Timing is everything – CHRONOTHERAPY

Our bodies are wonderfully deft at maintaining balance. As it turns out, though our natural state is not a steady one. Researchers are finding that everything from blood pressure to brain function varies rhythmically with the cycles of sun, moon and seasons.

Only one doctor in 25 is well versed in the growing field of ” chronotherapeutics” the strategic use of time( Chronos) in medicine. For example, asthmatics are most likely to suffer during the night, when mucus production increases, airways narrow and inflammatory cells work overtime. Yet most patients strive to keep a constant level of medicine in their blood day and night, whether by puffing on an inhaler four times a day or taking a pill each morning and evening.

If the night belongs to asthma, the dawn belongs to hypertension and heart disease. Heart attacks are twice as common at 9 a.m. as at 11 p.m. Part of the reason is that our blood pressure falls predictably at night then peaks as we crank up for the day. Most blood pressure drugs provide 18 to 20 hours of relief. But because they are taken in the morning, they are least effective when most needed.” Bedtime dosing would prevent that lapse, but it would also push blood pressure to a dangerously low level during the night.

Researchers say that the antihypertensive drug verapamil has a long-acting tablet that releases no medication until four hours after it is ingested. By taking it at bedtime, patients get peak protection during the early morning hours while averting the usual hazards of nighttime dosing. The clock could prove an equally potent weapon against cancer. Many cancer drugs are less toxic if they are used only at certain times of the day. And the timed treatments have improved survival rates for people with leukaemia and ovarian cancer.

The daily rhythm is not the only one that could affect cancer treatment. In researches, the data of 59 women patients who had undergone surgery for breast cancer and found that those operating on midway through the menstrual cycle enjoyed better 10-year survival rates than those treated at other times of the month. Those studies suggest that mid-cycle breast surgery may bring a 30 percent survival advantage. And unlike most new treatments, this one would cost no more than what it replaced.

Time, after all, is free.

Dr S.k.jha