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"Take the chicken out to thaw before I go to work."
"Did I lock the back door?"
"That Sampson proposal has to be finished by Friday."
"Where's my red sweater?"
"What did Cindy mean when she said my haircut made me look younger? Did I look old before?”
Is this the kind of "roof chatter" that goes on in your head as you lay sleepless in your bed? Does that chatter racing through your mind keep you from falling asleep? Maybe so, but probably not.

If you can’t get to sleep, maybe it's your adrenal glands instead, the half-inch high and 3 inches long endocrine glands located on top of the kidneys. When any emotional or physical stress enters your life, your adrenals react by producing cortisol, which helps you in your "Flight or Fight" response. Your daily levels should be highest in the morning and drop evenly throughout the day until it's at its' lowest before bedtime.  

If your adrenals are exhausted because your stress is chronic or you've never really recovered from a major stressful incident, those levels can be out of balance or too high at night. So even though you were tired all day and couldn't wait to go to bed, you're "wired" when it's time to go. You lay there wide-awake so your mind starts filling up with all that chatter. And unfortunately, you usually worry about the 38 things you think you need to do or haven't done correctly rather than reflect on the 97 things you did successfully that day. But maybe you're not awake because of all the things going through your head, you're awake because of the cortisol imbalances and that makes your mind active. You start playing all those guilt, fear and anger videos because there are no distractions, you're up alone and it's nighttime, which is always a bit more threatening.  

If you're waking up in the middle of the night, it may be blood sugar related. If you eat ice cream or something sweet before bed, the processed carbs/refined sugar will cause a sudden rise in your insulin level. The pancreas mistakes how much sugar is coming in because it's so concentrated. The excess insulin significantly lowers your blood sugar level. Your brain needs glucose to work so it can wake you up to address that. Try something with more protein and less sugar or carbs before bed.  

Here are some other suggestions for sleeping problems;
Keep the Bedroom dark, quiet and comfortable.
No caffeine, alcohol or heavy foods for 6 hours before bedtime.
Put the lights out at the same time each night.
No TV in the bedroom.
Use your bed only for sleep and sex; not work or reading the paper.
Never lie in bed awake for more than 20 minutes. Get up, do something, go read but don’t watch TV.

For more information about the Adrenal system and insomnia go to
[Link Removed]

By Michael Madden D.C.


Drmadden, Your links have been removed, please consider upgrading to premium membership.

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Member Comments

    • 0 votes vote up vote up

      3sa wrote Apr 2, 2009
    • I break all those rules...no wonder I can’t sleep!



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    • 0 votes vote up vote up

      Vikki Hall wrote Apr 2, 2009
    • I break them all too......frown



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    • 0 votes vote up vote up

      (華娃娃) ChinaDoll wrote Apr 2, 2009
    • I woke up last night in the middle of the night - guess why?  I had 3 oreo cookies with milk before I went to bed!!!!!

      Now I know. tongue out



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 2, 2009
    • Dear Bernadette,
      Not sure how to privatize a message to you. Do you want me to comment publicly on your question? Want to make sure first. If you want a private email back, go to my website and contact me through that. If not, I’ll be glad to give you my opinion in this public forum.
      DrM
      [Link Removed]


      Drmadden, Your links have been removed, please consider upgrading to premium membership.



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 2, 2009
    • A home saliva test can determine which, if any, Stage of Adrenal Exhaustion(1, 2 or 3) you may be in, depending on your four daily individual amounts and one collective daily amount of cortisol. Post-Traumatic Stress Disorder can be a considerable health challenge. Because it’s more “on the inside“, patients often don’t get the proper attention, care and empathy that a simple broken leg would get. It’s also usually much worse on your whole system in the long run.
      The test will also show your DHEA level, which is a very good barometer of how strong, healthy, etc your overall system is. You can add on to this test and find your female and male hormone levels also without doing anything additional for the test.
      You will need to limit dietary stressors and find ways to deal with lifestyle stressors, even if you can’t eliminate them. Very exact amounts of plant-based nutraceuticals (natural pharmaceuticals) are taken for specific amounts of time, depending on your test results. These nutritional and lifestyle alterations will balance the cortisol and hormone levels.
      The saliva test will tell you whether or not the Adrenals are most likely contributing/ causing the sleeping problems.
      Here is more information about saliva tests if you are interested.
      [Link Removed]
      Try doing things in your diet, lifestyle and nightly habits first to see if you can improve your sleeping issues. It may be simpler than you think.


      Drmadden, Your links have been removed, please consider upgrading to premium membership.



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    • 0 votes vote up vote up

      (華娃娃) ChinaDoll wrote Apr 2, 2009
    • Hi, does insurance cover this normally or is this an individual order?  How long does it take for the result to come back?  Also, your site mentioned Do not take any sublingual products.
      (anything you take under the tongue)  What would that be?



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 2, 2009
    • Depends on your insurance coverage. Some do, some don’t. It generally takes about 5-6 business days from the time you send off the completed test. Some people take certain vitamins, herbal or homeopathic products sublingually. They get into your system much faster this way. You only have to avoid them that one day.



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    • 0 votes vote up vote up

      Mztracy wrote Apr 3, 2009
    • I can never get to sleep. My mind goes a hundred miles a minute. But, my issue is disease related: Multiple Sclerosis. I am not huge on sugars. I am more a paleolithic diet, gluten free, etc.  

      I have serious fatigue daily, but try not to nap too much as then I cannot sleep. I do have a daily ‘keep me up’ medication that I only use if I am going somewhere and need to be alert. And even then, I only take early so as to not affect me at night.

      I take pain meds due to my leg and back pains issues, only sometimes at night to help me sleep, but even then I cannot fall asleep.  

      My bed IS used as my sanctuary and where I spend a lot of time due to the fact I cannot get around too easily and it is better on my back to sit and lie here than in my wheel-chariot.



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 3, 2009
    • Tracy,
      Congratulations on getting on the Paleolithic diet and off of gluten. It’s hard to do but very good for lowering the physical stress in your system. Some in the health care community believe that MS patients may have more Vitamin E, Glutathione, CoQ10 deficiencies and intestinal permeability. If gluten does bother your digestion, stomach or intestines, you may want to do a stool test to see if there’s some parasites or bacteria in there keeping some level of inflammation around. Do a four day stool test as opposed to a one day test. The one day test misses a lot of things.

      An MD who spoke at a Detox seminar I attended last fall, makes any new patient of his that has a systemic disease, get a heavy metals urine test. You take a chelating agent by tablet and then do a urine test throughout the day at home. Blood tests often only show problems when the person has had a recent or very significant exposure to heavy metals. Once the metals go into your body they go elsewhere. For example, Lead goes into the bones and fat tissue. The chelating agent draws the metals out of the hidden areas and dumps them into the urine to be measured and detoxed.  

      Having MS is a major stressor on just about every system in your body and I’m sure your Adrenals have suffered accordingly.



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 3, 2009
    • Yes, Mercury fillings are a huge source of heavy metal poisoning. But there are metals in cosmetics, drinking water and pesticides also. Deodorants and cooking utensils can give off aluminum. Cadmium, Arsenic and Lead are in cigarettes and cosmetics. Lead is also in paint, contaminated dirt and dust. You can breathe in metals in certain working environments or toxic air. If you do have heavy metals in your system there are a lot of ways to detox. The best ones are those that combine;
      1) A chelating agent of some kind to draw them out
      2) A nutritional program to cleanse, detox and replenish
      3) Sweating or cleansing in saunas, especially the infrared kind  

      Here’s a January 2009 article from the Canadian government on metals in cosmetics.
      [Link Removed]


      Drmadden, Your links have been removed, please consider upgrading to premium membership.



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    • 0 votes vote up vote up

      Mztracy wrote Apr 4, 2009
    • ty very much for your reply.
      I am going to get with my doctor about these tests.

      Maybe one day MS will be no more and I will sleep!! estatic



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    • 0 votes vote up vote up

      UK Girl wrote Apr 4, 2009
    • I’ve had toothache all this week which has driven me mad and my dentist has recommended I change all my fillings - he has now done the back four - the pain has been awful but I’ve actually slept better and feel better ..... so over the next 6 weeks he is redoing all my teeth .......I’ll be broke but better



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 4, 2009
    • Dear Vicki,
      You are to be applauded for taking that uncomfortable and somewhat expensive step. You will be better for it in the long run. Just to give you an idea of how dangerous Mercury is, here is an excerpt from an article on how to dispose of Mercury.

      “Contain the mercury as well as possible, preferably in a heavy glass jar with a lid which seals.
      Keep the container in a safe location where children and pets cannot disturb it.
      Your local government should have a hazardous waste disposal facility, the first option would be to find them in the phone book and call for a schedule of drop off times and further instructions.
      There is a website devoted to all environmental waste and hazardous materials that can direct you and provide information on disposal, the address is [Link Removed] and when you visit it, you can enter your zip code and it will give you specific information on local hazardous waste services.”

      THAT‘S how toxic it is and yet most of us have it in our mouths.


      Drmadden, Your links have been removed, please consider upgrading to premium membership.



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 4, 2009
    • How old is your daughter? Her age and general sensitivity would determine how aggressive to be and what agents to use to detox any mercury that may be present. The initial testing process is the patient taking some chelating agent tablets over the course of a day, drinking lots of water and collecting all the urine during a 6-8 hour window. You then send  that test kit to the lab to see what, if any, heavy metals are in the urine.
      When people have had problems in the past with heavy metal detox, it’s often because they either took too much of the chelating agent and felt sick from it or they didn’t do the replenishing of the good minerals it also takes out. Besides taking detox herbs to clean out the metals that the chelating agent removes from tissues or bone, you also take a lot of amino acids, vitamins, fiber and eat a very healthy diet while you‘re doing it. Some natural chelators are Vit C and E, Milk Thistle, Cilantro and Garlic.
      The actual heavy metal urine test itself is around $125-150 depending on where you get it done. Lab companies can send the test kits to your house, you can do them there and then send them back.



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    • 0 votes vote up vote up

      Daffygirl wrote Apr 5, 2009
    • Dr Madden,

      Extremely interesting dialog - I recently changed to BHRT and during the course of discussion it was decided to do the saliva test for cortisol and DHEA. I would be interested in your take on having a normal cortisol level but zero  DHEA. Was told she'd never seen such a test in 12 years of working with BHRT and adrenal function. Needless to say, I really didn't get an adequate explanation of why, what,etc. I am now taking DHEA troche, extra vitamins at breakfast and lunch; 500 mg "C" 4x/day; and a adrenal support mineral at bedtime.  

      Frankly, I’m choking on all these pills - multiple doses, 4x/day - (vitamins and minerals coming out my ears!!).

      Your observations will be appreciated.

      Laurie



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 5, 2009
    • Dear Laurie,
      It makes sense if your cortisol is “normal” but your DHEA is very low, THAT I can easily explain. If the DHEA is actually zero, I would do the test at a different lab. Never heard of such a thing. Some hospital labs don’t have the quality control and/or the higher quality lab techs so a number like that sounds like an error. Because if your DHEA level IS normal, then you don’t need all those supplements. I think Biohealth does the best job with adrenal tests.

      Let’s start out with a normal cortisol and DHEA and a “normal” patient. Stress comes into your life both emotionally and physically. Your body reacts by making a lot of cortisol so that number goes up and your DHEA begins to go down. Your poor body keeps trying its’ best to fight off the stress by continually making more cortisol. But eventually it begins to weaken and although it’s trying, it just can’t keep it up. So as the stress continues or returns, the adrenals try to make the cortisol but they‘re beginning to be exhausted (Stage 1 going into a 2), so the total cortisol number in a test will read “normal” because it’s back down in the normal range from where it was when the stress first started.  

      If the stress never gets handled and the adrenals never get help, the next Stage is Stage 3 where the cortisol level continues to drop so you have a low cortisol with the low DHEA.

      So the fact that your DHEA is low shows that the cortisol is actually a Stage 2 adrenal exhaustion as opposed to a normal level. If the DHEA were normal and the cortisol were where it is, then the Adrenal system would have checked out just fine.

      Hope that wasn’t too confusing. I will clarify the vague parts if you need me to do that. This stuff is easy when you do it for a living but complicated when it’s new to you. Feel free to ask away.



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    • 0 votes vote up vote up

      Houselady wrote Apr 5, 2009
    • Glad I found this site and this article about sleeplessness. Thanks for all the insites!



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    • 0 votes vote up vote up

      Daffygirl wrote Apr 6, 2009
    • Dear Dr Madden,

      Thank you for the answer - BioHealth did the test - my DHEA was 0.38 with a cortisol/DHEA ratio of 90.5. Far and away above the reference range! She is treating me for Stage 2 adrenal fatigue on a 12 week protocol of vitamins/minerals (from BioHealth sister company - very expensive and not covered by insurance), the DHEA (ins covered), increase fruits/veggies, and try to relax (the word is not in my vocabulary but I’m making an attempt - at least I quit the killer job). I’m exercising 5-6 days each week for an hour or so (treadmill) and do a resistance workout 3x/week.  

      Sleep is slowly returning, blood pressure is still up (I have a hx of hypertension and am medicated yet my understanding is generally those w/adrenal fatigue have low BP), exercise is helping my mood tremendously altho the weight around my middle refuses to budge (lol).  

      I presume you agree (as much as you are able w/out seeing actual medical records) w/her plan - getting feedback in this area is near impossible given my location. I would ask if you are aware of any supplier of appropriate vitamin/mineral supplements that are a little easier on the pocketbook?

      Again, thank you for  the response. Laurie



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    • 0 votes vote up vote up

      Michael Madden DC wrote Apr 6, 2009
    • A DHEA that low is unusual but very conceivable. A complete zero isn’t acceptable but 0.38 is possible. It just means that your system has been taking hits for a very long time. It’s hard when you start making changes because we all want to get back to normal quickly. But it literally took years for you to get to those numbers and it will take at least 12-18 months for you to get back to where you should be. Try to enjoy the journey. With that diet and exercise regime, you will feel, look and be better and better as you continue it.

      The idea for treating you for a Stage 2 Adrenal Exhaustion makes sense given those numbers but I don’t know exactly what vitamins and minerals you‘re taking so I can’t give you feedback until I do.  

      Regarding cost. I spent 25 years in practice treating people for things that were often not covered by their insurance companies. The bad news is that you‘re already paying so much for major health insurance that it feels unfair that you have to pay out of your pocket for something else. The good news is that when you DO pay out of your pocket, you follow instructions, suggestions and protocols much better. You are more emotionally and logistically invested and subsequently get better results. It’s money, there’s always more of it out there in the universe. Your health on the other hand, is a much more precious and finite commodity. Whatever you spend to get healthier is worth it! Let me repeat that. Whatever you spend to get healthier is worth it! Ask anyone who doesn’t have their health and that’s what they will tell you.

      You‘re on the right track. Congratulations on doing something good for yourself. Too often women take care of themselves last when they should be taking care of themselves first.

      Here’s a handout I give my patients about the cost of supplements.

      Michael Madden D.C.

         [Link Removed]

      Contrasting Retail Supplements with Doctor Provided Supplements

      Often, a patient will express questions about taking the supplements provided through their healthcare provider.  The patient rightly wants to know why they should pay the premium price for these supplements rather than buy inexpensive supplements through retail outlets such as Costco, GNC or their local drugstore. In pondering this issue I am reminded of something a wise professor of mine once said, if you really want to understand an issue in healthcare....just follow the money.  What?  Following the money leads me to the higher price and higher profit of the doctor provided supplements, right?  Wrong.

      In the US, the retail market is approximately 92% of the supplement market.  The remainder, 6-8%, is the doctor provided market. By "following the money" you will see the basic difference is in what drives profit for each segment.  

      The retail market supplements compete mainly on price...lower price (combined with attractive labeling) spells increased sales and profit.  Because consumers can rarely sense a direct effect from retail supplements, it's almost impossible for them to judge quality objectively.  So, retail supplement manufacturers are highly motivated to use the cheapest ingredients they can find, thereby increasing profit. And because there is little regulatory oversight in the supplement manufacturing industry, it's not difficult to cut corners on product quality.

      The doctor provided supplement market competes on quality.  The doctor that provides these supplements to his patients put his/her reputation on the line when providing them.  As such, the company that can assure the best quality ingredients and formulation in this market will be the most successful and profitable.  If they fail in this regard, they will fail to be profitable, and most likely fail as a business venture. This is because quality and correct formulation really do make a difference that the patient can feel.

      So, without the market-driven motivation to produce high quality (as with doctor provided supplements), the retail supplement manufacturers have very little motivation to spend the extra money associated with sourcing the highest quality ingredients.

      Retail Supplement Manufacturers = motivation to reduce costs
      Doctor Provided Supplement Manufacturers = motivation to increase quality

      This may seem simple, but if you really, really think about business, and the reason for being in business, you will understand that it is first and foremost profit.  The doctor provided supplement manufacturers have to pay attention to quality or they will not maximize profit.  The retail supplement manufacturers have to pay attention to lowering costs to maximize their profit.

      In conclusion, instead of a patient asking themselves why the doctor provided product costs more, it would be a much more revealing question to ask how is it possible for the retail supplements to cost so much less.....follow the money.


      Drmadden, Your links have been removed, please consider upgrading to premium membership.



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    • 0 votes vote up vote up

      Paula Bertucci wrote May 9, 2009
    • Hi Dr Madden..
      boy oh boy..this is right up my alley..ever since I had my kidney removed 6 years ago...I have dealt with adrenal stress off and on...you are so right on with so much you are suggesting. I’ve done the saliva test..not enjoyable ..but worth getting results. I was wondering if you have ever suggested the following product to address stress. I use to work in a Health Food store...so I know the brand line is a good one....it’s by Gaia Herbs..Siberian Rhodiola Rosea...it’s an adaptogenic respnse to stress. I am in Menopause..I take 2 every night before bed..it really helps me get a deep restful sleep...most of the time and is non habit forming..any thoughts on this??

      Again,
      Thanks for being here,
      PAula



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    • 0 votes vote up vote up

      Michael Madden DC wrote May 10, 2009
    • Dear Paula,
      You mentioned that the saliva test wasn’t enjoyable. A typical one just has the patient spitting into 4 different tubes over the course of one day. Did you take a different kind of test? Your herb is fine, I believe it’s a kind of generic adrenal support. When you had your kidney removed, did it take out or affect your the adrenal glad on that side? Supplements can be much more specific to build up the adrenals themselves as opposed to something that just supports it. What you would take would be determined by the stage of exhaustion your glands are in. Did you get specific results with levels of cortisol and DHEA?



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    • 0 votes vote up vote up

      Megdalia Valentin wrote Aug 15, 2009
    • I break all of them too. Very Night. I have bad insomia plus a big case of depression



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    • 0 votes vote up vote up

      Michael Madden DC wrote Aug 16, 2009
    • You break all of what? Read the other blogs of mine about female hormones and depression.



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