Melatonin is a well known sleep supplement. You may be wondering: “Should I take melatonin?” This article outlines why I prescribe melatonin, including the benefits of melatonin, drugs that deplete melatonin, how to dose melatonin, side effects of melatonin, and some safety notes about melatonin in certain populations (autoimmune, pregnancy, breastfeeding, infants).
Even though melatonin is safe, it’s always a good idea to check with your physician before taking it or giving it to your child.
What is Melatonin?
Melatonin is an important hormone that not only regulates sleep but also regulates the gastrointestinal tract, inflammation, hormones, immune function, and more. In the body, it is created from serotonin, which in turn is created from 5-hydroxytryptophan (5-HTP). 5-HTP is a derivative of the amino acid tryptophan that is found in protein containing foods and supplements.
Top Reasons That I Prescribe Melatonin
Melatonin helps regulate the circadian clock, helps reduce inflammation, helps modulate the immune system, and is a potent antioxidant. The reasons why I prescribe melatonin are related to these functions, but melatonin does so many things in the body that we are still learning about!
1. Restore Sleep
Sleep is the most common reason why I prescribe melatonin. However, it isn’t useful in every insomnia case. I find it most helpful for restoring circadian rhythms (after travel or holidays), treating side effects of stimulant meds that keep kids awake, and insomnia after head injury as well as when lifestyle, medication, or aging have resulted in low melatonin levels that result in difficulty falling sleep.
2. Digestive Problems
There has been a lot of research done on the use of melatonin for digestive concerns. It is helpful in reducing the pain associated with IBS and improving sleep for those who have IBS. It can also be helpful as part of a treatment for reflux.
3. Neuroinflammation
Melatonin is a strong anti-inflammatory and antioxidant for the brain. It is helpful for recovery from concussion and post concussion syndrome. I sometimes encourage my patients who are at risk of head injury (due to sports or occupation) to take melatonin preventatively throughout the sports season. There’s evidence that melatonin can be helpful in other conditions that feature brain inflammation, like depression, fibromyalgia, cluster headaches, and migraines.
4. COVID-19 Treatment Support
Melatonin is receiving increased attention for its ability to improve immune function and treat infectious disease. Early research has indicated it to be an effective treatment for COVID-19 as an addition to other treatments. It is included in my sample COVID-19 treatment protocols for adults, kids, and pregnant or breastfeeding mothers.
5. Restore Melatonin Levels Depleted By Medication, Lifestyle, or Aging
Melatonin levels naturally decrease as we age. Melatonin levels may also be negatively affected by lifestyles that involve heavy screen use, chaotic sleep schedules, and less time outside. Certain medications (see below) are known to deplete melatonin.
6. Support Female Reproductive System
More information is being discovered about how melatonin supports the female reproductive system. Melatonin often plays a supporting role in treatment plans for both male and female fertility, endometriosis, and PMDD.
7. Treatment And Prevention Of Cancer
Melatonin can be used as an adjunctive therapy in the treatment and prevention of some types of cancer. Melatonin can also be used to help reduce the neurological side effects of chemotherapy.
What Drugs Deplete Melatonin?
Some classes of drugs are known to deplete melatonin. Simply taking one of these medications doesn’t mean that you automatically need to supplement with melatonin. Our bodies’ melatonin production can often keep up with the extra demand, especially with short term treatments. Additionally, some of these medications may interact with melatonin.
However, if you are having issues with sleep, digestion, or mood after starting one of these medications, it may be worthwhile discussing melatonin supplementation with your doctor.
- Topical, inhaled, and ingested corticosteroids, including Prednisone, Hydrocortisone, and Fluticasone
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), including Ibuprofen, Diclofenac, and Naproxen
- Selective Serotonin Reuptake Inhibitors (SSRIs), including Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil, Pexeva), and Sertraline (Zoloft)
- Beta Blockers, including Atenolol, Bisoprolol, Metoprolol, and Propranolol. These medications end in “ol”.
Melatonin Drug Interactions
Melatonin may interact with certain types of drugs. Melatonin can cause excessive drowsiness if taken with sedatives or hormonal contraceptives. Melatonin can increase the risk of bleeding if taken with other blood thinning drugs or supplements. Melatonin might decrease the effects of seizure medications, blood pressure drugs, or immunosuppressive therapies. Melatonin might change the requirements for diabetes medications. Melatonin can interfere with the liver clearance of certain drugs.
Melatonin Side Effects
Melatonin rarely has side effects. The most common side effects are headaches, dizziness, nausea, and drowsiness. Other possible melatonin side effects include: mood changes, reduced alertness, confusion, disorientation, mild tremor, and stomach cramps.
Melatonin Dosing In Kids and Adults
Melatonin is usually given in doses of 0.5-5 mg in children and in doses of 3-10 mg in adults. Dosing for certain conditions can be much higher. More melatonin isn’t always better, especially when it comes to sleep. Taking a higher dose than needed can cause rebound wakefulness (around 2- 3 am) and vivid dreams or nightmares.
Melatonin is usually given before bed because it can cause drowsiness. 90 minutes before bed is considered the best time to give melatonin, but some people find that liquid melatonin is faster acting.
When melatonin is given long-term to children to counteract the effects of medications, doctors often recommend taking a break at least once a year. Speak to your doctor about what is right for your family.
Safety Notes About Melatonin In Certain Populations: Autoimmune disease, Pregnancy, Breastfeeding, and Infants
Autoimmune Disease
Melatonin is used cautiously with autoimmune disease because it has a significant effect on the immune system. There is a possibility that it could contribute to a flare-up. That hasn’t been my clinical experience, but it is worth keeping in mind.
Pregnancy And Breastfeeding
Melatonin is considered safe in pregnancy and breastfeeding. A recent review of 15 studies found no significant adverse or safety concerns when pregnant and lactating women took melatonin. However, it would usually not be my first choice of therapy for pregnant or breastfeeding mothers. Usually women who are pregnant or lactating need a more nourishing supplement.
Co-sleeping
Melatonin could decrease parents’ responsiveness during sleep, which could make co-sleeping less safe.
Young Infants
Melatonin should be avoided if possible in young infants who are developing their sleep-wake cycles. However, there are times when melatonin is an appropriate therapy if prescribed by a doctor.
Summary
Melatonin is a naturally occurring hormone that has many important functions in the body. Melatonin can be used to restore sleep-wake cycles and reduce neuroinflammation. Melatonin can also be used as part of a treatment plan for infectious disease (including COVID-19), conditions related to the female reproductive tract, gastrointestinal symptoms, some types of headaches, depression, and more.
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