| Test Results Suggestive of Chronic Nighttime Stress: A G.I. Pathogen Problem? |
12.30.11 11:07:37 |
Transcript of Video:
Hi. I’m Dr. Christopher Mote, and today is another ARK Clinical Pearl.
Something I want to share with you is a pattern on the cortisol test that is fairly common. It comes up frequently when we have consultations with other clinicians, and it’s the pattern that is indication of nighttime-related stress. So when you get your four sample cortisol back, if the morning and the last sample, or the bedtime, are both higher than the middle samples, so if there’s an absolute elevation or maybe they’re just higher than the two samples in the middle of the day – either way – then what you have is a patient who’s experiencing some HPA axis activation when the access should be shutting down.
So, for example, if they’re low at noon, low in the afternoon, and then the bedtime is coming up, and they’re up in the morning, that’s a patient who’s experiencing HPA axis while they’re sleeping. And frankly, they may not be sleeping. So over the years I’ve seen patients who have this pattern, and we have found a specific pattern of stress in these patients.
Now, theoretically, it could be any of the three stressors. Mental and emotional, so I guess if they were having some type of vivid dream state, which has happened in a couple of instances, or if there’s low blood sugar, that could stimulate it through the evening, but by far the most common pattern that we’ve seen or cause that we’ve seen for this pattern has been patients with GI pathogens.
So when we get stool testing on these patients, we’ll find parasites like Blastocystis hominis or cryptosporidium or Giardia lamblia, and then we go back and we look, and yeah, sure enough, those patients had stimulations of their HPA axis at bedtime and through the night.
So to help them get sleep and repair, which is so critical to the restoration of the HPA axis, we use phosphatidylserine, a hundred milligrams about 6:00 or 7:00 at night, and again at bedtime to help bring that HPA axis down and keep it down through the night, and then go looking for – with the stool tests, go looking for the cause for that HPA axis activation, and frequently you’re gonna find these patients have some type of GI pathogen.