I often suggest OTC melatonin supplements for my patients with insomnia issues or as a sleep aid for those who are traveling to different time zones. In my experience, the hormone is very effective most of the time.
Chemically known as N-acetyl-5-methoxytryptamine, melatonin fascinates me. New research suggests that the benefits of the supplement may extend beyond improving sleep.
Known for its powerful antioxidant properties, melatonin is secreted from the pineal gland. As we age, we secrete less of it. Some researchers believe this may be why we develop age-related diseases.
In murine studies, melatonin has been shown to increase the lifespan of mice by 20%. There have been no studies in humans, so there is no proof of claims that taking melatonin will increase your life span. This hasn’t kept advertisers from touting the possibility though, so beware.
Melatonin has also been shown to retard or stop the growth of cancer cells in the laboratory environment. Patients with certain kinds of cancers, in particular breast cancer and prostate cancer, have decreased amounts of melatonin in their blood, researchers have discovered.
In other cancer research, studies examining melatonin alone and administered with traditional treatments, including chemotherapy, radiation therapy, immunotherapy and hormone therapy, have yielded mixed results. Some findings suggest melatonin may increase survival and quality of life, but others have shown no benefit to patients.
I use melatonin in my practice for patients with mild insomnia. I have used it in patients with restless leg syndrome, periodic limb movements of sleep and REM sleep behavior disorder.
If patients are opposed to prescription medications, I often suggest melatonin. Occasionally, I have used it as an adjunct to other sleep medications to keep patients from becoming tolerant.
Most of the melatonin that you find in your local vitamin or drug store is probably safe, but because it is classified as a supplement, melatonin is not FDA approved. I remind my patients of this.
Strengths vary greatly from micrograms to more than 80 milligrams, but using the smallest dose possible is probably best, as the pineal gland naturally secretes only minute amounts each day. Keep in mind that melatonin is a hormone and high doses can affect other hormones.
Doses can be increased as needed, but I usually prescribe doses of no more than 6 mg to 10 mg at most. More often that not, I prescribe only 1 mg to 3 mg before bed. Some practitioners use more, but I’m not comfortable recommending higher amounts.
Doses in studies vary greatly from micrograms to 80 milligrams or more. Keep in mind that melatonin is a hormone, so high doses can affect other hormones.
Melatonin has also been used to help those with nicotine withdrawal, benzodiazepine withdrawal, cluster headaches, tardive dyskinesia and in patients with fibromyalgia. The list of health benefits continues to grow.
Increasing our natural release of melatonin is important and should be recommended before suggesting supplements. This means reminding patients to put away the computer, iPad, iPhone or other electronic device at least two hours before bedtime to allow the darkness to signal the pineal gland that it’s time for a great night of sleep.
I’ll update the blog with more information on melatonin, as I learn more about this powerful hormone.
Sharon M. O’Brien, MPAS, PA-C, is a practicing clinician with an interest is helping patients understand the importance of sleep hygiene and the impact of sleep on health.