A Root Cause Medicine Approach
|
December 10, 2021

Can't Sleep? Make Sure You're Getting These 3 Micronutrients

Medically Reviewed by
Updated On
November 8, 2024

Why do we need sleep? How much sleep is the right amount of sleep? Why do some people thrive off of six hours while others could sleep for weeks if given the opportunity?

There is definitely no one size fits all approach to sleep deprivation. What works for one person can have no effect or even worse and adverse effect for another. With so much information out there, I thought it was time to explain this topic thoroughly.

So before reaching for those sleeping pills, check out the below article on the many reasons you may be having a hard time sleeping; some might surprise you.

This article highlights what test I use when an insomnia patient walks into my office and how to supplement based on the test results. Because we really should be getting into the habit of testing, not guessing. 🤓 We could help a lot more people if we actually got to the root causes of what’s going on.

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Sleep Deprivation Signs & Symptoms

While sleeping, the immune system is regenerated, blood sugar levels are balanced, the brain is activated, and the hormones are regulated.

If a person does not get enough sleep, they can be at risk of developing many health issues, including obesity, insulin resistance, a weakened immune system, and cognitive issues.

Symptoms

  • Daytime Drowsiness
  • Reduced mental alertness
  • Poor hand-eye coordination
  • Poor concentration and focus
  • Micro Sleeps
  • Insulin Resistance
  • Lower immunity

How Much Sleep Do We Need for Optimal Health?

It provides recommended sleep durations for different age groups

Sleep Deprivation Possible Causes

Lack of sleep can be from many causes; a new baby, a strange house, too much caffeine, etc. All of those reasons can be easily adapted to and overcome. But if you are one of the millions of chronic sleep-deprived sufferers who can’t quite figure out what’s “wrong,” check out some of these commonly overlooked reasons.  

Micronutrient Deficiencies

Micronutrients affect the hormonal and neurotransmitters pathways involved in sleep. Making sure they stay at optimal levels is necessary for proper sleep rhythms.

Magnesium

  • Magnesium increases GABA, a brain neurotransmitter, which is responsible for slowing your thinking down and helping you fall asleep
  • Increasing magnesium can help those with restless legs syndrome

Vitamin D

  • Vitamin D helps to improve sleep quality, reduces sleep latency, and raises sleep duration.

Vitamin B6

  • Vitamin B6 aids in the production of the hormones serotonin and melatonin. A lack of vitamin B6 has been linked to symptoms of insomnia and depression.

Hormone and Neurotransmitter Imbalance

Unbalanced of Cortisol and Melatonin production

In a perfect world, the master stress hormone cortisol should be in sync with the master sleep hormone melatonin. Each hormone counterbalances the other in a precise rhythm. When cortisol is high (morning), melatonin should be low, and when melatonin is high (evenings), cortisol should be low.

Unbalanced cortisol to melatonin levels can be caused by many factors, including adrenal fatigue, night shift work, and stress, to name a few.

Neurotransmitter Imbalances

Neurotransmitters are chemical messengers the nervous system uses to relay information from one nerve to another.

Genetics, environment, chemicals, and nutritional deficiencies are a few factors that can impact neurotransmitter production.

Imbalances in neurotransmitters can cause the brain and the body to be over or under-stimulated, producing neurological or psychological symptoms like sleep disturbances, anxiety, and chronic fatigue.

Imbalances in the neurotransmitters Glutamate, Histamine, Dopamine, GABA, and Serotonin are often linked to sleep disturbances and insomnia.

Functional Medicine Labs to Test for Sleep Deprivation

Micronutrient Test

By checking nutrition status, you can narrow down exactly what nutrients your patients lack and, therefore, can properly supplement as needed.  

Reference Range for Magnesium (whole blood sample)

Standard Reference Range: 3.6~7.7 mg/dL

Functional Medicine Optimal Range: 3.6~7.7 mg/dL

Reference Range for Vitamin D (whole blood sample)

Standard Reference Range: 20 and 40 ng/mL

Functional Medicine Optimal Range: 40-70 ng/mL

Reference Range for Vitamin B6 (whole blood sample)

Standard Reference Range for: 4.0~83.0 ng/mL

Functional Medicine Optimal Range: 4.0~83.0 ng/mL

Top Micronutrient Test Ordered by Rupa Health Practitioners

Spectracell (Whole Blood)

Genova (Serum, Whole Blood, & Urine)

Cortisol and Melatonin Test

Most functional medicine practitioners will measure cortisol and melatonin throughout the day to ensure they are rising and falling during the appropriate time frames. We want to make sure cortisol is highest in the am and melatonin is highest in the pm.

The Sleep Balance Profile is an all in one test that measures the daily fluctuations of melatonin, cortisol, and cortisone to assess the sleep/wake cycle.

Reference Range for Cortisol (urine)

Morning: 5-25 mcg/dL

Reference Range for Melatonin (urine)

Evening 4.3 – 25 pg/mL

Neurotransmitters Test

As stated above, neurotransmitters play a very important role in sleep as well as mental health. Our current environment can cause chronic stress throwing neurotransmitters out of balance. Many times these unbalances can go overlooked for years because their symptoms can mimic other chronic conditions.

Reference Range for Glutamate (urine)

Standard Reference Range: 1213-4246 μg/g Cr

Functional Medicine Optimal Range: 1515-2710 μg/g Cr

Reference Range for Histamine (urine)

Standard Reference Range: 3.6-44.3 μg/g Cr

Functional Medicine Optimal Range: 5.2-15.3 μg/g Cr

Reference Range for Dopamine (urine)

Standard Reference Range: 103-282 μg/g Cr

Functional Medicine Optimal Range: Optimal 144-240 μg/g Cr

Reference Range for GABA (urine)

Standard Reference Range: 167-463 μg/g Cr

Functional Medicine Optimal Range: 193-367 μg/g Cr

Reference Range for Serotonin (urine)

Standard Reference Range: 47.6-140.3 μg/g Cr

Functional Medicine Optimal Range: 61.0-103.2 μg/g Cr

Top Neurotransmitter Test ordered by Rupa Health Practitioners

ZRT (Urine)

Functional Medicine Treatment for Sleep Deprivation

The first step in treating sleep deprivation is finding the root cause. Testing is an important and easy step to add to the treatment plan. There is a common phrase in medicine “test don’t guess.” This is true for almost everything. Find exactly where your patients are deficient or have excess and then address those imbalances.

Nutrition

What you choose to eat is one of the most important factors determining how well you sleep. Focus on whole foods that are high in the nutrients that the patient was lacking based on the micronutrient test. Studies also show that people who follow a low inflammatory diet had less issues with sleep.

Micronutrient Supplements

High quality single or multivitamin/mineral formulas can help address underlying deficiencies. Vitamin injections and IV drips also work quickly to give higher doses in very deficiency patients. Work with a practioner to get the proper supplement for your needs.

Neurotransmitters and Hormones Supplements

Only supplement neurotransmitters when needed. I see so many people trying to self-treat with over-the-counter supplements and they could be causing more harm than good.

A great example is melatonin. Not everyone with sleep issues is melatonin deficient, yet it is a commonly advised supplement for insomnia. If you are already making appropriate amounts of melatonin, adding in more will most likely not be effective. Worse, it could have side effects like sleepiness or grogginess the next day, perpetuating the chronic fatigue cycle.

Sleep Hygiene Schedule

A proper sleep hygiene schedule is the next step in helping sleep-deprived patients. And this is a tricky subject as most people are addicted to their phones or TVs, which can actually decrease melatonin and increase cortisol at night.

Our devices can also fluctuate our happy chemicals serotonin and dopamine, depending on what you read or watch. Ever got an amazingly sweet message or comment at 9 pm? Guess what? Serotonin and Dopamine rush. What about a scary movie late at night? Fight or flight will be all over the place affecting cortisol levels.

As stated above, these neurotransmitters play an essential role in the sleep/wake cycle.

It’s important to go back to our roots (at least for a few hours before bed) to allow our hormones and neurotransmitter to balance, so we can get restful sleep throughout the night.

Humans are meant to wind down after the sun goes down (melatonin production) and rise with the first light (cortisol production). Do your best to stick with a regular bedtime routine that allows you to dim all blue lights at least an hour (preferably more) before bed.

Another tip is to move your body during the day to burn off extra calories (calorie consumption equals energy). If moving is complicated for you, start small, reach for a goal of 5k steps a day, and then continuously add up. Movement can also balance hormones and neurotransmitters.

Black-out curtains and lower room temperature in the house have been shown to help the body prepare for rest.

Supplements for Sleep

Like many other integrative practitioners, I love supplements just as much as the next person. But fair warning, they should only be used short term as a “band-aid treatment.” We need to focus on bringing our body back to balance to do the job it is meant to do.

But for the sake of this article, here are my top 5 favorite supplements for sleep.

Suan Zao Ren Tang (SZRT)

SZRT is a traditional Chinese herbal formula used for centuries to help the body relax and promote natural sleep. This formula is suitable for those who have trouble turning their minds off before bed. It’s also used for those who suffer from anxiety before bed. This formula has been studied for its effects on insomnia in anxiety patients and has repeatedly proven its effectiveness.

Chamomile

Yup, I said it… Boring old chamomile, nothing fancy but don’t discount it! There is a reason why it shows up in almost every “sleepy” tea on the market.

Herbal teas are popular beverage choices when it comes time to relax and unwind, and chamomile is one of my favorites.

For centuries, chamomile has been used worldwide as a natural sleep and anti-anxiety remedy. It also helps calm stomach contractions, which is an added bonus in a world where over 45 million people in the United States suffer from gut health issues.

I personally like to sip on chamomile while winding down at night as part of my sleep hygiene routine. This is one supplement that I don’t mind taking daily as it’s a fairly safe herb with many health benefits.

Valerian Root

Valerian root should be used sparingly. I usually recommend paring valerian root with SZRT or chamomile. Many over-the-counter teas will also have valerian root in their “sleep” formulas.

Valerian Root is a mild sedative and is often referred to as “nature’s Valium.” It should only be taken when you are actually ready to settle down for the night and not for extended periods of time. Research suggests that valerian is generally safe for short-term use by most adults and can be used for insomnia and anxiety.

Summary

Sleep issues affect millions of people nightly. Uncovering what’s happening at the cellular level can help patients restore the body back to homeostasis and, in return, restore a natural sleep routine.

Before reaching for a sleeping pill or supplement, talk to your provider about specialty testing.

The top ones I recommend are Micronutrient testing, Cortisol, Melatonin, as well as Neurotransmitters. They may also want to check hormone production and thyroid health.

Why do we need sleep? How much sleep is the right amount of sleep? Why do some people feel okay with six hours while others could sleep for weeks if given the opportunity?

There is definitely no one-size-fits-all approach to sleep. What works for one person might not work for another. With so much information out there, I thought it was time to explore this topic further.

So before considering sleep aids, check out the below article on the many reasons you may be having a hard time sleeping; some might surprise you.

This article highlights what tests I consider when someone with sleep concerns visits my office and how to approach supplementation based on the test results. Because we really should be getting into the habit of testing, not guessing. We could help more people if we actually got to the root causes of what’s going on.

[signup]

Sleep Deprivation Signs & Symptoms

While sleeping, the body supports the immune system, helps balance blood sugar levels, activates the brain, and regulates hormones.

If a person does not get enough sleep, they may be at risk of experiencing various health challenges, including weight management issues, changes in insulin sensitivity, a less robust immune system, and difficulties with focus and memory.

Symptoms

  • Daytime Drowsiness
  • Reduced mental alertness
  • Poor hand-eye coordination
  • Poor concentration and focus
  • Micro Sleeps
  • Changes in insulin sensitivity
  • Lower immunity

How Much Sleep Do We Need for Optimal Health?

It provides recommended sleep durations for different age groups

Sleep Deprivation Possible Causes

Lack of sleep can be from many causes; a new baby, a strange house, too much caffeine, etc. All of those reasons can be adapted to and managed. But if you are one of the many who experience ongoing sleep challenges, consider some of these commonly overlooked reasons.  

Micronutrient Considerations

Micronutrients play a role in the pathways involved in sleep. Ensuring they stay at supportive levels may help maintain proper sleep rhythms.

Magnesium

  • Magnesium supports GABA, a brain neurotransmitter, which is involved in calming the mind and helping you fall asleep
  • Increasing magnesium may help those with restless legs syndrome

Vitamin D

  • Vitamin D may help improve sleep quality, reduce the time it takes to fall asleep, and support longer sleep duration.

Vitamin B6

  • Vitamin B6 aids in the production of the hormones serotonin and melatonin. A lack of vitamin B6 has been linked to sleep challenges and mood changes.

Hormone and Neurotransmitter Balance

Cortisol and Melatonin Balance

In a balanced state, the stress hormone cortisol should be in sync with the sleep hormone melatonin. Each hormone counterbalances the other in a rhythm. When cortisol is high (morning), melatonin should be low, and when melatonin is high (evenings), cortisol should be low.

Imbalances in cortisol and melatonin levels can be influenced by many factors, including stress and irregular work hours.

Neurotransmitter Balance

Neurotransmitters are chemical messengers the nervous system uses to relay information from one nerve to another.

Genetics, environment, chemicals, and nutritional factors can impact neurotransmitter production.

Imbalances in neurotransmitters can affect how the brain and body function, potentially leading to sleep disturbances, mood changes, and fatigue.

Imbalances in neurotransmitters like Glutamate, Histamine, Dopamine, GABA, and Serotonin are often linked to sleep disturbances.

Functional Medicine Labs to Explore for Sleep Concerns

Micronutrient Test

By checking nutrition status, you can identify what nutrients may be lacking and consider appropriate supplementation.  

Reference Range for Magnesium (whole blood sample)

Standard Reference Range: 3.6~7.7 mg/dL

Functional Medicine Optimal Range: 3.6~7.7 mg/dL

Reference Range for Vitamin D (whole blood sample)

Standard Reference Range: 20 and 40 ng/mL

Functional Medicine Optimal Range: 40-70 ng/mL

Reference Range for Vitamin B6 (whole blood sample)

Standard Reference Range for: 4.0~83.0 ng/mL

Functional Medicine Optimal Range: 4.0~83.0 ng/mL

Top Micronutrient Test Ordered by Rupa Health Practitioners

Spectracell (Whole Blood)

Genova (Serum, Whole Blood, & Urine)

Cortisol and Melatonin Test

Many functional medicine practitioners may measure cortisol and melatonin throughout the day to observe their patterns. Ideally, cortisol is highest in the morning and melatonin is highest in the evening.

The Sleep Balance Profile is a comprehensive test that measures the daily fluctuations of melatonin, cortisol, and cortisone to assess the sleep/wake cycle.

Reference Range for Cortisol (urine)

Morning: 5-25 mcg/dL

Reference Range for Melatonin (urine)

Evening 4.3 – 25 pg/mL

Neurotransmitters Test

As mentioned earlier, neurotransmitters play a role in sleep and mental health. Our current environment can influence neurotransmitter balance. Sometimes these imbalances can go unnoticed for years because their symptoms can resemble other conditions.

Reference Range for Glutamate (urine)

Standard Reference Range: 1213-4246 μg/g Cr

Functional Medicine Optimal Range: 1515-2710 μg/g Cr

Reference Range for Histamine (urine)

Standard Reference Range: 3.6-44.3 μg/g Cr

Functional Medicine Optimal Range: 5.2-15.3 μg/g Cr

Reference Range for Dopamine (urine)

Standard Reference Range: 103-282 μg/g Cr

Functional Medicine Optimal Range: Optimal 144-240 μg/g Cr

Reference Range for GABA (urine)

Standard Reference Range: 167-463 μg/g Cr

Functional Medicine Optimal Range: 193-367 μg/g Cr

Reference Range for Serotonin (urine)

Standard Reference Range: 47.6-140.3 μg/g Cr

Functional Medicine Optimal Range: 61.0-103.2 μg/g Cr

Top Neurotransmitter Test ordered by Rupa Health Practitioners

ZRT (Urine)

Functional Medicine Approaches for Sleep Support

The first step in addressing sleep concerns is finding the underlying factors. Testing can be an important step to consider in the plan. There is a common phrase in medicine “test don’t guess.” This is true for many situations. Identify where there may be imbalances and then consider ways to address them.

Nutrition

What you choose to eat can influence how well you sleep. Focus on whole foods that are rich in the nutrients that may be lacking based on the micronutrient test. Studies also show that people who follow a low-inflammatory diet may experience fewer sleep challenges.

Micronutrient Supplements

High-quality single or multivitamin/mineral formulas can help address underlying nutrient needs. Vitamin injections and IV drips may also be considered for those with significant deficiencies. Work with a practitioner to find the right supplement for your needs.

Neurotransmitters and Hormones Supplements

Only consider supplementing neurotransmitters when needed. Many people try to self-treat with over-the-counter supplements, which may not always be beneficial.

A common example is melatonin. Not everyone with sleep issues is melatonin deficient, yet it is often suggested for sleep support. If you are already producing appropriate amounts of melatonin, adding more may not be effective and could have side effects like sleepiness or grogginess the next day.

Sleep Hygiene Schedule

A proper sleep hygiene schedule is another step in supporting sleep. This can be challenging as many people are attached to their phones or TVs, which can affect melatonin and cortisol levels at night.

Our devices can also influence neurotransmitters like serotonin and dopamine, depending on what you read or watch. Ever received a nice message or comment at night? That can boost serotonin and dopamine. What about watching a scary movie late at night? That can trigger stress responses affecting cortisol levels.

As mentioned earlier, these neurotransmitters play a role in the sleep/wake cycle.

It’s important to create a calming routine before bed to help balance hormones and neurotransmitters, promoting restful sleep.

Humans are naturally inclined to wind down after sunset (melatonin production) and wake with the first light (cortisol production). Try to maintain a regular bedtime routine that includes dimming lights at least an hour before bed.

Another tip is to engage in physical activity during the day to use up energy. If moving is challenging, start small with a goal of 5,000 steps a day, and gradually increase. Movement can also support hormone and neurotransmitter balance.

Using blackout curtains and keeping the room cool can also help the body prepare for rest.

Supplements for Sleep

Like many other integrative practitioners, I appreciate supplements as a temporary support. However, they should be used as part of a broader approach to help the body regain balance.

For the sake of this article, here are some supplements that may support sleep.

Suan Zao Ren Tang (SZRT)

SZRT is a traditional Chinese herbal formula used for centuries to help the body relax and support natural sleep. This formula may be suitable for those who have trouble calming their minds before bed. It’s also used for those who experience anxiety before bed. This formula has been studied for its effects on sleep in individuals with anxiety and has shown potential benefits.

Chamomile

Chamomile is a well-known herb often found in "sleepy" teas.

Herbal teas are popular choices for relaxation, and chamomile is one of my favorites.

For centuries, chamomile has been used worldwide as a natural support for sleep and relaxation. It may also help calm the stomach, which is beneficial for those with digestive concerns.

I personally enjoy sipping on chamomile while winding down at night as part of my sleep routine. This is one supplement that I feel comfortable using regularly as it’s a generally safe herb with many potential benefits.

Valerian Root

Valerian root should be used with caution. I usually suggest pairing valerian root with SZRT or chamomile. Many over-the-counter teas include valerian root in their “sleep” formulas.

Valerian Root is sometimes referred to as a "mild sedative" and is often called “nature’s Valium.” It should only be taken when you are ready to settle down for the night and not for extended periods. Research suggests that valerian is generally safe for short-term use by most adults and may support relaxation and sleep.

Summary

Sleep challenges affect many people. Understanding what’s happening at the cellular level can help individuals support their body's natural balance and, in turn, promote a healthy sleep routine.

Before considering sleep aids, talk to your healthcare provider about potential testing options.

Some tests to consider include Micronutrient testing, Cortisol, Melatonin, as well as Neurotransmitters. They may also want to check hormone production and thyroid health.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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