Tag: sleep

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Glymphatic system – yes- sleep helps protect against Alzheimer’s dementia

Following up on Friday’s easy answer day (previous post) – yes, the glymphatic system of the brain does help protect against Alzheimer’s dementia, (7, 8, 14, 17), and sleep, especially one of the deeper stages of sleep (low-delta), is important. (10, 11, 13) Sleeping on your right side may help promote better fluid drainage through the glymphatic system of the brain (sleeping on your right side puts the left side of your body with your heart farther up above the rest of your body, a pillow between your knees and a neck support may also help). (Social media link, reference source: Neurology Reviews, 2) (12) *I had trouble finding anything very specific about whether right or left side was better for glymphatic and lymphatic drainage – this article from an Ayurveda specialist describes how the anatomy is better suited to sleeping on the left side than the right side – the aorta leaves the heart on the left so laying on the left side allows the flow to go downhill with the aid of gravity. (https://lifespa.com/amazing-benefits-of-sleeping-on-your-left-side/ )

The circulation by the heart can help move fluid through the brain but only indirectly due to the on/off pressure of the arterial pulse. The regular lymphatic system of the body is a drainage system for the brain fluid system but the blood brain barrier prevents direct interaction. Specialized water pumps in some types of brain glial cells help provide circulation within the brain by pumping water in two directions within the second layer of thick membranes that separate the soft brain tissue from the bony skull. (3)(4)(15)(16)

Overall the fluid within the brain does circulate and there is a visible, small, pulsing movement that has been amplified and can be observed in a video: (5). The spread of a dye within the brain can be observed in a different type of brain scan, the fluid diffusion is not rapid taking 24 hours to reach a maximal point, and the movement of the dye was most prevalent (see color chart) near the skull: (6). The glymphatic system as defined as the specialized glial cells with water pump channels is located in the area near the skull. (4) Diffusion of fluid throughout deeper areas of the brain where the blood brain barrier is not found can occur to a small extent through membranes. (9)

Exercise may also help the glymphatic system function better. (18) The lymphatic vessels and lymph nodes in the neck are the initial drainage route for the glymphatic system cleansing of the various fluid filled areas of the brain. Stretching exercises and rhythmic walking type exercise can help move lymphatic fluid from farther areas of the body to the torso and urinary system for eventual excretion.

Small amounts of alcohol – one third of a serving; to moderate – one or two servings per day (too much may not be helpful); may help the detoxification of the brain fluid by mechanisms that are not well understood yet but which seem to involve the glymphatic system. (19, 20) The mechanism may involve the effect of alcohol on GABA receptors, it can activate them which in general would have a calming/inhibitory effect, (23), however GABA receptors also are involved in promoting more production of the water pump Aqaporin 4 channels in neural stem cells within the subependymal zone. (24) The subependymal zone is in the lateral part of the lateral ventricle which is a cerebrospinal fluid filled area near the center of the brain, (27), which is involved in fluid balance and drainage of the glymphatic system. (25) GABA receptors are also involved with flow of chloride ions across membranes (for an inhibitory effect on nerve signaling, (pp 126-131, 1), and affect fluid balance in areas of the brain without the blood brain barrier which makes diffusion of water across the brain membranes more possible. (26)

Alcohol also inhibits the action of the excitatory neurotransmitter glutamate, particularly at the NMDA receptor, (23), which is an excitatory ion channel and also allows calcium to enter the cell where the mineral can activate many functions within the cell. (pp 120-126, 1) If drinking alcohol is not preferred or legal due to age or advised due to pregnancy or possibility of becoming pregnant then GABA (gamma-aminobutyric acid) is available as an over the counter supplement, typically in a form that melts in the mouth to promote more direct absorption. While it is not typically referred to as an amino acid due to its role as a neurotransmitter, it is simply an amino acid, a smaller molecule from which proteins can be formed. The level of GABA a has been found to be reduced in the brains of patients with severe Alzheimer’s Disease and its use as a treatment has been studied, (29), levels in other abnormal brain cells were found to be elevated in a specific area of the brain of patients with Alzheimer’s Disease and treatment to increase transport of GABA has also been studied. (30)

Or sleep, in the form of a short nap, may also help promote GABA. Naps may benefit our health in part because of a beneficial effect on GABA promotion by increased glymphatic action in the brain – twenty minutes of sleep may be adequate. (28)

An overview of the glymphatic system and lifestyle and dietary tactics that might improve its function are described in a video by a nutritionist: (21); and also in a self-help style article by a different person: (22).

Some types of magnesium supplements including magnesium threonate may also help. Magnesium within the brain has many functions including inhibiting the NMDA glutamate receptor which would prevent excess calcium from entering the cell. (pp 120-126, 1)

We tend to hear about neurotransmitters such as serotonin for depression or dopamine and Parkinson’s disease, yet we rarely hear that calcium is the mineral that signals the release of both of those and over one hundred other neurotransmitters that are involved in nerve signals within the brain or throughout the body (page 85, 1.Neuroscience, 6th Ed.). Neurotransmitters include excitatory and inhibitory chemicals and they activate or inhibit the firing of a nerve signal. GABA can be a calming/inhibitory neurotransmitter that may be low when anxiety is a problem. Magnesium is the mineral inside cells which helps control how much calcium will be allowed to enter. Excess calcium can cause excess release of neurotransmitters. Magnesium deficiency can also be involved when anxiety is a symptom.

Adequate fluid is also likely important for adequate cleansing of waste from the brain by the glymphatic system. Problems with edema/swelling in other areas of the body or problems with hypertension may indicate problems with the lymphatic system in general. Moderate exercise helps the muscle power of movement also move extracellular fluid and lymphatic fluid through the lymphatic vessels to lymph nodes to be filtered by blood cells. Waste is removed into blood vessels for later excretion by the kidneys.

Additional note – adenosine was mentioned in the series on demyelination as a chemical that may lead to more breakdown of cells or myelin. It is produced as a metabolite of normal energy production and increased levels seem to be involved in our beginning to feel sleepy, signaling a need for rest – which would then give the brain clean up glymphatic system a chance to work on decreasing levels — so feeling sleepy? Your brain may be trying to tell you it is time to clean up after a strenuous workout whether physical or mental.  (See the What Makes You Sleep? section in the NHLBI article about Sleep Deprivation and Deficiency)

For more general information about promoting sleep and coping with insomnia see the post “Sleep and Health.”

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326841/Reference: pp 85-112, “Synaptic Transmission,” Neuroscience, 6th Edition, Editors D. Purves, G.J. Augustine, D. Fitzpatrick, W.C. Hall, A.S. LaMantia, R.D. Mooney, ML. Platt, L.E. White, (Sinauer Associates, Oxford University Press, 2018, New York) (Barnes&Noble)
  2. Glymphatic System May Play Key Role in Removing Brain Waste, Neurology Reviews, 2016 October;24(10):13   https://www.mdedge.com/neurologyreviews/article/114150/alzheimers-cognition/glymphatic-system-may-play-key-role-removing
  3. Understanding the Glymphatic System, Neuronline, adapted from the SfN Short Course The Glymphatic System by Nadia Aalling, MSc, Anne Sofie Finmann Munk, BSc, Iben Lundgaard, PhD, and Maiken Nedergaard, MD, DMSc http://neuronline.sfn.org/Articles/Scientific-Research/2018/Understanding-the-Glymphatic-System
  4. Tsutomu Nakada, Ingrid L. Kwee, Fluid Dynamics Inside the Brain Barrier: Current Concept of Interstitial Flow, Glymphatic Flow, and Cerebrospinal Fluid Circulation in the Brain. The Neuroscientist, May 24, 2018, http://journals.sagepub.com/doi/10.1177/1073858418775027#articleCitationDownloadContainer
  5. Bruce Goldman, The beating brain: A video captures the organ’s rhythmic pulsations. Scope, Stanford Medicine, July 5, 2018, https://scopeblog.stanford.edu/2018/07/05/the-beating-brain-a-video-captures-the-organs-rhythmic-pulsations/?linkId=53912604
  6. Geir Ringstad, Lars M. Valnes, Anders M. Dale, et al., Brain-wide glymphatic enhancement and clearance in humans assessed with MRI. JCI Insight. 2018;3(13):e121537 https://insight.jci.org/articles/view/121537?utm_content=buffer13f62&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer
  7. Brain discovery could block aging’s terrible toll on the mind. University of Virginia Health System, EurekAlert! Science News, July 25, 2018, https://www.eurekalert.org/pub_releases/2018-07/uovh-bdc072518.php
  8. Da Mesquita S., Louveau A., Vaccari A., et al., Functional aspects of meningeal lymphatics in ageing and Alzheimer’s disease, Nature, 185,191, Vol 560, Issue 7717, 2018/08/01. https://www.nature.com/articles/s41586-018-0368-8
  9. Albargothy N. J., Johnston D. A., MacGregor‑Sharp M., Convective influx/glymphatic system: tracers injected into the CSF enter and leave the brain along separate periarterial basement membrane pathways. Acta Neuropathologica (2018) 136:139–152 https://link.springer.com/epdf/10.1007/s00401-018-1862-7?shared_access_token=oYhOYaeYOAlkFhECIjAc6Pe4RwlQNchNByi7wbcMAY7lrBk-VqU01OilsaKMVR9FXaHRKmFQ1tkD03g-Q04DmsYSxRC_gucPZRYlFW0xfyU2pYNfhmwcokVbMCreuzU3wBLsjKpRasKo-6HXTJLMHNXMqFbaSsQVIB34EgzIUsc%3D
  10. Tamara Bhandari, Lack of Sleep Boosts Levels of Alzheimer’s Proteins, The Source, Washington University in St. Louis, Dec. 27, 2017, https://source.wustl.edu/2017/12/lack-sleep-boosts-levels-alzheimers-proteins/
  11. Yo-El S Ju, Sharon J Ooms, Courtney Sutphen, et al., Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels. Brain, Vol 140, Issue 8, 1 August 2017, Pages 2104–2111, Oxford Academic, https://academic.oup.com/brain/article/140/8/2104/3933862
  12. Krista Burns, American Posture Institute: Proper Sleeping Posture for ‘Brain Drain,’ April 5, 2017, https://americanpostureinstitute.com/proper-sleeping-posture-for-brain-drain/
  13. Patricia Farrell, Sleep: Everyone Needs It and So Do You, March 16, 2017, https://www.amazon.com/dp/152061294X
  14. Melanie D. Sweeney, Berislav V. Zlokovic, A lymphatic waste-disposal system implicated in Alzheimer’s disease. July 25, 2018, https://www.nature.com/articles/d41586-018-05763-0?utm_source=twt_na&utm_medium=social&utm_campaign=NNPnature
  15. Nadia Aalling Jessen, Anne Sofie Finmann Munk, Iben Lundgaard, Maiken Nedergaard, The Glymphatic System – A Beginners Guide, Neurochem Res. 2015 Dec; 40(12): 2583–2599. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636982/
  16. Maiken Nedergaard, Steven A. Goldman, Brain Drain, Sci Am. 2016 Mar; 314(3): 44–49. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347443/
  17. Rainey-Smith S. R., Mazzucchelli G. N., Villimagne V. L., et al. Genetic Variation in Aquaporin-4 Moderates the Relationship Between Sleep and Brain Aβ-amyloid burden. Translational  Psychiatry, (2018) 8:47 https://www.nature.com/articles/s41398-018-0094-x.epdf?author_access_token=iK09AkugOzYXUjXJCpGfIdRgN0jAjWel9jnR3ZoTv0P4SU0l7P8A1C64dg2xJ-HX7jlpuvyMeHzBYm6I5D0yMRBsx023MtG5Y3KNpj4EoNEqA4ELFuByqeysfTCRKZdGegxohMN9WLBb_S6H0UZYpw%3D%3D
  18. Brown B., Rainey-Smith S. R., Dore V., et al., Self-Reported Physical Activity is Associated with Tau Burden Measured by Positron Emission Tomography. Journal of Alzheimer’s Disease, vol. 63, no. 4, pp. 1299-1305, May 30, 2018 https://content.iospress.com/articles/journal-of-alzheimers-disease/jad170998
  19. Chloe Chaplain, Drinking wine every day could help prevent Alzheimer’s, experts say. London Evening Standard, June 6, 2018, https://www.standard.co.uk/news/health/drinking-wine-every-day-could-help-prevent-alzheimers-experts-say-a3856646.html
  20. In Wine, There’s Health: Low Levels of Alcohol Good for the Brain. Feb. 2, 2018, University of Rochester Medical Center, https://www.urmc.rochester.edu/news/story/5268/in-wine-theres-health-low-levels-of-alcohol-good-for-the-brain.aspx
  21. Brianna Diorio, Glymphatic System 101, video,August 8, 2018,  https://vimeo.com/283708099?ref=tw-share
  22. Sydney, How To Detox Your Brain By Hacking Your Glymphatic System. A Healthy Body, May 18, 2018, http://www.a-healthy-body.com/how-to-detox-your-brain-by-hacking-your-glymphatic-system/
  23. The Effects of Alcohol on the Brain, The Scripps Research Institute, https://www.scripps.edu/newsandviews/e_20020225/koob2.html
  24. Li Y, Schmidt-Edelkraut U, Poetz F, et al. γ-Aminobutyric A Receptor (GABAAR) Regulates Aquaporin 4 Expression in the Subependymal Zone: RELEVANCE TO NEURAL PRECURSORS AND WATER EXCHANGE. The Journal of Biological Chemistry. 2015;290(7):4343-4355. doi:10.1074/jbc.M114.618686. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326841/ (24)
  25. Plog BA, Nedergaard M. The glymphatic system in CNS health and disease: past, present and future. Annual review of pathology. 2018;13:379-394. doi:10.1146/annurev-pathol-051217-111018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803388/ (25)
  26. Cesetti Tiziana, Ciccolini Francesca, Li Yuting, GABA Not Only a Neurotransmitter: Osmotic Regulation by GABAAR Signaling. Frontiers in Cellular Neuroscience, Vol. 6, 2012, https://www.frontiersin.org/article/10.3389/fncel.2012.00003 DOI=10.3389/fncel.2012.00003 ISSN=1662-5102 (26)
  27. Kazanis I. The subependymal zone neurogenic niche: a beating heart in the centre of the brain: How plastic is adult neurogenesis? Opportunities for therapy and questions to be addressed. Brain. 2009;132(11):2909-2921. doi:10.1093/brain/awp237. (27)
  28. Robert I Henkin, Mona Abdelmeguid, Sleep, glymphatic activation and phantosmia inhibition. The FASEB Journal, Vol 31, No. 1_supplement, April 2017, https://www.fasebj.org/doi/abs/10.1096/fasebj.31.1_supplement.749.4  (28)
  29. Solas M, Puerta E, Ramirez MJ. Treatment Options in Alzheimer’s Disease: The GABA Story., Curr Pharm Des. 2015;21(34):4960-71. https://www.ncbi.nlm.nih.gov/pubmed/26365140 (29)
  30. Zheng Wu, Ziyuan Guo, Marla Gearing, Gong Chen, Tonic inhibition in dentate gyrus impairs long-term potentiation and memory in an Alzheimer’s disease model. Nature Communications, 5,  Article number: 4159 (2014) https://www.nature.com/articles/ncomms5159 (30)
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Translational Research – translating research into patient care strategies

“The answer is 17 years, what is the question: understanding time lags in translational research” – Morris, et al, 2011 (1)

It takes far too long for research findings to be ‘translated’ into health messages or techniques that reach the patient in need of health care guidance – 17 years on average according to the review of research study by Morris et al (2011). The team’s conclusion is that translational research is in need of further study but with more well defined terms and types of measurements so research by different teams can be compared. Twenty three studies were reviewed but the research parameters were diverse and not readily comparable. (1)

As a person with training and experience as a health care professional I followed general recommendations for general health and weight loss for many years but they didn’t help and I kept getting more sick with problems that didn’t show up on lab tests. Being told regularly that my symptoms must therefore be psychosomatic (mentally based) and that I should see a talk therapist did lead me to spending time with talk therapists and it helped somewhat but I kept getting more sick.

I knew I was physically sick, not just mentally making myself sick from stress or anxiety because I wasn’t always stressed or anxious and had always had some minor but chronic health problems as a child. So I eventually gave up on the standard not-helping-much answers and instead paid closer attention to my daily routine and dietary choices and slowly stopped doing any of the things that seemed to make me feel worse the next day. With the pay attention method I got somewhat better. Fibromyalgia and chronic fatigue symptoms were improved. Iodine supplements helped me with weight loss and a low dose antibiotic protocol developed for an autoimmune type of condition helped relieve my severe migraine problem.

Prescriptions can be quick and easy answers but they don’t always work, sometimes makes things worse, can delay trying other strategies that might work better – and can be expensive in insurance co-pays or be an out of pocket self pay expense. Health needs adequate sleep, with black out curtains and no lights, not even a digital alarm clock – keep it in a bedside table drawer or cover it with a towel. Even a little light at night can interfere with our production of melatonin and it helps with a variety of health needs throughout the body.

Health requires regular stretching and exercise that works out the heart and lungs and builds the other muscles somewhat. To maintain bone density requires weight bearing exercise – lifting weights in a warehouse or digging in a garden or in a gymnasium. Having the freedom to read text documents on your laptop while standing and using hand weights can multitask physical fitness needs with work or school needs. Varying positions and going for short walks occasionally is healthier than any type of job that requires too much of the same motions or having to stay in the same position for long periods of time.

Standing desks that can easily transition to a sitting desk can be as simple as a couple boxes under your laptop. Standing can allow some leg and arm stretches and then the boxes can be removed for some time spent sitting to type more intensively. Eight full hours in either position might be more of a health risk than being able to switch between the two options. (2)

Health requires all of the nutrients and additional fiber and antioxidants and other phytonutrients that aren’t considered essential in the same way vitamins are but may be necessary for more optimal health.

If it is reasonable to want to prevent measles or chickenpox, or other infectious diseases, then it seems reasonable to want to prevent age related degenerative disease by providing the body more of what it needs to remove toxins and rebuild tissue as it wears out. Even brain cells are replaced with new ones  – our entire body is not the same body that we had as a newborn. We are regularly removing old cells and growing new ones.

All truths are easy to understand once they are discovered. The point is to discover them. ~ Galileo

And the point of translational research is to improve the process of translating research findings into effective strategies for patient care. If research is still in early stages it may not be safe for all patients, finding out how to identify which patients it might help would then be a necessary step before translating the findings into patient education messages or health care protocols. How to guides ideally will always include safety warnings about which patients the health messages might harm if they were to use or be ineffective for their use.

As an individual it is good to know your rights as a patient and to seek health care professionals that take the time to listen. As a patient seeking a second opinion may be helpful and it can be helpful to write down your symptoms and mood changes, your daily diet or sleep habits, and any other routine habits in order to look back occasionally to see if any patterns show up in what is helping or not helping you feel better. We all need to remember that we are the ones living our lives and that makes us the ones in charge of taking care of our own health as best as we can.

It can take three weeks or more to build a habit and that suggests the reverse is likely true – and keeping a written tally sheet about the habit you want to change can help stay on track and help show where you may be veering off track. For more guidance, see Changing Habits, The Learning Center, University of North Carolina. (3)

Your Health Insurance agent is not your mother (probably), and in the current system large bills can lead to more profit for health insurance companies – so watch out for your  own budget by taking care of exercise, diet, and sleep habits and send your Health Insurance agent a nice card at the holidays instead of having them on speed dial for questions about your enormous co-pays. Insurance is nice but 10 or 20% of an enormous bill is still more than most of us have in the bank or can easily borrow. (4)

Bankruptcy due to health care costs has become too common – stay out of bankruptcy court by spending more time on daily health care habits – the research is fairly conclusive regarding the basics –

  • ideally at least 30-60 minutes of exercise 3-5 times per week,
  • drink plenty of water for thirst
  • and eat 5-9 servings of vegetables/whole fruit per day, get adequate protein, whole grains and essential omega 3 fatty acids without too much saturated and trans fats each day. Trying to include a serving of fatty fish three times per week can be a source of omega 3 fatty acids or vegetarian sources include walnuts, hemp seed kernels or ground flax seeds. Including a serving of beans, nuts and seeds on most days may increase the amount of magnesium and other important trace nutrients in the daily/weekly diet.
  • Six hours of sleep seems to be a minimum need for most people and more than eight hours on a regular basis may be too much or a sign of health or depression problems in adults once they are out of the teen years, (teens may benefit from ten hours of sleep per day, (6)). Short naps during the day can be a healthful activity and may increase work productivity, 20-30 minutes may be ideal. Longer naps may lead to waking up groggy instead of refreshed. (5)
  • Social activity and other relaxing hobbies also seem to be helpful for health.

/Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes. Thanks./

  1. Zoë Slote Morris, Steven Wooding, and Jonathan Grant,

    The answer is 17 years, what is the question: understanding time lags in translational research., J R Soc Med. 2011 Dec; 104(12): 510–520. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241518/

  2. Robert H. Shmerling, MD, The Truth Behind Standing Desks, Sept. 23, 2016, Harvard Health Blog, Harvard Health Publishing, health.harvard.edu,  https://www.health.harvard.edu/blog/the-truth-behind-standing-desks-2016092310264?utm_campaign=shareaholic&utm_medium=twitter&utm_source=socialnetwork
  3. Changing Habits, The Learning Center, University of North Carolina, https://learningcenter.unc.edu/tips-and-tools/changing-habits/
  4. Why Your Health Insurer Doesn’t Care About Your Big Bills, propublica.org, https://www.propublica.org/article/why-your-health-insurer-does-not-care-about-your-big-bills
  5. Napping, sleepfoundation.org, https://sleepfoundation.org/sleep-topics/napping
  6. See Chapter Two: The Lost Hour, Po Bronson and Ashley Merryman, NurtureShock: New Thinking About Children, Twelve, Hatchette Book Group, New York, 2009 http://www.nurtureshock.com/

Additional references for more information on translational medicine:

Excerpt from a post about my own genetic screening (Genetic Screening can give guidance about potential medication adverse reactions, 2018):

Additional reference for further discussion of the advances in the use of genetic screenings for medication risk is available in a book that is already slightly dated with the rapid advances in technology but as a starting point it is helpful for an overview on the history of technological advances in the area of medical care: The Creative Destruction of Medicine: How the Digital Revolution will Create Better Health Care, by Eric Topol, M.D., 2013. Basic Books. ISBN: 978-0465061839. (1) (“Book Review…,” and summary, by Jung A Kim, RN, PhD, PubMed_2)

One of the pioneers in personal genetic screening was Esther Dyson, a venture capitalist. She quoted a colleague regarding why she agreed to be one of the first ten participants in the Personal Genome Project:

“You would no more take a drug without knowing the relevant data from your genome than you would get a blood transfusion without knowing your blood type.” [128] (1)

The future of individualized health care will include genetic screening for everyone and what isn’t addressed in the book by cardiologist and translational research specialist Eric Topol, M.D. is the use of genetic screening for individualized nutrition guidance. In addition to discovering what medications may work better or be more dangerous for an individual genetic screening can target which types of exercise or diet plans may be more or less beneficial and which nutrients may need to be restricted or supplemented more than the average guidance.

My previous genetic screening was for fewer genes but which were chosen as most commonly a problem for children on the autism spectrum – I had 11 of the 30 and the guidance led to supplements and diet changes that have helped me feel better and have better mood stability – Methylation Cycle Defects – in me, Genetic Screening “For Research Purposes Only” – at this stage “For Research Purposes Only” is a legal phrase as genetic screening is not considered consistent enough for use as a diagnostic tool, but my personal health is of significant interest to me.

  1. Eric Topol, M.D,, The Creative Destruction of Medicine: How the Digital Revolution will Create Better Health Care, 2013. Basic Books. ISBN: 978-0465061839.  (1) Chapter 5, Biology: Sequencing the Genome, page 117: [128]
  2. Jung A Kim, RN, PhD, Book Review: The Creative Destruction of Medicine: How the Digital Revolution will Create Better Health Care, Health Inform Res. 2013 Sep; 19(3): 229–231.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810531/ PubMed_2)

[128] Esther Dyson, “Full Disclosure,” Wall Street Journal, July 25, 2007, A15.

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When and What, two important questions

Regarding the question of school shootings and increasing safety the question of what to control may need to include questions of who and when. It has been said that guns don’t kill people, people kill people and that is true but people can be more lethal to themselves and others when guns are more readily available. Nations such as Australia had a significant reduction in the number of suicide by gun after increasing gun regulations. So the question of who might be answered with more help for those at risk of suicide and the question of when might be answered with sleepless teens.

A very simple change in timing of high school and university class schedules has been recommended as research suggests attendance and grades are improved with a later start to the young adult’s school day and also it may help with reducing impulsiveness and suicide risk. (page 89-93, When: The Scientific Secrets of Perfect Timing, Daniel H. Pink, Riverhead Books, New York, 2018) (penguinrandomhouse.com/when-the-scientific-secrets-of-perfect-timing) The book includes a range of tips and research examples about our bodies biological clock and best time to achieve more of our goals.

Sleep deprivation has been associated with oxidative stress in the brain, reduced memory ability and decision making ability. While modifying the schedule of young adult education would have some difficylty for adult caregivers and school personnel the strategy has helped increase grades and reduce dropout rates in the few places it has been tried.

Making guns less accessible has been found to reduce suicide rate in countries where it has been tried but gun access is only part of the issue. Helping reduce the number of young adults and others with suicidal tendencies is also important and modifying schooling for young adults might be a strategy that could help. The nation of Iceland has a large number of guns per capita(average number of an item per average citizen) and yet they have a much lower rate of gun violence then in the U.S.. they also have an education system that is very supportive of extracurricular activities for students. Funding is provided to support groups of sports or other interest groups and all students are encouraged to participate in some extracurricular activity.

Addition, May 18, 2018: The mental and physical benefits of adequate sleep for adolescents is also discussed in the book Nurtureshock.

Nurtureshock, by Po Bronson and Ashley Merryman (https://www.amazon.com/NurtureShock-New-Thinking-About-Children/dp/0446504130)

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes. 

 

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Hypothyroid or Iodine Deficient ?

Both is the answer or kind-of is the answer to the question in the title. I realize I never answered it directly in the post or may not have explained it clearly. We may have the RDA, the Recommended Daily Allowance, of iodine in a supplement or fortified products each day — but if the environment and diet are also providing the chemically similar minerals bromide, perchlorate (chloride), and fluoride then the body may be making thyroid hormone with the atoms of bromide, chloride and fluoride instead of with atoms of iodine and a lab test might show the presence of thyroid hormone but that lab test wouldn’t be testing specifically for the presence of iodine.
     Thyroid hormone might be present that contained bromide, chloride, or fluoride, or a combination, but it wouldn’t actually function within the energy pathways in the body and symptoms of tiredness and other symptoms of hypothyroidism.  A very large dose of iodine taken for one month can help the body replace the wrong atoms in the thyroid hormone with atoms of iodine. The presence of bromide, chloride and fluoride may be involved in risk for autoimmune thyroid disease and cancer of the thyroid or other endocrine glands. More is included on these topics later in this post. It can also help resolve the pain of fibrocystic breast disease, that topic isn’t included in this post but I did find it helpful for resolving that condition for me, and it hasn’t returned. I had symptoms of it for years and the standard answer is along the lines of “we don’t know,” – well I know that for me my condition resolved after taking a large dose of iodine for one month and then a smaller but still larger than RDA dose for several years — but I didn’t know about or forgot the selenium and ran into hyperthyroid problems, more on that –>
*This updated post is not about being fat or thin, or “body-shaming,” inner beauty has nothing to do with size, however good health can have to do with size.  Mood and skill in social settings can also be affected by size.  Information about cancer is included in this post because a problem with iodine deficiency can increase risk for cancer.
     The commonly used treatment for hypothyroidism within the current medical community is simply replacement of the thyroid hormone which is not addressing iodine deficiency for the thyroid gland or for the rest of the endocrine glands and the rest of the body. The thyroid organ can preferentially take up iodine when there is a limited supply, so a diagnosis of hypothyroidism suggests the rest of the body has even less iodine than the thyroid gland. Other side effects of hypothyroidism include depression, extreme tiredness, feeling cold, a tendency towards gaining weight and for constipation – everything slows down in the body when there is inadequate thyroid hormone or when it is present but not functioning correctly.
     It is more comfortable to not weigh an excessive amount and it is more comfortable to have energy and not feel depressed and cold.
     Showing the two pictures below is again, not about “body-shaming,” but was to give some idea of my past. Overweight women are somewhat invisible to men and to other women who care a lot about image. I have the social skills of an overweight woman, not those of a woman used to fending off unwanted attention from strangers or old acquaintances. I’ve never been to a fancy “cocktail party” if such a thing still occurs outside an episode of Mad Men (aka/the 1950’s). Or – more accurately – I have the social skills of someone with child trauma issues who may not have tried much in life and never gained experience and learned better skills.
     It takes a while to learn what you don’t know and further, to learn how many layers of not-knowing-what-you-didn’t-know and that you’ll have to learn about and work through before you will really get to the core issue or issues.
     A core issue revealed in the first picture is hyperthyroidism – I look thinner than typical for me. In the second picture I’m heavier but that was the weight that stubbornly stuck no matter how hard I tried to diet and exercise it off – until I took the large dose iodine supplement. My problem turned out to be the selenium. I didn’t learn about that until later after having developed hyperthyroid symptoms. Autoimmune thyroid problems can fluctuate between hypothyroid – low activity, and hyperthyroid – elevated activity. The first picture is me with hyperthyroidism and the second picture is hypothyroid.
     We all do need iodine though. I have to limit how much I eat now because I still have an overactive autoimmune thyroid condition. I do eat some iodine foods but not much iodized products or any supplements and I do try to eat selenium rich foods regularly, which is about two Brazil nuts per day.
     There aren’t many foods naturally rich in selenium. Coastal ocean microbes transform it from the form found in the ocean water into a form that can be carried in water droplets in the atmosphere where it is rained onto Brazil nut trees in the Amazon rain forest – isn’t our planet amazing?

We all need iodine.

This is how I spent most of my years as an adult, before I took iodine supplements.

The rate of infants born with congenital hypothyroidism has been escalating, baffling many, unless you consider an older diagnostic term – cretinism or iodine deficiency. Cretinism is somewhat reversible if the infant receives adequate iodine after diagnosis, the thyroid gland would grow and begin to produce hormone naturally. If the infant is treated only with synthetic thyroid hormone, then organ development would continue to suffer and the baby will probably need the drug for the rest of its life. Weight gain, fatigue, apathy and depression are common symptoms in adults and children born hypothyroid typically are petite and can have reduced IQ. Women can’t grow babies out of synthetic hormone, but that is what they usually are given if diagnosed with hypothyroidism instead of iodine deficiency.

All of our glands need iodine not just the thyroid gland. The pineal gland, also known in more  ancient terms as our Inner Eye, [crystalinks], has the second largest uptake of iodine and it is crucial for melatonin and a good night’s sleep. [5, 6] The mammary and prostate glands need iodine as well. Prostate and breast cancer also may involve an underlying iodine deficiency [2, 3] and the substitution of bromide, perchlorate and/or fluoride.

Lab tests have become a primary diagnostic tool and if the science underlying their use was wrong then the diagnosis based on the tests may not be very reliable. Our bodies have learned how to fool the lab test’s expectations of goiter by producing thyroid hormone containing fluoride or bromide. The gland is functioning normally but the hormone it is producing won’t prevent the symptoms and malfunction of hypothyroidism.

I had all those symptoms, but my lab tests were normal and therefore I was normal, or so I was told. However, after attending a seminar by Dr. Brownstein, I started a high dose iodine supplement that is equivalent to the amount of iodine provided by the sea weed in the traditional Japanese diet. The supplement that I have taken daily for six years contains 83 times more iodine than our current RDA. Our national guideline for iodine has not been changed since it was created in the 1940’s. Salt doesn’t have that much added to it and we aren’t really using much iodized table salt anymore. Do we reach for the salt shaker when we think about any other vitamin

It is important to get adequate amounts of the trace mineral selenium when supplementing with iodine, especially when using a large dose of iodine. Selenium is essential for the enzyme that breaks down excessive amounts of the active thyroid hormone. Excessive thyroid hormone can cause hyperthyroidism which can be associated with extreme mood and physical symptoms. Selenium can be toxic when excessive amounts are consumed for months.

Approximately two Brazil nuts provide the recommended daily goal of 200 micrograms of selenium. A one-a-day or prenatal vitamin would likely include 200 mcg of selenium. “Selenium” [ods.od.nih.gov/factsheets/selenium/]

A peer reviewed article with seaweed nutrient content information suggests that there is a wide range in iodine levels between different types of seaweed and between different samples of the same type of seaweed. [10]

The case study does not mention selenium. Hyperthyroid problems induced by abrupt increased intake of iodine may be mitigated by increasing selenium intake at the same time.

Kelp supplements can contain an unreliable amount of iodine. Out of 17 supplements tested the iodine content ranged from 45 micrograms to 57,000 micrograms. [1]

The kelp supplements content as tested is unreliable and potentially dangerous due to the unknown amount that might be contained. Seaweed also may contains goiterogens that interfere with thyroid function and occasionally toxins or other contaminants can be present due to the variability in ocean waters. [healthlibrary.epnet.com/GetContent.aspx?token=af362d97-4f80-4453-a175-02cc6220a387&chunkiid=21786 ]

Excessive iodine chronically can lead to toxicity side effects that include acne, a metallic taste in the mouth, a persistent mild cough and nasal discharge. The metallic taste can be a short term side effect due to bromide stores being exchanged for iodine. The RDA has been 150 micrograms. The Iodoral supplement that I have been using for six years contains 1250 micrograms of iodine/iodide which is a mega dose but is consistent and known, breaking the tablets and using a portion for a smaller daily dose is possible.

“Those at increased risk of developing hypothyroidism include: Postpartum women, Women with family history of autoimmune thyroid disorders (AITD), Those with previous head, neck, or thyroid surgery or irradiation, Those with other autoimmune endocrine disorders (e.g., type 1 diabetes mellitus, adrenal insufficiency, or ovarian failure), Those with nonendocrine autoimmune disorders (e.g., vitiligo, multiple sclerosis), Patients with primary pulmonary hypertension, Those with Down’s or Turner’s syndromes. 

The following biological activities are particularly impaired by hypothyroidism: Calorigenic modification, Oxygen consumption throughout most tissues, Protein, fat, and carbohydrate metabolism, Augmentation of calcium ATPase activity in cardiac muscle, Mitochondrial ATP production, G-protein-coupled membrane receptor activity, Organ-specific effects. 

The clinical manifestations of hypothyroidism (see Symptoms) are the result of effects occurring at the molecular level because of the impact of thyroid hormone insufficiency.” Read more: [medicinalplants.us/hypothyroidism ]

December 15, 2011 addition:

  • “Asian countries, such as Japan, have low rates of breast cancer, while Western countries have cancer rates that are many times higher. 25,26 However, when Japanese girls are raised on westernized diets, their rate of breast cancer increases dramatically.”  [cancerproject.org/survival/cancer_facts/breast.php]
  • Some statistics about prostate and breast cancer rates compared to iodine levels. [drdavidbrownstein.blogspot.com/2009/05/rapid-increase-in-thyroid-cancer.html]
  • www.faostat.fao.org – world food supply statistics. ***The world three year average consumption of Aquatic Plants ( aka seaweed) for 2007-2005 is zero if you remove the three out-lying values out of the 154 countries with data. The countries with Aquatic Plant consumption are China – 20.39 grams/capita/day, Japan- 4.02 gr/cap/day, and the Republic of Korea – 35.28 gr/capita/day. [faostat.fao.org/site/610/DesktopDefault.aspx?PageID=610#ancor]
  • The Japanese intake of 4.02 grams Aquatic Plants may provide a safe amount of iodine without an excess of goiterogens that may be provided in the Chinese 20.39 average intake or the Republic of Korea’s 35.28 grams/capita/day of Aquatic Plants.
  • The World’s Healthiest Foods website,”Sea Vegetables, What’s New and Beneficial about Sea Vegetables?” – recipes and health information for a variety of sea vegetables. [whfoods.com/genpage.php?tname=foodspice&dbid=135 ]
  • Nutrient information for Kelp lists iodine content as 415 micrograms per 20 gram serving. The U.S. Nutrient Data Base # 11445, Seaweed, Kelp Raw did not have a line for Iodine content. Based on the wide range in content found by the research team in citation #1 it would be hard to estimate how much iodine the Japanese, Chinese, and Republic of Korea citizens might be consuming on average – but it is clearly an excellent source. [whfoods.com/genpage.php?tname=nutrientprofile&dbid=51]

For more on hypothyroidism and pickle’s value as a side dish, see my post:  [Vitiligo, hypothyroidism and melanin]

Plastics, pesticides, herbicides and other chemicals may be a major cause of the feminizing of our young men [13] but the lack of iodine is also at fault. The prostate and testicles need iodine in addition to the thyroid, mammary and pineal glands. Switch to stainless steel drinking bottles and filtered water if you are worried about chemicals that disrupt the endocrine system; avoid soda (metal cans are lined with plastic) it is so acidic that it is leaching magnesium from you anyway; and take a high dose iodine or tested seaweed supplement. Boys will only continue to be boys if we provide their pregnant mothers and their growing bodies with nutritious building blocks. We still can’t build a functioning body out of pharmaceuticals or synthetic hormones.

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./
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  1. Norman JA, Pickford CJ, Sanders TW, et al. Human intake of arsenic and iodine from seaweed-based food supplements and health foods available in the UK. Food Addit Contam. 1988;5:103-109. www.drbrownstein.com/homePage.php
    [drdavidbrownstein.blogspot.com/2009/05/rapid-increase-in-thyroid-cancer.html]
  2. Most Asian Men Have Better Prostate Cancer Survival Rates, Finding could help to govern treatment approaches, study suggests. By Steven Reinberg, HealthDay Reporter,  [abcnews.go.com/Health/Healthday/story?id=4508275&page=1]
  3. Race Plays A Key Role In Prostate Cancer Survival Rates, sciencedaily.com,  [sciencedaily.com/releases/2006/06/060613072943.htm]
  4. Watanabe R, Hanmori K, Kadoya H, Nishimuta M, Miyazaki H, Nutritional Intakes in community-swelling older Japanese adults: high intakes of energy and protein based on high consumption of fish, vegetable and fruits provide sufficient micronutrients, J Nutri Sci Vitaminol (Tokyo). 204 Jun: 50(3): 184-95, [ncbi.nlm.nih.gov/pubmed/15386931]
  5. On Pineal calcification and its relation to subjective sleep perception: a hypothesis-driven pilot study, Volume 82, Issue 3, Pages 187-191 (30 June 1998)  [psyn-journal.com/article/S0925-4927%2898%2900013-4/abstract]
  6. Richard Mahlberg, Thorsten Kienast, Degree of pineal calcification (DOC) is associated with polysomnographic sleep measures in primary insomnia patients, [sleep-journal.com/article/S1389-9457%2808%2900154-8/abstract ] 
  7.  “Selenium” [ods.od.nih.gov/factsheets/selenium/]
  8. [ncbi.nlm.nih.gov/pmc/articles/PMC1924637/table/tbl3/]
  9. [ncbi.nlm.nih.gov/pmc/articles/PMC1924637/]
  10. Müssig, K., Thamer, C., Bares, R., Lipp, HP., Häring, HU., Gallwitz, B., Iodine-Induced Thyrotoxicosis After Ingestion of Kelp-Containing Tea, J Gen Intern Med. 2006 June; 21(6): C11–C14. doi: 10.1111/j.1525-1497.2006.00416.x. PMCID: PMC1924637
  11. Leung, A.M., Pearce, E.N., Braverman, L.E., Iodine Content of Prenatal Multivitamins in the United States, N Engl J Med 2009; 360:939-940, [nejm.org/doi/full/10.1056/NEJMc0807851]
  12. Jian-Ying Zhan, Yu-Feng Qin and Zheng-Yan Zhao, Neonatal screening for congenital hypothyroidism and phenylketonuria in China, World Journal of Pediatrics Vol. 5, Number 2, 136-139,  [springerlink.com/content/w7054w4550233404/]
  13. Why so many teen-age boys are wimpy, irresponsible, unmotivated and bored: one of the reasons, gatesofhorn.com,  [gatesofhorn.com/blog/why_so_many_teen_age_boys_are_wimpy_irresponsible_unmotivated_and_bored_one_of_the_reasons]

I need to talk about iodine a bit before I get to the vitamin D and calcium story. I don’t think I would have kicked my migraine and autoimmune problems if I hadn’t conquered my undiagnosed hypothyroidism first. The body can’t do anything without energy and the thyroid hormone is our energizer. Hypothyroid bodies become super efficient at not wasting energy and people can gain weight on 600 calories a day – you can’t live on that. Extreme fatigue, depression, apathy, hair loss, infertility and miscarriages are also common symptoms.