Integrative Medicine Helps Patient with Anxiety and Sleep

Patty Saunier of Bay Village, Ohio had been what she called a “champion sleeper” pretty much her whole life. But out of nowhere in her sixties, sleeping became a nightmare.

“It got worse and worse over a year or so,” said Saunier. “I’d sleep okay one night, then the next night I’d be up. Then okay for a night or two, then up for a night or two. Eventually I was barely sleeping at all and got almost no sleep for several weeks. I’d worry all day about whether I’d sleep that night. It was a vicious cycle, and I was miserable.”

The exhaustion and frustration lead to anxiety and brain fog. Saunier visited several different doctors multiple times. They suggested taking Ambien and wanted to discuss sleep hygiene, but Saunier yearned for an answer to the underlying issue.

“I didn’t want to take a medication that would force me to sleep,” she said. “And I was already trying tips like sleeping in a cool, dark room. I knew there had to be a root cause, and I was desperate for someone to help me find it.”

At the end of summer 2021, Saunier found Kristin Kaelber, MD, PhD, an internal and lifestyle medicine specialist with University Hospitals Connor Whole Health.

Integrative medicine, also called whole health, focuses on treating the whole person – not just individual symptoms – by addressing the patient’s physical, emotional, behavioral and spiritual well-being. It’s a team-based method anchored in a trusted long-term relationship between patient and caregiver. Treatments can directly address problems and/or prevent them. Treatments are used on their own or as a complement to traditional interventions. Integrative medicine includes acupuncture, massage therapy, meditation, stress management, sleep management, herbal supplements, and diet and exercise consultation.

“With Patty, we started off by taking a very detailed history – really listening to her story and then ordering a few lab tests that could reveal the problem,” Dr. Kaelber said. “It’s important to start with the basics to know what you’re working with.”

Testing revealed Saunier was extremely deficient in vitamin B12. A normal level of vitamin B12 in the blood is generally 400 picograms to 950 picograms per milliliter (pg/mL). Saunier’s level was 79 pg/ml, the lowest Dr. Kaelber had seen in her career.

A severe vitamin B12 deficiency can cause sleep issues such as excessive daytime sleepiness, trouble falling asleep and insomnia. Other symptoms may include shortness of breath, headaches, difficulty concentrating, indigestion, and problems with balance and coordination.

“I prescribed an aggressive regimen of vitamin B12 shots to get Patty back up to a normal level,” said Dr. Kaelber. “Her vitamin D level was also low, which could worsen her symptoms, so we worked on bringing that up as well.”

Saunier first noticed a boost in her mood.

“After I began the B12 shots, better sleep wasn’t immediate, but I did notice less anxiety and brain fog. I felt better overall,” she said. “After a few weeks though, quality sleep returned too.”

Saunier, now 67 years old, continues to see Dr. Kaelber three times a year. They discuss lifestyle choices, diet and exercise. Saunier has improved her diet, now concentrating on eating more whole foods like fruits and vegetables and avoiding processed ingredients. In the past, she didn’t exercise, but now she works on moving her body every day and even does some strength training.

“We know from the literature that 80 percent of chronic medical problems can be improved or reversed with changes to lifestyle,” said Dr. Kaelber. “Patients love the work we do together because it allows them to be in the driver’s seat to improve their own health with simple changes to their daily habits.”

“Dr. Kaelber got to the bottom of the problem, which is what I wanted all along,” said Saunier. “Not only that, but working with her has greatly improved my overall health. I’m so grateful to her for her expertise and partnership on my health journey.”

Today, Saunier sleeps normally and has no unexplained anxiety or brain fog. The mostly retired freelance writer now feels she can show up better for herself, her three daughters and six grandkids.

“I love working in integrative and lifestyle medicine because of the difference we make for patients like Patty,” said Dr. Kaelber. “We’re here to educate, encourage and empower them to make the changes that lead to a better, healthier life.”