@SuzieSam - In my efforts to get a good night's sleep, I've come across 7 things which have helped me a lot, which may all be interrelated but I am going to list them separately here.
1. Increasing or enhancing GABA - GABA as you probably know is a calming neurotransmitter essential for sleep. You can take plain GABA, which does not cross the blood-brain barrier, but there are GABA receptors in other parts of the body so it can be helpful. However, the amino acid l-theanine does cross the blood-brain barrier and helps the brain produce GABA, so both plain GABA and l-theanine can be useful.
However, for me, taking these alone does not do a lot. A couple of years ago I learned that niacin and niacinamide sensitize the GABA receptors and when I added in niacin at night before bed (it seems to work better for me than niacinamide), I started sleeping better immediately. If I take niacin during the day, it makes me tired. It can slow down methylation and also increase GABA but I do fine with it at night. The niacin also lowered my cholesterol (I wasn’t trying to do that but it just happened)
Niacin will cause flushing - your skin gets red and hot and prickly, it’s temporary - it’s caused by vasodilation and is harmless. Actually I look forward to it now because it usually means I’ll be asleep soon. Niacinamide does not cause flushing and it’s supposed to be just as effective, but I wouldn’t take both. I was taking 500 mg niacin before bed and 500 mg more in the middle of the night. I’ve had to increase that due to a lorazepam taper I’ve been doing, but I think it would be an effective dose for most people.
DON’T get time-release or extended-release niacin - this has been linked to liver damage. And non-flushing niacin (which is available) will not be effective for sleep. I would either take plain niacin which causes the flushing, or niacinamide, and no other form of niacin.
Inositol also has been very helpful and it too enhances the effect of GABA - 500 mg before bed and 500 middle of the night is a good dose, some may need more.
I can’t tell anyone how much to take, just what works for me.
2. Cortisol - if cortisol is high at night, this can cause severe insomnia. The Adrenal Stress Index Test measures cortisol levels throughout the day/evening using 4 saliva samples.
13 years ago or so I had severe middle of the night insomnia and nothing would touch it, until I had that test done and discovered high cortisol at night. I was given Seriphos (originally formulated as phosphorylated serine) and it helped almost immediately. I had to titrate up to find an effective dose and found I needed 8 capsules a day (which is quite a high dose), taken in the morning on an empty stomach in divided doses - it caused insomnia when I took it at night, and then after a few months it made me tired and I realized my cortisol was going too low and I had to drop my dose, which was good.
Interplexus, the maker of Seriphos, changed the formulation around last May to phosphatidylserine, not the same thing at all as phosphorylated serine! And the new formula worked nothing like the old formula. Fortunately, Interplexus responded to customer outcry and are returning to the original formula. They said it should be manufactured by the end of this last December. However, if you decide to purchase Seriphos, make sure that you are getting phosphorylated serine. I wouldn’t be surprised if the ineffective formula (phosphatidyl serine) was still being sold for some time to get rid of stock. Whew! Sorry it’s so complicated! But I wanted you to have all this information.
I would not take Seriphos without having cortisol levels tested.
Relora can also be helpful in lowering cortisol. After the formulation change of Seriphos, I started taking Relora (at night) and it’s helpful, so if high cortisol turns out to be an issue for your husband, you might just try Relora. I think it would be fine to just try the Relora without the test.
3. Excitotoxicity - This explains what excitotoxicity is:
https://en.wikipedia.org/wiki/Excitotoxicity
I explained above how Vitamin C helped (and is still helping) me with this issue. Also, it would be very good to avoid MSG in all its iterations - it is an excitotoxin (it’s crazy, MSG is in almost all processed foods although you rarely see it labeled as such - there are articles written about all the ways manufacturers get around calling MSG, MSG, but instead are allowed to use innocuous phrases such as "natural flavoring" or "yeast extract", there are a lot more)
4. Blood sugar - low blood sugar at night can raise cortisol. I also just learned in that Wiki article on excitotoxicity that hypoglycemia is linked to excitotoxicity. In any event, low blood sugar can cause insomnia whether due to raising cortisol or causing neuronal excitotoxicity. I’ve been eating low carb for years , e.g., I might have some chicken and broccoli for dinner - no starches. And never realized it was contributing to my insomnia. It’s a long story but I’ve started eating a potato with dinner sometimes, or else I’ll have a few bites of potato before I go to bed; if I’m hungry middle of the night, I’ll have a few more bites of potato. This helps too to keep my blood sugar stable and to sleep better.
5. Serotonin - 5-htp, which helps the brain produce serotonin, also helps me with sleep. I take 150 mg before bed. I don’t tolerate prescription anti-depressants and think they can be quite harmful as well. I think instead we just need to get the proper nutrients to make what our bodies need - there is no such thing as a Prozac deficiency.
6. Melatonin helps too. Theoretically my body would make all it needs - it doesn’t - but all of us with ME/CFS have sleep issues.
7. L-glycine - this is quite calming and also helps with sleep. I take 2000 mg before bed and more in the middle of the night if I need it.
That's interesting,
@Mary.
I'm a big fan of niacin flushing - aside from anything else, the flush indicates you've reached the correct dose for you. I enjoy the prickling, tingling sensation. It does make me go bright red sometimes (more likely on an empty stomach), and the other day I took it before I dragged myself to a physio appointment. My reaction was somewhat delayed, and I ended up flushing right at the end of my session, which must have looked very odd to my physio!
In relation to your sleep, and what you found out about low blood sugar raising cortisol, niacin will raise your blood sugar. Niacinamide does not raise blood sugar, but neither does it lower cholesterol, which as you've found out, niacin does. I baffle my GP by continuously lowering my cholesterol. They keep lowering the ref ranges, so they can get more people on statins (which I will never agree to, thanks very much).
Niacinamide has been shown in studies to be as effective as diazepam. Niacin doesn't have the same effect.
I agree with you absolutely about avoiding timed-release forms of B3. It has indeed been proven to be hepatotoxic. I don't understand how it is still for sale anywhere.
Also in relation to sleep, the starch in the potato may be helping you to allow tryptophan, another sleep helper, to cros the BBB. All starches will facilitate this.
Does melatonin work for you? What dose do you find mist effective? I read recently that taking melatonin can cause you to wake up not that long after it has sent you to sleep due to some kind of rebound effect, I think it was a case of the natural production switching off in the presence of exogenous melatonin, and I have to say that that fits with my experience of it. It sends me to sleep, but then I wake up an hour or so later, and stay awake. Because of this, whatever it was I was reading was saying that lower doses are more effective at facilitating an unbroken night's sleep, which would seem to make sense.
Be aware that if you take chromium, it will eat up niacin and you will need a larger dose to schieve flushing. If you take chromium GTF, which is already pre-bound to niacin, it doesn't eat it up quite as much, though I still have to increase my dose a bit when I use chromium GTF.
I know there are other mechanisms at work that affect how much niacin you need at any given time, because pre-cancer and pre-increased hydrocortisone, 100mg was enough to make me flush. I used to take it after breakfast, so not even on an empty stomach, and then I'd flush in the car within the first 20 minutes of my 55 minute drive to uni, arriving looking a normal colour..
Since chemo et al, it takes at least 2-300mg, and more often 500mg. Possibly that could be due to my CFS and FM being exacerbated by cancer treatments. Maybe we have a greater need for it, use more of it up, burn through it faster, I'm not yet certain.
On 1mg chromium pic, it was taking 1g, which, because of the steroids causing a propensity tiwards iatragenic type ll diabetes (hence the chromium), I had to reduce. Again, the ref ranges for "pre-diabetes" keep being lowered. In 2013, my HbA1C was deemed normal at 55. In 2015, the cut-off point was lowered to something like 45, and my GP scared me silly with the threat of diabetes, and wanted me on metformin - also not something I would ever take.
Ashwaghanda also lowers cortisol, so that can be useful if you have high cortisol at night. If you're stressed about anything, that will obviously increase night-time cortisol, too, but then things like niacinamide and valerian can be very calming.
I'm also a huge proponent of Vit C, and have been dosing according to my BIP since the 1990's. Everyone's BIP (Bowel Intolerance Point) changes depending on how many physical, mental and emotional stressors you're dealing with at any particular time, and the greater the stressors, the greater your requirement becomes. Everyone's requirement is different,
The idea is that you work out your current BIP, then reduce that dose by a gram or two so and use that as your ongoing maintenance dose. That way, you get close to your BIP without actually reaching it. So if, e.g., 9g proves to be your BIP, you'd use 7-8g as your maintenance dose from then on, taken in divided doses each day.
You can only work out your BIP with straight unadulterated ascorbic acid Vit C. Timed-release would defeat the object of the exercise, and ascorbyl palmitate (fat-soluble) will just store. It has to be the water-soluble ascorbic acid. Fizzy, chewable and tablet formats are things I also avoid. Plain Vit C powder in capsules is what I always use. Powder in water is too sharp for me, but other people get on fine with that.
You know pretty fast when you've taken enough, usually within about 30 minutes of having just exceeded your tolerance point. It's best to do this on a day where you can avoid eating large meals, because ascorbic acid in these quantities will neutralise your stomach acid and if you eat a normal-sized meal, you won't be able to digest it. Being at home is also a good idea ;-)
Ideally, you need to avoid taking large doses of Vit C - by which I mean 2-3g at once - an hour or more each side of food when you're maintenance-dosing, but it's best to keep food to a bare minimum or even avoid it altogether when you're establishing your intolerance point. I once rather stupidly took 9g immediately before eating out in a restaurant with a group of people I was on a residential course with, because I was tired and struggling, and mega-doses of C always perked me up. My poor stomach practically exploded with gas. It was painful (and explosively noisy!) to say the least. Embarrassing? Not much!
When I wasn't doing too badly, pre-2007, 6g would often be my BIP, but when I was struggling with uni work on top of CFS, it would take more like 15-20g. Back in the mid 90's, before my thyroid and adrenal issues were addressed, I once took 45g and still didn't reach BIP. By then it was 2am, so I had to give up for the day.
According to the BMA, in one of their prescription drugs identifier books, it says that 99% of Vit C goes directly to your adrenals, so that would explain why greater stress means you need more Vit C, and also probably why you've found it so helpful in lowering your night-time cortisol levels, thus aiding sleep. That hadn't occurred to me until I saw your post title about sleep and Vit C (it should have!)
I'm off to read it now, so thanks for that post, too
