The adrenal-sleep connection

Many people with CFIDS and/or Lyme Disease have sleep problems. Often they search for ways to help sedate themselves to sleep better, or ways to restore proper melatonin production, or address imbalances. There is another possible explanation that fits CFIDS and Lyme becasue of the adrenal exhaustion common in these conditions. People with depleted adrenals often can not sleep well because adrenals support sleep. They often can finally sleep once they start on cortisol replacement. In fact this has been a popular discussion on an adrenal list I belong to - how many of the people can sleep finally after years of sleep difficulties, once they get the proper adrenal support. And salt IS an adrenal support. It is almost as good as cortisol. I have been on both cortisol and salt/c and have experienced that it is the same type of benefit, the adrenal support helps the sleep (in my case and in others also). Probably also the salt is improving the digestive dysbiosis which means less toxins to detox during the night. But if this is the primary benefit, it will probably wax and wane as you herx. So how do you know if your adrenals are shot? Is there a test? Or is it obvious if you are living in chronic fatigue and pain that they're gonners. And what about cortisol replacement? Is that safe? Here is what I have learned about these questions.

The primary symptom of exhausted adrenals for me is that energy ‘runs out’ early in the day (say, around 12-2 PM), I feel horrible when I get an ordinary virus – like I might die, and any stress at all saps so much energy that I must lay down. Also, sleep problems and chronic kidney-area pain or lower back pain whenever I lay down and relax. There are others but I would say these are primary. The problem is that when adrenals are exhausted they have actually lost some of their capacity, and therefore a person with exhausted adrenals is living with a condition that is basically a sub-clinical form of Addison’s Disease. I believe that a LOT of late stage Lymies have this and do not realize that it is an actual injury to the adrenals that should be addressed separately.

Also, one of the most telling symptoms is to lose all body hair from the lower legs, and eventually the upper legs as well. This is a strong indicator of adrenal exhaustion, but it reverses when the adrenals heal. BTW, my adrenals are slowly healing on salt/c, but I still have to treat them, and I must support them well during bad herx cycles.

There are several tests, the most useful is the Adrenal Stress Index (ASI), which is a very simple saliva test you take at home and send to the lab. You take several samples over a 24-hour period. This shows the levels of many adrenal hormones, and compares them to normal. A typical person with adrenal exhaustion has levels about half of normal, although sometimes there are reverse levels also (one time of day the cortisol is too high, another time of day it is too low), which show general regulation problems from chronic infection load. Most doctors who are ‘into’ natural medicine know about this test. A good place to get the ASI test based on a phone consultation is http://www.chronicfatigue.org/ – they have reasonable rates and are a non-profit treatment center for adrenal-related issues.

Cortisol is a hormone that is involved in adrenaline production, it is a safe supplement to take, but if a person takes too much the body may become dependent. However, there was controversy over this drug early on because its over-use caused problems. Then a Dr. Jeffries proved a number of years ago that a level not exceeding half the biological dose is safe and will not alter the body’s metabolism in any negative way. Taking too much is a problem because when we have high adrenal levels the immune system is depressed. There was a lot of misinformation about this about 20-30 years ago, and that still persists in the minds of many medical practitioners.

Some recent research has proven that about half of the people with chronic fatigue syndrome have adrenal glands that are half the size they should be based on body mass. I don’t think the reason is clear yet, either atrophy or genetics, but it was a surprise to learn this. Some people just seem to have low adrenal capacity. And as adrenals are taxed heavily with chronic infections, this is a big issue.

There are other ways to boost the adrenals, such as licorice root and salt. Because I have chronically exhausted adrenals and probably have lost some adrenal function (For now anyway) I must take adrenal support every day. On days when I go off salt (I try to take a day off now and then to rest the kidneys), I must take cortisol (Cortef) or a lot of licorice. The typical healthy adrenal gland makes 40mg of cortisol per day. I usually take 5-10mg of cortisol on days off salt, or days with high stress. So probably my daily adrenal production is lower than it should be by at least that amount. Many people take 20mg daily, and for some this has completely reversed their health problem (usually chronic fatigue type issues).

Historically, licorice was the natural treatment for Addison’s, because it acts as a re-uptake inhibitor for adrenaline. Some people treat only with licorice and adrenal extracts. I use very small amounts of licorice only because large quantities of licorice increase estrogen and lower testosterone levels. But in small quantities it does not seem to be a problem.

There are many other herbs that can be helpful in treating adrenal exhaustion. If you are serious about this topic I would recommend getting the book ‘Adrenal Fatigue’ by James Wilson (he is unique, he is an ND and DC with a PhD in nutrition). There are dozens of books on the subject but this one seems to be one of the most highly regarded, and his program does help many people, without using cortisol.

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Review of several Salt-based Protocols

This is my quick review of the current salt-related protocols for treating Lyme Disease, Chronic Fatigue Syndrome, and Fibromyalgia. Rumor has it that a number of physicians are conducting small-scale clinical trials of some variations on these. Will be interesting to see how that turns out.

Each of these includes the basic combination of Salt and Vitamin C. There are various theories about why this works, but for the most part this is a synergistic 'discovery.' If you are interested in using Salt/C, I recommend reviewing most or all of these sites. One important warning though, I believe that there is one major omission in all of these, and that is that they lack any special kidney support or consideration for kidney health. While there is some controversy about this, my own experience has been that the kidneys need to rest from the higher Salt levels now and then. So I take one or two days a week off the protocol, and also take a full week off if my kidneys start to ache. However, some people seem to have little or no kidney distress from Salt/C. So caution is indicated, but hope for the best. Some people are recovering from these protocols alone, and some are improving a lot by combining Salt/C with other treatments. However, nobody claims that Salt/C is a cure for any of the conditions being treated. Most of the protocols, with the exception of Klinghardt, include indefinite use of the Salt/C.

Original Salt/C protocol (Lyme-focused protocol by anonymous recovered
persons, posted in 1999, their story has been validated) - http://www.lymephotos.com. This is probably the site that 'started it all.' The careful experimentation and following a hunch payed off in a major way. The people who discovered this protocol are continuing at full dose, and staying well now for 6+ years.

Enhanced Salt/C protocol (more comprehensive, includes immune-boosting,
detox, Rife, etc., by Marc Fett, recovered from Lyme Disease) -
http://www.fettnet.com/lymestrategies/ . Marc is now using a reduced level of Salt/C and is continuing to stay well. Many other people are experiencing success from this protocol. Marc adds a lot of extras to Salt/C including supernutrients, multimineral supplements, immune boosting, etc.

Enhanced Salt/C group (Discusses Marc Fett protocol, Marc moderates) -
http://health.groups.yahoo.com/group/lymestrategies/. This group is reporting great success with Salt/C. This is a support-oriented group, and people working through the herx response are able to get useful feedback from others who are ahead of them on the protocol. Most of the people in this group have purchased Marc Fett's 'e-book' about his Enhanced Salt/C protocol. The group also discusses the original Salt/C protocol and other related topics.

Recup, a Sodium/Potassium/Calcium/Magnesium blend (Alfred Blasi
protocol, recovered from severe FM/CFS) http://www.alfredblasi.net/eng/experiencia/ingles.HTM. This is the web site containing Alfred's story of recovery from a nightmarish Fibromyalgia and Chronic Fatigue condition. There are links on this page to the manufacturer of the mineral supplement Alfred invented. Alfred's patent rights were donated to ongoing research into the use of his protocol. The manufacturer is in Spain.

Recup group (Discusses Blasi, FM/CFS, Alfred participates from time to
time)
http://health.groups.yahoo.com/group/AlfredblasiprotocolFMSCFS/ . This is a Yahoo group dedicated to discussion of the Blasi protocol. This is a support group of sorts, and people get help working through issues related to using Recup for FM/CFS.

Dr. Klinghardt Protocol (Uses Salt/C as a 3 month parasite cleanse
adjunct, Lyme-focused) http://www.neuraltherapy.com/word/Lyme1204.doc . This is a doctor-recommended protocol with many improvements reported, my own MD recommends this protocol. Incidentally, Klinghardt also has a neurotoxin cleanse protocol, and
heavy metal recommends. See:
http://www.neuraltherapy.com/articlesProtocols.asp

Experimental Salt/C discussion group (Discusses Salt/C for all conditions) http://health.groups.yahoo.com/group/salt-n-c/
This yahoo group discusses Salt/C treatments in general, mostly for CFS/ME type conditions. This is a new group (May 2005).

Co-Cure Salt Page (Discusses natural salt) http://www.curezone.com/foods/saltcure.asp
Although not a protocol, this page is a wonderful explanation of why we need, and are deficient in, the minerals contained in natural salts. If you are considering using ANY salt protocl, I highly recommend reading this page.

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Starting the Salt/C protocol

Here is my experience over the first few months of using a Salt/C protocol. This is a 'reduced' salt load protocol. Because I am over-sensitive to most treatments, and seem to have weak kidneys, this is a very conservative approach, and it seems to be working as well as the more aggressive protocol that some people are advocating. Please note that I worked up to this serving of Salt/C very gradually, over several weeks. I started out at just 1g of salt per day, and 500mg of Vitamin C every other day. Being gradual with this is important because of the possibility of a die-off reaction as the salt begins powering the immune system to kill the Lyme bacteria (or possibly even killing bacteria directly in some locations in the body, such as in the digestive system).

I take 4g of salt and 1.5g of vitamin C per day. I alternate between natural whole salt, and salt tablets. The salt tablets are 1g. The natural salt is granular, like table salt, but it is from an ancient sea. For the granular salt, 4g is about one teaspoon. I take a half teaspoon just before breakfast, a quarter teaspoon before lunch, and a quarter in the late afternoon. If I have very low energy I add an extra eighth teaspoon at diner. I do NOT use table salt, only medical grade pure salt tablets, or natural 'whole salt' such as RealSalt or Krystal salt. The Krystal salt is probably the best, based on reviews from a lot of people using Salt/C. Also, I take each serving of salt in a glass of water, at least 8 oz. The vitamin C I use is Ester C, which is a slower release. I take 500mg of the Ester C with each 1g of salt, for the 1.5g vitamin C per day. This is generally considered a safe dose of vitamin C, although some doctors prefer 1g per day (important for those who have a history of kidney stones, for others much higher doses seem to be fine).

Several groups are advocating much higher doses of Salt and Vitamin C for Lyme, I have their links on the blog main page. They believe a therapeutic dose is 12g of salt and 12g of vitamin C per day. I have not tried that high of a dose yet, and am hoping that this lower and somewhat safer dose will continue to work for me. Perhaps some people need more, I know we are all unique. Some people may do better on the full 12g protocol. I'll describe my experience of starting the Salt/C protocol, and also include some information on the different salts I have tried.

According to reports by people using the salt/C treatment, at first most people experience some extra fatigue, some sleep during the day for a few days. This happened to me a few times, and I NEVER have slept during the day before. Even as a child I could not often sleep during the afternoon nap time. So the salt must really be having an effect. However, I found that I can’t take it in the late evening, or it actually keeps me awake at night. Different people respond differently. Some people have the opposite response, and take the salt at night to help them sleep.

New symptoms may appear on Salt/C, particularly in the early weeks, but old ones diminish, so there is some sort of trade-off, probably due to the bacteria moving around. Many people feel little pin pricks around the body and on the skin, and the belief is that this is co-infections, parasites trying to escape the salt. Some people experience small bumps on the skin, such as on the back or arms or chest. They feel like insect bites, and some hypothesize that they are due to parasites, microfilarial worms, trying to exit the body.

There is a silver lining to all the flare-up, or symptom worsening on this treatment; the salt/C treatment gives most people more strength so they are more able to tolerate the die-off effect better. That is true in my case. I feel a little better almost immediately on the salt, and can tolerate the die-off better than I ordinarily would. This is unique among ALL of the Lyme treatments I have ever tried or read about. Virtually all of the other treatments make you both sicker and weaker at the same time, and you have to endure a lot to get better slowly.

Here are some other possible reactions to salt. Sometimes there are some heart palpitations when starting the salt, that is normal and will eventually resolve, and they are not too bad. It probably has to do with the shock of the nerves working properly again, and the body making adjustments as the bacteria load increases. Usually it passes quickly, but when that persists, I prop myself up on a few pillows for a half hour and rest, and then it passes. Does not happen often anymore, and some people never have this particular symptom. I also have experienced a heart mini-palpitation sometimes when I change position, usually when I lie down, I believe this is an adjustment, it does not persist. The Lyme bacteria often infects the heart, so that may be involved. That is then a good sign, if it is removing an infection from the heart area!

Another common symptom worsening from the salt is joint pain, I have had a little of that, not too much though. Also, some people get more vision disturbance events and have strange persistence in their vision (something they look at that is bright persists for 10-20 minutes after they look away from it), but that just means the bugs are dying and releasing their toxins, and the body clears that up regularly. Also, be aware that all of these reactions happen with ANY successful Lyme treatment.

Again, one major benefit of the salt is that you are stronger on the salt. This is due to the support of adrenals by salt. Also, there are some major and immediate symptom reductions, for instance, my anxiety level is about 50% reduced when I take salt. I have no idea why this is, but I am glad for that. Also, my digestion immediately improved, within a few days. I did have some worsening of Candida symptoms for the first week, then they started improving, and now are much better than before, and that is common. Also, the viral load appears to be reduced. Certainly a good sign.

I did have a Lyme diagnosis before starting Salt/C. I know some people have started the protocol because of their suspicion that they had Lyme. Apparently, with Lyme, you can get a positive result regardless of whether you are on treatment, so some people do start the treatment before they are diagnosed. If their symptoms worsen, that can be taken as a sign of Lyme die-off, although most will still want or need a test result.

I started my Salt/C experiment very slowly. The LymePhotos website recommends 8-12g per day of salt, and that works for some people, but others appear to need much less. I am only taking 4g per day, and I increase to 6-8g per day once every few weeks which I believe provides a 'pulse' and knocks down the bugs. I have read in some places that the Lyme bacteria reproduces on a 30 day cycle, it is very slow, but very hardy. So the 'pulse' approach maybe effective, even if there is only one or two pulses per month.

People who have been sick for a long time have a very high load of the Lyme bacteria, and need to whittle that down slowly. I am definitely in that group and have a very high load. There is a vision test that can show how high a person's Lyme load is. That is at www.chronicneurotoxins.com. I flunked that test only after I started treating the Lyme. I had taken it earlier and passed the test. The difference apparently is that some people detox the Lyme neurotoxins well, and then they will only show the neurotoxin presence when they are killing off the bacteria.

There are three types of salt that are known to work by people using Salt/C. These are CNC salt tablets (by Consolidated Midland), RealSalt (www.realsalt.com), and Hunza (Krystal) Salt. The dose for the RealSalt or Hunza Salt is ¼ = 1g. The CNC tablets are 1g already. I am rotating between RealSalt and CNC tablets. I also am using the Hunza salt, and believe it is the best of the three. CNC must be ordered through a pharmacy, but no prescription is required. The tablets are very convenient and seem important at first, they are medical grade unprocessed salt.

When I use the salt tablets, I take extra minerals with the salt. I take ¼ teaspoon of Concentrace with each 1g CNC salt tablet. Concentrace is a liquid mineral supplement that is balanced with all necessary trace minerals, it is available at most vitamin stores (www.traceminerals.com). If you use the CNC tablets extra minerals such as Concentrace are critical with each dose. If you use RealSalt or Hunza, you will already be getting some minerals, and you do not need as many extra mineral supplements, probably just a daily mineral tablet.

The CNC tablets must be ordered through a pharmacy, or purchased online. No prescription required, but they are usually not a stock item. Here is a source: AmericaRx . I get them at a local pharmacy. Very cheap, $6.99 for a bottle online, a dollar more through the local pharmacy, but no shipping cost if you order from the pharmacy.

In spite of the appearance, table salt is NOT natural salt. It is usually a Sodium-Chloride (NaCl) extract from sea salt. What we are sold as table salt is an extract from real salt. Like something from a chemistry lab, not from the earth. We need the real thing. Most people tolerate natural salt well, because that is nothing but a collection of minerals, and we need all of them. On the other hand, many people react to table salt, including with high BP, because of its unbalanced (complimentary minerals are missing) and adulterated nature (the addition of fillers, stabilizers, and use of bleach for coloration). Some sea salts are good, but some are processed similarly to table salt, including the bleach. A few people have tried Celtic and French sea salts, which are not processed, and think that works for the protocol. However, they are not as pure and may contain harmful metals or toxins from polluted ocean water. The mined salts (RealSalt and Hunza) do not contain those as they are ancient sources.

I do not get digestive upset from the salt, but some people do at first, until the stomach starts healing and gets stronger. Those who are sensitive and want to use CNC dissolve the tablet in water, and sip it slowly over a half hour or so. That works for some people. But for some people that makes the stomach worse, and they do better taking the salt serving all at once. I just use RealSalt or Krystal salt in water, but I can also take the CNC tablets straight. BTW, I was on HCL for digestion before the salt. After the salt, no more need for HCL. The CL in HCL comes from salt.

Regarding adrenals, most people with CFIDS and/or Lyme have adrenal exhaustion. I do take a larger dose in the morning to help the adrenals. I started initially at 1-2g per day on CNC tablets. Then I worked up to 8g per day for a few days, and had a massive herx and could not take salt for several days. Finally I tried RealSalt for a month, then I settled down to current dose levels with Krystal salt, which seems quite effective. I may increase again in a few weeks, still learning.

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