Melatonin- high night time cortisol- help please

[sandrab1969]

I have been prescribed this... But struggling with finding the right dose while changing to armour... With a few side effects currently...Is melatonin likely to give me any additional side effects or am i best holding back starting until things even out with my armour!?- i am struggling getting to sleep with the mega high night time cortisol.... Having a bit of a nightmare all in all at the mo. advise pleeeese. Thank you. X

[vajra]

Hi Sandra, I'm no expert and have only recently started working with melatonin and other methods to get control of cortisol levels which seem to have been high for most of my adult life - so this is entirely subjective and personal.

It's highly likely that in my case high cortisol as a result of chronic stress/exaggerated stress responses - some combination of foetal programming/post traumatic stress and stressful work - was likely the root cause of the gut and auto immune problems that led to thyroid auto immune disease, a thyroid cancer and a thyroidectomy.

The thyroid is these days well replaced (I take mostly T3 with some T4), but the cortisol seems to be the main driver of residual gut, high blood pressure, lowered energy and a tinnitus problem. Plus various joint aches and the like.

I've recently been trialling melatonin to help my sleeping too, as my cortisol levels seem also to stay high at night - I was sleeping, but not waking up rested, and was easily disturbed.

1. Judging by web reports and common pill sizes here's a tendency for people to take very high doses of melatonin - many multiples of the biolgical norm.

2. I seem to find (as here web.mit.edu/newsoffice/2001... that 0.3 - 0.5mg taken about 1/2 hour before bed does a great job of giving a good night's normal feeling sleep - from which I wake up feeling rested and fresh.

3. The timing of taking it is critical. It metabolises and takes effect in about 1/2 hour, and is processed/washes though very quickly. Taking it at irregular times can re-set our body clock, so taking it at the right time and having a regular bed time helps.

4. It seems best to head for bed very shortly after taking it, and to avoid bright lights or other stimulation (TV/computer etc) in this time - staying up leaves me feeling sleepy/groggy, and the chances are that most gets metabolised before sleep in this situation anyway.

5. There's mentions about of a slow release variety which I haven't tried - maybe there can be some benefit from a more prolonged effect for somebody with very high cortisol levels all night.

6. It had the effect in my case of causing grogginess/slow waking up for a day or two at first - but this as reported elsewhere quickly wore off.

7. Higher doses do as widely reported seem to produce intense dream experiences, and can lead to (maybe temporary?) morning grogginess.

8. I've no idea how it shakes out longer term (there's not much information about - except the suggestion that lots in the US take it long term), or what happens if its abruptly stopped. (so far it seems fine - i've slept normally if a bit more lightly on trial nights where i've not taken it)

The melatonin definitely helps my sleeping, but I guess the holy grail has to be to address the underlying cause of our high cortisol.

I'm also working along the lines reported in this series of web pieces: medicinegarden.com/2011/02/...

The Seriphos she mentions (phosphorylated serine) has worked very well in the short term (for a couple of months) to reduce my cortisol levels and my blood pressure (it feels like living in a different world - my gut symptoms an stressed feelings settled almost immediately), but I don't know yet if it's going to pull off the reported re-programming of my HPA axis. (that's the system whereby the brain controls cortisol levels - it gets stuck at the 'high setting' in the case of chronic/exaggerated stress responses) - but rest, diet, life situation and re-programming of our responses are clearly also important.

I'm working with EFT (emotional freedom technique), and meditate a lot.

Seriphos reportedly can be used at night to block cortisol production too, but I've only limited experience. (as in i take one before bed)

There's not a lot of info about on Seriphos interplexus.com/pdf/seripho... - other than lots of reports of people like us taking it - in sometimes very high doses. It's a supplement (maybe some sort of fatty acid?), is widely available from US health shops, is non prescription, and seems to have been in use for quite a few years by naturopaths in the US - but who knows???

I've found this manual (titled Mastering Your Life) very useful. It sets out causes and the treatment approach used by Clymer Health in the US (a naturopathic clinic) to treat chronic stress/chronic fatigue/adrenal exhaustion by the above means: clymer-healing.myshopify.co...

I'd be interested to hear of more experiences of working with issues to do with high cortisol....

ian

[tegz in reply to vajra]

Very interesting info, Ian.

I've long puzzled over the Melatonin links with sleep patterns.

Sainsburys used to sell milk with it in- but stopped it now.

I had a bad childhood and suffered from over-reactive stress responses for years- now much better, as retired +hypo

Really good that you get so much benefit from a low dose, too.

I must look into this again...

[vajra in reply to tegz]

Ta Tegz. Here's a few fairly random links I found when digging about melatonin. The first is a very cautious and conservative take on the topic.

The last is an interesting suggestion that beta blockers (which i seem to have to take for blood pressure, and which it'd be great to get off given their tendency to mess with energy levels) may mess with melatonin production and can cause disturbed sleep:

your-doctor.com/patient_inf...

sltbr.org/melfaq.htm

ch.ic.ac.uk/local/projects/...

ncbi.nlm.nih.gov/pmc/articl...

I'd a pretty stressful upbringing too - starting with being born very highly premature. Plus some major life events/accidents which didn't help either. All of which likely pre-disposes to chronic stress problems.

My suspicion is that life history/exerience is with modern lifestyles and poor diets a very big part of chronic stress too - which in turn is a big cause of thyroid and other metabolic and immune illnesses.

The mental/programming aspect of the issue is big too I think. As in that chronic stress is to quite a high degree a subconscious but learned response. Which by the right means can be changed - using the emotional freedom technique mentioned, or biofeedback methods.

I don't know how true it is, but there's reports about that if we continue for too long in a highly stressed state that the limbic brain takes over control of the adrenals from the hypothalmus - and basically drops a concrete block on the throttle.

Leaving us with the previously mention thermostat stuck at 'high'. Wired to the moon...

ian

[tegz in reply to vajra]

Thanks for that expansion. I took BetaBs for years and got off them eventually[ Docs weren't bothered much by a pulse of low 40's !!]

Do you mean that the adrenals get hammered and then the thyroid fails from overuse?

Maybe 'controlled hyper' is how I was for years- but I never realised...

Maybe why the Docs tread warily

[sandrab1969 in reply to vajra]

Thank you so much for all the info- i have tried previously seriphos... Which did not work... Then amytriptaline.... Made me mega groggy in the morning. Well tonight is the first night... Watch this space... Thanks again. S. x

[vajra]

The story seems to be Tegz that cortisol being normally a fight/flight hormone adapts the body to this end. By doing stuff like partially shutting down digestion and absorbtion of nutrients, raising blood pressure (leading eventually to heart and other cardiovascular problems), switching the metabolism to producing sugars for energy (causing weight gain and eventually a tendency to blood sugar control problems/ diabetes), shutting down bone calcification, reducing the effect of the sex hormones among others. (see e.g. en.wikipedia.org/wiki/Cortisol - but there's lots more if Googled)

The gut causes problems especially quickly. It leads to chronic indigestion, inflammation, poor absorbtion of nutrients, eventually leaky gut and consequent auto immune problems. The thyroid is for some reason quickly hit by the latter - so after some time we end up with Hashimotos, Crohn's and the like. Adrenal exhaustion follows after some years of chronically elevated cortisol levels.

Put simply we're not supposed to be permanently stressed. When operating correctly cortisol provides a boost for risk situations, but is supposed to fall away quickly again.

When high cortisol becomes the norm it has many negative longer term health effects - see the link.

Here's a couple of links on sleep cycles and influences:

talkaboutsleep.com/category...

ethesis.helsinki.fi/julkais...

thefreelibrary.com/Eliminat...

ian

[tegz in reply to vajra]

Thanks, I'll pursue -

I'm still struggling with 4 hour sleep batches and wake up almost every night, 4am on the nail.!

My adrenal stress profile is lower now- but the backlog may mean that melatonin levels are more critical- that's why it was in the back of my mind for further work.

The UAT has taken my focus somewhat of late, as you may have noted

[vajra]

Seems like we're all on a journey Tegz. It'd be nice to be able to presume our health...

Look for some material showing the normal cortisol and adrenal cycles - they may not be in the same chart. This is naturopath territory - your average GP won't know about it, and won't necessarily reconise this sort of elevation of cortisol as significant per se. (they diagnose stuff like Cushings disease and Adddisons when the levels get immediately life threateningly high or low)

Cortisol levels normally start to build from very early, maybe 4.00am. Then peak strongly mid morning, and drop away for the rest of the day and night. Melatonin may act to reduce cortisol levels. There's normally a sharp burst of melatonin naturally released by the onset of darkness to set us up for sleep. This clears after a couple+ hours - certaily by maybe 4.00am.

If extra melatonin is taken at bedtime it'll possibly help us get off to sleep and stay that way for a few hours, but it seems likely to be done and dusted by 4.00am. By which time if you have a particularly strong surge of cortisol coming through you may wake up?

Judging by reports some with high night time cortisol take Seriphos before bed and during the night if they wake up to get them back to sleep - it's not a sleeping pill. i.e. its action i think is to block the recptors for ACTH (?) the hormone that triggers the release of cortisol by the adrenals. So that it's seemingly best taken an hour or a bit more before a cortisol surge occurs to prevent it.

This ideally points to getting some adrenal stress testing done (e.g. the Thyroid UK Genova option), as this is the means by which we can find out when our costisol levels are high and low. The test is normally done during waking hours, but there's presumably no reason not to take samples at intervals overnight too - although I don't know if Genova can provide ref ranges for that period. (but there's plenty of standardised 'normal' profiles on the web)

DHEA by the way is I think protective in respect of many of the underirable effects of high cortisol - that's one reason why it's typically tested for with an adrenal profile.

Failing this it may be possible to learn to tell by other symptoms when our cortisol levels are rising/falling. My blood pressure rises with it, and the tinnitus kicks in as it's rising or falling. Plus if my cortisol levels are high my face tends to feel flushed and hot.

Fluctuations in cortisol levels it seems can be very hard to predict, and can be very variable depending on the time of day - depending on our mind state. programming and the state of adrenals. Early stage chronic stress just leads to high cortisol all day, through the night as well if it gets bad. After a time though the adrenals start to become exhausted, and then we tend it seems to get surges when they recharge, but very low levels when they are tired. Which surges can be very pronounced but short lived, and it seems may occur at any time of the day or night depending on your programming/circadian rythm. The rythm can be very badly disturbed, with the result that an individual cycle may bear no relationship whatsoever to 'normal'.

Mental phenomena can be a trigger as well as the programmed daily cycle - for example dreaming or reveries related to post traumatic stress. Like all these things it feeds itself - in that high and low cortisol seem also to be able to deliver depression and anxiety too.

Seriphos (see the data sheet and links above) definitely has reduced my cortisol levels, but they rebound as it wers off after a few hours. I've struggled to get good information on the use of it. It's a supplement rather than a drug or anything like that, but it's hard to know if taking it longer term brings any risk. Likewise there's not much about dose. I need about 6 x 100mg daily, maybe another one on a bad day to get control - and that's not untypical. Some report taking more, I've seen mention of eight. The recommendstion is clearly that it shouldn't be taken for more than sevral months at a time - why I don't know. Hopefully by then the re-programming kicks in.

There's other stuff as well that helps reduce/metabolise cortisol - vitamin C, magnesium, and other supplements. (search) Also some homonal treatments to persuade the adrenals and the HPA to tone down the stress response, but again there's not much info published...

Hope this help, but take care to do your homework as it's pretty fuzzy territory and I'm only reporting my own experience....

ian

[vajra in reply to vajra]

PS Here's a page about Rohodiola Rosea - another adaptogen ( a herb in this case) it's said is reckoned to be very effective in eabling the body to adapt to and tune fdown its stress responses: lef.org/magazine/mag2011/se...

I'm only starting to investigate it now, and know nothing about it beyond the above. it's the piece says taken with siberian ginseng and schisandra chinesis.

ian

[3poppy3 in reply to vajra]

this is all so complicated !! I wish we could go to a specialist centre and get a proper diagnosis and treatment. I am a nurse and I struggle to get my head around all the intricate workings of our endocrine system, so glad I found this forum. I am always astounded by the knowledge we as a group have gathered, it has certainly changed my opinion about the diagnosis and treatment of UAT. I work one or two night shifts a week and this plays havoc with my energy levels and how I feel generally, probably because it interferes with the normal sleeping patterns and circadian rythyms and puts extra stress on the adrenals. I also wondered if having a very stressfull life brought on my UAT, and I don't seem to cope at all well with any level of stress now. Thanks for all this info will certainly try some of your suggestions and should really get my cortisol levels checked

keep up the good fight

Sue

[vajra]

Ta Sue. Bear in mind that i'm just sharing what I've pretty recently tripped over, and am definitely not offering advice.

It's always such a detective job. So hard to know what is going on in our own minds and bodies, and how or whether various treatment options work.

It seems like life never hands us the answers on a plate - that we're required to take responsbility for ourselves, and to work for what we learn.

There's quite a bit about regarding the ability of shift work to mess with sleeping cycles - although individuals seems to vary quite a bit in their reponse.

I worked rotating shifts for about a year early on in my career, and had to quit. There's something funny/fragile about my control of sleep cycles, but by a few months in I was hardly sleeping at all. It took me almost 18m to get back to normal again.....

ian