Speaker 1:
Welcome to the Dr. Gundry Podcast where Dr. Stephen Gundry shares his groundbreaking research from over 25 years of treating patients with diet and lifestyle changes alone. Dr. Gundry and other wellness experts offer inspiring stories, the latest scientific advancements and practical tips to empower you to take control of your health and live a long, happy life.
Dr. Stephen Gundry:
How did you sleep last night? If you answered not great or could have been better, you are not alone. According to the Centers for Disease Control and Prevention, about one in three adults in the United States reported not getting enough rest or sleep every day, and this is a big problem. You see, sufficient sleep isn’t just to give you the energy to do the things you need and want to do. It’s actually crucial for our overall well-being and longevity. Ever find yourself dealing with frequent nighttime bathroom trips or snoring, disrupting your sleep? You are not alone here either. That’s why in this episode, I’m sharing my tips and tricks to help you bid farewell to those unwelcome interruptions and help you sleep soundly. We’ll also discuss bedtime snacking. Is it beneficial or harmful for sleep quality? Stay tuned for this episode all about how to sleep like a baby.
Just wish you could sleep through the night without being jolted awake with the need to pee? Well, if this happens to you once in a while, it’s probably no issue. But today we’re going to discuss why this might be happening on a regular basis, either every night or several times a night. We’ll start with men first, but women stay tuned, this is for you as well. First of all, the most common obvious cause of men getting up to go in the night is an enlarged prostate gland. Now, an enlarged prostate gland is incredibly common. 50% of men over the age of 50 actually have an enlarged prostate gland, and it jumps to 80% of men 70 and older. Now, even scarier, one in nine men will deal with prostate cancer in their lifetime. We recently heard about this happening to King Charles and notoriously to our own Secretary of Defense, so it’s a very common problem.
Now, are there symptoms that you might have an enlarged prostate? First of all, one of the more common ones is you find yourself getting up once or twice at night to go pee. The other maybe not so obvious is that it takes you a while standing there to get your stream started, and you have to wait and think about it. The other thing that’s incredibly common is if you have an enlarged prostate, you actually don’t completely empty your bladder. Now, here’s a trick that I’ve learned from my urology colleagues right down the hall from my office in Palm Springs is that once you finish, go do something for 10, 20 minutes and then come back and try again. You’ll notice that you’ll have actually quite a bit of urine in your bladder. And particularly if you’re planning on making it through the night, men, go to the bathroom about 20 minutes before you plan on going to bed and then do it again right before you go to bed.
But one of the things that you are not going to believe me about is that an enlarged prostate is not something that is normal as you get older. I’ll say that again. It is not normal to have an enlarged prostate as you age, and there is now significant, impressive evidence that prostatic hypertrophy, prostatic enlargement is actually due to leaky gut, to intestinal permeability, to literally bacteria and bacterial particles going directly from the rectum to the prostate. They sit right next to each other, and that inflammation in the prostate is what causes prostatic hypertrophy. Now, I’ll give you a personal example. I used to have an enlarged prostate, but when I started on my program, miraculously, my prostate shrunk miraculously. Well, it’s not miraculous at all. I stopped seeding my prostate with bacteria and bacterial particles, LPSs, and the inflammation that accompanied that died down. So I’m approaching my mid-seventies now, and I don’t have enlarged prostate and I don’t have to get up at night.
So think about that the next time you get up at night and are bothered by that. Maybe, just maybe changing your diet and eliminating a leaky gut is just what you’re looking for. Now, how do you deal with this? Well, the easiest way is to get my new book. Gut Check gives you the whole plan of stopping leaky gut, or you can come and visit at episode 164 right here with Dr. Mark Stengler’s conversation, who gives great advice on how to deal with an enlarged prostate. Are there supplements that can help? There are actually a number of interesting supplements on the market that are certainly worth trying, but you’re not really going to impact the underlying cause of this. Are there foods to help? Well, the best foods to help are actually the foods that feed friendly bacteria and avoiding the foods that are going to cause leaky gut.
And just to reiterate, try to stay away from almost all grain products except millet and sorghum. Try to stay away from beans unless they’re pressure cooked or fermented the appropriate way. Try to stay away from the nightshade family of vegetables, potatoes, eggplant, tomatoes, bell peppers, goji berries, or peel and deseed them or ferment them. And women I haven’t forgotten about you, women do feel a need to pee in the middle of the night. Now, in my practice, I actually see a lot of women that have irritable bladder. There are various theories about what causes irritable bladder, and obviously the first that comes to mind is a acute or a low-grade urinary tract infection, a UTI. Now where UTIs come from has been changed, subject to debate with the discovery of the human microbiome. For years, we were convinced that most urinary tract infections came from either honeymoon cystitis, and one does not need any imagination to imagine where that comes from.
But number two, most women were blamed for wiping the wrong way; wiping up rather than down. But in fact, most urinary tract infections are now been traced to particular strains of E. coli, which are prevalent in factory-farmed chicken. Now, how in the world is that possible? Well, I told you women that pay attention to what was happening to men. The E. coli that you eat colonize your rectum, and they have a direct shot from your rectum to your bladder, and they set up shop inside your bladder. Now, what’s interesting is that E. coli is capable of not only causing this bladder irritation and infection, but there are some fairly simple maneuvers to make these guys less likely to colonize your bladder. Everybody knows about the benefits of cranberry juice in urinary tract infections and avoiding urinary tract infections in women, but the active ingredient in cranberry juice is a compound called d-mannose.
It’s actually an interesting sugar molecule that coats E. coli, that prevents them from establishing themselves in your bladder, establishing a biofilm, and I’ve found it particularly effective in my patients. So the dose is 500 milligrams, and I like people to take it at least twice a day–once in the morning and once at night. It’s been very, very useful in my practice. However, there are a lot of women and men for that matter, who have irritable bladder that has absolutely nothing to do with a urinary tract infection.
What’s been interesting to me is that many of my patients with irritable bladder are sensitive to a type of lectin that I’ve not written about in any of my books previously until Gut Check, because I didn’t want people to think I was crazier than everybody thinks I already am. This class of lectins are called aquaporins and there won’t be a test, but aquaporins are present in potatoes, white potatoes, they’re present in spinach, they’re present in corn, they’re present in soybeans, they’re present in tomatoes, and they’re present in bell peppers. Oh, and by the way, they’re present in tobacco. You’ll notice a number of the things I just named are nightshades. These are different than the regular lectins in that they can actually cause bladder irritation. And one of the surprising things is that a number of, particularly my female patients, they’re big-time spinach eaters or-
Dr. Stephen Gundry:
There’s big time spinach eaters or french fry eaters or baked potato eaters, and they love their tomatoes, so this is another reason to be on the lookout for these culprits. Now, bad news, with regular lectins, you can peel and deseed these particular nightshade family and eliminate most of the lectins, but unfortunately, the aquaporin is in the flesh. So for you folks, I want you to actually get rid of your peeled and deseeded tomatoes, your peeled and deseeded peppers, your tomato sauces that are peeled and deseeded, your tomato paste, and just see if that makes a difference. I think it might surprise you. We’ve had some really good success with this in our female patients. I know you want to have your spinach salad, but if you have an irritable bladder, try this trick. Get rid of the spinach for a while, get rid of your french fries for a while and stop eating popcorn.
Now, if none of these signs are your issues, here’s what else can be happening. People who have congestive heart failure or who have swelling in their feet or their lower legs, one of the things that happens when you lay down is that all that fluid gets reabsorbed from your feet and legs and it’s pumped back to your heart because you’re now flat and your heart has to dispose of all that extra fluid and it hits your kidneys. So if you have swelling in your lower legs, that’s usually the culprit. One of the things you can do early in the evening is stretch yourself out on a couch while you’re watching TV. Or better yet, do exercise snacking where you just do some jumping jacks or dance to a music for two to three minutes and pump that extra fluid back to your heart before you go to bed.
Now, the second thing that happens is great number of us unfortunately drink a lot of water or drink alcohol for dinner or late into the evening, and that water has to go somewhere. So first things first, don’t have that glass of water before you go to bed. Secondly, please stay up after drinking alcohol because another thing that’s going to really wake you up is that alcohol wearing off about two to three hours after you go to bed and you’ll be wide awake. Finally, many, many people unwittingly are woken up by sleep apnea and that sudden need to take a breath because, quite frankly, you’ve become hypoxic. You have low oxygen levels. One of the best ways, if your partner tells you you’re snoring, please take that seriously. That snoring is not normal.
Get yourself an Oura ring, which I have on here. They’re relatively affordable. I have no relationship with them except I’m a big fan and an early adapter and Oura rings can actually watch and report the number of times you have episodes of drop in oxygen saturation on your nightly report. If you see that as a common occurrence or if you see that that episode correlates with you waking up wanting to go to the bathroom, then it’s time to get a sleep apnea study. They’re actually easy to obtain. They can even be done now at home. You don’t have to be overnighted in a sleep apnea center.
So last, any other tricks? Well, Dave Asprey recently mentioned using raw honey or MCT oil to help. I certainly haven’t seen that in my practice, but I’m not a huge fan of raw honey in the first place because, sorry, it’s still fructose. Does it have some interesting prebiotics and possibly probiotics? Yes, it does, but I think the risks outweigh the benefit. Again, try d-mannose, particularly if you’re a woman, and see what happens. Now I know what you’re saying. “I just wake up at three o’clock every morning and it has nothing to do with needing to pee and I can’t go back to sleep.” I hear that all the time from a lot of my patients.
First of all, once again, please, please, please do not have a heavy meal or drink alcohol and then go to sleep. It’s nearly a guarantee that you’ll be up in two or three hours. Many of my patients are woken up with heartburn or GERD, and that’s what wakes them up. One of my tricks, and remember I was a cardiothoracic surgeon for most of my career, and we operated on people with GERD, heartburn, and one of the things that we learned very early is we could prevent a lot of heartburn and GERD by having our patients sleep on their side, their left side. Now, what happens when you sleep on your left side is you trap a lot of air in the top part of your stomach called the fundus, and it actually pushes up on your left diaphragm, and it’s actually one of the main causes of hiccups, by the way.
But if you sleep on your left side, that air is basically forced out of your stomach in the form of belching or burping, and that air no longer is going to actually push contents out of your stomach. Now, how do you sleep on your side? Well, get yourself some big pillows and put one behind you and one in front of you. There are actually devices, pillows that you can buy on the internet that force you to sleep on your left side. Finally, get yourself a lot of dogs. We have four dogs on our bed and invariably one or two of the dogs luckily lean against my left side, my back side and kind of force me onto my side. Lastly, I should mention, get yourself dogs that don’t want to get up in the middle of the night to go pee. That’s a very important consideration that I’m still trying to teach my rescue dogs to do.
Finally, listen to your spouse or significant other. If they tell you you’re snoring, take that seriously and get yourself a test because that, quite frankly, can save your life. One of the classic signs of sleep apnea is this waking up at night and can’t get back to sleep. Finally, it could be something very physiologic. Around four o’clock in the morning, normally, a hormone called cortisol, the arousal hormone, begins normally rising to get you ready for the morning. It raises norepinephrine, adrenaline, to get your blood pumping to actually raise your blood pressure so that when you step out of bed being prone, you don’t faint when you fall out of bed.
The other thing it’s trying to do is mobilize sugar so that, believe it or not, you don’t faint from lack of sugar when you get up and you’ll have plenty of glucose before you break your fast, breakfast, to get you going in the morning, and sometimes it’s just a simple sleep process that is entirely normal. One of the benefits of having dogs is that they will usually get you up around sunrise, and quite frankly, my wife and I get up about five o’clock in the morning because that’s the time to get up if you have dogs. So those are the tricks. If you find that late morning, like four o’clock in the morning, five o’clock in the morning, you just can’t get back to sleep, that’s actually a sign that your cortisol is working properly and a lot of times get a dog and you won’t have to fight it anymore.
Now, if you’re still experiencing all of this, please, please, please, this is something you do not want to ignore. Men, a big prostate can actually damage your kidneys because you do not empty your bladder properly and urine backs up in your kidneys. It’s called obstructive neuropathy, and it’s a fixable condition that you want to fix because I’ve seen too many men damage their kidneys often to the point of no return because they put up with the fact that they have to get up two, thee, four times a night because of this big prostate. So if that’s you, go see a urologist or at least talk to your family doctor.
What causes snoring? Now, snoring is officially known as obstructive sleep apnea. That sounds kind of scary, doesn’t it? Well, obstructive sleep apnea is one of the things you want to avoid, particularly if you like your brain. Your brain actually enjoys getting oxygen, particularly while you’re sleeping, and when you have snoring episodes-
Dr. Stephen Gundry:
When you have snoring episodes, many, many times your oxygen levels drop dramatically. And snoring is the first sign of mischief. So pay attention to your significant other and/or spouse. If they’re waking you up saying, “Turn over,” or, “You’re snoring,” or your spouse literally sends you to the other room or is sleeping with a pillow over their ears, that’s a sign that you need to pay attention. Because if you are snoring that bad, as Dr. Aiman has said on my podcast, you’re actually starving your brain cells. And one of the shocking findings of snorers is that they’re killing part of their brain and it looks very much like Alzheimer’s disease. So please, please pay attention to snoring.
So what causes snoring? Well, there’s a lot of potential causes. First of all, some people, particularly with not a very prominent chin, unwittingly, when they sleep, their tongue falls into the back of their mouth, and the tongue falling back into the back of your throat is actually causing obstructive sleep apnea and snoring.
Now, that one is actually a remarkably easy fix. The first thing I do with my patients who are snorers like this is I do not let them sleep on their back. And that’s one of the first tricks to use. I like my patients to sleep on their left side, and I’ve posted another video on the benefits of left-sided sleeping. You can use two large pillows to prop yourself on your side. There are pillow-like devices that you can get on the internet, and you just type in anti-snoring pillows, and you’ll actually find a number of them that actually are very successful at putting you on your side. For the most part, that will keep your tongue from falling in the back of your mouth/throat.
There are dental devices that are available to pull your jaw forward, and a lot of times these work. I like to send my patients to a holistic dentist who specializes in snoring treatments. Many times, ear, nose, and throat physicians, ENTs, otolaryngologists also will have specialized devices for this purpose.
And finally, quite frankly, weight loss is my most effective treatment for snoring. Why weight loss? Well, it turns out that we put remarkably a lot of fat storage in our mouth, cheeks and neck. And that fat can actually contribute to compromising your airway. And invariably, when patients go on my program for another reason, say it’s for the treatment of diabetes or the treatment of an autoimmune disease treatment of arthritis, one of the side effects that the spouse notices is that their husband or wife stops snoring. Oftentimes, I have patients return from a trip to Europe for several weeks, found that they were snoring over in Europe, and when they came back they discovered that they had gained five, seven pounds. And as soon as that trip weight fell off, the snoring disappeared.
Finally, a lot of my snoring patients or their spouses or significant others notice that the snoring corresponds to when they’ve had either/or too much to drink or too much to eat late at night. And alcohol in and of itself will change the motor tone, the muscular tone in your airways. And again, listen to your bedmate, and if your bedmate notices that this is the trend, that’s an easy fix. Either stay up for a few hours, let that food and the alcohol digest, or simply don’t eat late into the night, don’t drink and then go to bed. So those are great tricks. Snoring is a warning sign.
Secondly, we know that people who have sleep apnea do not get good quality sleep. And good quality sleep, it turns out, has a reciprocal effect on preventing snoring. I hate to sound like a broken record, but the average adult needs somewhere between seven and eight hours of sleep every night. And a lot of that sleep needs to be deep sleep. And unfortunately, snoring really interferes with deep sleep. So just because you are getting six hours of sleep, may be inadequate to get you the sleep you need. And just getting more sleep many times is part of the process of preventing snoring.
Now, are there other tricks we can do? Well, I’ve had a video showing the benefits of olive oil. If you have a jigger of olive oil before you go to bed, you will lubricate your tongue and the back of your throat. And remarkably air moves much better across those passages. And it’s a great trick to try. It often does the job. Other tricks that you can use, mouth taping has become popular. Many people inadvertently are mouth breathers, particularly when they’re on their back, and many people have less than adequate nasal passages. Interestingly enough, experiments have shown that taping your mouth before you go to bed forces you to breathe through your nose. And many times that’s a effective treatment.
But word of warning, make sure that you have adequate nasal passages to accomplish this. One of the easiest ways to test that is to try alternate nasal breathing like in the yoga practice where you close your mouth and close one side of your nostril and breathe in and then close the other side of your nostril to breathe out. First of all, it’s a great breath control method that you really ought to be practicing on a regular basis. But it’s a great way of deciding whether it’s safe for you to do mouth taping before you go to bed.
Finally, try out a side sleeping pillow. They’re really not very expensive. And always, always, always check in with your bed partner to see if any of these tricks are making a difference. And the important thing is, if these tricks are not making a difference, then it’s time to get a sleep study, a sleep apnea study. Because Dr. Aiman and I are in complete agreement; if you have sleep apnea, that’s a dangerous thing that needs to be treated.
One of the keys to a healthy life is getting a good night’s sleep. But did you know that your brain actually has its own housekeeping system that works while you sleep at night? Even more fascinating, how this system runs has everything to do with when you eat before you go to sleep. Now, let’s bust a myth right now. If you are eating before bed, choose a small evening snack that includes some fiber and protein like an apple and one to two tablespoons of peanut butter. The fiber helps slow the rise of glucose after eating and the protein helps with muscle repair and healing. What a bunch of… Contrary to popular belief, anything that you eat too close to bedtime can give you more than just a stomachache or reflux or GERD, it can actually disrupt your sleep and the nightly brainwash that you should be getting, not to mention it will actually decrease your energy and increase the risk of obesity.
Now, recently two studies have been done looking at the effect of eating before sleeping, one on mice and the other on humans. The study done on mice found that mice who were fed a high-fat diet consumed during the active phase of their daily cycle had greater energy expenditure resulting from the metabolism of food to produce heat, and they burned fat without eating before bed. The human study found that late eating actually increased hunger the next day, decreased the amount of energy when they were awake and raised the obesity risks in humans who ate late in the day. So not only can eating before bed affect hunger, energy and weight, not a good thing, but it actually interferes with your deep sleep and when brainwashing happens. Now, deep sleep is really important, so I want to spend some time talking about-
Dr. Stephen Gundry:
It is really important. So I want to spend some time talking about that. Your brain actually undergoes a wash cycle every night, and you have a lymph containing glymphatic system in your brain that was recently discovered. During this time your brain undergoes a literal wash cycle where your brain sweeps away junk and debris like amyloid, like tau proteins that accumulate during the day, and it literally washes them out. Now this usually occurs during deep sleep, and for most people, deep sleep occurs fairly early in the sleep cycle. Now it turns out that deep sleep is controlled very much by what’s happening in your gut. Let me explain.
During deep sleep and during this wash cycle you should have increased blood flow to your brain to power this wash cycle. If you eat anything, most of your blood flow is directed down to your gut for the process of digestion. And believe it or not, the process of digesting your food takes tremendous amounts of blood flow. I’m old enough to remember that if we ate lunch, we would not be allowed to go swimming for an hour after we ate because the old wives’ tale was that we would get cramps in our legs and die from drowning. Now, there was actually a bit of truth to most wives’ tale, and there was truth to this. After you eat a huge amount of your heart’s cardiac output goes to your gut to aid in digestion. In fact, about 25% of it goes to your gut. So, there wouldn’t be enough to go to your muscles if you were swimming and your muscles would get cramps and you’d drown.
Imagine the fact that after you eat your brain wants lots of blood flow during deep sleep to do its washing, and if you eat before bed, close to bed, your brain will cramp up and it won’t get the wash that it needs. And those dangerous proteins like tau and amyloid will build up. And that’s why one of the studies that has shown eating near bed actually is associated with memory loss, not a good thing. The other thing that has been interesting is that a diverse gut microbiome actually helps you have deep sleep in which that brainwash can take place. So if you take care of your gut microbiome and give your gut a rest, your brain will actually get the cleaning. It matters.
All right, so what to do? First of all, try at a bare minimum to stop eating three hours before you go to bed. As you know, in my books, I’d prefer four hours because quite frankly, digestion, particularly if you eat a fairly big dinner, is a long process. And so the more time you can have away, finished from digestion, the better you’ll do in washing out your brain. Your brain needs that time period. So bare minimum, three hours, preferably four. What does that mean? If you go to bed at 11:00 then you really want to finish the last thing you eat by about 7:00, preferably 6:00. I know our society doesn’t do that. There actually is a lot of wisdom to the old maxim, eat like a king at breakfast, a queen at lunch, and a pauper at dinner. And that actually old maxim comes from the fact that ancient cultures knew that something was going on that probably affected their well-being by eating late at night.
Now our culture promotes the opposite. Eating a large late dinner, or even worse, a snack right before bed that forces your body to spend its efforts, digesting your food during the night when it should be cleaning the gunk out of your brain, its priority. Now, you can accomplish this without starving, eating twigs, counting calories, or putting in hours at the gym. So how do you do this? First of all, back off the time before bed. If you have to have something before bed, if you just can’t take it, if you actually want to prepare your brain to make it through the night, then have some MCT oil with a shot, have some MCT powder. Even if you have to have an MCT-based bar. The MCTs will be broken into ketones in your liver, and ketones will be available to actually fuel your brain during your sleep.
My other trick is have a piece of extra dark chocolate. There’s a great new allulose based chocolate. The brand is GATSBY. I have absolutely no relationship with them. You can have a square of it. But here’s the trick. Whether it’s dark chocolate, whether it’s allulose based chocolate, put the square in your mouth and suck on it, don’t chew it, and just let it melt. Number one, it’ll actually take quite a while to melt. You’ll get the flavor you are looking for a longer time. But here’s a spoiler alert, chewing anything before bed starts the digestive process. Your brain literally feels the chewing and alerts your digestive system to get more blood flow going because here comes something to digest. So the very act of chewing that healthy apple and that peanut butter is contrary to what your brain needs to be doing right before you go to sleep.
So why you should never eat before bed. And if you want to keep your brain happy, think about MCT oil rather than that apple in peanut butter. Don’t hurt your brain right before you go to bed.
Time now for not one but two audience questions today. On my recent Instagram Reel about berberine from last week’s episode 298 Tahu Snow Betty asks, “What is a good dose of berberine?” Well, it depends. Most supplements are sold in 500 milligrams and you’re asked to take one twice a day, and that’s a very good place to start. You could take it all at once or you could take a lower dose, but 500 milligrams is a great place to start.
Another question on the same post from @Godsgirlfreeinhim, “I throw up every time I take berberine. Is there a reason behind that and how do you avoid it?” Well, you avoid it by not taking it. Look, I am a big fan of supplements, but I know that each individual is different and that some of you will react to a particular supplement or a class of supplements. And so if it bothers you, please don’t take it, there’s lots of other ways to get good polyphenols into your life.
Now it’s time for the review of the week. The review of the week comes from my interview with Pendulum Life’s Dr. Adam Perlman on YouTube. AjayWang7985 says, “Thank you, Dr. Gundry and Dr. Perlman. You taught this rocket science of gut microbiome to me, an ordinary person, and made me understand how important it is. I am so grateful.” Well, thank you. This is why I do this. I want to bring you cutting-edge scientific information and hopefully present it in a way that you can understand it and fit it into your daily life. So thanks for writing, that’s why I do this.
Speaker 1:
I hope you enjoyed this episode of The Dr. Gundry Podcast. If you did, please share this with family and friends. You never know how one of these health tips can completely transform someone’s life when you take the time to share it with them. There’s also The Dr. Gundry Podcast YouTube channel, where we have tens of thousands of free health insights that can help you and your loved ones live a long, vital life. Let’s do this together.
