Clinical Evaluation Of The Patient
No definitive guidelines have been formulated for clinical evaluation of patients with low melatonin levels, in large part because a melatonin deficiency syndrome has not yet been defined as an independent entity. The secretion of melatonin is usually detected by analyzing the serum or salivary levels. The salivary levels are considered equivalent to serum levels except in the elderly or in patients with dry mouth. In the first situation, the validity, and in the second situation, the feasibility of salivary melatonin levels are compromised. If the treating physician suspects that melatonin deficiency may be responsible for a patient’s symptoms, it is tempting to consider the possibility of exogenous administration of melatonin. However, we must await more substantive clinical evidence before any precise recommendations can be made.
Can Support Better Sleep
Melatonin is often called the sleep hormone and for good reason.
Its one of the most popular sleep aids and a common natural remedy to treat issues like insomnia.
Multiple studies have demonstrated that melatonin can support better sleep.
One study in 50 people with insomnia showed that taking melatonin two hours before bed helped people fall asleep faster and enhanced overall sleep quality .
Another large analysis of 19 studies in children and adults with sleep disorders found that melatonin reduced the amount of time it took to fall asleep, increased total sleep time and improved sleep quality .
However, though melatonin is associated with fewer side effects than other sleep medications, it may be less effective .
Studies show that melatonin can lengthen total sleep time, shorten the amount of time it takes to fall asleep and enhance sleep quality in children and adults.
This type of depression is related to changes in the seasons and occurs each year around the same time, with symptoms typically appearing in late fall to early winter.
Some research indicates that it could be linked to changes in your circadian rhythm caused by seasonal light changes .
Because melatonin plays a role in regulating circadian rhythm, low doses are often used to decrease symptoms of seasonal depression.
However, other research is still inconclusive on the effects of melatonin on seasonal depression.
Scientists Pinpoint Dosage Of Melatonin For Insomnia
MIT researchers reported in the October issue of the Journal of Clinical Endocrinology & Metabolism that doses of melatonin, a pineal hormone that is secreted by humans at night, can help older adult insomniacs obtain a good night’s sleep.
During the study, Richard Wurtman, the Cecil H. Green Distinguished Professor and program director of the Clinical Research Center, and other MIT researchers examined the ability of similar doses to restore nighttime melatonin levels and sleep efficiency in adults over age 50.
Two groups of subjects were involved in the study–one group who slept normally and another who experienced insomnia. Each subject received one-week doses of either a placebo or three different doses of melatonin in randomized order. Each different treatment was separated by a one-week “wash-out period.”
“According to our research, the physiological dose of melatonin of about 0.3 milligrams restores sleep in adults over the age of 50,” said Wurtman, lead investigator in the study. “The adults who would normally wake up during the second and third thirds of the night were able to sleep through the night with the 0.3 milligram dosage.”
The MIT scientists, who included Irina Zhdanova, former principal research scientist in the Department of Brain and Cognitive Sciences, also showed that low doses of melatonin affect sleep in young individuals and can help children with a debilitating neurological disorder called Angelman syndrome to sleep though the night.
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How Much Melatonin Is Too Much
Taken on a short-term basis, melatonin has very few side effects and when they do appear, they tend to be mild. Research shows that some side effects of taking melatonin can include headache, dizziness, nausea, and sleepiness.3 The possible long-term side effects of melatonin use are unclear.3
Depending on the dosage, supplements can elevate the melatonin levels in the blood much higher than the body normally produces. For instance, dosages between 1-10 mg can increase plasma melatonin levels from 3 to 60 times their typical peaked levels7. Exceedingly high levels of melatonin might also contribute to fatigue, headaches, and might even affect human reproduction.5 Therefore, proceed with caution before opting for a higher-dose supplement and be sure to speak to your healthcare professional about your sleep issue.
Of course, if youre pregnant or nursing, you should definitely consult your physician before taking melatonin. Keep in mind that, like all supplements, melatonin might interact with certain medications, such as antidepressants, blood pressure or blood thinning medicines so best to check with your doctor or pharmacist before taking melatonin if you are taking prescription medications. In older adults, melatonin may remain active in their bodies longer than it does in younger people and also may cause daytime lethargy.3 Finally, the 2017 guidelines by the American Academy of Sleep Medicine recommend avoiding the use of melatonin in older people with dementia.
Risks Of Taking Other Drugs With Melatonin
Taking melatonin in any amount can be dangerous if you are also taking certain other medications. Unfortunately, this includes medications that can also make it difficult to sleep. People who use blood pressure drugs, for example, may have a lower amount of naturally occurring melatonin. However, taking melatonin can cause blood pressure spikes, which could be incredibly dangerous.
On the other end of the spectrum, birth control pills can lead to elevated melatonin production. Taking a supplement could push your concentration into dangerous territory. Individuals using anticoagulants may see an increased risk of bleeding if they also use melatonin. Those on corticosteroids should also avoid the supplement. It also isnt wise to take melatonin in conjunction with caffeine or alcohol. Both of those substances impact circadian rhythms and natural melatonin production.
Can I Take Melatonin Every Night
Melatonin is generally safe for short-term use, but further research is required to assess the long-term safety of melatonin use. In the United States, melatonin is considered a dietary supplement, which are regulated less strictly by the Food and Drug Administration than prescriptions and over-the-counter medications. Federal law doesn’t require dietary supplements to be proven safe to FDA’s standards before they are sold.
Furthermore, some melatonin supplements may not contain what is listed on the product label. Researchers tested 31 commercial supplements and found that most products contained far more or far less melatonin than what was listed on the label. Some supplements contained serotonin, a hormone that wasn’t recognized on the product label.
Although melatonin is generally regarded as well-tolerated, it may not be ideal for long-term use, unless specifically instructed by your doctor. Supplemental melatonin shifts the phase of the human circadian clock, and thus warrants caution. The principle of treatment of sleep disorders is first to find the cause of the sleep disturbance, and then treat the conditions causing the distress.
Treatment options for primary sleep disorders, or sleep disorders that aren’t caused by another medical or psychological condition, often include behavioral therapies. Sleep hygiene, sleep restriction, stimulus control, relaxation training, and cognitive therapy are examples of such therapies.
Does Food Contain Melatonin
A study published in Food and Nutrition Research notes that certain food products do contain various amounts of melatonin as measured by immunological and chromatographic laboratory techniques. How consumption of these various foods might affect endogenous production sleep or was not evaluated:
- Wine, beer
- Cows milk
Research finds that melatonin synthesis depends upon availability of the essential amino acid tryptophan, a needed component of the diet. If intake of tryptophan is severely restricted, synthesis of melatonin is significantly reduced in humans.
In the Nurses Health Study, no link was found between the consumption of various nutrients, such as folate, vitamin B6 and zinc and increased urinary excretion.
Diets rich in vegetables, fruits and grain products will contain considerable levels of dietary melatonin. The overall effect of dietary consumption on nighttime levels of melatonin is very limited. Melatonin production is primarily driven by the effects of light and darkness and by age, declining as we get older.
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Melatonin Dose For Adults
The right melatonin dose for adults ranges between .03 and 12 milligrams. As an important rule of thumb, remember that its always best to start with a smaller melatonin dose and increase as needed. Thats the best way to find the right dosage for your needs.
|0.5 to 8 mg at bedtime, on the day of arrival||Continue for 2 to 5 days|
If youre struggling with insomnia, consider starting with a melatonin dose of up to 3 milligrams. Use that melatonin dosage for 3 days, and then increase to between 56 milligrams if youre still not getting the desired results.
If youre taking insomnia for jet lag, start with a melatonin dose of up to 5 milligrams. Use melatonin the first night after you arrive at your destination. Or, if you know you suffer from jet lag, consider starting with a melatonin dosage 2 days before departure.
A melatonin dose of anywhere between 2 and 12 milligrams is appropriate for disrupted sleep cycles. Just make sure to discontinue taking melatonin after 4 weeks. If your disrupted sleep cycles persist and melatonin does not help within 4 weeks, consult a physician.
Finally, start with a melatonin dosage of 2 or 3 milligrams if youre struggling with long-term sleeping difficulty. Again, use for up to 4 weeks before consulting a doctor.
Toxicology And Potential For Harm
The acute toxicity of melatonin as seen in both animal and human studies is extremely low. Melatonin may cause minor adverse effects, such as headache, insomnia, rash, upset stomach, and nightmares. In animals, an LD50 could not be established. Even 800 mg/kg bodyweight was not lethal. Studies of human subjects given varying doses of melatonin for 3045 days, and followed with an elaborate battery of biochemical tests to detect potential toxicity, have concluded that, aside from drowsiness, all findings were normal at the end of the test period.
Animal studies suggest that melatonin can downregulate the pituitary/gonadal axis resulting in hypogonadism and/or delayed puberty. However chronic administration of low-dose melatonin in men did not alter blood levels of testosterone or luteinizing hormone. One case of extremely high melatonin levels associated with delayed puberty and hypogonadism has been reported. Pubertal development and resolution of the hypogonadism occurred spontaneously as melatonin levels declined over several years. Recent experimental evidence demonstrates that melatonin reduces sperm motility and that long-term administration inhibits testicular aromatase levels.
Preliminary animal studies suggest that melatonin may accelerate the development of autoimmune conditions. Melatonin transiently exacerbated neurologic symptoms in 1 patient with multiple sclerosis.
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What Is The Best Dose Of Melatonin
05/21/2021 | 10 min. read
Healthy Directions Staff Editor
Melatonin is widely used in order to improve sleep quality, and may help people who have a hard time falling asleep or even staying in bed.
If you are considering using melatonin supplements to improve your quality of rest due to sleep disturbances, melatonin may be an effective way to help you get a good nights rest.
But before you take melatonin supplements, there are a few things to help you get the most of it.
Melatonin is a hormone that gets produced by your brain in response to darkness, and it works to help with your sleep and circadian rhythm, which is basically your internal clock.
Because melatonin is produced when your body recognizes that your surroundings are dark, being exposed to lights at nighttime can interfere with your melatonin production and thus may also interfere with your ability to get a good nights rest.
Melatonin supplements are not an automatic fix — it is important to ensure your bedtime behaviors are conducive to melatonin production so that your supplements can properly do their job.
What Are Melatonins Side Effects On Kids
Potential, though mild, side effects of melatonin use in children include agitation, headache, dizziness and drowsiness. While it is not known for sure and more research on the long term use of melatonin in children is needed, its important to remember that melatonin is a hormone, and, as such, there is a possibility that it may affect hormonal development, including puberty and menstrual cycles.2
The Bottom Line
If your child occasionally has trouble falling asleep, instilling better sleep habits and routines might be in order. But if your child experiences significant difficulty falling asleep, melatonin might benefit, especially when its used in combination with behavioral interventions and healthy sleep practices.5
Most importantly, talk with your childs pediatrician before giving them melatonin to make sure its right for them, to understand the proper dosage, and to rule out any underlying health issues.
This information is only for educational purposes and is not medical advice or intended as a recommendation of any specific products. Consult your health care provider for more information.
1 Mayo Clinic. Melatonin. March 30, 2018. Accessed on: September 23, 2020.
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How To Get The Best Results
Light is the switch that controls when your brain makes melatonin. When you take a supplement, take care that you donât disrupt its effects with artificial light:
- Avoid your phone and other tech devices that shine brightly in the hours before bed.
- Turn off overhead lights in the evening.
- Bright light in the morning can signal itâs time to wake up.
Mg Or 5 Mg Melatonin: Which Remfresh Dose Is Right For You
If youre sick of counting sheep to fall asleep, it may be time to consider a high-quality melatonin sleep aid like REMfresh. Developed to mimic your bodys natural production of the sleep-inducing hormone, REMfresh is the only product delivering 99% ultra-pure melatonin for up to 7 hours. Ideal for individuals struggling with occasional sleeplessness or disrupted sleep schedules, a melatonin sleep aid like REMfresh may not only help you fall asleep and stay asleep, but it can also help you wake up feeling refreshed with no drug hangover.
If youre ready to improve your overall sleep quality with REMfresh, your first question is probably how much should I take? Available in 2 mg and 5 mgs formulations, the correct melatonin dosage depends on your individual sleep problems and needs.
Finding the Right Dose of Melatonin
Before you jump to purchase the highest dose of REMfresh melatonin available, you should be sure that youre taking the right amount to treat your personal sleep issues. Everyone is different and what works for a relative or friend, may not have the same results for you.
REMfresh Senior Medical Advisor, Otolaryngologist and Sleep Medicine Specialist, David Brodner, M.D., explains how to find the right dose of REMfresh melatonin for your specific needs and what else you can do to improve your quality of sleep.
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Learn More About Melatonin
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How Much Melatonin Is Safe For Kids The Proper Dosage For Your Child
Quick Health Scoop
- Melatonin is a hormone that the body naturally produces.
- Melatonin helps regulate your circadian rhythmyour internal clock that regulates the sleep/wake cycle.
- Melatonin is a 100% drug-free sleep supplement and can help you fall asleep faster and may help you stay asleep longer.
- The proper melatonin dosage depends on your age and specific sleep issue.
When your childs bedtime hits, you might dim the lights, read a book, give a big hug and say goodnightall cues that its time for your little one to fall asleep. But what if they struggle to fall asleep? You might be considering giving them melatonin, a 100% drug-free sleep aid. After all, plenty of adults turn to melatonin supplements to help normalize their sleep. If you are considering this for your little one, you are likely wondering, is melatonin safe for kids? If so, whats the right melatonin dosage for children? Should they take the same melatonin sleep aid made for adults, or is there a children’s melatonin?
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Do Electronic Devices Alter Melatonin Levels
Light at night blocks the production of melatonin, and this has been shown to cause sleep disturbances in people who use electronics that emit light at night. Researchers have found that light from electronic devices can block the release of natural hormone melatonin at night. The effect was most significant for younger children, with nighttime levels reduced by up to 37 percent in certain cases. This can also be problematic for children between ages 9 and 16.
Studies show that light after dark lowers melatonin levels which may lead to difficulty in initiating sleep. Electronic light-emitting devices such as the television, laptops, smartphones and tablets often find their way into the bedroom at night, or are used after dark. Children should not have electronics, including TVs, in their bedroom at bedtime and everyone should avoid use of light-emitting devices and screen time at least one hour before bedtime.
What Are The Symptoms Of A Melatonin Overdose
It is important to note that just because a supplement is unlikely to be lethal, that does not mean that unwanted or troubling side effects cannot occur. Concerning symptoms have been reported with higher doses of melatonin.
Possible symptoms of too much melatonin include:
Because melatonin can affect the cardiovascular, dermatologic, and central nervous systems, those with other conditions may be vulnerable to additional risks. Evidence suggests that melatonin supplementation may induce depression, particularly in people predisposed to or currently experiencing this malady. Research on this topic, however, is conflicting, since some studies have demonstrated the potential for melatonin to treat depression.
People taking blood thinners, like warfarin, and benzodiazepines should be careful, as there is a possibility for interaction. Those with epilepsy should also exercise caution, as melatonin has been associated with increased seizures.
Research suggests that elderly people, who have lower natural levels of melatonin, may be more sensitive to the effects of melatonin supplements. Therefore, older people are encouraged to check with their doctor before taking melatonin and start with the lowest possible dose.
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