Rethinking Insominia with Dr. Stasha Gominak – The Natural Man Podcast

Mike Sea: Hey, this is Mike Sea of the Natural Man Podcast – the Natural Man Podcast is intended as general information for educational purposes only and should not be constituted as medical advice, diagnosis of any kind, or as a substitute for medical treatment. The information provided in this podcast is not meant to replace the advice of or treatment by any physician. Do not rely upon any information to replace consultations or advice received by qualified health professionals regarding your own specific situation. If you suspect that you have a medical problem, you are urged to seek competent medical help. The Natural Man Podcast and its representatives and agents disclaim any liability for any negative or other medical or other outcomes that may occur as a result of acting on or not acting on any information contained in the podcast. The views and opinions expressed by the host and all guests are their own and their appearance on this podcast and on the website of the Natural Man Podcast does not imply an endorsement of them or any entity they represent and does not necessarily reflect the views and opinions of the Natural Man Podcast.

That’s it. Here we go. Calling all health nuts, this is the Natural Man Podcast. Welcome to the Natural Man Podcast. My name is Mike Sea, thanks for joining us for another episode. This is an exploration of health wellness and discovering new ways to improve one’s vitality. Today, we’re particularly excited because we’re going to dive deep into the area of sleep medicine. Insomnia is a big part of sleep medicine and it’s a growing epidemic. Today it is the most prevalent sleep disorder in adults, and some studies suggest that nearly 30% of US adults suffer from some form of insomnia. Though there are numerous prescriptions and over-the-counter medications that can be used for sleep issues, there is a growing body of physicians who have turned to alternative methods of addressing sleep disorders, both using behavioral strategies as well as addressing nutritional deficiencies.

There are many neurological processes that must align when we sleep. When something is off, we can slip into bouts of insomnia very quickly. If we don’t address these imbalances, and sometimes it’s more than simple behavior modification, sleep is a complex process that relies heavily on an intricate balance of these neurological processes in the brain. Our guest today has studied sleep medicine extensively. She attended medical school at Baylor College of Medicine in Houston, receiving her MD degree in 1983. She completed her neurology residency in 1989 at the Harvard-affiliated Massachusetts General Hospital in Boston. From 1991 through 2004, she practiced as a general neurologist in the San Francisco Bay area. In 2016, she retired from office practice and now teaches clinicians and individuals, drawing on her extensive knowledge of sleep medicine. Please welcome Dr. Stasha Gominak. Dr. Gominak, thank you for being here today.

Dr. Stasha Gominak: Hi Mike, thanks for inviting me.

Mike: Absolutely! We’re thrilled you could make the time to hang out with us. I’m a big fan of your work. You’ve done a ton of research and I can’t wait for you to share the many different things you’ve uncovered in sleep medicine.

Stasha: Thanks! I think it’s exciting too.

Mike: Absolutely! I know you’ve done a ton of research on insomnia and how Vitamin D plays into sleep. In your opinion, what are some of the primary causes of insomnia?

Stasha: It is my view that most people with insomnia have a combination of two major things: the Vitamin D is low, but playing as big a role is that Vitamin D is a growth factor for the bugs in our bellies, or for our microbiome. I really don’t think most people get sick until they have low D and they have lost the microbiome. I think it’s those two factors.

My experience in this is completely clinical experience; trying to match what I see in my patients, and now my clients, to the science that’s in the background. I’m very much into biochemistry, so I always try to pull the articles that might support why something happens. But most of the things I stumbled into had never been reported before. The idea that Vitamin D actually runs our sleep is not too far-fetched if we think of it as a hormone made by the sun that runs hibernation. It’s really about having a different belief system around what Vitamin D is about.

Pretty soon into using Vitamin D to help my patients sleep better, it stopped working. Then I stumbled into this issue with the microbiome and the B Vitamins. There’s a second piece which is the microbiome. This second piece hasn’t been looked at by anyone else. That’s really important.

What I have on my website are two things that no one else is talking about: D runs sleep and there are Vitamin D receptors all over the cells that run sleep. The second is that the microbiome is the source of the B Vitamins. They’re really not from the food. If you don’t have the right microbiome, you actually have multiple deficiency states.

There are also some roles the microbiome plays in the absorption of small charged ions like iron, iodine, copper, and zinc. Many of the deficiency states the functional medicine specialists and the people who actually know more about that stuff than I do, are seeing something that develops in the background as we lose our microbiome. Therefore, getting the microbiome back is one of the pivotal events to getting your sleep better.

Mike: That’s interesting! Do you think that as we age, we have more possibility of getting insomnia and having more sleep issues? Do you think it’s a natural progression for all humans’ microbiomes to change as they age or is that something you think can remain stable it is?

Stasha: It is “natural” in that there are processes that haven’t been fully elucidated but are well documented that our ability to make Vitamin D per time spent in the sun goes down as we get older. If we have time, we can talk about some ideas about that but that part has been well documented. What that implies then is that maybe there’s actually a mechanism for getting old because getting old is not a chronological age. You know that some people who are 95 can still run and haven’t had their joints replaced. That means that’s the potential for human beings. We won’t live until 500 years but I’d rather be that person than the person who’s getting their hips replaced at age 20 or has heart failure at age 40.

Once I got into this, it seemed to me that the natural progression of aging was always about D going low and losing your microbiome. Then there’s a combination of deficiency states that start to manifest and there’s always a sleep disorder. We say old people don’t need to sleep as much. That’s a lie. When you stop sleeping, you start aging faster. There’s always a sleep disorder before death as you normally age. If we can reverse that when it first starts, even for elderly people, we can have a better life that lasts longer. We’re all going to die of something, eventually, but I think it’s a reversible process.

Mike: Have you worked with patients who have not had a lot of sleep issues into their 80s and 90s? Is it possible we can find somebody up in that age range still sleeping a solid eight hours a night?

Stasha: Sure and those people don’t come to the doctor. That’s a really important point. Doctors are only introduced to people who have medical challenges. In fact, it was not normal to go to the doctor 50 years ago. We didn’t have doctors for everyone. It was not this concept that you pop out and you get a doctor assigned because there weren’t any doctors around. There were whole populations between the late 1940s and the 1980s that really never went to the doctor until they got into their 70s unless there was trauma. We had already done things with immunizations that decreased the number of tragic deaths from Polio, Diphtheria, Measles, etc.

We had childhood illnesses but there are two generations there proving that people who are living outside and mostly have a rural life, don’t get sick as much. They don’t have to go to the doctor. If you think of it that way, we compare our current population to that population and ask if they were at the very best they could be because they still lived outdoors. We didn’t have air conditioning or computers; we didn’t actually live our lives indoors. What does that look like? What was their life like?

I have relatives on my husband’s side of our family who have 10 kids who live to adulthood. Four or five brothers have 10 kids,  so there’s a whole passel of them and they all do fine. They live outdoors because there’s no air conditioning. When they get their physical complaints and their sleep complaints, it is much later in life. I’ve got a whole generation there to look at. The kids start to have their sleep disorders a little sooner than their parents’ generation because now if they drive a tractor, they have an air-conditioned tractor.

It’s my view that you can link the onset of the sleep disorders, and there are genetic parts to it, but you can link the onset of the sleep disorders to the actual living circumstances. There are really interesting studies looking at diet as being the primary motivator for heart disease, diabetes, etc. And there are these really interesting studies that show if you take somebody who’s a banker in the city but is otherwise genetically from the same population as somebody who’s a rice farmer, the rice farmer doesn’t get the early-onset heart disease, diabetes, etc. There’s something very unique about being a rice farmer in that they don’t really have good tractors because rice grows in water so they still are pretty much outdoors all day. That lifestyle actually has a different outcome.

It’s the same thing in Mexico. In parts of Mexico, where they’re still digging in the ground with a stick. I had a house in Mexico at the time I was stumbling into this. I wondered why these people, who are just down the street from this resort, you really can’t tell if they’re 65 or 85. Ultimately, the 85-year-olds start to get sleep disorders too.

We’ve lived and then we have the dying phase which starts with the sleep disorder, that’s about 10 years. Now the dying phase starts in infancy and that’s really sad.

Mike: It’s tragic. There’s a lot of research out there that reinforces the point you’re making that natural light reinforces and strengthens that circadian clock. When we’re around artificial lights like I am in the studio right now; this light is actually bad for me. There’s no balance of UV and Infrared Light the way it’s balanced naturally in the sun.

Since we touched on that, what’s your take on electronics? we’re always staring at screens now. The average American has three to four different devices that emit blue light into our eyes. That must be a big component of the work that you’re doing with patients.

Stasha: To be frank, I only really talk about things nobody else is talking about. There’s really good stuff about blue light. There’s really good stuff about the timing of eating affecting when you sleep. A guy named Panda has some amazing videos about this;  really smart dude.

Most of the stuff I have on my website is there because no one else is talking about it. But there are multiple cycles. You really have to look at it as we know so little about sleep. There is a link between blue light. There’s a link between retinoids like Vitamin A and the retina and actual sunlight going through the eye linking us to the 24-hour cycle. 

That’s one cycle. Then, the one I stumbled into is a second cycle, which is the annual cycle. This second process is also governed by sunlight and exposure on the skin. also with the vitamin playing a role – and then we can talk about the fact that it’s not really a vitamin. That’s about the Vitamin D Cycle which allows us to move our metabolism, our fertility, and our sleep around based on what the seasons are. We can coordinate having a baby at a time when there’s food. Our survival advantage would be completely linked to that. We are so human-focused on biology that we missed the bigger picture.

All the animals have been here for millions of years. The dinosaurs slept exactly like we did. They had to sleep in exactly the same way. Their brain construction is the same. That means the engineering of these amazing processes that allow us to be awake and then flip a switch, go to sleep, sleep effectively, remember, learn, grow, and repair. Those were all perfected in the dinosaurs and yet we know very little about them. You really need to step back and think of it in those terms to get a full picture of how Vitamin D fits into it. It doesn’t matter what humans say about Vitamin D. Biology doesn’t care one bit what humans say about it.

Mike: Absolutely! I heard one distinguished physician once say that on the subject of clinical trials, nature doesn’t care about man’s rules. That went right through me when I heard that.

You talk a lot about sleep switches within our brains and how those become dysfunctional over time. Can you elaborate a little bit on the mechanics behind how those switches work?

Stasha: I really like that word. Cliff Safers group in Boston does primary research on sleep, coined that term in the last 20 years. I like the fact that he used that switch analogy. He actually stole it from the software engineers who are programming. Talking about it as a flip-flop switch, which was the term he used, the graphic I use for it is slightly different than his, so if you picture one of those old Frankenstein movies. Those switches are mechanical and connect two metal connectors that pass electricity. Then you flip it to the other. That means that A state and B state can never coexist.

When I tell people you can always be either awake or asleep but never both, everybody giggles because it’s such a bizarre idea. But there are a lot of people who become sleep-deprived enough that they can have a foot in both states. When you have a foot in both states, really we don’t know what’s going on there, but we do know that it was primarily engineered to be in one state. We’re awake using our body or a different state, asleep, repairing and replenishing.

That engineering diagram is supposed to be in one or the other. Once you state that and you start to look at it that way, any time that’s not working correctly you start to get rusty sleep switches. Those sleep mechanisms have to repair themselves in deep sleep. If your sleep switches continue to slowly be cheated on their repair, you start to have pictures where you can actually be experiencing something that’s really a dream while you’re awake. We know that happens because in spy movies and as soon as you catch the spy, you sleep-deprive them and by day four, they are completely unable to tell reality from fantasy. You can make someone psychotic by sleep-depriving them in a very short period of time.

You take that idea and ask, “What if I sleep-deprive someone over a slower period of time, not on purpose, but because they can’t sleep? We can only do what our brain will do. So it’s not really a voluntary state to have insomnia. We’ve treated it as though it’s the patient’s fault. We’ve just sidestepped it and we said insomnia’s not my field. See you later. No sleeping pills. All of us have been made afraid of sleeping pills. If I have a choice between drug-induced sleep and no sleep – what I’ve learned is it’s better to have drug-induced sleep. It’s true that you will get addicted to the medicines but what if you can do the medicine plus whatever you’re deficient in?

My belief system about sleeping pills changed dramatically once I got my hands on the idea that maybe this is a deficiency state. We could give back this Vitamin D and the brain would have what it was missing. What would that look like? What if we gave sleeping pills, a CPAP device for sleep apnea, and some Vitamin D? What would the patient experience? It would be dramatically different!

Sleeping pills are a crutch; that’s true. But the reason we use a crutch is so that the leg gets to heal. The crutch doesn’t fix the broken leg; the body always fixes itself. We doctors are really not fixing anything. We can reposition the two pieces of bone to help the leg heal better and then the crutch keeps our weight off of it. But the body then has to heal itself. If you look at it that way, sleeping pills are another tool.

And, every single sleeping pill is different. That’s really weird. I ended up using 25 different sleeping pills – I got really good at the sleeping pills! They all have different mechanisms. Most of the time, we don’t understand what the hell they do, yet when I would find the one that would be right for this person and this biochemistry, the patient would make advances that were dramatic.

We think of supplements, or we think of natural things, as being different than drugs. They’re really not. They’re both chemicals. If you get into the mindset that I have and listen to this person, you realize this person is unique. Their brain chemistry is unique at this moment. This is the only way they can sleep. You don’t want to leave them there because they don’t want to be on it, and it’s not the final answer, but if you use that as a tool and they actually get better sleep with it than without it, then it’s just one more tool.

The fascinating part is I got to see people who have been on sleeping pills for 10 years and who just stopped them. I would say that’s dangerous and they said, “You told me that but eventually if my body didn’t want this drug anymore, I would wake up and  stagger around. That’s what happened to me a month ago and so I lowered it by half and then I stopped.” I was so glad they didn’t have a seizure. 

We, as physicians, don’t get to see someone go from the deficiency state of low D and wrong microbiome to normal D and high microbiome and then watch what the body does with that. I got to watch people come off of their sleeping pills! They don’t want to use them and, in fact, the brain will tell you when it’s time to come off. You will have a different experience.

If you’ve been using this drug for three years now and you feel dopey in the morning,  you’re going to want to stop it. What you’re really asking, when you’re not sleeping, is how do you get me sleeping again? Then we try things. Each person is quite unique. You try stuff and you wind up with my stuff after you’ve done diet, exercise, blue light blockers, and all the things that are already in existence. It’s not that they’re not important. If they’re not successful, then you get into my stuff.

You start asking if there are things that the brain is lacking; the basic chemical building blocks you could give back that would change it. Then there’s a whole different outcome. It’s totally fascinating.

Mike: It is. You touched on something that was interesting and I realize it’s not a one-size-fits-all, but you were telling me that people who are on sleeping pills just add supplemental Vitamin D into their protocol and there have been changes just in that small addition in your practice?

Stasha: This whole thing started with me measuring B12 levels pretty much by accident. I’m doing sleep studies on all these young, healthy females and teenagers with headaches. Because they’re a younger, healthier population, they don’t have sleep apnea. They don’t have drops in oxygen. What they have is no Rapid Eye Movement sleep. That’s not an airway problem. That’s a brain problem. I’m a neurologist and we’re supposed to be responsible for that.

Why don’t they have any REM? Nobody’s talking about it yet. They’re generating sleep studies around the world that have abnormalities but there’s no comment about it on the front page because they don’t know what to do about it. As soon as I come in and tell them they have no REM sleep, they ask what are we gonna do? I don’t know. I have no idea. No one’s writing about it so we’re completely out there on this frontier.

Then one of my patients has a terribly profound B12 deficiency. For the first time, I’m reading these nerdy articles about single cells firing. So I’m thinking about it on a cellular level. I wonder what if we are deficient in this? So I end up measuring the D levels too. I start giving D and B12 and it works for a while. People get better. But they pretty quickly get worse again. Things really fall apart and there’s a lot of pain.

It turns out you really don’t want to take D without bringing back your microbiome. The whole population in the US, who started D in Covid,  in the next five to ten years, are going to have terrible outcomes if they don’t bring their microbiome back. 

The microbiome has always been the source of the eight B Vitamins. That’s why there are eight things called B. Nobody ever talks about that but why would we have A and then eight things called B? That doesn’t make any sense. They all come from the belly bugs. Now that we have a huge body of literature about all the things that bugs do, we know that the bugs have made B Vitamins; but we’ve been told that they came from the food. So we focused on diet.

You can look at the other interviews about what happened to my patients, but ultimately, if you don’t have a normal microbiome when you up the D and sleep a little bit better, your body begins to ask for more of these building blocks to use to make the repairs. And there are other vitamins that are part of the cellular processes. If you don’t have those, you start to use up your stores. You don’t have the primary source of B5, Pantothenic Acid, which is not in the food, not available, not supplied to our body in the food anywhere, despite what any other author on the internet says. If you use up your stores of B5, you will start to sleep terribly.  Your sleep will get worse. Your pain will be worse. There are other things linked to that. The burning neuropathy that’s all over the place now is a multi-issue that can be put back together. My recommendation is anybody who’s doing D needs to be doing their D levels regularly and they need to be on my site learning about B50 to bring back their microbiome.

Once they do those two pieces, the next issue is getting your sleep to be as good as it can possibly be and investigating a few other things. Because each person’s a little bit different, someone with mild insomnia, early on, it’s really easy to fix. Somebody who’s 24 and was a lifeguard until they were 18 before they got a job at a warehouse had lots of sun exposure as a teen. Now they’re starting to have insomnia. That person just goes back. All you have to do is regenerate the microbiome piece.

The reason I got interested in that is it turns out that the vitamin doses from our microbiome are very very specific. We were meant to have that foursome, four phylum bacteria supplying those eight chemicals. Our biology came second; they were here first. That means I don’t have to know what the doses have to be. I don’t have to know whether I believe all the other nutritional dietary recommendations – there’s been a lot of decay in the research on vitamins since the 80s when the doctors just said to eat a good diet. Now there’s a lot of dogma that isn’t really well supported by the articles and we have this huge body of literature about the microbiome.

If you take that literature and you set it next to what we know about vitamins, in fact, the literature in the last two years has been fantastic. The first article that actually supported this hypothesis that D was trophic to the microbiome, and that was really an assumption of mine based on Walter Stumpf’s articles, was based on the fact that IBS showed up at the same time as sleep apnea, fibromyalgia, and chronic fatigue. Those all started in the 80s. Once you picture it that way, then you realize all these things started to slide in at the same time and then we started to see infertility and autism. They all started to rise. When you look at it that way you think D must be a trophic factor and establish our microbiome but there were no articles. I thought there would be but there weren’t.

It wasn’t until 2020 that we had the very first article that moves the D around in humans and watches the microbiome population change. We have a bunch of other articles now  saying: D to mice, mice to microbiome, and the microbiome then makes the raw materials that make the endocannabinoid system. Our whole nervous system is linked to what the bugs are making in development especially but also throughout our lives as well.

Some of the pain I started to see in my patients is probably around the endocannabinoid system going missing at the same time. So the B Vitamins are not the only important part. There’s a whole range of chemicals. We probably know 1/100th of what’s going to turn out to be coming from that.

Mike: That’s fascinating! I’ve never heard it explained the way that you put it, Dr. Gominak. Once you start increasing your sleep duration, you ramp up that natural repair process. Then, if you don’t replenish, you’re going to drain your resources. That’s a lot to swallow. Nobody’s having that conversation.

Stasha: Nobody. It’s not something I would have come up with. It’s something that happened to me. I’m there with these patients, giving them D, thinking I’m going to be a hero. We’re all getting better and at the end of two years, we’re all a wreck. My D is perfect; it’s 65. We all get better and now we’re all going through the same thing. That’s really important. And we’re out there on this frontier. I’m saying things like well, what do you think is wrong? I don’t know and I’m not into supplements. I’m not as knowledgeable as some of my patients about supplements.

For the first time, we’ve opened the possibility that we could be missing things. My sleep is failing at the same time so when we all fail dramatically at two years, the timing of that is really thought-provoking. Also, I spent the first four years watching people using CPAP and sleeping pills. They got better and then they failed within four years. The CPAP effect goes away.

Everybody comes back and says they’re still wearing it but they only felt great in the first year. That means there’s this mechanical device that’s allowing people to fall into deep sleep, and when they get into deep sleep, they feel so much better and their diabetes goes away. But soon the brain is not happy with only that crutch. It’s the same thing with sleeping pills. As soon as you think you really have it all figured out, nope, it fails again, No, the brain wants something else.

I was left feeling around, wondering what the heck else it would want. We’re all failing and that’s the only reason I would ever do vitamins because I had this negative education against them as a physician. But then this woman walks in with a book about B5, Pantothenic Acid. I’m trying to pretend I’m okay with it and will read it. To be truthful, I have to think, as a lot of people think, that information falls in your lap when you’re ready for it. She brought this book in because B5 helps Rheumatoid Arthritis and the people trying it get better sleep. There’s literature about B5 and sleep in the 1950s and the references are in this book. So I’m happy from a physician’s point of view because there’s some science about it.

It’s about people being starved of B5 who get insomnia in two weeks. It’s there and I’m pretty desperate. My patients are pretty desperate. So we take this certain dose recommended in the book and we all feel worse. We all get insomnia from it instead of sleeping better. That means there’s a dose effect. Then I’m stuck with the fact that every other reference says there is no Pantothenic Acid Deficiency. Yet this just gave us all insomnia and 30 out of 40 people come back and ask if I was trying to kill them with this. The reference says 400 mg. They were pissed off for good reason.

Why would 30 out of 40 people come in and tell me the exact same words and experience something different than what’s in the book? This D is doing something that’s changing the chemistry over two years. What’s up with that? I’m a biochemical person. If you walk into the vitamin literature through the focus of sleep, you never get anything out of vitamins. If you’re not sleeping, you can give vitamins from here to tomorrow; you can eat whatever you want. All of those good ideas about using these nutritional bases to improve how you feel only repair if you’re sleeping.

I would see these dramatic differences. And if someone has insomnia and they don’t sleep, they don’t get better. The vitamins just float around and don’t get used. So looking at it through a sleep lens is having a specific outcome that you want. It also means you think of vitamins in a different way. I’m taking this supplement – whatever it is – to achieve a certain outcome. If it makes the opposite happen, you better listen because that means the brain doesn’t want that supplement. We don’t think about it that way. We don’t teach that way. We don’t say you want to take this supplement so you can accomplish this endpoint and once that endpoint is reached, your body is going to tell you, just like it does with the sleeping pills, that it doesn’t want it anymore.

None of the animals are taking supplements. So it’s a really big mental shift. Think of this as a broken biochemical-engineered set of switches, and they are broken because we were deficient. Then we put in these things and it’s miraculously engineered to fix itself. Once you give it the raw materials, it remembers what to do – because I don’t really know. I’m not fixing their sleep – it sleeps and then it fixes itself. It actually fixes itself. That’s miraculous! But that’s what we were designed to do.

Once it does fix itself, it will tell you it doesn’t want these other things anymore because it’s back in a homeostatic place.

Mike: Yeah. That’s fascinating! I think that we don’t listen to our bodies. Nature tells us when something’s wrong. A disease state is the body’s alarm bell going off that we’re doing something wrong and we need to switch gears. There’s this whole side of medicine that isn’t on board with that idea. It’s more symptom suppression and I think it’s a slippery slope.

Stasha: It’s very difficult. First, I had to be converted into someone who would ask how the patient feels with this. And then realize that I’d better listen or bad things are going to happen. It was not easy for me, as a physician, to move there. But pretty soon, I realized if I told a patient that we’re doing these Vitamin D levels every month for years on end sometimes the patient comes back saying they think their D is high. I can say I’m the one with the data; I’ve got the numbers and I think it’s low. Sometimes they turned out to be right.

Then I’d want to know how they knew that and sometimes they can’t tell you. That meant that Vitamin D is something that reflects in how we feel. There’s a huge complexity of that in the background, but once you get there, you realize you better listen to what they say.

The next step is giving the patient or the client permission to always do what their body says is the right thing to do. Everything on my website is about my patients coming back and saying:

Patient: “You told me to do blah, blah, blah, and I got all screwed up.” 

Me: “You look pretty good right now.”

Patient: “I’m feeling good.”

Me: “What did you do? Tell me what you did.”

I had to be open-minded enough because we were all desperate to actually step out of the expert role and say teach me about that. How did you learn about that? What happened to you?

That experience got me into places that are really weird where I can’t really find explanations for why there’s a time frame after you get your microbiome back; three to four months later, if you are sleeping normally, your body will then ask for more B Vitamins. Then for a span of six to nine months, you will have to take more. That’s totally bizarre.

There is a huge mind shift here that needs to happen in supplementation as well as in medicine. We really won’t do well with D until we give the patients permission to say they don’t feel good on this or they don’t feel good when their D is X but feel better when it’s Y.

We are not set up to do that. Instead, we have nine hundred forms of Vitamin D that pharmaceutical agencies have made. That means that they’ve used them in animals and they’ve used them on humans. If we don’t recognize that these are chemicals, that affect our thinking and our mood, then we just throw these things around. 

We call it a vitamin so we can just throw it around and give it as an experiment to people on dialysis. They’ll return and say, “Since you started giving me this thing for my bones, I can’t sleep.” We won’t listen. Biology doesn’t care about our little human-centered qualification that D is about bones.

Mike: You’re right. We touched on aging earlier and how things change physiologically for us. I heard you in a previous talk mention how our ability to synthesize Vitamin D goes down as we age. If our bodies just don’t work as well as when we were younger, does supplementing with Vitamin D offset that? Or, can we spend more time in the sunlight? How do we remedy that?

Stasha: Excellent question, Mike!

This is a little bit gnarly. If I’m talking to a 25-year-old, who’s had normal physiology and just briefly, in the last four years, lost their microbiome, whether they ever had IBS or not, the body is really designed to take all these deficiency states and fix them up, no problem.

If I’m having the same conversation with a 65-year-old, or with myself, it’s really a different setting. There’s a complexity that the dermatologists missed about sun exposure. When dermatologists in the 80s started to say we have sunscreen now, you really don’t want to be in the sun, there was no accompanying chorus of neurologists,  endocrinologists, or renal specialists who had recognized that D was active in their organs in keeping the organs healthy. They didn’t go behind the dermatologist and talk about safe sun exposure.

Yes, burning is not right, but really what we’ve done since the 80s is we have bought ourselves sleep disorders, autoimmunity, and incorrect mental and physical development in childhood, all to save us from squamous cell carcinoma of the ear at age 75. Yes, it’s true that we can have some positive outcomes, but in the dermatologist’s willingness to say, “I know about my organ the skin, but I’ve ignored the other millions of effects of D,” we’ve wound up in these new epidemics. It’s now only in retrospect we can see that they started in the 80s and that they all link back to a combination of D and the microbiome.

It’s hard to see that as it’s developing. These are all old diseases, it’s not like Vitamin D Deficiency and the loss of the microbiome is new. It’s always been there. In the 1700s and 1800s when doctors were writing down symptoms, some of the things they were looking at, heart failure, diabetes, and depression, all the things they were describing are walking in the door now because the person is D low and they lost their microbiome.

These are all old, old diseases and we haven’t alerted to the fact that these old diseases are presenting in younger and younger and younger populations. There is really interesting literature about D and why that happens, but in fact, the answer to your actual question is we don’t know what’s going to happen. It’s my belief that D by itself does not bring back the microbiome. That was my experience. I thought if D was low and we lost our microbiome, all we had to do is feed the D back to those bugs, and the ones that liked D will grow back.

But it didn’t happen. At two years, IBS is still terrible and we’re all getting worse. And then the next question was, we know the bugs need D, but what else could they want? Then I stumble into the B Vitamins. Each one of the B Vitamins has a colonic bacteria source and a food source. Oh! They’re just feeding each other vitamins and we haven’t given them the Bs. The ones in the background need to grow forward and overtake all the bad guys. So you need a combination of D plus all Bs in a large dose that has actually been done a little bit in naturopathic healing by using fermented food and what they called the Antipolyneuritic factor. This was really a yeast preparation that had yeast and bacteria growing in it; the stuff you use to make beer and bread. They use that to treat pellagra and berry berry. That was the vitamin deficiency state they treated it. What grew out of that was discovering that these chemicals being made by bacteria – this is back in the really early 1900s; 1910s,  20s, 30s, they’re just starting to isolate these chemicals growing out of these bacterial cultures – are bacterial growth factors. All of the Bs were bacterial growth factors. Then we discovered that they were necessary for humans, but the connection between the bugs growing inside us that are really supplying it didn’t get made.

When you then put that there and ask what happens now when we have a whole population that’s been deficient and we add it back? Can we correct what’s going to happen to them? Nobody really knows. I don’t really know what’s going to happen when I try to reverse this process. There have been people who have been brought back from burning neuropathy with these preparations but I don’t know what’s going to happen to them in the long term.

I really do think we’re all going to still die of something, so you can manipulate this to some extent. I also think that it’s sleep, not vitamins, that’s the key. It’s likely that each one of us is still going to have some genetic stumbling blocks, even if we can get this vitamin picture as good as we can. We’re really in the very early phases of seeing that once I put the microbiome back together, once I have the D on board, and once I sleep better, what’s going to happen to the population in the longer term?

Mike: Yeah. Just these different paths you’ve gone down in your experience, you’re literally blazing a new trail in this field.

Stasha: It’s satisfying but it’s scary at the same time because we really don’t know what’s going to happen.

Mike: Every time I hear you speak, it’s mind-blowing. I learn so much. It’s wild; I love it. I’m a geek for this stuff. I appreciate the work that you do

You mentioned in a different talk, that you don’t recommend K2, which is often recommended with D by a lot of physicians in functional medicine and allopathic medicine. When you look on the store shelves, it’s often packaged together, K2 plus D or D plus K2. Why do you take issue with K2 supplementation?

Stasha: I don’t actually take issue with it. Here’s what actually happened to me. I’m dealing with people who really like allopathic medicine and I’m in a regular practice. They have headaches, seizures, or tremors, so they’re on seven or eight medicines already. Then I’m going off in this direction that they weren’t actually attracted to. They don’t come in because they want to do supplements and I’m trying to convince them to take an additional six pills. I’m taking a multivitamin, B50, 3 D pills, and maybe B12. So it’s not that I’m not interested in or don’t care about K2. It’s that I was really focusing on D and the other vitamins’ effect on sleep.

K2 plays no role in sleep. What K2 does is – it doesn’t have anything to do with D absorption; it is not a cofactor for D, that’s incorrect – it’s a cofactor for the function of calcium going into bone instead of into places where it doesn’t belong. There is an FAQ on my site addressing this because it’s asked all the time. It says if you have osteopenia or osteoporosis, or if you know you have calcification in places where it doesn’t belong,  then you should be using K2.

K2 is made by our intestinal bacteria so every single person who follows this path and gets to the right sleep program has other deficiencies. One of the reasons the multivitamin is in this program is that there are many other mineral deficiencies. Some people need more calcium, some need more magnesium. Most of the time, I really want you to focus on what’s helping you sleep. If you need magnesium because you’ve got headaches or cramps or it seems to help you sleep, then you do it. But I’m not really interested in taking 18 different supplements just to cover every single thing that might happen.

Instead, I want to rely on knowing that this program is designed to bring back the microbiome. Our microbiome has been a primary source of K2 throughout our lives so the reason humans have covered the globe like roaches is that we are very adaptable to many different diets. To me, that means in the setting of living outdoors and having a normal microbiome, we can actually exist and thrive and take over all the other animals on the planet with pretty varied and pretty narrowed diets.

I really don’t think the whole story is I have to do this diet or that diet and these supplements. I really think it’s more about putting back together the original biology. K2 comes from my belly and K2 is in my multivitamin. Are there any other things about me specifically that would make me want to add K2 instead of just automatically adding it at the beginning?

Mike: Let me switch gears here for a moment. What do you define as a good night’s sleep? Is it different for different people? Is it a set amount of hours? I know it’s the million-dollar question. I know people debate this issue. I want to know what you think of that.

Stasha: We have data from the 1960s that came out of the Stanford Sleep Studies. I was growing up at that time – keep in mind we did not have sunscreen and the people being studied were Stanford medical students and college students, so there’s a generational effect – but the normals we got out of those original studies usually fall asleep at around nine or ten and wake up at six. They usually have eight hours of sleep with four hours of deep sleep, two hours of slow-wave sleep (on your tracker, it’s called deep sleep, which makes it kind of confusing), and two hours of REM. That’s very general.

Having said that, it’s pretty unusual to find people who can do that now. And in younger populations, it’s even worse. Almost 80% of kids born in the last 10 years have sleep disorders. So I think your statistic of 30% of the population has insomnia, in children, I think it’s even higher than that. If you look at what the Stanford Sleep Studies show as normal now, the recent studies show that if you study teenagers and people in their early 20s, there’s a big uptick in their brain activity between 11 pm and 1 am. Their response to that is to start high school at 10 am, which is not a bad idea, but what they don’t realize is they’re studying Vitamin D-deficient kids who have the wrong microbiome.

In the first part of life, up until around puberty, the kids are tired when they wake and they need longer periods of time. It’s unusual for them to have insomnia. It’s common for them to have a sleep disorder but the presentation is usually they’re fatigued, cranky, and a little strange, they’re doing weird things that we don’t quite understand. Whatever you call that, that is the beginning.

They can’t really physically sleep long enough to complete their sleep when their D is low. Remember, the D being low was a winter message that meant we were hibernating, sleeping for 16 hours, so you wouldn’t kill all those little kids in your teepee with you. You don’t have enough food to really support the eight kids in that teepee and if they don’t sleep a lot you know you’re in there for four months.

Let’s say there’s a big survival advantage to them sleeping longer. What we’ve done now is wake them up at 6:00 am to go to school when their body is in a physiologic state that needs 18 hours of sleep. That used to be a big survival advantage. Then, at puberty, it changes and all of a sudden, they have trouble falling asleep. We blame it on their computer and their devices.

So your question is what’s normal sleep? Let’s just say we don’t know because nobody’s seeing me as having normal sleep, that’s for sure! They may think they have normal sleep and then you do a sleep study because they have epilepsy or they have headaches and they don’t even have a sleep complaint. That’s what their sleep has been like since the day they were born.

That’s another really interesting thing. This is the only body I’ve ever been in. How would I know what normal sleep is? So we judge normal sleep by our sleep and our family’s sleep because otherwise, we have no way of knowing. So you start to do sleep studies on people that look tired and are seeing a neurologist. What you see in their sleep study is they have an hour of deep sleep; maybe they have no deep sleep. This is not good. Why is this happening?

You really can’t just rely on going to sleep at 10 and waking up at nine but I’m tired. It’s not just about the characteristics of the sleep. It’s what the person feels like during the day. If they have medical problems, if they’re seeing a doctor for something, my claim would be they don’t have normal sleep. I have a very low threshold for saying you probably have a sleep disorder now.

Ultimately, we have a new phase where all the people I’m working with have sleep trackers now. We’re actually entering a new era where “normal” people who aren’t even seeing a doctor are sick and have a sleep disorder. That’s why they got an Oura Ring or other sleep tracker. Now they’re watching what happens to their sleep every single night, over time, at home, without all these electrodes. They’re actually telling me new stuff. 

So, what is normal sleep? Well, I got to see people who, for instance, at the most extreme end, are people who’ve been working nights for the last 30 years, who are now on disability because their body is so wrecked and they’re still sleeping during the day. What do they say about that? They guess it’s because they worked nights for so long. Normal humans cannot work nights. They get fired because they fall asleep when they’re supposed to be working. That means the only people who will work nights are the ones with the sleep disorder. And if you take them out of that setting it actually makes them sleep during the day. They still sleep during the day.

I grew up with the dogma that there are night owls and there are morning people. That’s all I knew. If you encourage people to sleep when their brain can sleep instead of being a sleep nazi, telling them to wake up an hour earlier all the time – which was the only thing we had to tell them – if you let them sleep during the day,  give back the vitamins, and just be patient, they flip over to ten pm to six am.

Ten to six is what everybody gets to even if you have a preconceived notion about it. Every once in a while people can go 9:30 to 5:30, but they flip into an eight-hour cycle. Now, there’s an intermediate phase which is when most people doing my program get all the vitamins on board, they sleep a lot and you have to tell them why.

“I know you came to me so you could feel better during the day and I know that you had a little bit of insomnia but mostly fatigue. What you have now is you just want to sleep all the time over the weekend. You slept nine hours and then took a three-hour nap. I know this is not what you want; this is not what you signed up for, but you have to think about the fact that you are actually doing something which is allowing you time in deep sleep to fix your sleep switches. You must go through that transition phase to arrive at the place where you have healthy sleep switches. Then healthy nightly maintenance is eight hours. But if you have a lot of deferred repairs that you haven’t been doing for 20 years, you will have to sleep longer than that to get those repairs done.”

There probably is a whole scheduling program like the brain does X every night; a list of certain things it looks at every single night. Then it has things it does once a week, once every two weeks, and once a month. A lot of the maintenance has been deferred. Things are falling apart in there and now you have to put it all back together. Then you finally arrive at a normal eight-hour nightly maintenance. So my short answer would be it’s not just what my sleep is like, it’s what are the things that show up during the day that show me that my sleep, even though as far as I was concerned it was okay, my sleep isn’t as fully restorative as I would like.

Mike: That’s a very detailed answer; thank you. I know nobody’s perfectly healthy; it’s just part of the human experience. But what if somebody doesn’t get those eight hours but they feel okay, their energy is okay, and they’re alert? But they start getting sleepy at nine or ten o’clock? Is that a good place to be? Can we listen to our bodies then?

Stasha: I would not mess around with supplements if that’s how you feel. The populations coming after supplements are one that’s sick and the other is looking for peak performance. Athletic peak performance and longevity is a different way to enter into this. I think it’s a little dangerous to head toward peak performance and just make assumptions. If you’re going to go into any supplement for peak performance, you listen to what your body says about it. D is dangerous. It’s like taking testosterone. D is a hormone. Our history is really strong with testosterone. If you give it once a month instead of the normal physiologic dosing of any hormone, you get a really different result and it can be very dangerous. That means, if you’re going to use D you have to put on your hormone cap. You have to read all the literature about what happens with testosterone and use that as a model. Then you have to go toward how can I give this in the most biologically normal way? You really want to do bioidentical hormones. That’s why we’re calling it that, which means you really want to use the sun and UVB light. If you use UVB light by itself inside, what you’re doing is changing the fact that these other wavelengths are not accompanying it. Just because we don’t know that Infrared does X, Y, and Z with the D means you really want to pursue the most natural approach you can and use the supplements sparingly. If there’s nothing wrong with you. Otherwise, you get into a place where your body didn’t really want to be.

I think it’s okay to say if you feel great, don’t have any complaints about anything, and are functioning great, I don’t think you should be dabbling in this stuff.

Mike: That makes sense. Dr. Gominak, I want to keep talking but we’re running short on time. So we’re going to have to invite you back for part two of this at some point if you’ll join us again. I feel like we’ve just scratched the surface here.

Stasha: Yeah, let’s do another one. Let’s do one about kids, one about the B vitamins and how they manifest.

Mike: Yeah! Now we’re talking about a miniseries! How can people find you before we go?

Stasha: My website is www.drgominak.com. It’s been criticized as not a very relevant name, but I’m the only Gominak on the planet. I have a workbook, which is actually a path. It works like your own private assistant to take you through what is really a program about a year, year and a half in duration.

Most of the material on my website is free – it’s the ‘why’ – it’s what we’ve been talking about. The ‘how’ is pretty specific and it gives you all the ways to get your D levels done, what you need to know about Vitamin D levels, and how we have them done. There are some specific things you need to do to make this work for you and that is in the workbook. I also have two sets of videos. One is about fertility, pregnancy, and the first year with your infant because that’s a special situation. The second set is if you want to use the RightSleep program with children. 

Mike: Awesome! Thanks for being with us today; we’ll definitely have you back. We appreciate all the work that you do.

Stasha: Thank you so much, Mike.