Doctor's Data and Labrix teams have joined forces to produce educational content for providers. 

 

Earn up to 14.5

CME credits!

Laboratory, Endocrine, & Neurotransmitter Symposium

October 4 - 6, 2019

Portland, OR

Approved for 4.25 Pharm CEs from the OBNM!

Gain additional clinical insight and treatment considerations to evaluate some of the most prevalent and challenging conditions that patients present with, including depression, anxiety, altered mental focus and stamina, sexual dysfunction, sleep disturbances, addictions and dependencies, weight management, and chronic disease. Register now to get the early bird price of $329 (reg. $379).

 

Wellness Wednesday

Webinar Series

Topic: Taking Action - Hormone Testing and Prescribing

By: Heather Hydzik, ND

August 7, 2019

Join Labrix clinical staff and special guests on the first Wednesday of every month at 9:30 AM and 12:00 PM PST. This free, live webinar series will cover a variety of neuroendocrine topics that will enhance your knowledge, with clinically applicable testing and treatment considerations. 1 CE credit available upon attendee request.

 

AANP

Portland, OR:

August 15-17, 2019

Labrix will be in Portland for AANP on August 15 - 17. Come chat with our booth representative and learn more about testing with Labrix and Doctor's Data.

 

AARM

San Diego, CA:

September 12-25, 2019

Make sure to visit our booth at AARM in San Diego. Chat with our booth representatives to learn what's new.

Seasonal Shifts and Sleep Quality

 

By Krista Anderson Ross, ND | August 6, 2019

As we enter the last lazy month of August, it’s time to start thinking about getting healthy for the fall. For some, the new year starts in January, for many the new year starts when school is back in session. As the days begin to shorten and nights lengthen, it is the perfect time to reset the diurnal clock for optimal functioning.

As with all mammals, humans are subject to the effects of the earth’s rotation and the solar day. As a result, most physiological processes oscillate in a daily fashion. Certain signals, or zeitgeibers, influence the diurnal rhythm. The most potent zeitgeibers are light and dark. This time of year it is easier to get up in the morning due to increased light, and more difficult to settle down for bed due to a later sunset. In the fall and winter it is the opposite: easier to fall asleep at night due to the darkness, but harder to wake up in the morning.

One of the best ways to increase health is through maximizing sleep, which leads to healthy levels of melatonin at night and optimal cortisol levels during the day. Cortisol follows the curve of light: it is highest in the morning 30 minutes after waking — the “cortisol awakening response” — and lowest in the evening and at night in darkness. Conversely, melatonin follows the curve of darkness: it begins its ascent at dusk and reaches its peak in the middle of the night, during sleep, when cortisol levels are lowest. The light of morning shuts down melatonin as it descends from peak levels in the darkness of sleep, enabling cortisol levels to rise upon waking. Cortisol suppresses melatonin levels during the day and melatonin suppresses cortisol levels in the evening and at night. 1,2

The diurnal rhythm of cortisol, being at its highest in the morning and flattening out as the day progresses, is known in the scientific literature as a “slope.” Flatter diurnal cortisol slopes are associated with poorer mental and physical outcomes than more robust slopes. Flatter slopes are also associated with a higher incidence of inflammatory processes. 3 Melatonin’s function as a free-radical scavenger and potent antioxidant are well documented in the scientific literature. As well, melatonin’s anti-inflammatory effects are becoming more recognized. 4

24 hour exposure to light is nearly ubiquitous in the modern world. Even brief durations of bright light and dim light during the diurnal hours of darkness are disruptive to the circadian system, with endocrine disrupting properties.6  Epidemiological studies have revealed an association between the disruption in the circadian system as a result of shift work and/or night work, and a higher incidence of several diseases including cancer, diabetes, cardiovascular risks, obesity, mood disorders, age-related macular degeneration, metabolic and endocrine disruption. The potential mechanisms include the suppression of melatonin from artificial light at night (ALAN), sleep deprivation and circadian disruption. Light has such a powerful impact on human physiology that the International Agency for Research on Cancer (IARC) has classified shift work as a “probable carcinogen to humans.” 5, 6

While blue light from technological devices may have the most pronounced suppressant effect on melatonin production, recent small studies suggests that exposure to natural, full-spectrum light throughout the day can counterbalance the melatonin-lowering impact of electronic light at night. This points to the ultimate power of natural bright light, suggesting exposure to “some” natural light may attenuate the melatonin-inhibiting effects of evening light. 7,8,9

The good news is that shifting one’s environment to reflect a healthy diurnal rhythm is not difficult, but requires intentionality. Many communities enforce outdoor lighting ordinances, also known as “the dark sky movement,” to reduce exposure to ALAN. Indoor lights can be dimmed to mimic the setting of the sun, supporting dim light melatonin onset (DLMO).

Refraining from screens one hour before bed time can help increase melatonin production, and light blocking glasses are available if evening exposure to indoor light and screens is not avoidable. Short bursts of outdoor light every couple of hours, or use of full spectrum light indoors, can mimic the bright light of the solar day, and attenuate the melatonin-lowering effects of artificial light at night. School districts are adjusting school start times to reflect adolescents’ increased need for sleep for academic performance, and physical and mental health; and many workplaces are offering full spectrum lighting in the workplace, and/or frequent “sunshine” breaks.

How can you know if a circadian rhythm imbalance may be impacting your patients’ health? Consider a Doctor’s Data/Labrix four point cortisol test which measures the diurnal rhythm of cortisol, and for the month of August 2019 we will test PM melatonin for free on any kit that is returned with 4 cortisols ordered. Profile ordered must include AM30, noon, evening and night cortisols. Kits must be received by August 31, 2019. If you have questions, please contact your account representative.

 

References

  1. Pandi-Perumal SR, Trakht I, Spence DW, et al. The roles of melatonin and light in the pathophysiology and treatment of circadian rhythm sleep disorders. Nat Clin Pract Neurol. 2008;4(8):436-447.
  2. Hickie IB, Naismith SL, Robillard R, et al. Manipulating the sleep-wake cycle and circadian rhythms to improve clinical management of major depression. BMC Med. 2013;11:79.
  3. Adam EK, Quinn ME, Tavernier R, Mcquillan MT, Dahlke KA, Gilbert KE. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017;83:25-41.
  4. Jones TM, Durrant J, Michaelides EB, Green MP. Melatonin: a possible link between the presence of artificial light at night and reductions in biological fitness. Philos Trans R Soc Lond, B, Biol Sci. 2015;370(1667)
  5. Touitou Y, Reinberg A, Touitou D. Association between light at night, melatonin secretion, sleep deprivation, and the internal clock: Health impacts and mechanisms of circadian disruption. Life Sci. 2017;173:94-106.
  6. Russart KLG, Nelson RJ. Light at night as an environmental endocrine disruptor. Physiol Behav. 2018;190:82-89.
  7. Pandi-Perumal SR, Trakht I, Spence DW, et al. The roles of melatonin and light in the pathophysiology and treatment of circadian rhythm sleep disorders. Nat Clin Pract Neurol. 2008;4(8):436-447.
  8. Rångtell FH, Ekstrand E, Rapp L, et al. Two hours of evening reading on a self-luminous tablet vs. reading a physical book does not alter sleep after daytime bright light exposure. Sleep Med. 2016;23:111-118.
  9. Stothard ER, Mchill AW, Depner CM, et al. Circadian Entrainment to the Natural Light-Dark Cycle across Seasons and the Weekend. Curr Biol. 2017;27(4):508-513.

Disclaimer: All information given about health conditions, treatment, products, and dosages are for educational purposes only and do not constitute medical advice.