Why we should go with the flow of our biological clocks

After years fighting my circadian rhythms, I've learned to follow them

Susan Payrovi, MD avatar

by Susan Payrovi, MD |

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What’s a reliable way to wreck your mood? Fighting your circadian rhythms.

I’m a recovering night owl. I used to get more done between 10 p.m. and 2 a.m. than I did in the other 20 hours of the day. I routinely studied past 2 a.m. during college and medical school, cramming in massive amounts of information during these magic hours when my brain was sharp, fast, and focused.

My late-night antics continued into my anesthesiology residency, where I lived for the action-packed trauma cases only Los Angeles could provide. It was thrilling to work with my co-residents to bring patients back from the brink of death.

But a peculiar thing would happen every time I was on my week of night shifts, working from 7 p.m. to 7 a.m. By the second or third day, I was sad. Ready-to-cry sad. The world looked gray. I moved more slowly. I even lost my enthusiasm for work, friends, and life in general. I couldn’t snap out of it.

This pattern showed up every time I worked that week of nights. But within a few days of resuming day shifts, I’d be back to my old self again, zipping around, feeling enthusiastic and happy.

So why the low mood?

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Connecting with my environment

I was fighting my circadian rhythms (otherwise known as our biological clocks). I was active when my clocks wanted me to sleep during the dark hours. I was asleep when my clocks wanted me to be active during daylight.

Circadian rhythms are clocks built into our cells to monitor the environment and orchestrate the timing of all the microscopic activity that happens in our bodies. They help us adapt to changes in the environment. For example, they raise your melatonin when it’s dark to put you to sleep, and they suppress bowel movements at night so you stay asleep. Circadian rhythms trigger ovulation midcycle to support fertility and ensure the survival of the human race. These same clocks suppress hunger in the morning and boost appetite in the evening to ensure you have enough calories on board while you fast as you sleep.

Without these clocks micromanaging our physiology, we wouldn’t survive very long. When our behaviors and activities go counter to these clocks, the clocks try to adapt. However, it takes days to several weeks for them to catch up. Meanwhile, the body perceives this shift as a danger signal, unleashing its defense mechanisms to produce inflammation — not a great scenario for someone like me, with multiple sclerosis (MS) and predisposed to autoimmunity.

So how do these circadian rhythms keep our physiology on track? They look to the environment for clues, and the most reproducible clue is our cycle of daylight and darkness. Other environmental clues include barometric pressure, ambient temperature, and even phases of the moon. Our day-to-day behaviors also influence these clocks, including our patterns of eating and moving, as well as stress and social interactions.

You’ve experienced circadian rhythm disruptions. Think daylight saving time or travel to another time zone. You might have noticed your sleep is poor, mood is off, and energy is low. It takes days to weeks for your clocks to sync back up with the pattern of light and dark in your new environment.

Back in my residency days, I was asked to fight my circadian rhythms one week at a time. Even as a peppy 25-year-old, I wasn’t immune to the effects of fighting my clocks: neurotransmitters for mood were thrown off, and hormones, gut function, and appetite were disrupted. Worst of all, this change was fuel for my immune system to create inflammation.

The good news is that the human body is dynamic and always trying to restore balance. Flipping my work schedule back to days allowed me to sync with the natural cycles of day and night, and I felt good again.

One of my biggest “aha!” moments when studying functional medicine was that building health requires cooperation with Mother Nature. If we choose daily routines that sync with her natural rhythms, our delicate microscopic processes will tick away as intended.

Stepping back and thinking big picture, wakefulness at night (as a student, anesthesiologist, and mom to three kids) was a chronic stress on my biological systems. No doubt it played a major role in driving my autoimmune process forward to the point where one day it was given the name “multiple sclerosis.”

While I can’t get rid of this ugly diagnosis, I can be intentional about building routines that follow the natural rhythms of my environment — working during the day, sleeping at night, and hanging out in nature as much as possible. These signals reassure my immune system that all is well, and it’s OK to move away from inflammation and autoimmunity.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.


Lise Couturier avatar

Lise Couturier

Can I sign up to Dr PayroviTRUE medicine wellness program
I lost my GP CAREER after 4 years practice due to md

Susan Payrovi, MD avatar

Susan Payrovi, MD

Hi Lise,
Thank you for your message. I'd love to learn more about you. You can sign up on our website for the weekly QA's with me as well as upcoming webinars and the newsletter. https://truemedicinems.com/ms-health-and-wellness-webinars/

Kim Ahmed avatar

Kim Ahmed

Spot on! I was diagnosed with RRMS in 2003. Worked for the Postal Service starting in 1984 and retiring in 2021, stayed on graveyard shift(11:00pm-7:30am) for 37 years, sleeping during days was always a struggle to get enough sleep, even for healthy people! After having Covid in 2020 diminished me greatly, I feel. Knew it was time to go in 2021, still need naps during the day!

Susan Payrovi, MD avatar

Susan Payrovi, MD

There must be a special place in heaven for people who work nights to make the world go around: medical personnel, security, postal workers, aircraft personnel, janitors, who did I miss?? But shouldn't they be compensated extra for putting their health at risk? his health risk. BW the W.H.O. in 2006 i think recognized night shift work as a carcinogen. We need more awareness of this risk. Kim, thank you for your service, and glad you have returned to days. And naps are awesome and much needed for all!

Marie T Kelfer avatar

Marie T Kelfer

my husband is medically trained and does not believe in functional medicine - why is that?

Susan Payrovi, MD avatar

Susan Payrovi, MD

Hi Marie!
Well, I'd start by asking him. Functional medicine is not a religion. It's a scientific, evidenced-based framework for looking at the body through systems of function, rather than as organs as we do in western medicine. I actually had to go back and buy my college biochemistry textbook to relearn it so I could understand what was happening in the mitochondria, immune pathways of inflammation, and beyond. You can check the links in the article to see the evidence backing my statements.
But I do understand your questions on a deeper level. We as physicians tend to dismiss anything that was not a part of our training. I had zero hours of nutrition training and didnt "believe" in nutrition until I got sick and all of a sudden had a reason to go and look for additional solutioins. I've worked with thousands of patients and I can tell you that our western medicine paradigm often does not fully address chronic disease. This is where functional medicine shines. Thanks for your question!


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