or my dad Oh, he had terrible insomnia. He's on antidepressants that are okay, genetics are not your destiny. So I don't care how your parents sleep or not sleep. That is not your destiny. There are root causes that we can identify. And we can address these we can get them on paper, and we can retest and show you look, your basics is back up great because you needed that because you were also low in serotonin, which you needed more of because both of those ingredients, boom, make melatonin, you didn't have that recipe. And now on paper, you're reporting improve sleep, hooray. But look at the labs, we can confirm you fix the mechanism of these neurotransmitter issues and these nutrient deficiencies. And that is just why we do what we do.
Dr. Justin Marchegiani: Exactly. The other thing I would say is going to be female hormones. female hormones play a big role, especially progesterone, because progesterone is a natural gaba chloride channel opener opens those gaba chloride helps flood gaba into the zone, which helps you relax. So female hormone issues, especially for menopausal women can be a big ones, we got to look at estrogen, estradiol and progesterone that's really important. I would also they're also kind of like their modulating supplements that can be helpful that may not plug into the root cause. So when I'm with the patient, I'm working them up. I'm trying to figure out what's the underlying mechanism? Or is it multiple systems meaning is there poor digestion, indigestion, poor gut issues, and then autoimmune stuff with adrenals and thyroid, and maybe some detoxification issues, we try to focus on each of those systems, work on the diet like nutrient dense anti inflammatory, low toxin, get digestion, good, stabilize blood sugar, flood nutrients into the zone. And then we're going to run organic acids and we're going to see neurotransmitters, we're going to see be six amino acid status, we're going to look at serotonin and dopamine, adrenaline, that can help on the amino acid side. We mentioned things like melatonin, that's always a later stage always want to do the amino acids first. But then there are things like California Poppy, or like you mentioned lemon balm, or Valerian or CBD as other like natural compounds that are out there that can be helpful, that may help either kind of attenuate that sympathetic response, and may help just kind of upregulate GABA a little bit. It may just have a very kind of sedative kind of relaxing effect, usually working as a natural kind of benzo right and flooding with gaba. So if you plug one of these natural things in, don't just think that that's it. Always try to trace it back to the mechanism that drove the issue. To begin with. You really always want to think root cause and then expand out. And if you find a supplement that helps try to always trace it back to what the original mechanism was. Does that make sense?
Evan Brand: Yeah, does man you just like opened up a whole new can of words here. So I'm going to take a few minutes on packet. You mentioned thyroid you mentioned autoimmunity. So hashimotos it's really common to have sleep issues, because if that immune system is attacking the thyroid, all of a sudden you've got some of this hormone leaking out into the bloodstream. So some of the things that you and I will do, yes, we can use the herbs. But one could argue that even the herbs are not root cause because if the antibodies are attacking the thyroid, yeah, it's great to go and use mother work to calm the heart down. But the tachycardia that's causing the insomnia is coming from the thyroid and this person is eating gluten. They're doing sandwiches for lunch, so We got to work backwards on getting those thyroid antibodies down. So that- not so. So that's my comment there. But then you opened up a whole nother can of worms, make sure I circle back to mold and Lyme and co infections real quick, but go ahead.
Dr. Justin Marchegiani: So just to highlight one thing, when we're working with patients, we're always thinking that way, we're always thinking, Okay, we're going to try this, try this, we're going to connect it back to the mechanism of action. But I know a lot of people are going to be listening, they'll be like, Oh, I'm going to try this supplement or that and they're writing their list down and what things are going to try, that's cool. But just you know, if you don't have that clinicians mindset, you may ignore the root cause. So if you have an issue where you're trying a couple of things, and you're not quite getting the results, or it's a steady issue that's continuing to happen over the years, make sure you reach out to a good functional medicine doctor, like myself, or Evan, the we can kind of work you through that. But at least try a couple things on your own. But don't ignore that root issue and get a good functional medicine person to help you. If that issue is more chronic.
Evan Brand: Yeah, because it's not a deficiency of passionflower. Right, right. So it's not just like we joke on drugs, it's not a deficiency of those either. Now, let's just briefly open up a whole nother can of worms here Lyme mold, co infections, mast cell issues, these things very, very, very much affected my sleep. And so Lyme really affects sleep. So make sure if you have a history of tick bites, or if your partner has it, because it can be sexually transmitted, that you address it, you either test for it, or you just try to go after it using herbs and see if you have a positive or negative reaction. I can tell you with confidence just using Japanese knotweed, for me improves my sleep quality. What's the mechanism? Well, Japanese knotweed is anti inflammatory because of the resveratrol, but it does help to kill the spire Riki borrelia burgdorferi, which causes Lyme. So so that's that, and then mold. Mold really, really affects the nervous system. And it will down regulate melatonin, Dr. Shoemaker. He's kind of like the main medical doc that's talked about mold for many years, he discusses all the hormones that get affected, your testosterone can go low, you can have issues with Msh. So then you start to burn easily and you can't get a good tan, and you can get your antidiuretic hormone is messed up. So now you're up in the middle of the night to go pee three, four or five times a night and people report Well, I sleep fine. But if I didn't have to pee, I'd sleep better. It's like, well, what's the mechanism of the peeing? Is it a prostate? Is it a mold thing? Is it a toxin thing? metals? Yeah, adrenals heavy metal dosterone.
Dr. Justin Marchegiani: You can't hold on to your fluids. So you're dumping your minerals all the time.
Evan Brand: So if you're supporting adrenals, and aldosterone can come back up, right?
Dr. Justin Marchegiani: It's Yeah, it's very possible. So supporting the minerals will help because you're just not going to have the loss of the minerals. So the minerals are really important for your cells to work well, sodium, potassium, and for your electrolytes and for your heart. So those are really important things to kind of keep in, keep in mind, for sure.
Evan Brand: Babesia bartonella, co infections, any can any kind of CO infection, those can affect it. Chronic pain, of course can affect sleep. So if you've got some type of an issue like mycoplasma that's affecting the joints, or maybe you've got prepatellar, some kind of bacterial infection attacking the joints that causes pain that causes sleep issues, this is why you need help. You can't just go by passionflower and assume all your problems are going to go away.
Dr. Justin Marchegiani: Yep, a couple other questions are coming in here live on the chat as we go. Yes, low thyroid hormone can cause sleep issues I've seen reports of and some patients who have low thyroid will even add one of their thyroid doses a little bit before bed. And that can help as well. So it just depends if you actually have low tea, you want to take it during the day, but then also sometimes at night, it can be helpful, sometimes just supporting it during the day is enough to spill into night and help asleep. And yeah, things like pregnenolone right before bed can be a little bit stimulating. So anyone that has sleep issues will try to do their last dose of pregnenolone like around 3pm da ga less stimulating, but if you're on the fence, you know, always do it really early, just to rule that variable out and see if that's a problem or not.
Evan Brand: Yeah, that's good. Yeah, progesterone, I experimented with a little bit of that before bed. Wow. You can tell it hits the GABA receptors. I mean, well.
Dr. Justin Marchegiani: Progesterone is great, like a lot of my female patients that need it will do that, you know, an hour or two before bed, and it really opens up the gaba. And if we need we can throw in some extra l theanine along with it, or some gaba itself. And that can be very helpful and really promote a lot of relaxation.
Evan Brand: Yep. So the toxic thing is just the toxin piece. You know, I think it's something that we didn't get into much till the end here. But it is something that would be in our standard workup where we'd be looking for these these kind of hidden, more nuanced root causes. And, you know, just to restate, you could go from referral to referral in the conventional medical world, and you're never even going to get close to the conversations or information that we just provided you today.
Dr. Justin Marchegiani: No, I mean, it's hard. The conventional medical model is a three to five minute visit. They're just trying to collect just enough symptoms to figure out what drug they're going to prescribe whether it's a rosarium or a benzo or an SSRI or what whatever other kind of mini me new drugs that are out there many meaning it's very similar to an old drug, just the new name, new Patent so they can re up that seven year patents. And that's kind of how a lot of conventional medicine works. They're not really diving in deep, they're not even really thinking about deep root cause mechanisms. They're just trying to get you to sleep. And it's sad, but it's system that we're in. And I'm glad that we have information like this. It's out there at your fingertips so you guys can be more informed and take some action to get to the root cause.
Evan Brand: Yeah absolutely. If you need any help please reach out to Justin or myself, his website is JustinHealth.com, my website, EvanBrand.com. And we love that you guys are here with us so more to come.
Dr. Justin Marchegiani: And put your comments down below. We really appreciate you guys listening, and I want to get some interaction about what you think works for you. I read the comments. So when I get feedback, like oh, this worked or that work, it really helps me because, you know, when you see thousands of patients like myself and Evan have, that's really how you get good. Like when you start off in this field, you get a really good base of physiology and biochem and nutrition, you apply it with yourself and your family and then patients around you. And then you grow as you get more patients and you get more data points. So it's very helpful. And then if you enjoyed today's podcast, please leave us a review, we'll put a link down below where you can click and you can leave us a review on iTunes, we really, really appreciate it.
Evan Brand: Yeah, share this with all your friends and family on sleep drugs, we can't legally tell them to get off of it, but we'll show them a different path.
Dr. Justin Marchegiani: Yeah, and if you're on benzos really important, that's a very, very, very slow taper. So if your doctor decides to take them off fast, be very careful. Sometimes these things have to be tapered over the course of a year. So just be very careful. If you're on drugs and very dependent. You want to do it responsibly and very slowly with the prescriber as you kind of taper down and as you fix the root underlying issues.
Evan Brand: Yeah, well said I mean you'll listen to this podcast you'd be like well screw those drugs I'm stopping! Bad idea don't do that same thing with like hypertension medications. I mean, we've done podcasts on naturally regulating you know blood pressure and some people, Oh my god, these drugs are terrible. I'm getting off of them. You can you could get rebound hypertension Same thing with the sleep drugs, you know, you can have a lot of issues with the GABA receptor I mean being so saturated with the drug and then you just going cold turkey, these are not cold turkey drugs.
Dr. Justin Marchegiani: Yeah, my general recommendation is get a good foundation, diet, lifestyle, sleep, movement hydration, get that there. Before you go in and ask that prescribed or start dropping the dose slow. So get the foundation right before you make any changes.
Evan Brand: Yeah I mean look, we want people to be healthy, we want them to be drug-free, if possible. And if that’s our goal ang long term plan, we love it but there’s a time and a place. So just hang in there, i know it sucks, people get so mad. I dont wanna be on this drug! They say that so often but they have to. That’s okay, i’m not judging you, it’s okay if you need it know. Let’s get you healthy.
Dr. Justin Marchegiani: Every now and then I find 1% of people having a hard time getting off of it or just can’t get their sleep right, but I would say 99% people are gonna be able to address significantly and improve their sleep. So stick at it, you have a really high percent, so keep it up and goodluck for everyone listening.
Evan Brand: Yep, absolutely. Well let’s wrap this up. JustinHealth.com for consults around the world, and EvanBrand.com. We look forward to helping you. Take care we’ll talk to you later.
Dr. Justin Marchegiani: Have a good one ya’ll. Bye.
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