A Quick Primer on Melatonin
Melatonin is a hormone secreted by the pineal gland in the brain that helps regulate other hormones and maintains the body's circadian rhythm. The circadian rhythm is an internal 24-hour time-keeping system that plays a critical role in determining when we fall asleep and when we wake up. Darkness stimulates the production of melatonin while light suppresses its activity. Exposure to excessive light in the evening or too little light during the day can disrupt the body’s normal melatonin cycles. For example, jet lag, shift work, and poor vision can disrupt melatonin cycles. In addition, some experts claim that exposure to low-frequency electromagnetic fields (common in household appliances) may disrupt normal cycles and production of melatonin.
Melatonin also helps control the timing and release of female reproductive hormones. It helps determine when menstruation begins, the frequency and duration of menstrual cycles, and when menstruation ends (menopause). Many researchers also believe that melatonin levels are related to the aging process. For example, young children have the highest levels of nighttime melatonin. Researchers believe these levels diminish as we age. In fact, the decline in melatonin may explain why many older adults have disrupted sleep patterns and tend to go to bed and wake up earlier than when they were younger. However, emerging research calls this theory into question. In addition to its hormonal actions, melatonin has strong antioxidant effects. Preliminary evidence suggests that it may help strengthen the immune system.
If you are considering using melatonin supplements, talk to your doctor.
Uses:
Insomnia
Studies suggest that melatonin supplements may help induce sleep in people with disrupted circadian rhythms (such as those suffering from jet lag or poor vision or those who work the night shift) and those with low melatonin levels (such as some elderly and individuals with schizophrenia). A review of clinical studies suggests that melatonin supplements may help prevent jet lag, particularly in people who cross five or more time zones.
A few clinical studies suggest that when taken for short periods of time (days to weeks) melatonin is significantly more effective than a placebo, or “dummy pill,” in decreasing the amount of time required to fall asleep, increasing the number of sleeping hours, and boosting daytime alertness. Multiple human studies have measured the effects of melatonin supplements on sleep in healthy individuals. A wide range of doses has been used, often taken by mouth 30 - 60 minutes prior to sleep time. A study of 334 people aged 55 and older found that prolonged-release melatonin produced significant and clinically meaningful improvements in sleep quality, morning alertness, sleep onset latency, and quality of life in primary insomnia patients aged 55 years and over.
Osteoporosis
Melatonin has been shown to stimulate cells called osteoblasts that promote bone growth. Since melatonin levels may be lower in some older individuals such as postmenopausal women, current studies are investigating whether decreased melatonin levels contribute to the development of osteoporosis, and whether treatment with melatonin can help prevent this condition.
Menopause
Melatonin supplements may benefit menopausal women by promoting and sustaining sleep. Peri- or postmenopausal women who use melatonin supplements to regulate sleep patterns should do so only for a short period of time since long term effects are not known.
Depression
Clinical studies have found that melatonin may be useful in depression, especially associated with postmenopausal depression and anxiety. Other clinical studies show that people who suffer from major depression or panic disorder have low levels of melatonin. Healthy individuals with mild episodic depression and patients who have Seasonal Affective Disorder, (SAD -- a mild depression that correlates with fall and winter -- periods of light-phase shortening) also have lower than normal melatonin levels. Laboratory studies show that melatonin causes a surge in the chemical serotonin, which helps alleviate symptoms of depressive illness, including major and mild depression and SAD. Melatonin should be used with caution in people with depression and should be appropriately timed with light therapy and sleep-phase changes. Disruption of normal circadian rhythm by poorly timed melatonin administration may worsen depression. Melatonin use along with certain anti-depressant medications can pose potential health risks and should only be used under direct supervision of a qualified doctor.
Benzodiazepine Withdrawal
Some clinical research has found that melatonin may assist with tapering or cessation of benzodiazepines such as diazepam (Valium), alprazolam (Xanax), or lorazepam (Ativan). Sleep quality was improved in those stopping benzodiazepine use. Although preliminary results are promising, further study is needed.
High Blood Pressure
Several controlled studies in patients with high blood pressure report small reductions blood pressure when taking melatonin by mouth (orally) or inhaled through the nose (intranasally). Better-designed research is necessary before a firm conclusion can be reached.
Breast Cancer
Several studies indicate that melatonin levels may be linked with breast cancer risk. For example, women with breast cancer tend to have lower levels of melatonin than those without the disease. In addition, laboratory experiments have found that low levels of melatonin stimulate the growth of certain types of breast cancer cells, while adding melatonin to these cells inhibits their growth. Preliminary laboratory and clinical evidence also suggests that melatonin may enhance the effects of some chemotherapy drugs used to treat breast cancer. In a study that included a small number of women with breast cancer, melatonin (administered 7 days before beginning chemotherapy) prevented the lowering of platelets in the blood. This is a common complication of chemotherapy, known as thrombocytopenia that can lead to bleeding.
In another study of a small group of women whose breast cancer was not improving with tamoxifen (a commonly used chemotherapy medication), adding melatonin caused tumors to modestly shrink in over 28% of the women. People with breast cancer who are considering taking melatonin supplements should consult their doctors before beginning supplementation.
Prostate Cancer
Like breast cancer, studies show that people with prostate cancer have lower melatonin levels than men without the disease. Melatonin blocks the growth of prostate cancer cells in test tube studies. In one small-scale study, melatonin (when used in combination with conventional medical treatment) improved survival rates in 9 out of 14 patients with metastatic prostate cancer. Interestingly, since meditation may cause melatonin levels to rise it appears to be a valuable addition to the treatment of prostate cancer. More research is needed before doctors can make recommendations in this area.
Cancer-related Weight Loss
Weight loss and malnutrition are concerns for people with cancer. In one study of 100 people with advanced cancer, those who received melatonin supplements were less likely to lose weight than those who did not receive the supplements.
Rheumatoid Arthritis
Melatonin levels are lower in patients with rheumatoid arthritis than in healthy individuals without arthritis. However, when arthritis patients were treated with the anti-inflammatory medication indomethacin, melatonin levels returned to normal. The chemical structure of melatonin resembles indomethacin, so researchers suspect that melatonin supplements may work similarly to this medication for people with rheumatoid arthritis. However, this theory has not been tested.
Attention Deficit Hyperactivity Disorder (ADHD)
Although melatonin supplementation does not appear to improve the key behavioral symptoms of ADHD, it may be effective in managing sleep disturbances in children with this condition.
Heart Disease
Low blood levels of melatonin are associated with heart disease, but it is not clear whether melatonin levels are low in response to having heart disease or if low levels of melatonin cause people to develop this condition. In addition, several animal studies suggest that melatonin may protect the heart from the damaging effects of ischemia (decreased blood flow and oxygen that often leads to a heart attack). However, researchers are unclear whether melatonin supplements may help prevent or treat heart disease in people. More studies are needed before scientists can draw any conclusions.
Others Uses
• Sunburn -- A few small clinical studies suggest that gels, lotions, or ointments containing melatonin may protect against redness (erythema) and other skin damage when used alone or in combination with topical vitamin E prior to exposure to UV radiation from the sun.
• Epilepsy -- Preliminary clinical research suggests that melatonin reduces the number of seizures in certain animals and may reduce seizures in people with epilepsy. However, some researchers are concerned that melatonin (1 - 5 mg per day) may actually induce seizures, particularly in children with neurologic disorders. Since this research is in the early stages, some experts suggest that doctors should administer melatonin only to a select group of people who suffer from seizures that cannot be controlled by any other type of therapy.
• Sarcoidosis -- Some doctors use melatonin to help treat sarcoidosis (a condition where fibrous tissue develops in the lungs and other tissues). A few clinical studies suggest that melatonin may be helpful for those who do not improve from conventional steroid treatment.
• Schizophrenia -- Melatonin may be a useful short-term hypnotic for schizophrenic patients with insomnia. A clinical study found that melatonin significantly improved the quality and depth of nighttime sleep, reduced the number of nighttime awakenings, and increased the duration of sleep without producing a morning hangover. Melatonin also significantly reduced sleep-onset latency, heightened freshness on awakening, improved mood, and improved daytime functioning Melatonin may be a useful short-term hypnotic for schizophrenic patients with insomnia. Melatonin could be considered for patients in whom conventional hypnotic drug therapy or higher sedative antipsychotic drug doses may be problematic.
Melatonin also helps control the timing and release of female reproductive hormones. It helps determine when menstruation begins, the frequency and duration of menstrual cycles, and when menstruation ends (menopause). Many researchers also believe that melatonin levels are related to the aging process. For example, young children have the highest levels of nighttime melatonin. Researchers believe these levels diminish as we age. In fact, the decline in melatonin may explain why many older adults have disrupted sleep patterns and tend to go to bed and wake up earlier than when they were younger. However, emerging research calls this theory into question. In addition to its hormonal actions, melatonin has strong antioxidant effects. Preliminary evidence suggests that it may help strengthen the immune system.
If you are considering using melatonin supplements, talk to your doctor.
Uses:
Insomnia
Studies suggest that melatonin supplements may help induce sleep in people with disrupted circadian rhythms (such as those suffering from jet lag or poor vision or those who work the night shift) and those with low melatonin levels (such as some elderly and individuals with schizophrenia). A review of clinical studies suggests that melatonin supplements may help prevent jet lag, particularly in people who cross five or more time zones.
A few clinical studies suggest that when taken for short periods of time (days to weeks) melatonin is significantly more effective than a placebo, or “dummy pill,” in decreasing the amount of time required to fall asleep, increasing the number of sleeping hours, and boosting daytime alertness. Multiple human studies have measured the effects of melatonin supplements on sleep in healthy individuals. A wide range of doses has been used, often taken by mouth 30 - 60 minutes prior to sleep time. A study of 334 people aged 55 and older found that prolonged-release melatonin produced significant and clinically meaningful improvements in sleep quality, morning alertness, sleep onset latency, and quality of life in primary insomnia patients aged 55 years and over.
Osteoporosis
Melatonin has been shown to stimulate cells called osteoblasts that promote bone growth. Since melatonin levels may be lower in some older individuals such as postmenopausal women, current studies are investigating whether decreased melatonin levels contribute to the development of osteoporosis, and whether treatment with melatonin can help prevent this condition.
Menopause
Melatonin supplements may benefit menopausal women by promoting and sustaining sleep. Peri- or postmenopausal women who use melatonin supplements to regulate sleep patterns should do so only for a short period of time since long term effects are not known.
Depression
Clinical studies have found that melatonin may be useful in depression, especially associated with postmenopausal depression and anxiety. Other clinical studies show that people who suffer from major depression or panic disorder have low levels of melatonin. Healthy individuals with mild episodic depression and patients who have Seasonal Affective Disorder, (SAD -- a mild depression that correlates with fall and winter -- periods of light-phase shortening) also have lower than normal melatonin levels. Laboratory studies show that melatonin causes a surge in the chemical serotonin, which helps alleviate symptoms of depressive illness, including major and mild depression and SAD. Melatonin should be used with caution in people with depression and should be appropriately timed with light therapy and sleep-phase changes. Disruption of normal circadian rhythm by poorly timed melatonin administration may worsen depression. Melatonin use along with certain anti-depressant medications can pose potential health risks and should only be used under direct supervision of a qualified doctor.
Benzodiazepine Withdrawal
Some clinical research has found that melatonin may assist with tapering or cessation of benzodiazepines such as diazepam (Valium), alprazolam (Xanax), or lorazepam (Ativan). Sleep quality was improved in those stopping benzodiazepine use. Although preliminary results are promising, further study is needed.
High Blood Pressure
Several controlled studies in patients with high blood pressure report small reductions blood pressure when taking melatonin by mouth (orally) or inhaled through the nose (intranasally). Better-designed research is necessary before a firm conclusion can be reached.
Breast Cancer
Several studies indicate that melatonin levels may be linked with breast cancer risk. For example, women with breast cancer tend to have lower levels of melatonin than those without the disease. In addition, laboratory experiments have found that low levels of melatonin stimulate the growth of certain types of breast cancer cells, while adding melatonin to these cells inhibits their growth. Preliminary laboratory and clinical evidence also suggests that melatonin may enhance the effects of some chemotherapy drugs used to treat breast cancer. In a study that included a small number of women with breast cancer, melatonin (administered 7 days before beginning chemotherapy) prevented the lowering of platelets in the blood. This is a common complication of chemotherapy, known as thrombocytopenia that can lead to bleeding.
In another study of a small group of women whose breast cancer was not improving with tamoxifen (a commonly used chemotherapy medication), adding melatonin caused tumors to modestly shrink in over 28% of the women. People with breast cancer who are considering taking melatonin supplements should consult their doctors before beginning supplementation.
Prostate Cancer
Like breast cancer, studies show that people with prostate cancer have lower melatonin levels than men without the disease. Melatonin blocks the growth of prostate cancer cells in test tube studies. In one small-scale study, melatonin (when used in combination with conventional medical treatment) improved survival rates in 9 out of 14 patients with metastatic prostate cancer. Interestingly, since meditation may cause melatonin levels to rise it appears to be a valuable addition to the treatment of prostate cancer. More research is needed before doctors can make recommendations in this area.
Cancer-related Weight Loss
Weight loss and malnutrition are concerns for people with cancer. In one study of 100 people with advanced cancer, those who received melatonin supplements were less likely to lose weight than those who did not receive the supplements.
Rheumatoid Arthritis
Melatonin levels are lower in patients with rheumatoid arthritis than in healthy individuals without arthritis. However, when arthritis patients were treated with the anti-inflammatory medication indomethacin, melatonin levels returned to normal. The chemical structure of melatonin resembles indomethacin, so researchers suspect that melatonin supplements may work similarly to this medication for people with rheumatoid arthritis. However, this theory has not been tested.
Attention Deficit Hyperactivity Disorder (ADHD)
Although melatonin supplementation does not appear to improve the key behavioral symptoms of ADHD, it may be effective in managing sleep disturbances in children with this condition.
Heart Disease
Low blood levels of melatonin are associated with heart disease, but it is not clear whether melatonin levels are low in response to having heart disease or if low levels of melatonin cause people to develop this condition. In addition, several animal studies suggest that melatonin may protect the heart from the damaging effects of ischemia (decreased blood flow and oxygen that often leads to a heart attack). However, researchers are unclear whether melatonin supplements may help prevent or treat heart disease in people. More studies are needed before scientists can draw any conclusions.
Others Uses
• Sunburn -- A few small clinical studies suggest that gels, lotions, or ointments containing melatonin may protect against redness (erythema) and other skin damage when used alone or in combination with topical vitamin E prior to exposure to UV radiation from the sun.
• Epilepsy -- Preliminary clinical research suggests that melatonin reduces the number of seizures in certain animals and may reduce seizures in people with epilepsy. However, some researchers are concerned that melatonin (1 - 5 mg per day) may actually induce seizures, particularly in children with neurologic disorders. Since this research is in the early stages, some experts suggest that doctors should administer melatonin only to a select group of people who suffer from seizures that cannot be controlled by any other type of therapy.
• Sarcoidosis -- Some doctors use melatonin to help treat sarcoidosis (a condition where fibrous tissue develops in the lungs and other tissues). A few clinical studies suggest that melatonin may be helpful for those who do not improve from conventional steroid treatment.
• Schizophrenia -- Melatonin may be a useful short-term hypnotic for schizophrenic patients with insomnia. A clinical study found that melatonin significantly improved the quality and depth of nighttime sleep, reduced the number of nighttime awakenings, and increased the duration of sleep without producing a morning hangover. Melatonin also significantly reduced sleep-onset latency, heightened freshness on awakening, improved mood, and improved daytime functioning Melatonin may be a useful short-term hypnotic for schizophrenic patients with insomnia. Melatonin could be considered for patients in whom conventional hypnotic drug therapy or higher sedative antipsychotic drug doses may be problematic.