Time Holds The Key

Words: Dr Rajgopal NIDAMBOOR

Chronotherapy is the use of circadian rhythms in conventional medicine, where time, or timing, holds the key.

Homeopathy has, for long, used this seminal idea. Its therapeutic expression stimulates the body’s own vital force — the seat of biorhythms — and, the body defence system to work towards healing the overall psyche, while bringing about harmonious balance to the individual at three levels — physical, mental, and emotional.

Our sleep-wake cycle and full day-night functions are regulated by a smart, resident inner bio-clock that drives us all. What propels our bio-clock has mesmerised generations — right from the days of philosopher-scientist Aristotle. Yes, the working of the bio-clock is apparent not only through the process of our sleep-wake cycle, but also the regulation of body temperature, tolerance to pain, hormone levels, response to drugs, or medications, besides a variety of emotional deviations, such as depression, at the time of new and full moon nights.

Such biological rhythms represent changes that systematically recur in us — they include the daily ebb and surge of biochemical levels in the blood and reproductive cycles, among others. Research corroborates that every physiological, or functional, aspect of our bio-clock rises and falls with computerised regularity, or precision. These bio-rhythms, as they are also called, represent a perfect, delicate balance. So much so, a bio-clock that goes kaput can trigger, or lead to, a host of health deviations, or disorders.

Beyond Rhythm 

The frequency of our bio-rhythms relates to the duration of one complete cycle, or the number of cycles per time unit. There are three primary types of rhythms — viz., ultradian, infradian and circadian. The first ‘cadence’ encompasses of periods less than 24 hours — e.g., cardiac and breathing cycles. The infradian rhythms include our reproductive cycle, extending longer than 24 hours. Circadian rhythms, such as the sleep-wake cycle, have approximately a 24-hour cycle. The study of these biological rhythms is called chronobiology.

Research has surmised that the pineal gland and its hormone, melatonin, are the ‘seats’ of such a sequence — one that regulates and maintains our different body rhythms. This includes their synchronisation with one another and our external environment. Here goes. The levels of melatonin in depressed patients, to pick one example, reveal not just reduced values, but also a distinct variation in our body rhythms. Melatonin is a ‘chronobiotic’ substance. It has the ability to reset desynchronised body rhythms back to normal. One classical example is ‘jet-lag’ — the inability to resynchronise our body rhythms with the time of our destination. No wonder, melatonin has become a ‘panacea,’ as a low-dose supplement, for easing jet-lag, without the side-effects of prescription sleeping pills.


This brings us to the rapidly expanding field of chronotherapy, the use of circadian, or other rhythmic cycles in the application of therapy, where time, or timing, holds the key. The whole idea is also like ‘tuning’ into our body’s rhythms. To draw a cricketing exemplar, chronotherapy is somewhat analogous to a quality batsman’s swirl of the willow, where ‘timing’ makes, or breaks, one’s ability to score runs at a good clip. Put simply, chronotherapy is based on the therapeutic premise that by heeding to our body’s rhythms, or bio-clock, we could make medical treatment far less toxic and, at the same time, more effective and safe. Take for instance, asthma, which has a strong predilection to quivering its victim for a ‘wheezy’ ride, during the night, when mucous production escalates, the bronchial airways go into a ‘spasm’ and inflammatory cells exemplify their discordant presence with frenetic intent.

Why this ‘wheezy’ wheezing spree? Most asthmatic individuals, for instance, endeavour to keep a steady level of their conventional medicine in their blood — day and night — with small doses. New research has shown that a fairly large medicinal dose of any asthmatic medication would be just as safe and effective as multiple small doses — perhaps, even better for averting night-time attacks. A similar principle holds ‘good’ for hypertensive [high blood pressure] individuals, who have a proclivity for elevated blood pressure readings at daybreak. As statistics reveals, heart attacks and strokes are twice as common at 8:00am as at 10:00pm — the reason being our blood pressure falls, as a matter of physiology, at night. It tends to peak as we brace ourselves up for yet another hectic day in the chronicle of life told and retold.

Studies also suggest that our cardiovascular functioning is least efficient between 6:00am and 9:00am, while platelet constancy, blood pressure and pulse rate are characteristically at their peak two hours after we wake up. Elevated plasma cortisol, a common consequence of stress, likewise, ‘ups’ around 6:00am. It progressively declines to its lowest level late evening, before escalating again early morning, while the secretion of vasopressin, the anti-diuretic hormone, reaches its acme during the night, resulting in decreased urine formation.

Most conventional blood pressure drugs provide 24 hours ‘action.’ What does this connote? When such drugs are taken in the morning, they are least effective when most needed. It’s, therefore, as research suggests, imperative, also obligatory, for one to stick to a specific time for taking their anti-hypertensive pill. If you take your pill, for example, at 8:00am, it is working by 10:00am; but, by this time you’ve gone through a ‘bad’ four hours of the day without any fortification. This is reason enough why a bed-time dosage is recommended to prevent such a ‘glitch,’ albeit this could also ‘drive’ blood pressure levels to disturbingly low levels during sleep. So, is there a better way out of the impasse? Yes, an antihypertensive drug, a long-acting pill, that releases no medication until four hours after it is ingested. When you take the pill at bedtime, you ensure peak protection at dawn, while forestalling the typical ‘drawback’ of night-time dosing.

New Research 

New exciting research suggests that our circadian bio-clocks may share a familiar descent — the build-up of oxygen in the atmosphere 2.5 billion years ago may have possibly determined the evolution of our circadian rhythms. In addition, scientists have, only recently, identified a protein, which they aver, could be a strong marker of circadian rhythms, although they are not certain as to what actually ‘causes’ such rhythms per se. What has now given them a huge reason to smile is a common model that provides a feedback loop. The latest twist to the bio-clock tale has, therefore, unmistakably become medical science’s ‘new-fangled’ blueprint — the basis for circadian rhythm research in the future.

What adds fascinating substance to the novel prospect is a South Korean research team that stumbled upon and identified a new gene responsible for maintaining our internal bio-clock. The team led by Choi Joon Ho and Lee Jong Bin, and comprising of Ravi Allada and Lim Jeong Hoon of Northwestern University, US, experimented with transformed small fruit flies for four years. They found that there was an undiscovered gene that ‘deals’ with bio-rhythms in the brain and acts as a sub-atomic bio-clock, regulating the rhythm and life of each cell.

The landmark finding is a novelty by itself — it has laid the path to explain scientifically the precise role of the protein produced by the gene. The upshot is expected to resolve some of the knottiest questions associated with sleep disorders, jet-lag, eating patterns, bio-rhythms and so on.

Picture this. Our 24×7 life is wreaking havoc on our restful, sound sleep. Sleep is meditation. It is also therapeutic. However, most of us are overworked — for all the wrong reasons. We are also missing-out on our essential sleep time. We are waking up at 3:00am, or 4:00am, to check E-mail, send messages, or working odd shifts, or just getting up too early, or suffering from jet-lag, thanks to our ‘frequent-flier’ tag.

What’s more, our ‘chock-a-block’ lifestyle is upsetting the applecart of our circadian rhythms, no less. The outcome? We often present with circadian rhythm disorders [CRD] — the raison d’être for being insomniacs, to highlight one example, or being proud ‘envoys’ of an increasingly sleepless society, living on the edge of a health breakdown. This is the bad news. The good news is all of this, and more, is poised to change dramatically, thanks to the new finding — the bio-clock gene.

It holds an exhilarating prospect, a paradigm shift, for chronotherapy — one that could help ‘reset’ our bio-clocks back to its pristine and sublime balance, with more than a little help from personalised, or bespoke, homeopathic treatment.

Dr RAJGOPAL NIDAMBOOR, PhD, is a wellness physician-writer-editor, independent researcher, critic, columnist, author and publisher. His published work includes hundreds of newspaper, magazine, web articles, essays, meditations, columns, and critiques on a host of subjects, eight books on natural health, two coffee table tomes and an encyclopaedic treatise on Indian philosophy. He is Chief Wellness Officer, Docco360 — a mobile health application/platform connecting patients with Ayurveda, homeopathic and Unani physicians, and nutrition therapists, among others, from the comfort of their home — and, Editor-in-Chief, ThinkWellness360.

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