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authorphotoHello, my friends.  Welcome back.  I’m glad you’re here, and I hope you find this week’s blog interesting and helpful-albeit a little long due to the vastness of the subject.  Hang with me.  It’s worth the read.

We’re going to start this one off with a disclaimer because this is a very serious subject that needs to be studied, in-depth, before you decide to jump on the herbal relaxant/sleep aid bandwagon.

For starters, always remember that just because they’re natural and unregulated, that doesn’t automatically make them safe.  While side effects and overdose possibilities are generally far less with herbals, many do have them, including allergic reaction possibilities for those with sensitivities to certain compounds.  Always, always, always discuss any herbal regimen choices with your healthcare provider before starting one.

If you’re pregnant, thinking of becoming pregnant or breast feeding, do not, under any circumstances, take anything without first consulting your healthcare provider.  Most, if not all of the herbal relaxants and sleep aids are contraindicated, (or should at least be carefully controlled and supervised by a medical doctor) during pregnancy or while breast feeding.

More to the point, while everyone occasionally has problems sleeping, or gets anxious or depressed from time to time, if you’ve ever felt like hurting yourself of others, become disoriented or lose memories or parts of the day, hear voices or anything beyond common life anxiety or transient insomnia, see your doctor immediately.  Herbal supplementation will not help you.  As strongly as I support and believe in herbal remedies, there are many times when professional medical intervention and prescription medications are the only option.  Only a trained medical professional can diagnose the difference.

I, for one, am always thinking.  My mind never stops plotting, scheming and fantasizing about the latest book I’m working on, life…especially about what we’re going to do when we win the lottery.  While I know that I’m probably not going to see my face on a Publisher’s Clearinghouse commercial, or have to dodge paparazzi as I sneak into lottery headquarters to collect my winnings, thinking about the possibilities of life without financial worries is my happy place.  Unfortunately, my happy place becomes less appealing as I lay there awake some nights trying unsuccessfully to shut down my thought processes and get some much needed sleep.  On those occasions which, thankfully are fairly rare, I reach for an herbal tea or a capsule.

And on those occasions when the annual house or truck tax bill comes, or it’s time for my annual review at work, or the dreaded annual trip to the doctor and I start biting my nails and cursing our state and local government, the establishment as a whole or my sawbones, a herbal remedy is usually the order of the day.

But which one you ask?  Ah, that’s the purpose of today’s blog because, believe it or not, the choices are many and many of the choices may be the wrong one for you.

Believe it or not, one of the first questions I ask those who inquire about herbal relaxants or sleep aids is what they know about them.  Almost everyone, and those are the ones who have even heard anything about them at all, say Valerian and Melatonin.  While both are good options in many situations, they are far from the only choice and, in some cases, the absolute worst choice.

Let’s take a look at a few pros and cons.

Chamomile (Anthemis nobilis):  Chamomile, especially chamomile tea,(derived from the plant’s flowers) has been used for centuries to bring on sleep, ease an upset stomach and even treat diaper rash.  It is a herb derived from a flowering plant in the daisy family and a close relative to ragweed.  While its’ natural calming effects are widely known, it has also been used to treat skin irritations, inflammations and even diaper rash.  There are scads of lotions and creams on the market to ease those conditions.  I can’t vouch for their efficacy because I’ve personally never tried them.

Lately, a lot of study has been done on the benefit of chamomile for IBS (Irritable Bowel Syndrome), migraine headaches, PMS (Pre-Menstrual Syndrome) and a whole host of other maladies including skin conditions.  However, we’re concentrating on sleep and relaxation this week so here goes.

Of all the available herbal sleep aids, for those with mild sleep issues, chamomile tea is probably what you’re looking for.  With few exceptions, it’s probably the most mild of all sleep inducers and probably has the least potential for side effects.  A cup of chamomile tea about an hour before bedtime will help all but those with the most serious sleep issues (or way too much on their minds) slip off into a natural, peaceful sleep.

However, for those with allergies to ragweed or pollen, chamomile is not recommended as some mixtures may contain pollen and/or ragweed.  It is derived from a flowering plant in the ragweed family, remember.

Chamomile is also contraindicated in those taking blood thinners because chamomile contains a natural substance called coumarin (which is synthesized and used in the prescription medication Coumadin), a blood thinner.

Pregnant women should not use chamomile as it is considered an abortifacient (a substance that induces abortion).

Many people drink a cup every night before bedtime and claim that there’s nothing like it for bringing on sleep.

If you have no allergies to pollen or ragweed, are on no blood thinners and aren’t pregnant, try brewing a cup before bedtime.  I think you’ll be pleasantly surprised that something so simple could do so much good.

Valerian (valeriana officinalis):  Most of you, I’m sure, have heard of Valerian and have probably tried it or know someone who has.  I’ve even spoken with doctors who recommend it to their patients whose condition may be mild enough that they would benefit more from Valerian than from taking one of the prescription drugs with their associated side effects and, in many cases, chances for addiction.  Many use Valerian for different situations from insomnia to anxiety to menstrual cramps.  Many swear by it, some swear at it.

The sedative properties of Valerian are found in the root.  While it can be taken as a tea or a tincture, Valerian smells really, really bad.  Think of an un-air conditioned, long untended, boys locker room loaded up with basket after basket of dirty BVD’s and gym socks…at high noon…in the desert.  Multiply that by ten and you have the general idea.  Even the capsules, when purchased fresh, will cause you to pause, (and to hold your nose) before taking it.  However, this is one instance when, if Valerian is the right choice for you, the end justifies the means.  If you wanna play, you’ve got to pay, and for most, it’s a small price to pay for the benefits that can be had from its’ use.  Generally, taking the proper dosage about an hour before bedtime will, for most, insure a peaceful, restful night’s sleep.

However, it is not without its’ downside.  Many people who use Valerian wake up feeling drunk/hung over, or remain drowsy for a time after awakening.  Many have said that, along with the lethargy when awakening, they also get a headache.

For those with common, garden variety anxiety brought about by an abundance of life’s every day troubles, Valerian is known to relax, calm and render a feeling of overall peace and tranquility.  Some claim to get relief within an hour, for some it may need to build up over a few doses before the calming effects are realized.  However, Valerian is not a cure-all.  It is intended for temporary use.  If those anxieties persist, see your doctor immediately.

Valerian should not be used for extended periods.  When it is, you may may not be able to just stop taking it without revisiting the initial problem you were trying to solve in spades.  Anxiety, nervousness, shakiness and insomnia have been experienced by those going cold turkey after a long stint on Valerian.  Often you’ll have to taper your dose over two or three weeks when you feel you no longer need it.

Always insure that you buy the freshest capsules available and that there are no inert or inactive ingredients mixed in that you may be allergic to.  Valerian allergies are rare, but some are allergic to it.  More people, however, are allergic to some of the additives in cheap, bargain basement supplements.  I know, you’ve heard me say this time after time, but it bears repeating: always buy your supplements from reliable, American manufacturers and, whenever possible, buy those certified for vegetarians and vegans.  By doing this, you’ll insure you’re getting a consistent, pure and measured dosage with no harmful additives.

Some of the more rare side effects of Valerian are are persistent nausea and/or vomiting, stomach/abdominal pain, yellowing of the eyes or skin, dark urine and extreme lethargy to name a few.  These are generally reversible when the valerian is stopped.

Dosages vary from person to person.  Valerian is not a “one size fits all” supplement.  The recommended dose on the label may be too little or too much for you.  Caution must be used when determining your proper dosage.

For those taking prescription medications, especially statin medications, erectile dysfunction medications, other relaxants/tranquilizers or cough and cold remedies containing diphenhydramine, you should not use Valerian as it may lessen the efficacy of those medications or multiply the drowsiness already associated with them.

Before we move on to the next option, I just want to mention that none of the above is meant to scare you.  Valerian, for most, is a natural Godsend.  My only intention in mentioning all of the above is to insure that you’re well informed before you pop that first capsule.  Valerian is definitely not for everyone and the information above is certainly not the all inclusive definition.  Research all medications and supplements fully, and discuss them with your healthcare provider before you decide to take it.  It could save your life.

Melatonin:   Is actually a natural hormone that is produced by the pineal gland in the brain.  Its main purpose is to  regulate sleep and waking cycles and contributes to maintaining the body’s circadian rhythms.  Unfortunately, as we age, our body’s ability to produce melatonin decreases.  This explains why grandma and grandpa were always up at the crack of dawn.

Supplements, of course, are synthesized in a laboratory because, well, who’s going to volunteer to have their pineal gland tapped?  If that were even possible, I’m sure it would not be a pleasant experience so, technically, melatonin can’t be considered a natural remedy-but for many, it’s a sanity saver.

I’m a child of the night.  I work nights, as does my fiance’, so our sleep cycle definitely conflicts with the natural circadian rhythm of our bodies.  Being over fifty with decreased natural melatonin production abilities is also a major contributor to my occasional insomnia.  Luckily, Brenda is a sleep-a-haulic so sleeping is rarely an issue for her.  I, on the other hand, often have problems going to sleep for the reasons mentioned earlier.  On those nights when my ten-hour shift hasn’t totally exhausted me, mentally and physically (rarely), I reach for a sleep aid.  Sleep is a must whether your body wishes to cooperate or not.  For those of you who can drop off without a second thought, (narcoleptics excluded, of course) my hat’s off to you.  For those of you who cant, melatonin supplements might be the answer.

Surprisingly, some studies indicate that melatonin is ineffective for what is called “shiftwork disorder.”  Either I have some other sleep issue or, at least in my case and those of many I work with and have suggested melatonin to, I beg to differ.  Melatonin is usually my first choice, after a chamomile tea, when I can’t sleep and, for myself and many others that I know of first hand, it works.

The effects of melatonin and generally mild in those who tolerate it well and will usually just help ease you into sleep without your even realizing the effects (unlike most prescription sleep medications).  Side effects are generally mild or non-existent, but can include dizziness, daytime lethargy and headaches.   Other rare but documented side effects can include abdominal discomfort, mild anxiety, irritability, confusion and transient depression-especially in the elderly.

Additionally, if you take birth control pills, blood thinners, diabetic medications or immunosupressants, do not take melatonin without first consulting your healthcare provider.  Melatonin is released into the bloodstream so it may adversely effect other medications in your system.

Kava (kava kava):  I mention kava here with caution. Kava is a root found on islands in the South Pacific. Islanders have used kava for its’ medicinal qualities and in ceremonies for centuries.While a great many people do use kava for everything from sleep disorders and anxiety relief to a treatment for gonorrhea and as an analgesic (pain reliever), the possible associated side effects are many.  It is also used to treat asthma, urinary tract infections, depression and menopausal symptoms.

Research has shown that kava’s calming effects do relieve anxiety, restlessness, sleeplessness, and stress-related symptoms like tense muscles and muscle spasms.  It is probably one of the strongest of the readily available herbal supplements.

But!  Of all the herbal supplements I’ve studied, kava ranks right up there when it comes to possible serious side effects.  While certainly not one of the worst, and not a reason to totally disqualify kava as a possible, temporary supplement for sleep and/or anxiety, extreme caution and heavy research, including a discussion with your doctor, need to be done before you take it.

If you are currently taking antidepressants or other mood stabilizing medications, you shouldn’t be taking any herbal anxiety/sleep supplements unless they were recommended by your doctor.  However, kava is definitely not for you.  Kava will multiply the sedating effects of mood altering ( psychotropic drugs), as will alcohol.  Do not drink alcohol while taking kava.

Kava has caused liver failure in people without any history of liver ailments.  Anyone with any liver ailments should steer clear of kava.  While liver failure is a rare side effect generally seen after long term, extensive use of kava,  it needs to be considered when contemplating a supplement.

Allergic reactions are not common with kava, but they are a possibility.

I have tried kava and had no issues with it, but after researching all the side effects, decided to opt for Valerian when the need strikes.  Again, that’s just my personal opinion relating to a personal experience.  Valerian works just as well for me, personally, so that is generally my choice.  Your choice, of course, is dependent on your individual needs and tolerances.

Ashwagandha (Withania somnifera-Winter Cherry): Originating in India, and used for centuries in ayurvedic medicine as an adaptogenic (promotes homeostasis), the root and berries of the plant are used for various remedies including everything from control of thyroid and adrenal gland disorders to mental agility to osteoarthritis  to an anti-inflammatory to claimed reports of tumor reducing capabilities and increased white cell production in cancer patients and, of course, for sleep disorders and nervous conditions.

In an animal-based study published in 2000, researchers found that ashwagandha root had an anti-anxiety effect similar to that of Ativan (Lorazepam-a drug used to treat anxiety disorders).

Surprisingly enough, and as a lessening of the pain from the constant thorn in my side regarding many allopathic doctors and their “pooh pooh” attitude regarding herbal remedies, ashwagandha has actually made print in none other than Psychology Today, a well respected magazine on mental health-Follow the link for the whole article.  Here’s an excerpt:

“One 2012 study of 64 volunteers randomized asked subjects to take either ashwaganda or a placebo twice a day for 60 days. The ashwaganda group’s capsule contained 300 mg of a concentrated extract made from the root. During the treatment period, regular telephone call check-ins assured volunteers were consistently taking the herbs or placebo, and were used to note any adverse reactions. The treatment group given the ashwaganda root extract exhibited a significant reduction in anxiety scores after two months relative to the placebo group, without side effects. Most notably, serum cortisol levels were substantially reduced in the herbal group (Chandrasekhar et al., 2012). Cortisol is the stress hormone that goes up when we are stressed out.  Cortisol also creates longer term fatigue and mental fogginess, and brain structures for emotion and memory are damaged when cortisol is too high.” 

Ashwagandha is another herb that I have personally tried.  I loved it.  While it’s effects are more cumulative than immediate, the resultant overall relaxant qualities after a couple of weeks were impressive.  I stopped taking it when things in my world balanced out enough and I was trying to reduce my daily supplement intake down to the bare essentials.

Of all the relaxants, ashwagandha is generally considered one of the safest when used short term.  However, there are some cautions:

As I stated earlier, if you are pregnant, considering becoming pregnant or breast feeding, do not take ashwagandha or any of the other supplements mentioned without consulting your healthcare provider.  Ashwagandha is considered to be an abortifacient (a substance that induces abortion).

If you have high or low blood pressure, ashwagandha is contraindicated as it may lower blood pressure in those with low blood pressure, or reduce the efficacy of hypertensive drugs in those with high blood pressure on hypertensive medications.

Those with stomach ulcers should not take ashwagandha as it may irritate the GI tract.

Diabetics should not use ashwagandha due to its’ potential to lower blood sugar and may cause blood sugar to go to low.

People with autoimmune disorders should not take ashwagandha due to its’ penchant for increasing the immune system’s activity.

People with thyroid disorders should not take ashwagandha as it is known to increase thyroid hormone levels.

Hops ( Humulus lupulus):  I know the eyes of a lot of beer drinkers just sprung open.  For those who doubt the medicinal qualities of beer, read on.

The female part of the hop plant is used for the supplement as well as for making beer and numerous other uses.  Hops in herbal medicine are used to treat conditions from anxiety, inability to sleep (insomnia) and other sleep disorders, attention deficit-hyperactivity disorder (ADHD), nervousness, and irritability, to increase urine flow and even bring on breast milk.

Hops does work.  However, even more so than ashwagandha, the effects are cumulative and may take as long as a month for the benefits to be realized.  Generally, hops are taken in combination with valerian or lemon balm and is more often used for the treatment of anxiety over a longer term.  I have mentioned it here only because it is considered one of the safer herbs for sleep and anxiety and it does work when taken consistently for a month or more.

Pregnancy and breast feeding are about the only known concerns regarding side effects although in some, it has been reported to cause depression.  Those results are questionable regarding any direct correlation to the hops itself.

St. John’ s Wort (Hypericum perforatum):  The St. John’s wort plant has yellow flowers and is considered to be a weed throughout most of the United States. It has been used for medical purposes in other parts of the world for thousands of years.

St. John’s Wort got a really bad rap in the press a few years back.  I attribute that more to the fact that people were taking it willy-nilly without doing their research after a few careless ads were placed in the media regarding the numerous benefits of this herb-but those ads failed to list the side effects and contraindications associated with this now much maligned herb.

With that being said, and given the numerous side effects and contraindications associated with the use of St. John’s Wort, it is definitely not something that should be taken for the relief of transient insomnia or occasional anxiety which is the focus of this week’s blog.

St. John’s Wort has been researched extensively and is being used successfully to treat various anxiety and depression disorders, but it is my belief that diagnosis of those conditions and which ones will benefit from supplementation with this herb should be determined only by a trained medical professional.

St. John’s Wort is known to interact unfavorably with numerous prescription medications including, but not limited to, antidepressants, anti-rejection medications, blood thinners, anti-HIV medications and birth control pills.

Psychosis is a rare, but a possible side effect of taking St. John’s Wort, particularly in people who have, or are at risk for, mental health disorders-including bipolar disorder.

To summarize St. John’s Wort- while I do believe in its’ healing properties, I do not consider it a safe option for common use.  Should you decide to try this herb, speak with your doctor before starting and do your homework.

The herbs we’ve discussed today are far from a comprehensive list.  The number of herbs, minerals and supplements out there used for sleep and anxiety are legion.  I’ve just covered a few of the more common, heavily researched ones for this blog because when all the contraindications are considered and disqualified as not pertaining to you individually, all of these are believed to be safe and effective.

One further note on these and all other herbal supplements: Insure that your doctor is fully aware of all your entire  supplementation regimen so he or she  has a complete picture when prescribing.  Also, stop any and all supplements at least two weeks before scheduled surgical procedures, including dental surgery, to insure there are no interactions between the anesthetics and drugs used during surgery and your supplements.

If you’re still awake,  I guess that’s about all I have to say about sleep aids and relaxants…and in just over thirty-eight-hundred words!   Sorry!

In conclusion, work, your spouse,  finances?  At some point one of these and a whole host of other life challenges cause us to stress.  Stress causes problems with sleep and anxiety.  In those instances, one of the above will probably help you through it…short term.  If those feelings persist, see your doctor immediately.

The next time you’re in a crowd, look to your right and left.  One or both of the people you see are probably taking a prescription antidepressant or mood altering medication of some sort.  The stigma that was once attached to them has long since been forgotten.  What was once considered a life with a scarlet letter on your chest is now accepted as a serious medical condition and is treated accordingly with a myriad of new and safer drugs coming out constantly.  Never take depression or severe anxiety lightly.  There is help…and it’s just a phone call to your doctor away.

As always, if you have any comments regarding this blog or herbal remedies in general, good or bad, please feel free to leave them below.  If you have a comment or question that you’d rather not have seen on an open forum, please feel free to send me an email.  I always strive to answer all emails within twenty-four hours.

Until next week, I wish you peace, happiness and good health.  Be well, my friends.

Brian

 

 

 

 

 

 

 

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