#203: Stasha Gominak, MD-Low Vitamin D, Sleep, Gut Bacteria and Methylation

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About Stasha Gominak, MD

Dr. Gominak graduated from the Baylor College of Medicine in 1983. She lives in Portland, OR and specializes in Neurology.

http://drgominak.com/

What Others Are Saying About This Episode

Excellent interview by @MikeMutzel explaining the importance of Vitamin D in good sleep and self-repair in the body. https://t.co/Yv1XEhWjlr

— Tim (@ObviouslyTim) September 30, 2017

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02:29 Hundreds of Dr. Gominak’s patients, children, teenagers and young healthy females, didn’t have REM sleep.  These patients didn’t have sleep apnea. They were still breathing. By accident, Dr. Gominak discovered a patient with very low B12 levels. She began to also check vitamin D levels and found both were low in these patients. There are vitamin D receptors on the REM-related cells she had been researching.

04:42 Sleep apnea, fibromyalgia, chronic fatigue were not recognized in the 1960s and 1970s, because they were not epidemic. In the 1800s an entire population moved indoors for their entire lives to work in factories. They developed heart failure, non-healing ulcers, rickets, diabetes and renal failure. Now these diseases are epidemic.  Daily exercise a component. Certain diets around the globe are extremely narrow, but people can thrive on them when they live outdoors.

07:21 Vitamin D and the Brain Stem is a Major Player:  Brain stem is a series of switches for deep restorative sleep. There are a group of nuclei in the brainstem that have vitamin D receptors. When you provide vitamin D to those cells, the vitamin D goes into the nucleus and suppresses the enzyme that makes the neurotransmitter, acetylcholine. Acetylcholine helps us become paralyzed correctly so we can achieve REM sleep.

08:28 Every person who becomes deficient has a different mix of which neurotransmitters are not balanced. This means that a variety of sleep issues may manifest.

10:03 You must be paralyzed in order to achieve the proper levels of sleep. Dr. Gominak’s theory is that paralysis during sleep is done so our body can restore and repair tendons, muscles, arteries and other moving parts of our bodies. The brain stem nucleus is broken into 3 groups. One governs paralyzing your face, nose, and throat. Another paralyzes your diaphragm and chest wall. The rest paralyze the lower portion of your body. If you have pain upon waking in a particular part of your body, it could be that that did not undergo paralyzes while you slept and it was not adequately repaired.

14:21 Why would an 8 year old have more than one sleep disorder? Perhaps the brain stem nuclei switches are faulty and deep sleep paralysis goes too deep, closing the airway, or not deep enough and there is significant movement. Children must have deep sleep for growth, sexual development, and the creation of neurotransmitters that enable attention and brain development.

16:02 There has been a major historical shift from living/working/playing outside. We didn’t used to use sun screen. When air conditioning came into common use in the middle to late 1970 to 1980s, we spent more time indoors and chronic diseases began to increase. It is the same timeline for IBS and Celiac.

17:07 Once you replace vitamin D, the body slowly changes from a vitamin D deficient body to a B deficient body. After about 2 years of restoring vitamin D levels, and sleep normalization, patients manifest symptoms of MS. However, this is actually a vitamin B deficiency.  Vitamin D is a major player in MS.

18:08 While bears hibernate, their microbiome consumes the colonic mucus, which makes all of the B vitamins to meet the bear’s metabolic needs during hibernation. Does ours? Everything we do in every cell is linked to B vitamins. Repairs are linked to B vitamins. After 2 years, Dr. Gominak’s patients’ pain returned and increased. She learned that the B vitamin, pantothenic acid, is critical in sleep. B12 was already being used for its impact upon sleep.

22:05 Why Did It Take 2 Years to Become B Deficient? Dr. Gominak’s theory is that vitamin B stores in our gut were being used for repairs that the brain could now make during restored deep sleep. The symptoms of burning and pain went away after 2 days of supplementing with B complex. When supplementing with one B vitamin, Dr. Gominak learned that we should supplement with all of them. Her patients felt better with the complex than with the B5.

23:44 Each B vitamin has an intestinal bacterial source and a food source. If our bacteria make B vitamins, could it be that some of our B source is only from the gut? Perhaps there is a storage amount of B vitamins in our gut and after 2 years of repair, they have been depleted. We need to get the right gut bugs back. Sleep disorders and gut disorders are in parallel.

26:02 Wanted: Gut Bugs: If you go around the world and sample the gut bacteria of healthy 3 month olds who live outside, you will see 4 main species that make 8 B vitamins for each other. These came from mom. What if mom is vitamin D deficient and she does not have the right colonies?  These main species are needed to dissolve specific glycans in mom’s milk. If baby does not have the right bacteria, they get colic from breastmilk. Dr. Gominak believes that when your bacteria return, you react to an over dosing of B. The four general species are actinobacteria, firmicutes, proteobacteria, and bacteroidetes. The right bacteria protect us from autoimmune disease.

31:39 You can fix your own bacteria with vitamin D levels above 40 and take B100 or B50 for 3 months.  The microbiome plays a huge role in sleep. There may be other B vitamins that play a role in sleep. Dr. Gominak always gives all 8 B vitamins. The symptoms of having too little of a B vitamin are the same as the symptoms of having too much.

32:58 The sodium linked multivitamin transport system pumps 3 vitamins, pantothenic acid, alpha lipoic acid and biotin, into our digestive system and our brain. If you take a huge dose of biotin, you may worsen your sleep. It has been assumed that pantothenic acid deficiency does not exist because it is in every food. Coenzyme A is in every food, but it takes 5 enzymatic steps to become pantothenic acid. We must have those 5 enzymes in order to make pantothenic acid from our food. If we flood our system with lactobacillus, they compete with us for the pantothenic acid that our microbiome produces.

36:24 Dr. Gominak sees a correlation between autism and vitamin D deficiency. If children do not spend enough time in deep sleep. If you shorten the amount of developmental time, the brain has to triage and prioritize what needs to develop. In autism, social interaction has been left for last. Dr. Gominak has found that if you give the brain everything it need and a child can sleep as much as the brain wants, all of the deficiency states can be repaired, even at age 16. The brain keeps an accounting of what still needs to be done.

38:27 The development of sexual dysmorphism and sleep: Sexual discontent or dysmorphism is when what you feel about yourself does not match your genitalia. You are born with your genitalia, but the sexualization of your brain happens every night while we sleep. Endocrine development of the brain is related to estrogen levels secreted in your brain while you sleep. Sexualization of the brain happens slowly in the same developmental sphere as growth. The development of the body and the brain can be somewhat separate. After changing the genitalia of a person with sexual dysphoria, the depression and anxiety that comes from sleep deprivation is still there.

42:34 When a child cannot get out of bed in the morning, this is may be the brain demanding that they go back to sleep to get REM. When your vitamin D levels are low, you are supposed to be hibernating. Bed wetting means that a child is not getting into deep sleep and not making antidiuretic hormone to stop the production of urine. Leg movement, leg pain, sleep walking and sleep talking are related to this as well.

44:03 A lack of REM sleep cheats a child of their normal development. Send your kids outside more. Expose them to sun without or with limited use of sun screen to make their own vitamin D.

47:15 Children and adults normally make small subtle movements and tiny vocalizations, not talking, walking or falling out of bed.  If movements/activity increased, it means that the paralysis center is lacking what it needs to get perfectly paralyzed. This could be a deficiency in vitamin D or pantothenic acid. They work together to make acetylcholine, the primary player in getting us correctly paralyzed. Children who snore may be overly paralyzed.

48:27 Taking the Weston A. Price westernization theory to another level. Our western lifestyle impacts the development of the pallet. The pallet becomes narrower, the teeth become irregular and they are vulnerable to dental carries. Price believed that this is related to nutrition. However, the shape of the upper part of the mouth and jaw are determined by sleeping, deep sleep, and then the tongue sending sensory messages to the brain. You take away the tongue’s ability to do this because of an open mouth while sleeping. If a child is vitamin D/B deficient, they get a runny nose, increased allergies and they are not able to breathe through their nose. They will have a different formation of their lower face over time and teeth will be crooked.

51:16 Shame of Nakedness: The original western intrusion into tropical cultures brought a difference in food and a shame of nakedness. When clothing is worn, vitamin D production in the skin goes down.

56:02 Breastfeeding enlarges nasal passages: Babies that are able to breastfeed have to make a seal. Bottle fed babies do not and cannot breathe through their nose and develop their nasal passages as they should. If you enlarge the pallet, you enlarge the base of the nasal passages.

57:28 Dr. Gominak believes that vitamin D is trophic to the bacteria that we are supposed to have in our gut. Vitamin D supplementation by itself does not bring back the microbiome.

59:24 Pantothenic acid not only makes acetylcholine, it makes cortisol. Low cortisol will bring up inflammatory markers. Cortisol is what tells white blood cells to calm. Over time this impacts the development of autoimmune disease. Cortisol is used to respond to stress and you need a reserve.

60:11 Acetylcholine is a chemical used by the vagus nerve. The autonomic nervous systems are two intertwined reciprocal nervous systems. Fight/flight uses adrenaline. Rest/digest uses acetylcholine. HRV studies measure populations that have sleep disorders and find that the sympathetic is dominant and the parasympathetic is too low. There is no source of pantothenic acid in our body or our food. It is created by our gut bacteria. Dr. Gominak believes that they make a minute-by-minute or hourly supply. If you put an oral appliance in a person’s mouth, their HRV changes in a minute. The sensory system of the back of the pallet, the glossopharyngeal nerve, goes directly to the vagus. We are doing more techniques, like meditation, to up the vagus output. The extra stimulation of the vagus may cause it to eventually run out of raw materials.

01:07:46 A test result of pantothenic acid levels will parallel magnesium levels. It tells you what is in the blood, but not what is in the stores. We need a better way to measure pantothenic acid stores. As you dose high, the blood level doesn’t change, but the urinary excretion goes up. It may be the same with peradoxime.

01:09:10 Perhaps we are completely self-healing with REM sleep. Sleeping better triggers the brain to remember the deferred repairs. Perhaps, given the right setting, stem cells in the pancreas, the brain, the kidney and elsewhere can repair the body during REM sleep.

01:12:26 Dr. Gominak’s Morning Routine: First thing she assess her sleep and pain levels. She likes to exercise. She has coffee with heavy cream and starts working. She is starting a business to teach other clinicians to treat the deficiency state.

01:13:31 The ketogenic diet helps people to live longer. Being ketogenic during REM sleep helps us repair. We were probably designed to go into ketosis for at least 12 hours every night.

01:15:08 A new theory is that the tricarboxylic acid/CREB cycle, which is used when you are using fats as your energy supply, may have a different purpose. It may not be about making ATP. It may be about making water molecules that didn’t come from water and do not contain deuterium. When we use this cycle, it dramatically impacts how our mitochondria act. We probably age based upon the percentage of our water that is a deuterium molecule. The water in your mitochondria never passes across as a water molecule. Water is made inside utilizing water that does not contain deuterium. Deuterium containing water screws up the pump and gets stuck in the hole. It requires down time and repairs.

0101:19:33 Dr. Gominak’s desert island herb, nutrient or supplement: She finds that her summer vitamin D requirement is similar to other times of the year, no matter what her sun exposure.

01:30:35 Dr. Gominak’s Elevator Pitch: We can impact our children, especially children of color. It they don’t go outside, they don’t make enough vitamin D. It effects mood, feelings of self, ability to pay attention. Everyone with a vitamin D deficiency who cannot sleep, cannot be fully educated. Current literature suggests that if you don’t sleep right, it is your fault. It is not your fault. Dr. Gominak would like to dispel some of the dogma surrounding sleep and she wants to educate clinicians to treat this.