Why Are You Still Tired?

Continuing from the prior blog, we will delve more into sleep problems. Insomnia is incredibly common in America. Some people can’t get to sleep and other can’t stay asleep. I am still surprised that there are so few sleep experts in medicine.

If a person goes to a sleep center, it is almost always to be evaluated for sleep apnea. There are generally no physicians who specialize in getting someone a full night’s sleep. The rare provider that focuses on insomnia is usually trying to find the best prescription medication for the patient. This is where American medicine has evolved and many do not question this approach. It is often better than doing nothing.

As with just about every other area in health, I am trying to find better options for insomnia beyond simply bombing away with pharmaceuticals that shut the brain down. Most often, I will start the patient on magnesium and, preferably, after I check an RBC magnesium level.

Standard magnesium levels that a doctor would order tell us nothing about the body’s magnesium status because only about 1% of a person’s magnesium is in the bloodstream. The level in the blood is maintained in a tight range no matter how deficient the person. For the RBC magnesium level, there are two “normal“ ranges depending on which reference lab is used.

It is estimated that more than 80% of adults in American are magnesium deficient so RBC magnesium levels are another example where the “normal” range is unreliable. The majority of the population sampled for the “normal” range is deficient so it is skewed downward. For this reason “normal” rarely reflects optimal. If the lab uses mg/dL as the reference unit, you want to get the levels at least above 6.0. If they use the other reference unit of mmol/L, the goal is at an RBC magnesium level at least above 2.5 and more often around 3.0.

I will start most on either magnesium malate or magnesium glycinate at doses around 400-600mg daily. It can take up to a few weeks or longer to improve sleep depending on the level of chronic deficiency. If some 65-year-old patient has been magnesium and mineral deficient for 40 years, it will take some time to replenish their bodies.

We are conditioned for the quick fix. If a person gets a sleep medication like Ambien or trazodone, they are hoping they will sleep well the first night. Using magnesium takes patience but I have seen it work tremendously well on people that haven’t had a good night’s sleep for five years, ten years or more.

If basic sleep hygiene, blackout shades and magnesium don’t work, my next option is probably the supplement developed by Keith Parsley, MD. (I would encourage anyone with chronic insomnia to find and review some of Dr. Parsley’s ideas about sleep. His website is docparsley.com.)

From the website, his supplement called Sleep Cocktail is “design[ed] to ensure the naturally occurring nutrients needed to initiate and maintain sleep are present, in sufficient quantities, to allow natural, restful, and restorative sleep.”

Sleep Cocktail contains magnesium, L-tryptophan, 5-HTP, vitamin D3 and a small amount of melatonin so a person may have to cut back or stop other supplements if they start the supplement. This option would hopefully replace any prescription sleep medications.

In the next blog, we will explore thyroid problems in more detail. Thyroid dysfunction and thyroid hormone deficiency is easily in the top 5 of the most important, most underdiagnosed and most undermanaged issues in America.

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