Neurologist: The Shocking Link Between Vitamin D and Poor Sleep | Dr. Stasha Gominak

0:00 Shockingly, there is literature from the 1980s that shows that there are vitamin D receptors in the sleep switches that actually... perform... these particular duties for us every night. Well, if there are D receptors there, it has to mean that D plays a role... in how we sleep, which is D for duh. D runs hibernation. Physicians are still giving prescriptions of "D2," which is really a bad idea because the "D2" blocks... any "D3" that that person could have. So in someone who's deficient, it makes them more deficient. We must get into these deeper phases of sleep called slow wave sleep and rapid eye movement sleep. If we do not, we feel unrested, have troubles with our memory, we have trouble with our mood, we get various pain syndromes. So sleep is not as simple. As I close my eyes, I become unconscious, and then I wake up.

0:47 There are certain things that have to be done or you start to feel crummy. Most important part is you have to decide at the beginning of your journey what are the symptoms that are related to this. And it turns out every symptom you have is... to this. Normal humans don't go to the doctor because there's nothing wrong with that. They don't have any complaints. "Stasha" in our world, there's a lot of talk about the benefits of vitamin D, not so much in connection to sleep. So let's start there. This is a fabulous topic. Unfortunately, I'm just very very interested in this and my husband has to drag me away when we're at parties and everything because I want to talk to everybody about it. -- The unusual experience for me was I was very, very focused on sleep. I started to be interested in sleep.

1:32 I'm a neurologist. I was not trained specifically in sleep, but I had a general neurology practice in the early 2000s... And one of my patients, who happened to be a young, healthy female with headaches, asked me to do a sleep study on her. And at the time there was no... reason to do that. She didn't complain that her sleep was bad. She says, my husband says I snore. But her reason for wanting a sleep study was because she had terrible headaches. And I had about half of my practice in daily headache sufferers who are generally young, healthy females. She had a sleep study that showed moderate sleep apnea... And that by itself is not too surprising now because we're 20 years later... and now we've learned that you don't have to be an obese middle

2:20 aged male to have sleep apnea. But when she put on the "CPAP" mask. - After about... three to four weeks, her headaches went away, which was really weird at the time. There were no connections... in the journals between sleep and headache... There was... no reference at the time to sleep apnea in young, healthy females. So that was an unexpected... finding. And also I'd been doing neurology for headache patients... for 20 years prior to that. And I knew that it was... very dissatisfying for both the patient and myself. We would try these various medicines. Our idea of what causes daily headache now is still pretty poor, and we had pretty crappy outcomes. And so this was one other possible...

3:06 thing that might help my headache patients. With that in mind, I started to do sleep studies. And from 2004 to 2009, I literally did thousands of sleep studies, first on my young healthy females with headache, but then on anybody who would let me. Because all of the young healthy females had abnormal sleep studies. It wasn't obvious at first... because they did not have apnea. So apnea means stop breathing. The first patient had... apnea. We're probably not going to want to spend a lot of time talking about apnea. --- The thing that controls our ability to be asleep, unconscious, and... paralyzed and to still keep breathing is the brain stem, this little piece at the bottom...

3:54 of the brain that connects the brain to the spinal cord. That means that there is a place that is a neurology issue. It's in the brain that controls our ability to keep breathing... and not to relax our throat too much and stop breathing. So this is really a neurology problem... that has been historically dealt with by the pulmonologists who have the little machines that blow up air. So one, I really think that sleep apnea should have been a neurology issue. - And it turns out that what we're going to talk about most of this hour is that brainstem... not only has to do with how we breathe through this tube that's paralyzed, but also what is it that's allowing us to get into these deeper phases of sleep.

4:43 The patient whose headache went away. Something happened in her sleep. And since I'm very chemically oriented, you'll see as I just love biochemistry, I thought, well, gee, if she's just staying in deep sleep longer, she must be making some chemical that's making her head pain switch... go into the off position, which is where it's supposed to be... So I'm thinking, okay, well, this machine, the "CPAP" machine, is allowing her to stay in hospital a particular... phase of sleep longer. Then I'm doing these sleep studies, and as I'm looking at the sleep studies, what wasn't obvious to me at first had to be pointed out by the pulmonologist was, my pulmonologist said, I don't know if you've noticed this, but the patients you're sending me... are young,

5:30 healthy females and they really have a different pattern on these sleep studies. Most of them don't have any rapid eye movement sleep, which is one of the phases of deep sleep, or they have "REM" related apnea or their "REM" sleep is delayed. So... I was aware that there are deep phases of sleep and lighter phases, but I wasn't actually looking at what was... reported... as what was happening. I was looking at the report. The report... said no significant apnea... So for about two years I was like, what is different... about these women who have apnea and I can put them on the "CPAP" and the ones that don't have apnea, they both have the same complaints. And what was happening is the real stuff. The meat of the report

6:15 was there, but they weren't putting it on the front page. So the most important part of what happens during our sleep is that we must get into these deeper phases of sleep... called slow wave sleep and rapid eye movement sleep. If we do not get into those two phases and spend enough time in there, we feel unrested, we can have troubles with our memory, we have trouble with our mood, we get various pain syndromes... So sleep is not as simple. As I close my eyes, I become unconscious and then I wake up. There are certain things that have to be done or you start to feel crummy. Any questions about that or should I? No, keep going. But I want to make sure as part of this opening we talk about what an ideal sleep looks like in the different phases. Exactly. Okay, so let's get to that.

7:01 So when I'm looking at this, that there's not enough "REM" sleep, the first question is, well, why? And why isn't it on the report? And I always put this in there because there are many people who've had sleep studies already. They suspect that they don't sleep well... even though they're asleep for eight hours. And then they're told that their sleep study is normal. Many of the sleep studies do not report the full amount... of deep sleep that was recorded, the amount of rapid eye movement sleep that was recorded, and every person who spends enough time like their whole night in there in the supervised sleep study needs to have that information. Now... in the meantime, we have all these sleep trackers that will tell us this. And the sleep trackers really follow how long are we paralyzed? So what you can easily follow by something that's kind of like a gyroscope and called

7:48 actigraphy, that's in your "Apple" watch or in your "Oura ring" is when you're moving and when you're not, and when you're in deep sleep, you're paralyzed. That means you can actually put on a ring and say, I spent two hours paralyzed in the beginning of the night, two hours paralyzed at the end of the night. Normal sleep, which is a... slightly complex at the moment. But... let's go back to the 1960s when the very first studies were done. The first studies were done in the late 60s, early 70s at Stanford. The very first sleep lab was from 1972. I was graduating high school then. That means I could have been one of the first Stanford medical students to be measured. Which is, when you think about it,

8:33 compared to how old medicine is in a general sense, we left sleep for last. And that's kind of pitiful. But it's because we're humans and we just are unconscious during sleep. So we just don't think about it. But as I became more and more infatuated with the idea that if every single person in my neurology practice has a sleep disorder, then why am I not treating that sleep disorder at the same time as whatever specific disease they have?.. Because if most of these diseases are genetic, then they had that genetic tendency. Epilepsy, headache, tremor. I should be treating both of those. I'm giving these little medicines that modify it,

9:18 but I should be treating both. That means I start to ask all these questions about sleep. And all that humans have... when we started was, how long do I sleep? How do I feel when I wake up? How many times do I wake? As soon as I have these sleep studies and I can see that, wow. This sleep study shows that this poor 18 year old, this is what actually happened... This poor 18 year old... has no deep sleep. The normals from the 60s, 1972, the normals generated were young, healthy medical students and college students. They would have eight hours of sleep, four hours of it would be... deep sleep, meaning that the patterns of the electrical waves from the brain would be different.

10:05 The first two hours would be... slow wave sleep because the patterns would be slow and regular. And the other two hours were rapid eye movement sleep, where the eyes would be moving back and forth. Nobody knew what those were about. But what I then saw in my patients was, oh, they're sleeping for eight hours. They wake up at 3am, they go back to sleep, but they never get into rapid eye movement sleep. There was this consistent lack of rapid eye movement sleep in otherwise normal healthy people. Because that is a neurology problem. It's not due to the airway. It's not something I can give him "CPAP" for. The first question would be, well, why is that happening? And in fact, that's why they don't put it on the report. Because as soon as it's on the report, then I would say, hey,

10:50 "Jesse," you don't have any rapid eye movement sleep. And you'd be like, well, that's at least encouraging. I know there's something wrong with me and... I know I feel tired... And then you say, okay, fix me. What are we going to do? And I say, I don't know. I don't have a clue. Nobody has a clue. Until we actually observe that there's a consistent absence of this deep phase. Then we have a hard time even knowing that that's going on. Then the next weird part about this is how do we study these things? - What we're really doing in the science side is we're now taking a bunch of other Stanford medical students - - and college students and we're doing sleep studies in them. The sleep studies that have been done in the last 10 years at Stanford

11:37 Sleep Study Center, when you compare them to the early 70s show, these are the recent results. These are the modern normals that teenagers and kids in their early 20s have an uptick in the amount of brain activity between 11pm and 1am, so they don't even go to sleep until 1am. That means our response to that is to start high school later. What they don't know is that we're gonna talk about is those kids are all vitamin D deficient. They actually have a sleep disorder. If you compare them... to the people that were in my high school class who were being recorded at that time, they went to sleep at 9:30 and they didn't have any trouble falling asleep. But because they're not looking at it from a historical standpoint instead. So when you say what's normal?

12:23 The problem is that the current normal is... my kid wakes up five times a night. If you look at little kids, the sleep recordings on little kids now, or just the sleep behavior, it's horrible. So things have changed dramatically over the last 40 years. Therefore, it's a little deeper than just what's normal sleep. The next question would be if I have normal sleep, according to... looking... at my relatives and my mother and my grandmother and my aunt and everybody else that I know... But I feel terrible. Should I just stop there and say, oh, my sleep is normal? That's a little tough because all we really know is what our family sleep is. And then now they're going to watch you, "Jesse," and you're going to tell them what's normal.

13:10 What's normal is you get up in the morning and you're raring to go and you don't have a single pain anywhere. - You're not depressed, you're not anxious, you have enough concentration... and enough brain power to go through your whole day, whatever it is you're doing. And you get calmed down easily without even meditating... by 9 o'clock. And at 9:30 you go to bed and you fall asleep at 10. That is so uncommon. And the people who feel that and do that, they don't spend time on the internet looking at health broadcasts. They feel fine and they do everything so they don't find it's not interesting to them. And that's the odd thing about medicine is medicine is directed towards whatever walks in the door... that's not fixed, that's not functioning correctly.

13:57 We don't focus on what's peak... performance... per se. Okay, that was not the way we were designed. So at the end of five years of doing all these sleep studies, noticing this particular... very important... lack of rapid eye movement sleep, spending a lot of time thinking about why would there be this big change? Because I know that when I was 20 years old, I didn't have pain when I woke up. Nobody I knew was on an antidepressant. We didn't have trouble sleeping. I know that there's been a big shift in this for years. There was an 18 year old gal who actually did a sleep study for me in 2009... So I've been doing this now for five years and she had no deep sleep at all... She -- was a perfectly normal, beautiful girl about to go to college.

14:44 She had daily headache... And her sleep study, when you asked her, how's your sleep? She said, my sleep is fine. She would sleep for 12 hours easily, but she felt so tired. So that question, how's your sleep?.. Has actually a lot more depth to it than that. I see a sleep study that looks horrible... She's waking to light sleep... 35 times an hour. She's not awake. She doesn't know this is happening, she's waking. So that any time that her brain tries to get into this deeper healing phase of sleep, it's prevented, it's not because she's stopping breathing. So I have no answer for her. I can't give her a sleeping pill. She's asleep already for 12 hours. Okay, that means I'm now put into a totally different

15:31 mindset. - Something's badly wrong with this part of the brain stem that's running her sleep. But I don't have a clue what to do for her. And it wouldn't make any sense for... to her to give her a sleeping pill, which is really my only options. I had "CPAP" and sleeping pills. That was it. At that point, she said, I'm so tired. Is there anything you can do?.. And out of desperation, I did a "B12" level and a thyroid test. And her "B12" level turned out to be profoundly low. Because I was so desperate and because I had nothing else to offer to her. I thought, wow. - Wait, let me think about this differently. Maybe these little cells. And so in the meantime, I'm reading these articles about the anatomy of the brainstem.

16:18 What are the cells that actually do this for us, that get us paralyzed? Paralysis during sleep that's frightening. And I'm reading these really wacky articles about single cell recordings from... pacemaker cells in the brain stem that are firing at a certain rate, and they have to fire at this certain rate since the day you're born, actually way before that, till the day you die. And that's how things happen in the electrical system in our body. They have to have a certain firing rate. And I think, well, maybe those cells are "B12" deficient. I don't even know what "B12" does at this point. I was very interested in vitamins before medical school, but I was kind of brainwashed out of them after. So I thought, what if this is a deficiency state?

17:04 What if the brain... could do its work, but it doesn't have what it means? So I start to give "B12" injections. I'm sending them back to their internist for this. It turns out that in the meantime, since I was in training, internists don't get paid for giving "B12" shots anymore. Instead, they give them the bottle of the "B12" and the syringes. So my patients are giving themselves shots, and they all say the same thing... I'm giving my shots once a week because I get two good nights and then four or five bad ones. And I was wait, you're supposed to do it once a month. Well, the first thing that's important there is they actually... had a noticeable change in their sleep. It turns out "B12" has got a bunch of articles, at least 30 years of articles about "B12"

17:50 and sleep and feeling refreshed and activated. Most people will be "B12" deficient. You give them a shot, they go, wow, it gives me energy. We're focusing on still, how do I feel during the day? But... I feel energy... is usually paired with and I sleep better. But there's something wrong with the way that we've been doing "B12." So the shots are really not the way it should be given. It should be given every day. Every day is a pill. And then the second thing that happened within a few weeks was one of my patients said, my doctor told me I was vitamin D deficient. She gave me vitamin D and my wrist pain went away. And she didn't say anything about her sleep. She had a lot of problems with... pain and all other

18:35 complaints. And at the time, I didn't know enough to actually ask about those other complaints. But I said, I'm doing blood levels anyway, which was brand new. I would never do blood levels on my patients for anything. So I'm doing "B12," and I just throw in the D. And it turns out everybody was D deficient. Because I had never really thought of this as a deficiency state before. I had never really been interested in vitamins. It was a really big step to go into doing blood levels on people. And unfortunately, these blood levels are extremely complex and they have really limited utility. But what happened very quickly was between August of 2009 and December of 2009,

19:21 I was drawing "D" and... "B12" levels on everybody who had had a sleep study with me who had complaints of some kind either that they weren't any better, their headaches weren't any better, they still had body pain, and everybody's D was low. And that was in the setting of if we make D during the summer, they should be okay. It's August. So the next thing that happened was in December of that year, two guys who were on "CPAP" for their daily headaches come in and say, you told me that this "CPAP" would help me... have no headaches, and it didn't work. And I've been using it for a year. But that last time I was in here, you told me to get a D level, and then you sent me that little laugh slip about taking D. So I went out and bought it.

20:06 And about three weeks later, I start to realize I'm sleeping better and my headache's gone... Two guys tell me that within one week. And since I'm now pretty desperate and I'm looking for an answer and the Ds are all low, I go and look at the literature and shockingly, there is literature from the 1980s. Which is now 40 years ago, that shows that there are vitamin D receptors in the sleep switches... that actually perform these... particular duties for us every night. Well, if there are D receptors there, it has to mean that D plays a role in how we sleep, which is D for duh. D runs hibernation. So all you have to do is happen to by accident.

20:52 So I accidentally got into the literature written by a guy named "Walter Stumpf," who had a very clear... picture in his mind for what this hormone was about because it is not a vitamin. Calling it a vitamin has really ruined medicine's view of this chemical. And it has really made the entire public of the globe... suffer without needlessly. So it's not a vitamin. It doesn't come from outside, it's not in the food... Yes, it's true that if you eat salmon, you might get some of that salmon's vitamin D, but you might also get some of the estrogen from that salmon, if it's a female salmon. But that's that salmon's estrogen. It's not your estrogen. You can't.

21:37 So this is a hormone that means we make it from being outdoors. And if you look a little bit more deeply into the literature, 100 years ago, there are people... writing about... the fact that rickets, which was a disease of infants and toddlers. That was rather non... specific. It was... kids who wouldn't walk, wouldn't play, cried all the time, wouldn't sleep, they were just terribly cranky. They were showing that if you put them outdoors and put them in the sun for... a few minutes every day, that, that rickets would go away... And this is way before anybody shows... an X-ray of their legs

22:23 because the X-ray machine was just starting to be used. Those articles... already are talking about civilization... has made us move indoors. And as we move indoors, we are no longer living the biologic life that we were meant to live... 100 years ago. There are these really amazing realizations by the doctors treating these patients now in the meantime. Because it was called a vitamin and a nutrient and it's coming from food, and because medicine gets its head... stuck in whatever its thinking is, it is so slow... to move. It's labeled as a nutrient, it's labeled as a vitamin. We're going to keep it in that area. And so then they look for

23:09 what's the vitamin? Cuz I'm determined this is going to be a vitamin... that could come out of the food. And they do the studies looking for the chemical itself to treat rickets. They do the studies in rats, and rats are nocturnal animals. That's a special kind of mammal. That mammal doesn't need to be out in the sun to thrive. That means that that mammal actually has a vitamin D receptor... that can use a vitamin D that is much, much older than the ones that we make on our skin. And they come from fungus, so fungus mushrooms. So it turns out that rats can eat moldy bread and get the vitamin D that they need to be healthy and reproduce...

23:55 from vitamin "D2." So the first thing that was found was vitamin "D2," and it really was in the food, but it was in the yeast that was growing or the mold is growing on the food. And it's now that was in the 1940s, which means that it's now 80 years later. These studies are really clear... and they're in the literature. And there is a minority opinion... that has been squawking about this for 80 years, saying one, "D2" is not what all animals make on this planet. In fact, starting with flowering plants, "D3," which is a different chemical, came out. Despite all those articles. "D2" is still occasionally being put into things. Physicians are still giving prescriptions of "D2," which is really a bad idea because the "D2" blocks

24:42 any "D3" that that person could have. So in someone who's deficient, it makes them more deficient. Even in the last, especially since "COVID" when... there are like picturing it as two... background choruses, there's the doctors that actually were in the "ICU" with the patients dying who think that they're about to lose this patient, who give "D3" and 40,000 "IUs." And the patient wakes up the next day and their lungs look totally different... And those doctors are damn, this is amazing... And they start to turn out articles about how treatment in the "ICU" is turning around "COVID." And we can talk about why that is and why it's so dramatic.

25:29 But the second chorus is, oh, that's a vitamin. That shouldn't even be... something that we arrogant, smarter, more informed physicians should be talking about... because we've delegated the word vitamin to lesser humans... like nutrition and dietitians. We don't state that, but it's implied. That is really weird because all of these things that we artificially named vitamins are at the center of every biochemical pathway that we learn about in medical school. You can't just forget about those pathways. They're there. And just because we arbitrarily said one's a vitamin and oh, this is a drug company, new chemical.

26:14 So... we've changed medicine dramatically even in the 30 years that I've been practicing... to be so focused on pharmaceuticals. But what do all of us, including me, when I get sick, I don't want to take these medicines. I'm giving out like candy. I just want to get better. I don't want to have to take them... None of us want to take them. So in actual fact, we'd rather see a way to get back to our normal self. The key to my looking at all of this and seeing miraculous things happening in... mundane settings is that sleep is how we heal... It's not that vitamins are the only answer. Sleep hygiene is important. Whether or not you go outside is important. Your exercise and your diet, they're all important. They will all play a role.

27:01 But if you do everything that your doctor recommends and that you "Jesse," recommend and you still live indoors, you will not actually heal because you cannot really heal in sleep while you live indoors. And that piece has been ignored. Clearly in the last four years or since "COVID" when we all moved really indoors, there has been such a dramatic worsening in mood and physical... feelings that we're now starting to see movements about schools should be led under the trees. - There are people going to extremes, but... frankly, our biology... occurred living outdoors. You mentioned "D2."

27:46 That is not good, actually detrimental. So we want to avoid that. You also touched on D... in food. It sounded like not... important. I'm not sure if there's detriment there. It's not detriment. Talk about that piece before we move forward. The D in food. And then does that play a role... in... the benefits we're talking about? Or is that not enough to really count? Okay. Because we call this a nutrient. Everybody who writes about it says these are the right foods to get it from. And they always mention salmon. And in actual fact, when we make D on our skin from being in the sun from a particular wavelength.

28:33 So it happens that wavelength is... only there during certain fixed hours. If you live at the equator, you can get "UVB" light from probably around 10am to 3pm. And then at the equator, it never changes... It's still available during those because of the angle of the sun. So as it's coming up at, it's a different angle and that wavelength is blocked. If we move towards, let's say... Texas, where I am. There are only certain months of the year... where that "UVB" light will be available for me to make. Let's just assume that all of us live outdoors. That means that during the winter I would change... things. Well, this chemical... was...

29:19 perfectly adapted to our planet when the dinosaurs were successful. This chemical was old... at the time that the dinosaurs were here. That means it was already modifying... the behavior... and the... mechanisms within the body. So for instance, if I move to the far north or south on our planet where it's snow covered and there's no food available for four months of the year, I either... hibernate or I migrate. And I migrate to the equator. So the birds from northern Canada are migrating... now towards the equator because they can actually make use the "UVB" light at the equator continue their energy metabolism.

30:04 So these are all things we've all observed and we go, wow, isn't that amazing? They all fly to the equator... But why would they do that? Because it allowed for... one, they would have food sources that wouldn't be. So you have either two possibilities. You either migrate or you hibernate. Well, if I hibernate, it means I go into a hole and, and I sleep and I lower my general metabolism of the body. And we know that pretty specifically in bears. And we know that bears can actually go without eating for four or five months... We know that a lot of sea animals like whales... may actually be nursing their young and not eating for four months. Then there are all these other things that come up and say, well wait. If that bear has to be feeding

30:52 her cubs for those four months. How does she give those cubs their vitamins?.. If the vitamins come from the food and she's not eating. So there are little questions like that that crop up in the background. One, "D3" is the chemical that appeared on this planet from flowering plants. So it appears that historically "D3," slightly different, really showed up when there were two sexes. So yeast, fungus, do not reproduce sexually. They don't have two sexual forms, male and female... Everything that came... after, including flowering plants... and the great majority of the animals on this planet, insects birds, fish everybody... has two sexes. One of the important things that should happen...

31:40 when you live at the far north or south is you should put your reproduction into a place where your young can be born. When there's food, if you have your cubs and you don't have milk for them, if you birth your cubs in June, then you have to keep those cubs in... a hole which, manage your 2 and 3 year olds at home, keep them in a hole for four months, it's not going to happen... So there are these specific little things that were done in each animal. And keep in mind that there's. I don't believe there's a puppet master doing this. I believe that there are... successful animals that are still on the planet... and they were helped... in being able to become... dormant in the winter. Go through a span of time when there was very little food,

32:29 and then come out in the spring and become active and growth producing. And D at its core is about that... It's when it's low, you become dormant, you don't repair your tissues. And actually we see a lot of people walking around who are 100 or 200 pounds overweight... that have stayed in a winter mode and have gained a huge amount of weight because their D is so low. This stuff is in the literature since the 80s, but it was not interpreted by medicine because we've been looking through the wrong lens, more or less. It's not that taking in salmon estrogen, "D3" from the salmon is wrong, but it's that we've just proved over the last 40 years... that getting your D from food sources is not enough because we all have low Ds, enough to not be able to sleep,

33:17 not be able to be healthy, not to be in a good mood. It's very difficult to say, oh, all these diseases that we've seen increasing and moving into younger populations over the last four years are due to X. Everybody has an explanation, we eat non real foods, they're too processed, we don't exercise enough. Those are all true. But if you address all of those in your life and then you're sitting across the room from me and I'm your neurologist and you say, I've been doing paleo, I've done this, I've done that, I walk outside every day. You've done everything your doctor says... But I still don't sleep and I still have hypertension and diabetes and blah blah, blah. And... then I'm left with, could there be something else?

34:02 And it was that setting where I said, it looks to me like everybody's got abnormal sleep, why would they? And then I stumble into this. Vitamin D is playing a role in sleep. And then the next really important discovery is one, in order to get your D into a range where your sleep is better, your D has to go to a certain place within the D -- blood level. So this guy, "Walter Stumpf," and I published an article in 2012, that based on his scientific evidence of vitamin D receptors... and my clinical experience with my patients, if you get the D over 60 and you keep it in the 60s in a range between 60 and 80, that's when everybody in my practice started saying, you know what my sleep is better...

34:49 And that has continued to be very consistent. - Since then, which was 2012. So it's now 10 years. And that by itself was enough to get us better. Unfortunately, the second part of the story is D by itself makes us better, but it wasn't the full story... And that's when the second part comes along, which is the microbiome. All right, we're going to get there, but I want to talk more about this range of 60 to 80 being the ideal. Tying back to the hibernation migration piece of animals. Would you say it's normal throughout the year to have different periods... where vitamin D levels are elevated and then dip?

35:35 Somebody like me in Ontario who is here all year round and naturally in the wintertime not going to be getting as much sun, my vitamin D is going to come down. Could it be argued that that is normal to have those peaks and valleys throughout, say, a full year? It is completely normal for the D to move around... Otherwise there would not be able to. You wouldn't be able to make these alterations in our habits. So seasonality of reproduction would not exist. And being able to gain weight for the winter to get you through the winter would not exist. So the D should move up and down. So we mentioned the fact that we have normals from hunter gatherers who live outside.

36:22 That's a slightly different question than what should I as a neurologist do with someone who has a sleep disorder. When we're living in a time when not sleeping normally is not the new normal? We're asking slightly different question. We're saying, can I take this chemical that has a natural role in sleep that would go lower in the winter, which would mean we would sleep longer, and it would go higher in the summer, and we would sleep less time and spend more time outside and we would be more matched to what was happening, to the seasonality where we lived. - - We're taking that normal fluctuation of things and instead... of observing the normal, we're asking a question which is,

37:09 can I take what I know about this scientifically... and use it to improve my patient's health? And that's a really different question. So the first question most people have is, is there a normal level of D? What's the normal D level?.. And the next question is, is there an ideal D level?.. Because what we all want, when we're interested in, we're going to the internet for biohacking is, well, I don't want to be normal. I want to be better than normal. The question I had was a very simple one... If the D level is low in all of my patients and they have a specific rapid eye movement sleep deficiency state, and I can show that there are D receptors in this part of the brain that runs that system,

37:54 is there a D level where my patient would say, I'm sleeping better? And in actual fact, it was not easy. It was not hard to show that I would. --- I'm not a scientist, I'm a clinician. So all I did was ask my patients, how's your sleep now? And they'd say, terrible. And I'd go, oh bummer are you taking that D? And they'd say, yeah. And I'd send them down. And their D was still 45. And when it started to cross over 60, it was very consistent. Now, what you learn quickly once you get into the biohacking world is that everything is attached to everything else. So even though we can talk about an ideal level, a normal level, etc. I don't want to give anybody the idea that I am a D expert... I'm not...

38:40 because there isn't one on this planet. It is incredibly complex. So... anytime you want to step into biohacking and take vitamin D as a supplement, and it's not the same as walking outside and standing in the sun. You have done something... that has manipulated your biology, and you've actually done something that's taken that D and put it in your body at a time when you were not receiving the other energy wavelengths that came with being out in the sun. So the actual story is you want to get closer to what those hunter gatherers are doing. But there are a few things about if I want to get better enough so that I can actually go back to living outdoors,

39:28 or the actual practicality of my life just not going to allow me to live outdoors all the time. How can I hack this in a way that it's safe quote unquote that it won't cause... difficulties? So your first question, does it go up and down? Absolutely. Does it still go up and down in my people who are taking supplements? Absolutely. But the odd thing is 90% of them can say, my XYZ just came back for me. I get visual aura migraine. If my D drops into the high 50s, it's to 58. I start to have this flickering thing of migraine... It has to be there for a while before that happens. But I'll go into the lab and say, oh, I think my D is low and it's only 58.

40:14 So there's a difference between 62 and 58 that's been consistent for 10 years in me. And it's not just me, it's different. The symptom complex that comes when the D is too high or too low is unique for each person. There are groupings of that, but it still means that there is a specific blood level in the brain. And we aren't measuring the blood level in the brain. That's really important, but there's a specific blood level. And the only thing that we have to measure in all of my. What I'm calling the right sleep program is the vitamin D level. There are also some really big complications with the kind of vitamin D levels that are being done now. Which is another complicated issue. I don't know if you want to go into that or. We will. But I want to get into what you just said first...

41:00 You mentioned the fact that somebody working with you would still have fluctuations throughout the year. Is that just based on the fact that depending on where they're living, the difference in the amount of sun they're going to get throughout the year plus whatever supplementation they're doing besides that? Yes... So unfortunately, this is very complex. The first question would be to get, well, "Stasha," what dose of D should I take to get to a D level of 60? Every single person that I dealt with at the beginning, I was completely a novice. If I knew how complicated this was, I never would have gone down this road. I had a website called the "Vitamin D

41:46 Council" that was started by a guy named "John Cannell," who's a psychiatrist at the time. In the early 2000s, he was the first person who... finagled a way for lay people to get their D levels. So... unfortunately, it turns out that... we have this connection between here's a dose and here's a blood level. That's the way vitamins are taught right now. That's utter... bullshit. It is not true. You cannot measure a blood level of a vitamin that is being active in a cell, in a cell in the brain and think that the blood level reflects what's going on in that brain cell... It's not the same compartment. And you're not even if you take cerebral spinal fluid,

42:31 you're not measuring what's actually happening in the cell. It's not that I'm the only person talking about that. It's that we're never going to really get around that problem. And even people who measure levels of things in the white blood cells, when you draw blood, that's a white blood cell, it's not the same as your brain cell, it's not the same as your brain stem. So it turns out that you as a human being can tell me a lot about what your D levels are or what your "B5" level may be by what's happening to you... You can tell me those things and I can attach those symptoms and then you can take that thing and make it go away or come back in a way that's much... more dependable than the blood level. So the first issue is... these blood levels. The second

43:18 issue is the blood level doesn't tell you how long that person has been deficient. So I've got, let's say, 800 patients, 1,000 patients, and I'm giving them D dosing, and I have a very difficult time knowing what the dosing should be. The "FDA" says 1,000 "IUs," so I start giving 1,000 "IUs." And those first two guys who came in and said, my sleep got better. When you told me about vitamin D, all the women who came in January, after I came back and read all the literature, their Ds were lower. They had been 22 when I measured them in August. They're taking 1,000 "IUs" and their level's 18. So then, -- how much should I give? I have no idea. So over struggling for a whole year and then into two years... to figure out what's the right dose. Well, every single person...

44:05 needed a different dose. Some people needed 2,000, other needed 50,000... a day. That... is, this completely explodes all... the instructions that people give on the internet. Just take 5,000. Just take 100,000 on a piece of bread once a month. That's all made up. Everything I'm saying is a made up explanation, but it is an observation of a thousand people and what happened to them. And then I make up explanations for it. So the second piece is the dose that you need to go from a level of 20 to a level of 60 in the blood is dependent on how profound your D deficiency is...

44:50 and how long it's been that way. A 20 year old... who was a lifeguard until two years ago and has always been swimming and always been outside and lives in Los Angeles, who comes in after two years of working in the "Target" warehouse in the summer... and for the first time is having daily headaches and comes in to see me in September and has a level of 20. And is not going to be the same as... his... grandmother who has osteoporosis because her D has been low forever, has rheumatoid arthritis, has terrible pain, has a million other things wrong with her. She has been D low... at a level of 20 for 40 years... And every cellular system in the body that uses D has had to

45:36 turn that repair system off as she's been dormant for 40 years. The kid's only been dormant for two years... and he may not even have a sleep study sleep disorder yet that he's aware of. He may just be coming in with daily headache. So one of the really surprising things is The Endocrine Society, which is a group of endocrinologists. This should be an endocrinology... It is a hormone. We make it. The Endocrine Society put out in 2024 a recommendation... after lots of study. And they were... really smart. They said, you know what, we don't actually have enough clinical experience with how to dose vitamin D. And the reason why they don't is it's a vitamin. So they're not taking responsibility for it.

46:24 My observations over a period of 10 years are really valuable clinical observations, but I haven't done it in a scientific... way... I don't have it in a database, I can't put it in. And because our journals are not accustomed to taking clinical observations anymore, they won't take my clinical observation as being valid. But The Endocrine Society finally came out and said we do not have enough clinical experience... to know what to tell a clinician once they've done a D level. We don't know what dose to give to approach another D level. So our recommendation is you don't do D level. That was the recommendation. They've been asked to do that

47:11 and they completely sidestepped the responsibility... And they did also say... that all the clinical studies that are giving 4,000 a day... to half of the group. They said that's totally worthless... Fixed dose studies and hormones are ridiculous. Hormones are managed by blood levels. Thyroid, testosterone, estrogen, always blood levels. That means one of the difficulties is trying to put out. And I have a booklet and I have a website and I have recommendations. But you're still taking a little bit of a chance. You have to start off with X dose. You do your level again in a month and you see what happened to you personally. That is the core of how you use this hormone... What is my body asking for?

47:58 And that is totally different. As soon as you put that vitamin word on it. We've been all been told that there's a daily recommended dose. I can spend three hours. I had this happen with a group in Edmonton. I lecture for three hours about D. I give them all the history, I give them the whole thing... And at the end, the first question is, there should be a daily recommended dose. And I said, you're absolutely right because we named it a vitamin. But this doesn't have a daily recommended dose. -- That puts us in a very difficult spot. Now, if we weren't all so desperate and if I lived in Ontario, I'd be even more desperate. I'm interested in health. I don't want to get these diseases. I'm looking into this before they happen to me. Then the next question would be

48:45 what you haven't asked, but is it a very logical question. -- Should I be hacking around or playing around with this D if there's nothing wrong with me, if I'm not trying to fix something, is it bad for me to be supplementing? And I would say yes, it is bad for you to be doing that. You really need to have access to D levels. You have to understand it a little bit better... And unfortunately, if I get into this in a social situation, my first fear is you're going to take D, your D is going to go up. The D is going to tell the body it's time to repair things. You're going to start to make repairs. And the things that are used for those repairs are the vitamins, the real vitamins... that we don't make that are made by our bacteria in the belly.

49:30 And what I... next found out was if I keep somebody's D at 60 and I don't fix their source of these other building blocks, which are not only the B vitamins, but all the minerals, iron, all the other things that we use, the little pieces that come together to make a normal, healthy cell. If I don't fix that, you've actually sent a message to the bodies to try to repair things and you've depleted other things. So... you develop, you encourage other deficiency states. You quickly touched on something there that piqued my interest. And I want to get further into. The... vitamin D that we're getting... from sun exposure... versus supplements... And we also talked about food. So there's these three different

50:16 players that make for a gray area in different ways when it comes to dosing, because... different seasons we're going to have different exposure to different amounts of sunlight. But also, and you touched on this really quickly. Is the D we're getting from the sun... having a different impact on the body versus supplementing? Because there is likely... so much more going on there than science currently understands... And for us to think that we can go in and take a drop of vitamin D each day and get the same benefits seems foolish. It is foolish. It's well stated. So the other thing that you should know is there's a guy named

51:05 "Andrzej Slominski" and he came from Poland. This guy is brilliant. He's in a dermatology department, which is really weird. He's a primary scientist, he's a biochemist. He started in melanoma and then oddly enough went to melanin and then went to D. And melanin is also a hormone. And then he asks questions about D... that no one else thought to ask. Because he's looking at the physical structure of this chemical... and showing what it does in the receptor. It... has a three dimensional structure and he's thinking about how it fits into the receptor. He now has 10 years worth of articles that show that there are a rainbow of types of Ds. If you just look at vitamin D on the internet,

51:52 what you'll see is there's vitamin D, the storage form, that's the "25 OH." There's the active form, the 125. No, there are... probably 20 active forms. Maybe 25, maybe 30. That means when and most of the forms that he's finding on the skin that are formed by "UVB" light exposure are things that have to do with inflammation, scarring. - They're things that were naturally being made... to make sure that the "UVB" light exposure that... damages our "DNA" is being repaired... So you can show that there are articles back from the 90s where you take a squamous cell carcinoma, you grow it in a petri dish, you drop vitamin D on it, it converts to normal skin.

52:39 Because there were... processes already developed on purpose at the same time that were... aware of the fact that the "UVB" light would damage the "DNA" structure. So there are repair process that happened. That means we're giving one form of vitamin D. We're not giving it in the same setting that it's meant to be created, which is on our skin and in this rainbow of things. And there are other chemicals that actually have different names like "lumisterol" and other things that are named differently but are very similar structurally that are supposed to be there at the same time. - So that means there are multiple hormones being made... But then

53:24 there's a second... issue... and is even... deeper than that, which is there's really good literature that shows that infrared light, so other wavelengths, some that we can visually see, but others that aren't visible to us, that are penetrating our body... so that infrared light can penetrate 2-3 "cm" or more and has effects on mitochondrial health. -- And it affects the melatonin, which we've... artificially said is a hormone that has to do with sleep. But melatonin turns out to be pivotal to mitochondrial health throughout the body. So there are all these simplifications. So when someone writes a journal article and they talk about an experiment, then they're asked to write a chapter,

54:11 they tend to stop... to try to codify things and make them... understandable to a bigger public. And they oversimplify. When the actual answer is, if you have a sleep disorder, what should I do? The first answer is go outside... more. There are some things about that that we could go into in more depth, but... there are lots of people on the internet that are actually talking about their experience as being. Can't sleep until 4am... I've slept from 4am till noon the whole last 10 years. I go out and I have this camping experience where I camp the whole month... of... August in Quebec... and I start sleeping, I don't know, 10 o'clock.

54:57 So there are multiple things about not only light being perceived through the eye, but multiple wavelengths of energy that are being biologically integrated into our body. So at the end of all of this, one biohacking has its dangers. Two, I think it's valuable to know about it and it's within. But it's within a context of really seeing this as a set of beliefs. And if you really want to say I'm a normal person... and I don't have any diseases yet, what are the things I should do? That's a really different question. Then... I'm six. This is me. I'm 69 years old and I have... restless legs. And I have this and this and this... And I'd like to try this biohacking to see if I can get my restless legs to

55:45 go away so I can come off my medicine. Those are two really different questions, but they're often clumped together as though they're the same. They're not. Your question about Ontario is really important... because one of the things we referred to before was that there are lots of studies coming out of Finland with this really, really smart biologist. Now, if you look at who's been living where on the planet. There are lots of people who live in Sweden, Norway Denmark, Finland and they live to be 90 years old. Well, their vitamin D levels can't be the same as somebody who's living in an equator if they're not actually supplementing... But there are all sorts of other things that they do. Habits that they have that are health producing, like cold plunge...

56:33 and going... into saunas and other things that are, as far as I can tell, adaptations that have had similar effect or have substituted because their longevity is great. So it's only when we moved into the modern world and we sit at a desk... and we don't go out. And since most of... the Nordic countries... are phenomenal about exercising, I have clients who are in Norway... Their kids are skiing every day after school in the dark. -- The ski slopes are... lighted, but everybody, they didn't have a choice. If they wanted to go... get something to eat, they had to be on their

57:19 skis... So they lived outdoors much, much more. That means, if you're going to ask, do I have to supplement when I live in Ontario? Well, kinda because... you're not really raising sheep in Ontario anymore. You're not farming in Ontario, you're not a Native American living in Ontario. We were just in Alaska. And if you go... into what it would be like to live in Alaska and try to survive as an indigenous people, you wouldn't be sitting inside, there's no food in there, you would be outside all day long... until you were fatigued and then you would be sleeping in your little... whatever. So you might be inside your igloo if there were storms...

58:07 So it's much more wide ranging than that. And I think my view of what I'm doing is this is the very first step in the direction of trying to biohack in a cautious way and to be attentive to what my body tells me while I'm trying to change my habits to fit with what we're actually the normal things that all other animals do, which is to live outside more. For somebody that's going to take this on biohack, start supplementing with vitamin D. We know we avoid "D2." So we're going to supplement with "D3." We know we can't just blindly recommend a dosage. It's going to be different depending on the person and we need to

58:54 test and see how we're feeling. But when it comes to supplements, there's capsules, there's liquid, different types of vitamin "D3." Is there a certain type that you recommend? I have not seen any difference. And this also gets me into the supplement world, which I had no experience with at the beginning of this. I saw. Keep in mind that my population are people who like allopathic medicine or they wouldn't have been seeing me. And they take... five different pills because they're seeing a bunch of doctors, and now they're seeing a neurologist. So me convincing them to take... four vitamin D pills... plus a "B50," plus a multivitamin, plus a "B12" was not easy.

59:40 And it had to be cheap... and easy. -- Because of the population I was working with, I wasn't saying, gee, this is the brand I want you to take. I also don't like the idea that we should be making a 400% markup on something that should be free. These are people who are sick, and you can go outside and get this for free. - How... right is it for me to be making a bunch of money on repackaging this? So, one, I don't really have a favorite brand. I really think that you should get whatever it is that you can afford. It shouldn't be expired. I don't think there's much difference between whether it's gel caps or tablets. I think that the most important thing is paying attention to the dose.

1:00:27 - Every other chemical you put in your body, the dose is important. And we have been coaxed into this level of ambivalence or... lack of interest in what's in the multivitamin to a point of saying, oh, multivitamins won't hurt you, and they're good for you... Neither one of those things is true... Multivitamins can have anything in them. You don't ever read the back. And it turns out the dose inside that, especially the B vitamins, is pivotal and whether or not you'll sleep or not. So my biggest struggle was not... which brand should you buy. Almost everybody says, why don't you just publish your own bottles and just give it to me? No, because the reason why I'm not doing that is you have to learn what the dosage is...

1:01:13 You have to connect. Oh, I took a vitamin that has... 55 milligrams of "B5" in it, and I couldn't sleep at all. My other, and I go and I pick up the empty bottle out of the trash can, and I see that my other multivitamin had 15... and I was sleeping. Well, each person has to make that connection for themselves. So I insist that they have certain vitamin doses and that they read the back. But I'm not really much into which supplier. I also have not been convinced that more expensive is better. The whole supplement industry is around. I'm going to brand my own. I'm going to put what I think is best in there

1:02:00 and... what's best for one client at this phase might work well, but it may be disastrous for the next person. That means you really have to be applying these chemicals... to what am I personally trying to accomplish, what have I done for the last 10 years, that sort of thing. - And most of the people who are... interested in supplements are not really... into that. They just want to know what's your recommended dose? And they're not interested in trying to connect. The recommended dose depends on where you are, what are these symptoms and how do you learn how to attach these symptoms... to the dose you should take. And the fact that one, when we're in a deficiency state, we're going to be...

1:02:47 taking more and then... when we get the microbiome back and they're producing the things that we were supposed to have for the last 20 years, you can't make up the 20 year span loss overnight. That means you have to take a little bit more for a fixed period of time. But then you will reach a point where that big dose is too much and their body will tell you that and then you come off of it. That's a really different way to think about vitamins and supplementing. One of the common vitamins coupled with Vitamin D is "K2." Do you feel like that piece is important or is it something you avoid or advocate for?

1:03:33 I address it in the "FAQs," I address it on my website. The "K2" is really not about D absorption. "K2" is about once the D does its work and it helps us to absorb calcium, "K2" has a different responsibility where it directs the calcium into the places where it's supposed to go and it keeps it from going to places where it's not supposed to go. It directs the calcium into the bone instead of into your tendon attachments or into your arteries. And so people who've had osteoporosis or osteopenia have bone effects of being D deficient. Therefore, I think they should take "K2." People who have not had bone effects. "K2" is coming from the bacteria in your gut. So bringing back the gut back to normal gut bacteria is a pivotal

1:04:21 part of the "RightSleep" program. We're going to talk about that when we talk about the microbiome. So I don't recommend "K2" be added specifically... It's frequently in the multivitamin as well... So under certain circumstances. All right, I want to make sure we're clear on the type of testing to get done. Because if you go to your doctor with this new information we're sharing today and you're going to aim for that 60 to 80 range for your vitamin D. The likely... test you're going to get isn't the one you want... So let's talk about what that is and then what you recommend. When I was first doing these tests, I was completely unaware of any anything. And I just sent them off for vitamin D tests. And it just so happened that my lab was doing

1:05:07 what is called a liquid chromatography, mass spectroscopy, D level. That is... a... big, huge machine that has this. All these different things that it does. It's a half a million dollars to buy that machine. Every single lab that's testing any hormone from our body, thyroid, testosterone, estrogen, has to be shot into that machine because these hormones have very specific... confirmations that have to be done by this machine. At the end of 10 years of doing those "Ds," I started to notice that there were other doctors in my community who had decided they wanted to do D levels on their patients, and they bought a vitamin D machine and they're using that machine and the D levels that they were getting

1:05:54 a week away from the ones that my patients were doing. For me, these two labs... were having differences of 10 or 20 points. - When I'm saying you should be between 60 and 80, and this lab that I'm using says Your level is 60, and your other doctor's lab says it's 80 in the same week, that's totally different. One says we should go down, one says we should go up... And so I would call them and I would say, what's wrong with your machine? And -- they'd say, my machine is fine. And I've done all the blah, blah, blah. And it turns out that they're using these machines that are set up as immunoassays. If you picture the little tests we do for "COVID," the "COVID" test is an immunoassay. You make a little antibody. This is something that our body makes.

1:06:40 It's a little lock and key recognizing the "COVID" virus... And you put that on a piece of paper and then you find a way to... attach a color marker to it. So what you're looking at is this little tiny band with a red or blue. That sort of thing is called an immunoassay because doctors started to do a whole bunch of vitamin D levels... starting at the same time that I was doing middle 2000s to 2015. And the doctors don't have any way of knowing what the physical manifestations of D deficiency are. So they don't know how to interpret this lab result. The labs were looking for cheaper ways to do vitamin D, so they just started to move over to immunoassays. And unfortunately,

1:07:25 each company like "Roche" makes a machine that does it and "Abbott" makes a machine that does it. And they're all different antibodies and, and they all have... different normals. They are all supposed to be compared to this... gold standard, which is the liquid "LC-MS" technique. But they're compared within the range that usually walks through the door. So if 90% of the people who walk into the lab have a D level between 10... and 40, then they can say my immunoassay varies... It is linear, it's about the same as... the gold standard. But if you go above 40,

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