Articles

JET LAG: Naturopathic Considerations to Ease Frequent Flyer Fatigue

The following is a reproduction of a Millennium Health Centre editorial article which appeared in the Health Educator' magazine published in B.C., Manitoba and Ontario. The content is shortened to accommodate a newspaper space allotment. As such, it is not academically cited with references. These are available, so please feel free to email your questions.

Regards,

Dr. Stephen F. Jones B.Comm., N.D.
Doctor of Naturopathic Medicine

Most readers are familiar with the general concept of 'jet lag'. Those who must travel frequently for work are all too familiar with this condition. You leave on the 'red eye' from Toronto (in one time zone) and arrive in, say, Halifax (in another time zone) at what your body thinks is around 4:00 am but the clock on the airport wall says its 7:00 am and you better get ready for that breakfast meeting - having "lost" a few hours. The result of this 'jet lag' (otherwise known as "circadian dysrhythmia") is a litany of physical and psychological symptoms, the most noteworthy being the sense of fatigue and mental exhaustion. It is experienced when the body is subjected to an artificial alteration in its 'internal clock' (if you will), not that much different than a shift worker who is continually switched from days to nights.

The underlying mechanism causing this jet lag, however, is not simply the loss of a few hours of sleep. Rather, it is the result of a fundamental disruption in the inherent 'circadian rhythm' (or 'internal clock') of all human being's bodies. This rhythmic process has been likened (quite accurately) to oceanic tides and the analogy seems to help patients understand this internal, on-going process of their bodies. These circadian rhythms are not an esoteric or energetic concept, but a well researched and medically accepted principle that defines and describes how our bodies undergo predetermined, regulated, daily fluctuations in the production of various hormones, as well as daily fluctuations in sleep and physical patterns (such as blood pressure). These circadian rhythms are essentially set to a fixed 24 hour period. At set time intervals during this fixed 24 hour period, the body produces hormones, anticipates sleep, anticipates to be awake etc. etc., according to what time the body believes it to be. So, if the body is expecting it to be 5:00 am it will be, for most of us (!), expecting to be asleep and producing certain hormones and biochemical changes. If, in fact, the body is awake, then it experiences an interruption in its expected biological functioning. The lights, as they say, may be on, but the manufacturing plant is not working up to speed.

As part of this daily circadian rhythm, humans have a recognized sleep pattern that assumes (perhaps incorrectly) that we sleep at night and are awake during the day. During this sleep period, our bodies attempt to 'rejuvenate' themselves and, in doing so, produce many essential hormones (such as thyroid and adrenal hormones - usually produced in the early morning hours). The sleep pattern is to a very large extent regulated and controlled by a hormone called Melatonin. This hormone, produced in the brain, regulates when your body expects to be asleep and when it expects to be awake. Accordingly, it regulates when you feel tired and when you feel mentally and physically alert.

So what happens when this sleep pattern in disrupted by traveling between time zones is that the normal production of essential hormones, along with your body's 'rejuvenation' period, is significantly disrupted by altering the most basic 'internal clock', or circadian rhythms, of your body. Envision the ocean tides, if you will, coming at a time other than their daily occurrence due to some unknown causative agent. The impact would be noteworthy on the function of marine life and human activity tied to the oceans. Well, in the 'tides' of your circadian rhythms, travel between time zones can shift the time of the 'tides' or eliminate them entirely by confusing the body's internal clock mechanism. Production of hormones such as DHEA and cortisol (adrenal hormones which help your body deal with stress) and thyroid hormones (which regulated our metabolism), to name a few, can be significantly impaired. Accordingly, mental alertness, energy, anxiety and stress control, blood sugar regulation and many other physiological and psychological conditions can be negatively impacted.

Of greater consideration, however, is that Melatonin production can be impaired or outright prevented (as the body may be awake when it should be asleep producing the Melatonin), leading to a state called Sleep Rhythm Reversal. As a result, the body will feel tired when it should be alert and a resulting state of fatigue, mental impairment and possibly irritability can result. Your at your breakfast meeting with a roomful of rested ambitious executives and your body thinks its bedtime. Here's hoping you are not auditioning for 'The Apprentice' and are looking at Mr. Trump in your dreary state….

So, understanding that 'jet lag' is very real and the end result of an alteration in some important, regulated brain chemistry and hormones, what can you do to offset, or at least minimize, this circadian barrage? Well, the answer is inherently Naturopathic, as you must review your lifestyle, diet and use of very natural medicines to find some relief. No 'magic' drug will help treat jet lag (or for that matter, other causes of circadian dysrhythmia such as shift work, excess alcohol use or even Alzheimer's disease).

To start, you must obviously look at the use of melatonin. As jet lag invariably involves alterations in melatonin production and regulation, replacing it (via melatonin supplementation in a pill form) when you expect to have this alteration can 'level the playing field'. Several medical studies have demonstrated that supplementation with this natural hormone can alleviate the symptoms of jet lag, including the fatigue, mental impairment and general mood alterations ('Effects Of Melatonin On Jet Lag After Long Haul Flights', British Medical Journal 298, 705-707, 1989 and 'Melatonin and Jet Lag: Confirmatory Results Using A Simplified Protocol Biological Psychiatry 32, 705-711, 1992). While some debate has existed as to when is the best time to take the melatonin for air travel (ie. a few days before flying or only on the day of flying), recent study suggests that use on the day of travel and for 5 days after may provide the greatest benefit. In fact, the study indicated that use of melatonin prior to flying could actually aggravate the jet lag (Biological Psychiatry 33, 526-530, 1993 as published in the Encyclopedia of Nutritional Supplements, 1996, Prima Publishing).

While melatonin has been readily available without restriction in the United States, Canada has restricted the use of this natural medicine over the past decade. Recent changes in legislation has apparently opened the door for melatonin to once again be available in some jurisdictions in Canada. Once must bear in mind, however, that melatonin is a hormone and its use should be supervised by a health care provider familiar with it proper use and dosage.

Aside from replacing the key hormone involved in causing jet lag (ie. the melatonin), one must, as always, look at the 'bigger picture' of their health if they wish to reduce the impacts of jet lag. Being a nutritionally oriented clinician, a personal bias will start with your diet. First, take a look at your consumption of obvious aggravates of fatigue and mental clarity - that is to say coffee and alcohol. Many frequent travelers aid the discomfort of cramped plane seats with a few alcoholic beverages while in flight. They then try to 'pick themselves up' on landing with a strong brew (coffee) prior to their meeting or planned activity. The problem is that the alcohol is a sedative, it depletes critical B vitamins (needed for energy, efficient adrenal function and the production of serotonin - a crucial neurotransmitter involved in mood and even sleep!) and it can dehydrate you leading to not only a hangover, but impaired mental thought and even greater fatigue. The coffee will then causes over-stimulation of the central nervous system and will serve to lower blood sugar levels - all combining to making you more tired, more irritable and less focused in thought (not to mention a possible headache and agitation).

This predicament can be aggravated by eating nutrient poor, overly refined foods such as breads and bagels, not to mention diving into the chips and 'junk food' / take out food before, during and after your flight. These foods can cause fluctuations in blood sugar levels which will aggravate the fatigue, anxiety, irritability, mental fatigue etc. that you may experience due to the jet lag. In addition, they simply do not provide enough nutrients for adequate energy and metabolic function.

The answer, of course, is to follow the advice of your mother so long ago. That is to say, eat regular, small meals comprised of fresh fruits and vegetables, along with good quality proteins such as chicken, fish, tofu, nuts and seeds. While these foods should be consumed ever day, in the case of jet lag, start eating more like this the day before, day of and day(s) after your flight (until your return flight). These foods will stabilize blood sugar and provide the nutrients your body needs for proper energy production and hormone function. Eat 4-6 small meals vs. 1 or 2 large meals per day.

Next, consider the use of some herbal medicines called 'Adaptogens' because they help the body (in particular the adrenal glands) deal with stresses, such as flight, jet lag and work demands. Once such herb to consider is Rhodiola rosea (a.k.a. golden root - not golden rod- or Artic root). Studies have demonstrated that use of this herbal medicine can improve sleep, enhance work performance, eliminate fatigue and even prevent high altitude sickness (Acta Physiol Pharmacol Bulg 1986;12:3-16). One study of medical residents on night shifts (ie. also experiencing circadian dysrhythmia) showed that supplementation with Rhodiola greatly improved fatigue and mental performance (Phytomedicine, 2000). Other adaptogenic herbs include the varied ginsengs species and Borage. As always, a trained clinician familiar with these medicines should be consulted before using these herbal medicines.

Another useful consideration includes the use of homeopathic medicines. Homeopathic medicines are tailored to the individual's constitution to find not only a medicine to prop up one's energy after jet lag, but to treat the unique and individual symptoms which may accompany the fatigue. Stated differently, many homeopathic medicines are 'indicated' for jet lag, but a clinician familiar with homeopathy must sort through the maze of possible medicines to find the one suited to the individual traveler. Once determined, this medicine can frequently be used for future flights, offsetting fatigue, mood changes, mental function, leg cramps, and, well, you name it.

Beyond these considerations, the individual traveler may consider a great variety of adjunct interventions to assist their jet lag. Spinal adjustments (by a Chiropractor of Naturopath who uses spinal manipulation) prior to and after the flight may reduce discomfort while traveling and allow for improved mental and physical function after the flight. Acupuncture points can be pointed out by your Naturopath or acupuncturist which the patient can apply pressure to (ie. 'acupressure') during the flight. Such 'acupressure' can help treat motion sickness, anxiety, muscle pain and even to assist with sleep in the new time zone. Finally, one may look at using additional supplements prior to the flight to offset travel induced symptoms. Examples would include magnesium to prevent muscle spasms while in the tight seats or ginger to reduce nausea.

In all, 'jet lag' (a.k.a. circadian dysrhythmia) is a very real phenomenon which represents an alteration in important biochemical and hormonal processes. The good news is that research and medical experience has shown that the varied symptoms can be modulated and possibly eliminated. Inform yourself, ask for advice from a clinician familiar with the treatments discussed and make it a priority to treat yourself ! Your career, if not your vacation, is worth the effort.

Best of health to you and your family and enjoy your travels.