Circadian rhythm dysfunction

[Carrie Hardy]

Hello All!

I have a 62y/o male who has contracted COVID-19 at least 3 times over the past 2 years.   With each iteration he is experiencing a worsening of circadian rhythm.  He is currently only able to go to sleep in the early morning hours (around 4:00AM) and wakes in the early afternoon.  I have recently started him in DSIP but this has made his sleep worse.  Any thoughts or recommendations?

Thanks

[Leonard Pastrana]

Was the DSIP taken at bedtime? Sometimes it makes it worse. We try taking it earlier and earlier in the day until we find the right time.

 

Some other options to look into:

-VIP Nasal Spray 1 spray in the morning and at noon. https://journals.sagepub.com/doi/10.1177/0748730409332042 https://www.jneurosci.org/content/34/17/6040 VIP was also looked at in COVID https://pubmed.ncbi.nlm.nih.gov/35322471/

-Epithalon 10mg daily for 10 days then 300mcg daily

-Sytrinol (Nobiletin) 300mg at bedtime.  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236315

We identified retinoid acid receptor-related orphan receptors (RORs) as direct targets of NOB, revealing a pharmacological intervention that enhances circadian rhythms to combat metabolic disease via the circadian gene network. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832569/

“Recently, nobiletin has also been shown to affect circadian rhythms via their enhancement, resulting in protection against metabolic syndrome”

[Carrie Hardy]

Hello Leonard!

Thank you very much for the quick response.  I have already asked the patient to move his DSIP to the mid-afternoon. If this doesn’t work for him then I will discuss either the VIP or Sytrinol.  He is already on eipthalon (by a previous provider) and I will talk with him about this as well.

 

[Mitchell Fleisher, M.D., D.Ht., D.A.B.F.M.]

You may also wish to address the chronic inflammatory response from the CV-19 infection with BPC-157 500 mcg po BID and Thymosin Alpha-1 0.25 ml SQ daily for 6-8 weeks.

[Carrie Hardy]

Hello Mitch

Thanks for the input.  I failed to mention that we are working on systemic inflammation as well with thymosin alpha.

Carrie

[Morgan Camp]

Quick Q: Is there an ideal time of day for the Epitalon dosing?

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