Peer-Reviewed Articles
The hypothalamic-pituitary-adrenal (HPA) axis interacts with sleep in multiple ways. This article reviews the effects of the HPA axis on sleep and the converse. The hormones secreted by the hypothalamus and anterior pituitary that interact with the adrenal cortex are discussed, with implications on sleep disturbances and insomnia. A review of the stages of sleep and sleep architecture is given, and particular attention is paid to the role of cortisol. A dysfunctional HPA and alterations in the rhythm of cortisol production is described as a basis for understanding many cases of insomnia. This abnormal cortisol production and cycling is the basis for the hypothesis and the small body of research on the use of natural therapies to regulate the HPA axis and cortisol production.
Citicoline (cytidine diphosphocholine, CDP-choline) is a novel nutrient with a broad spectrum of benefits for conditions associated with symptoms of neurological dysfunction. An endogenous compound, citicoline is an essential intermediate in the synthesis of cell membrane phospholipids and its formation is the rate-limiting step in phosphatidylcholine synthesis. It plays several important roles in human physiology, including enhancement of structural integrity and signaling for cell membranes, support of acetylcholine synthesis, and synthesis of betaine, a methyl donor.
In this literature review we discuss the accumulating body of preclinical research which shows honokiol to have wide-ranging biological and clinically relevant effects, without appreciable toxicity. In vivo studies suggest that honokiol’s greatest value is in its multiple anticancer actions.
The standard of care is clear: Drugs that interfere with the formation of active tamoxifen metabolites are important to consider and relevant to patient care, but genetic polymorphisms that do the same are not.
The current standard of care does not include detection of asymptomatic atherosclerosis. Instead, traditional risk factors are evaluated, the patient is put into a low-, medium-, or high-risk category, and lipid targets are determined by the clinician depending on the category. Thus, coronary artery disease is not detected early. We know that early detection of cancer saves lives. The same is true for atherosclerosis.
