Top Five Reasons That I Prescribe Melatonin In My Integrative Medicine Practice  

in Supplements

Melatonin is a well known sleep supplement, and you may be wondering: “Should I take melatonin?” This article outlines the benefits of melatonin, drugs that deplete melatonin, how to dose melatonin, side effects of melatonin, and some safety notes about melatonin in special populations (pregnancy, breastfeeding, infants). 

Even though melatonin is extremely 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 in humans regulates not only sleep, but also 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 which 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 that I prescribe melatonin are related to these functions, but it also does so many more things in the body that we are still learning about!

Restore SleepReasons That I Prescribe Melatonin - Dr. Green Mom

Sleep is the most common reason that I prescribe melatonin. It isn’t useful in every insomnia case though. I find it most helpful for restoring circadian rhythms (after travel or holidays), for treating side effects of stimulant meds which may keep kids up, for insomnia after head injury, or when lifestyle, medication, or aging have resulted in low melatonin that results in difficulty getting to sleep.

Digestive Problems

There has been a lot of research into the use of melatonin for digestive concerns. It is helpful in reducing the pain associated with IBS and with helping improve sleep with people who have IBS. It can also be helpful as part of a treatment for reflux. 

Neuroinflammation

Melatonin is a strong anti-inflammatory and antioxidant for the brain. It is helpful for recovery from concussion and post concussion syndrome. I also sometimes encourage my patients who are at risk of head injury  (because of sports or occupation) to use melatonin preventatively through the sports season. There’s also evidence that melatonin can be helpful in other conditions that feature brain inflammation like depression, fibromyalgia  cluster headaches, and migraine

COVID-19 Treatment Support

Melatonin is getting 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, pregnant and breastfeeding mothers

 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.

Support Female Reproductive System

More and more is being learned 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.

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, 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 melatonin side effects could 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. Higher doses 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 the liquid melatonin is much faster acting. 

When melatonin is given long-term to children to counteract the effects of their medications, doctors often recommend taking a break from it at least once a year. Speak to your doctor about what is right for your family. 

I have a great tasting raspberry-vanilla liquid melatonin available in my shop.

Safety Notes About Melatonin In Special Populations Autoimmune disease, Pregnancy, Breastfeeding, and Young Babies 

Autoimmune disease: melatonin is used cautiously with autoimmune disease because it has a significant effect on the immune system. Meaning there is a theoretical 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 something more deeply nourishing. 

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. I have prescribed 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), for conditions related to the female reproductive tract, for gastrointestinal symptoms, for some types of headaches, for depression, and more. 

References:

Melatonin – Mayo Clinic

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