Questions:
RE:
Sleep Apnea
Insulin ...Weight Gain... Fat Storage...Protein Synthesis...and... More


Question:

    How Does Sleep Apnea Cause Low Testosterone? I have chronic insomnia. Is this a cause of low testosterone also?

Answer:

    Sleep Apnea causes numerous sleep arousals and this in turn is sleep deprivation. This increases insulin resistance and decreases levels of thyroid hormone.---The Lancet, 1999. Chronic insomnia yields sleep deprivation also, and can cause all these same problems. What is one of the major problems facing our teenagers today, as well as many other Americans? Sleep deprivation!

But first, some background.


Let's look at the things Sleep Deprivation (decreased sleep) causes: :

  • Increased cortisol
  • Increased adrenaline and nor-adrenaline; esp. adrenaline
  • Increased insulin resistance which generates a rise in insulin
  • Decreased thyroid hormone (T4 & T3)
  • Decreases testosterone (sleep length is critical for testosterone) synthesis
  • Decreased prolactin which implies decreased immunocompetence.

Note: :

  • Testosterone peaks around 8:00 am; Testosterone is lowest at approximately 8:00 pm. Have blood drawn for testosterone test at/or near 8: 00 am for your circadian cycle.
  • Shift workers who adapted to this shift work and obtained restful sleep during the day had normal testosterone levels---Journal of Clinical Endocrinology and Metabolism, 2005
  • Shift workers who were dissatisfied with their jobs had low testosterone; but, when they got quality sleep--whether at night or day, they became more satisfied with their work place, especially as their testosterone levels rose, via better sleep cycles
  • In some cases, testosterone has been shown to cause sleep apnea. The mechanics of how this comes to be is not resolved yet. But one thing stands clear: Administering high-dose testosterone worsened sleep apnea, in elderly men, having sleep dysfunction and breathing difficulties (or patterns) when asleep.

    If the quality of sleep goes down, Testosterone goes down. Breathing disorders during repose affect the quality of sleep one gets. There are numerous breathing disorders. Here, we will discuss only sleep apnea; referencing your question.


Sleep Apnea :
What is it?

Sleep Apnea happens when one sleeps in which there is a cessation of airflow for 20 to 30 seconds. The least it occurs is for ten seconds. This occurs a number of times a night.

Involved with Sleep Apnea (SA) are snoring, arousals from sleep, and hypoxia--"a deficiency of oxygen in body tissues..."---Oxford Dictionary of Biology: Fifth Edition; 2004.

You can see that lack of oxygenation for various periods throughout the night when your body tends to build some 23-odd hormones between 2 to 4 AM can result in your operating the next day on the reduced previous day's hormones if possible, provided they haven't been degraded by the liver.

Namely, you are going to be tired, irritable, grouchy, foggy-headed, and a host of other problems associated with poor quality sleep. Incidently, marijuana causes a break in forming the required hormones between 2-4 am.

Soldiers who have been sleep deprived, under stress, and rigorous physical training show declines in testosterone, DHEA, and androsten(e)dione in the range of 70 to 90 percent.

Another study demonstrated that cadets from Norway undergoing similar to the soldiers showed they no longer had the aggressiveness and/or initiative to fight, and had less beard growth---all signs of hypogonadism (inadequate gonadal function, such as deficiencies in sex cells--sperm/ova--and decreased secretion of gonadal hormones).---References:
Opstad PK, Aakvaag A. 'Decreased serum levels of oestradiol, testosterone and prolactin during prolonged physical strain and sleep deprivation and the influence of a high calorie diet.' Eur J Appl Physiol Occup Physiol, 1982; 49 (3): 343-8; Opstad PK, 'Androgenic hormones during prolonged physical stress, sleep and energy deficiency.' J Clin Endocrinol Metab, 1992, May; 74(5): 1176-83.

PoliceMag.com, December 2006, page 72, writes:
"...in many sleep deprivation studies, the first two symptoms are irritability and poor decision-making."

A thirty-year law enforcement veteran, Neal Rawls, writes in, Be Alert Be Aware Have A Plan: "A soldier out on patrol or in combat is in a high state of alert. That state's exhausting and stressful."

Knowing this, it would be apropos to test the cortisol (stress indicator) levels and testosterone morning levels of troops in Iraq. We can tell you--for the most part--what it will be and dispense with the testing and give testosterone replacement for the men. You don't want your fighting men stressed out with low testosterone levels when their very lives depend upon it! They would be:
  • Slow to react,
  • Not as attentive as usual, and possibly have
  • Some cognitive deficits.

If you have trouble staying awake during the day and fall asleep easily; fatigued to the point of exhaustion; and snore, See your physician; you may have developed or be developing sleep apnea.


Sleep Apnea
Two Types :

  • Central:
    This is caused by chemicals acting on the CNS (brain and spinal cord). This may cause breathing problems. Obesity may or may not figure in the breathing problems.

  • Obstructive (most common)
    This is caused by an obstruction of the pharynx (throat area). This area is between the mouth and the esophagus (food tube to stomach), and the windpipe. The pharynx serves as the passageway for respiratory gasses.

    The excess fatty tissue in excessively overweight people (and some not so overweight) around the neck area and within the neck area, collapses or shuts off the trachea as one sleeps, restricting air flow to the lungs. This diminishes or stops oxygenation to the body tissues. The stress to the body, trying to inhale during the sleep cycle, also causes problems. Cortisol rise is higher at this period and this can cause resultant problems. Cognitive dysfunction can be a problem of continued onslaught of high stress related cortisol.

    Incidently, you don't have to be fat to cause Obstructive Apnea. It has happened in some bodybuilders who develop 17 - 18 inch necks---you would think all that neck musculature would keep the pharynx area from collapsing into the windpipe, but evidently on some, it didn't. The internal musculature must have relaxed during sleep and tonus wasn't maintained and caused obstructive sleep apnea.

    During sleep apnea, sleep interruption occurs because there is a decrease in oxygenated blood. Many men who have this dysfunction, SA, also have erection problems, so they take Viagra to develop and maintain tumescence. Brazilian researchers, as reported in Archives Internal Medicine, 166:1763-1767, 2006, state that Viagra may generate sleep apnea.

    The mechanism is that Viagra inhibits phosphodiesterase, an enzyme used to break down nitric oxide (NO), and thus enhances buildup of NO. NO is used in vasodilation of the arteries and thus brings about a reduction in blood pressure and therefore, enhances tumescence, penile congestion with blood. An excess of NO can increase airway congestion.

    Now, with this background, when sleep apnea occurs, hypoxia (a deficiency of oxygen to body tissues from inadequate inspiration also occurs).This is an extreme stress, such that each cell of the body is affected. This includes the hypothalamus-pituitary-gonadal axis. Any problem that interferes with any functioning in this axis can cause little to no testosterone synthesis.

    The severe stress of hypoxia in sleep apnea causes reduction in growth hormone (GH), prolactin, luteinizing hormone (LH) and thyroid hormone (TH) secretion. Muscle and adipose (fat) tissues use of glucose is diminished as well. The immune system is affected too--it drops in "search and destroy" missions for the "enemy," non-self.

    As the decreases above are occurring, the following increases occur: Adrenaline, noradrenaline, and cortisol.

    All the above says one thing: The homeostasis (balance) of the body and its chemistries are out-of-balance.

    This is why we are now seeing more madness, irritability, "road rage," and unreasonableness out "there" and in your own home. Our technology is fostering much of these problems---and eating "organic" ain't gonna solve it. It's now gone too far. This is just part of the problem that is about to burst upon us in 2007!

    Imagine what it will be like when the deep recession bursts upon us and there ain't no money out there, food shortages ('07 - '08 ?), joblessness, and sky-high prices--chaos will reign supreme--there is very little time left.

    The have-nots will take from the haves. The good-strong must help the good weak.

    In 10 to 15 to 20 years, when we start to breathe again, and things start to settle down, we might start to respect this planet and its inhabitants once again. In the meantime your job is to survive in the best shape possible. See When The Hell Breaks and Gun Page.

    When this total chaos is over, we will eat locally grown food---real organic food, and live in close-knit communities, and realize what we have just been through and many of its causes---but my how quickly we forget!


Question:

    Dear Doctor: My physician told me at my recent checkup that: "You are too fat!" Then he said boldly, "If you don't lose that weight, you will be diabetic in less than 18 months." I am pre-diabetic he says. He also contends that I am insulin resistant. How does he know that?

Answer:

    Wellll...it sounds like you may be a bit peeved and feel a wee-bit contentious yourself. Actually, be thankful for the straight truths your strong-voiced physician has handed you. He knows the tremendous problems you face once diabetes sets in and age and ill-health move in your direction. Maybe...just maybe he knows something of the coming crises facing Americans. He just may know that you will fare far better if you have all your toes literally on your own two feet and can see out of both eyes.

    The test, I am sure he has had performed concerning your blood chemistries, may not look good. If he has run a Fasting Insulin (I believe all Americans should now have this done immediately so they can know how to respond during the coming crises with regard to food ingestion and what they should be storing for survival now). If high, you are definitely in insulin resistance---not good at all. If your fasting blood sugar is over 85 mg/dl, get it between 70 - 85 mg/dl. Much research is showing the latter to be the optimum range. Most labs have their ranges from 65 to 99 mg/dl; many fasting sugars I see are in the 90s. When the average physician sees 92/95 mg/dl..."hmmmm...okay," he responds. But research shows this now to be too high. Get your glucose down if in high normal to the levels recommended. Also get a glycosylated hemoglobin test. It tells us what your sugar has been for several months. The test is referred to as Hemoglobin A1c.

    Now...let's get to the fat of the matter! Insulin resistance is the metabolic process whereby target tissues; for example, muscles and adipose (fat), no longer are as sensitive to insulin's effects and therefore require more and more insulin to effect a metabolic change. A diabetic out of control can literally chew up all of his protein stores and release them in the form of amino acids in a futile attempt to get the glucose he needs as he is "drowning" in a sea of sugar (glucose) that is not being utilized because he is not using his insulin effectively---insulin resistance. He will literally undergo protein wasting in severe diabetes mellitus. Your physician is trying to educate you now to avoid the extreme weakness and organ derangement and failure resulting from this.

    This sea of sugar results in an excess of "Advanced Glycation End Products" or known as AGEs. This is not a healthy condition nor a state to be in. AGEs are formed in small to moderate amounts in healthy states. This is the process whereby glucose binds with proteins leading to deleterious effects. This is why you want to find out where you are with regard to "sugar" binding with protein, hence the test: Hemoglobin A1c (HbA1c). There are two items by Vitamin Research Products one helps lower insulin resistance and the other, AGEs. For the former problem and the latter it creates, respectively, try GlucControl and AGEBlock. For more information, VRP's website: www.vrp.com

    The University of Chicago, has discovered a relationship between poor glucose control, as evidenced by HbA1c, and sleep deprivation or poor quality of sleep in Type II diabetes. Diabetics of this nature who sleep poorly tend to have higher long term blood sugar, shown from HbA1c testing. When the glycosylated hemoglobin (glucose binding with protein) is indicated, it shows that blood sugar control has been poor for some time and the Type II diabetic has greater risk for complications from diabetes. Thus if you are sleeping poorly and have insulin resistance or, are a Type II diabetic, then have your physician order a Hemoglobin A1c laboratory test. The duration of sleep and the quality you get are good prognosticators of your blood sugar control over long periods of time.---Knutson KL, Ryden AM, Mander BA, Van Cauter E. 'Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med. 2006, Sep. 18:166 (16): 1768-74.

    In severe diabetes mellitus, this insulin lack, if you care to call it that, can cause atherosclerosis in the extreme, promoting strokes, heart attacks, and vascular conditions that can fell you in a moment's notice.

    Here we have plenty of insulin but due to resistance of the peripheral tissues (muscles of legs and arms), adipose or fat tissues in the body and other tissues, insulin is unable to act in the tissues but is piling up. This insulin resistance promotes fat synthesis as in your case---weight gain---because you are getting too many calories; especially carbohydrates (starch), and insulin promotes storage of excess food stuffs.

    Your insulin resistance and weight gain has your body singing, "Let the good times roll." The pancreatic hormone, insulin, is released to the blood stream when high levels of blood glucose are evident from all the ingestion of continuous foodstuffs. The insulin is the signal to the body tissues that the "party" has just begun! Good times are here and excess food will be stored as fat in adipose tissues and as glycogen (stored glucose). But when times are hard, fat and muscle are thrown into the "fat of the fire" for energy, and we witness the wasting of flesh (muscle tissue and fat tissue) as seen in concentration camps and starvation and famine zones of the world.

    If you go into diabetes mellitus and become out-of-control When The Hell Breaks because of the stress cortisol effects; or, your body can't get insulin or use insulin effective (as in Type I or Type II diabetes, respectively), the insulin lack generates protein depletion (muscle wasting) and an increase in amino acids in a vain attempt to get more glucose converted from amino acids, then you will be in a severe state of extreme weakness and organ malfunction. You will literally be devouring your own flesh trying to supply glucose to the tissues that won't work because insulin is not available or it is but you are out-of-control. You are insulin resistant.

    No, growth hormone will not suffice to stop the muscle wasting in this case. You need growth hormone and insulin to interact synergistically to build growth. Why? Because each one works for the cellular uptake of certain amino acids and not the other with some overlap of still others.

    Now is the time to listen to your doctor! Soon....very soon now, "the good times will end" and the "lean years" will begin. The party will be over. You will have another type of stress when this happens not ever witnessed in America since its birth. The cortisol release will go through the roof. If you start adjusting your intake of foodstuffs judiciously and modestly, not only will your insulin resistance come down as your weight retreats, but you will be acclimatized to eating less, but more nutritious foods with density to hold you from wanting to eat all the time. You will be satisfied longer.

    You want real complex carbohydrates with mostly the fiber; protein with God- made fats inherent with the associated vitamins He put into them. Get off the polyunsaturated fats now and get them the way man originally did. He ate them inherently with foodstuffs. Eat red meat with a little saturated fat.

    Eat fatty fish and ingest Norwegian Cod Liver Oil. Drink whole milk, not 2% or skim. Eat all the broccoli, okra, tomatoes, asparagus, leafy greens, cabbage, and vegetables grown above the ground with little to no absorbable starch. Eat modestly from potatoes, beans, rice, peas, spaghetti.

    Eat no soy in any form except that which is fermented. Do not eat fast foods. Most have MSG in them to keep you coming back and this chemical causes addiction to their product. It also reduces, as polyunsaturated oils, the thyroid activity, and this then allows fat generation. Walk, exercise, lift weights. Take vitamins and minerals, and if you train hard, ingest whey protein powder.

    Being insulin resistant, pre-diabetic---the sentence is pronounced. Don't let it happen. Get busy. Eat less, move around more. The only way to eat less is to judiciously choose those foods that give you the most bang for your development. You are probably in andropause. This means you have a number of problems developing and one is low testosterone. Get checked by your physician. Get treated for it if low. Diabetics have now been shown to be low in this necessary hormone. Soon, if it hasn't already happened, your attitude will be negative; you will be easily inflamed, grouchy, irascible and just plain cussed. Friend...don't rot away!


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