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Melatonin
(MEL)

Sleep related problems? Before using over-the-counter or prescription medications, try melatonin first. It has a good safety record, it is not habit forming and is shown in many scientific studies to be effective.

Insomnia / Sleep Disorders / Jet Lag - We highly recommend trying melatonin first before using any prescription medications to help with sleeping problems. All the current research information points to significant benefits from using MEL with practically no major side effects, safety or toxicity issues. That is the bottom line.

Valerian is another alternative herb to try as well.

For the other uses - We appreciate the safety profile of this supplement. This natural remedy is very cost effective. For conditions like chronic fatigue syndrome and fibromyalgia, it is worthwhile to try it out to see if it works. We suggest using it for at least 4 weeks and perhaps up to 12 weeks.

Table of Contents

Facts and FAQ
Suggested Benefits and Traditional Uses
Side Effects, Toxicity and Warnings
Common Drug & Health Condition Interactions
Dosage & How to Take It

Evidence of Benefits (Leaf Rating System)

	Jet lag Many studies found that using MEL after the flight helps with adjustment to jet lag. Multiple studies strongly support this use although some studies do show that it does not help.
	Insomnia Taking this supplement reduced the time it takes people suffering from insomnia to fall asleep As well many of them reported improved quality of sleep. This supplement is an effective sleep aid. Another natural remedy that is also used to treat insomnia is valerian. Melatrol is an example of a product that contains this herb, valerian and several other ingredients used to treat insomnia.
	Shift work A recent well-designed clinical trial involving 86 shift-work nurses showed that taking 5 mg of MEL at night was effective in helping the workers fall asleep.
	Delayed sleep phase syndrome (DSPS) Studies show that taking melatonin improved insomnia, mental health, vitality and pain in people suffering from DSPS.
	Insomnia in health people Studies show that taking this supplement in healthy patients older than 55 years reported improvements in sleep quality, morning alertness and quality of life.
	Breast cancer Many studies seem to suggest that lower levels of MEL is somehow linked to increased risk for breast cancer. In lab studies, the supplement was able to slow down the growth of breast cancer cells. Combining MEL with standard chemotherapy was significantly better than just chemotherapy alone. It increased survival rate by 50% compared to just using the chemotherapy alone. If you plan to take melatonin for breast (or other) cancer conditions, you must discuss this option with your physician.
	Headaches In a well-designed study involving 20 patients with cluster headaches, taking MEL was able to reduce the number of attacks each week. The dosage used is 10 mg in the evening.
	Nicotine withdrawal A small study showed that taking a dose of 0.3 mg of MEL 3.5 hours after stopping nicotine helps to ease the symptoms of anxiety, irritability and craving for the next 10 hours.
	Sunburn / UV protection / Sunscreen A topically applied cream containing MEL showed that it can block the effect of sunlight exposure. Combining it with vitamin C and E enhanced its effect.
	Depression / Seasonal affective disorder (SAD) Studies show that this supplement may be helpful in reducing the symptoms of depression and anxiety. Studies show that people suffering from depression has lower than normal levels of melatonin. Lab studies show that this supplement can increase the serotonin levels which might explain why it might be helpful in treating depression.
	Attention deficit-hyperactivity disorder (ADHD) Studies seem to show some benefits in helping children suffering from ADHD to sleep better. However, taking this supplement did not improve their ADHD conditions.
	Chronic fatigue syndrome (CFS) Some studies show that taking 5 mg of this supplement in the evening for 12 weeks helps to reduce fatigue and increase concentration. However, another study did seem to show any significant benefits.
	Fibromyalgia A small study showed that this supplement can reduce pain in people suffering from fibromyalgia.
	Irritable bowel syndrome (IBS) Two studies seem to suggest that taking this supplement helped improve the sleep pattern, bloating, abdominal pain and overall quality of life of those suffering from IBS.
	Rheumatoid arthritis (RA) People suffering from rheumatoid arthritis have lower levels of MEL. The chemical structure of this supplement looks like the anti-inflammatory drug indomethacin and expert believe this is the reason why it seems to work to reduce pain.
	Prostate cancer Men with prostate cancer has lower levels of MEL. In lab studies, this supplement was able to slow the growth of prostate cancer cells. One study showed that combining this supplement with standard chemotherapy improved survival rate.
	Sexual activity enhancement / Enhance libido Anecdotal reports suggest that MEL enhances libido in men. A study in rats injected with MEL showed that all measures of sexual activities were significantly enhanced including ejaculations in otherwise impotent rats. Of course, studies will need to be conducted in clinical trials to see if applies to humans.
	High blood pressure (Hypertension) Several studies showed that taking this supplement resulted in a small drop in blood pressure. This may not be significant compared to taking blood pressure medications.
	Heart disease Some studies done in animals seem to show that MEL can protect the heart from damage. It seems that having a low blood level of MEL is related to heart disease. But experts do not know whether low MEL levels causes heart disease or that having heart disease causes low MEL levels.
	Menopausal symptoms Studies seem to show that taking MEL did not help with easing menopause symptoms. However, it may be helpful in treating women who are suffering from insomnia from their menopause symptoms.

Facts and FAQ about Melatonin

Sleep disorder affects up to 70 million Americans. That's about 20 percent of the U.S. population. Insomnia means the inability to sleep. This problem even affects up to 25% of children. When chronic insomnia occurs, it will lead to poor daytime function, lower performance and fatigue and drowsiness during the day. Hence the interest in melatonin use.

Melatonin is extensively studies both in animals such as rats, dogs and human. On the U.S. market is a prescription drug called Rozerem (ramelteon) that binds to receptors much like what melatonin does (except much stronger of course) to treat insomnia. Why not try the natural product first?

What is melatonin?

Also known as pineal hormone, it is a natural hormone produced by the pineal gland located in our brain. Through a series of chemical reactions in our body, tryptophan is converted to serotonin, which is then converted to MEL. Melatonin supplements can be extracted from the pineal glands of beef cattle or chemically made in the lab.

Very small amounts of MEL can be found in many plants including rice and bananas.

This hormone regulates the circadian rhythm. It determines when we fall asleep and wake up. Secretion starts around 9 PM and reaches the maximum between 2 AM and 4 AM. Melatonin seems to trigger the need to sleep.

By exposing ourselves to light, the pineal gland makes less MEL. Darkness, on the other hand, stimulates the gland to make more melatonin. As well, shift work, jet lag, excessive exposure to light sources and poor sleeping patterns and habits can affect the production of this hormone.

Other factors that can affect the melatonin levels in our body include other health conditions or problems such as fibromyalgia and depression. Indeed research studies even show that listening to therapeutic music will increase MEL levels in some people.

It is believed that as we age, our body makes less MEL. This could explain why older people experience more problems with insomnia.

Other functions that MEL serves in our body include growth hormone production, sexual development, regulation of the menstrual cycle, sexual activity and pain control. It also shows powerful antioxidant and immune regulating activities. Indeed, it is believed to be up to 10 times more potent than vitamin E as an antioxidant.

Can you stimulate your own melatonin production?

Yes indeed. Some experts suggest sleeping in a completely darken room or use a sleep mask to cover your eyes. Surprisingly (or perhaps not surprisingly), meditation is shown to increase the melatonin levels as well.

Does low levels of MEL affect or cause cancer?

Low levels of MEL might increase the risk of developing cancer. It is seen that people living in darker regions and the blind have a lower incidence of breast cancer. As well, research studies seem to suggest that MEL might even be able to treat and cure cancer. Of course, we'll need more clinical studies to prove this claim.

Suggested Benefits and Traditional Uses

Oral

Alzheimer's disease
anti-aging / aging prevention
antioxidant benefits
anxiety treatment
asthma
attention deficit hyperactivity disorder (ADHD)
brain cancer
cancer prevention
colitis
chronic fatigue syndrome (CFS)
contraception / pregnancy prevention
depression
enhancing sleep in healthy people
erectile dysfunction (ED)
epilepsy / seizure disorder
extending life / increasing longevity
fibromyalgia
headaches
heart disease
high blood pressure (hypertension)
HIV / AIDS
insomnia due to various health conditions
insomnia in the elderly
irritable bowel syndrome (IBS)
jet lag
libido enhancement
lung cancer
menopause
migraine headache
nicotine withdrawal
osteoporosis
Parkinson's disease
prostate cancer
rheumatoid arthritis
seasonal affective disorder (SAD)
sedation prior to surgery, procedure or MRI examination
sexual activity enhancement
shift-work related disorder
skin cancer
sleep aid
smoking cessation
stroke
tinnitus
trouble falling asleep (delayed sleep phase syndrome)
weight loss due to cancer
withdrawal from narcotic use

Topical (on the skin)

sunburn treatment
UV light protection / sunscreen

Side Effects, Toxicity and Warnings

Side effects that have been seen in research studies are very mild. The following side effects have been reported:

drowsiness during the day
dizziness
headache

However, these side effects are no more common than taking a placebo (sugar pill).

Other side effects reported include:

vivid dreams
tremor
anxiety
stomach cramps
irritability
depression
confusion
nausea and vomiting
lowered blood pressure (hypotension)

Because this supplement might cause drowsiness, avoid driving or using dangerous machinery for up to 5 hours after taking melatonin. Find out first how it affects you.

Overdose on this supplement may lead to significant increase in the reported side effects.

Probably Safe - In adults, this supplement has been shown to be safe. It has been used safely in research studies lasting up to nine months. There are no significant dangers of using this supplement.

May Be Unsafe - There are research studies done on using this supplement in a small number of children. Levels of MEL is higher in younger people and they may not or should not receive this supplement.

Always start with the lowest suggested dose and increase gradually. MEL should be given to kids only under the supervision of your healthcare practitioner.

Pregnancy and Lactation - Because of hormonal effects, pregnant or nursing women should avoid taking this supplement. High doses of this supplement may show contraceptive effects, thus preventing pregnancy.

Common Drug & Health Condition Interactions

Sleeping Pills / Benzodiazepines / Alcohol - caution

Since this supplement may cause drowsiness, combining it with prescription sleeping pills such as Ambien (zolpidem), Imovane (zopiclone) or benzodiazepines such as Ativan (lorazepam), Valium (diazepam) might increase drowsiness.

Avoid combining with alcohol, narcotics or other prescription or non-prescription products that are known to cause drowsiness. Ask your pharmacist or physician first if you are not sure.

Warfarin / Blood Thinning Medications - caution

There are reports of some bleeding seen in people combining MEL with blood thinning drugs such as Coumadin (warfarin), Plavix (clopidogrel), heparin and others.

Avoid using if possible to reduce the risks of bleeding and let your pharmacist and physician know that you are or are planning to take melatonin.

Epilepsy / Seizure Disorder - caution

There are reports of increased risk of seizure in children with epilepsy. Use melatonin with caution in this group of patients.

Sleep Apnea - caution

One small study conducted by Maksoud et al. (1997) showed that people suffering from sleep apnea did worst in their apnea index results when they were taking this supplement. The researchers suggest caution on using this supplement in this group of patients.

Dosage & How to Take It

MEL is available in tablets, capsules, cream and sublingual (under the tongue) tablets, timed released and lozenges. Current, there is no "normal" dosage that a person should take. Suggested typical doses are based on dosage used during research studies which ranges from 0.3 mg to 10 mg taken once daily. (Higher doses have been used for certain conditions.)

To avoid side effects, always start with a low dose and increase gradually until you get the benefits for your condition. Avoid taking too much as the side effects may increase as well.

Promoted as a sleep aid, some brands also include the herbal supplement valerian.

Insomnia

In research studies, dosage ranging from 0.3 to 5 mg taken at bedtime has been used.

Jet Lag - Eastbound flight

Consider taking a dose of 0.5 to 5 mg prior to flight during the early evening and then at bedtime for at least four more days.

Jet Lag - Westbound flight

Consider taking the supplement for four days at bedtime in the new time zone.

Unable or difficulty in falling asleep

Consider taking up to 5 mg of the supplement one to four hours prior to bedtime. Continue this for up to a month before making a decision to stop taking it because it does not seem to work.

Waiting up too early

Consider taking a higher dose right at bedtime or choose a long-acting or controlled-release formulation. Continue this for up to a month before making a decision to stop taking it because it does not seem to work.

Use in children (6 months to 14 years)

Doses of 2 to 5 mg has been used in some studies. However, there are reports of seizures caused by dosage from 1 to 5 mg.

Use with caution and under the supervision of your physician if your child has a history of seizure disorder.

Products to treat insomnia

Melatrol Sleep Aid

Valerian - Useful natural remedy for insomnia

What is Insomnia?

Negative Health Effects of Insomnia

Insomnia Tips - Lifestyle changes to prevent and treat insomnia

Home Remedies for Insomnia

Selected References for Melatonin
Revised: December 15, 2009

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Melatonin (MEL)