Melatonin: Should You Stop Taking It?

Introduction to Melatonin and Sleep Struggles

[00:00] You tired? Did you not get a good sleep? Actually my sleep was not bad last night despite being on call. So that interferes with sleep. But we're going to talk about melatonin, a supplement that you may or may not want to try to help you get to sleep if you have difficulty sleeping. Right, it's very very common. Lots of people are taking it and maybe not taking it the right way or for the right

What Is Melatonin and How It’s Produced in the Body

[00:20] reasons or maybe they're even taking too much. So speaking of things that help you fall asleep, welcome to Talking with Docs. I'm Dr. Paul Zalzell. Dr. Bradley. So today we're going to talk about the supplement melatonin. Right. So it's actually a hormone. It sure is. Right. But you can buy it. So melatonin is a hormone that's made in our pineal gland about

[00:40] 5% of it, but 95% is actually made at a subcellular level in our mitochondrion, the little energy factories that live inside of all of our cells. So it's a little gland in the brain and it produces the melatonin, which affects the cell receptors in the hypothalamus that regulate your circadian

[01:00] rhythm. Right, so that part of our body that tells us kind of day-night cycles as the seasons change and as you wake up and as you go to sleep. Which can be really messed up if you're a shift worker and you're trying to flip your body from that natural circadian rhythm of the day-night cycle. Right, and the way it's made actually your body takes tryptophan and then converts it to serotonin and that serotonin becomes melatonin.

[01:20] We've talked about tryptophan before in some of our other videos about the turkey myth and about serotonin's benefit. So yeah, they're all connected. Okay, so it is a hormone, right? And the hormone system is awesome. The hormone system is that system in your body that lets one organ that's far away from another organ communicate with each other, right? Underrated system. Everyone's all excited.

Melatonin as a Supplement vs Hormone – Regulation Concerns

[01:40] side with the nervous system and the musculoskeletal system, right? But the hormone system just is important. I agree with your call. And how its body parts communicate. It is quite amazing. Like carrier pigeons almost. A little bit, yeah. Okay, and then melatonin is one of those hormones. I'm a bit surprised actually that it's considered a supplement and not a drug because it does have quite a few effects. Agreed.

[02:00] And what kind of falls under the umbrella of the FDA is a little bit weird to be honest and seemingly arbitrary sometimes. Yeah, with all due respect to the FDA. Right. So let's start there actually with with respect to supplements. So the most important thing is that A, they're not regulated. So some studies into melatonin specifically have shown that B or A is not getting

[02:20] melatonin and B, the amount can really really vary anywhere from 0% of what they're claiming to I saw up to 400%. So the doses are very very erratic and so you have to be really really careful with supplements. And that also makes it very difficult to study. People have tried to do randomized controlled trials or meta-analyses or review analyses to see

Challenges in Research and Evidence Gaps

[02:40] What the evidence shows as to whether or not melatonin works. When you have such varied uses of melatonin, various preparations, the studies are very heterogeneous, therefore trying to draw conclusions from pooling the data can be very difficult. Right, and like we say in all of our videos, the lack of potential evidence for something's benefit does not mean it doesn't work.

[03:00] It just means it hasn't been studied properly and the results have not been kind of delineated yet So take everything we say with a little bit of a grain of salt today Okay, so we've talked about melatonin what it is how it works in your body. It's part of the hormone system. Yeah Does it work? Okay, and before we get there if you use melatonin if you've taken melatonin in the past leave a comment

[03:20] Let us know how much you take whether it worked or not if you had any side effects share it with other people because there are a lot of you. Yeah, it's very common. Have you tried it? I have not tried it. I have. Yeah, and? I think it helped. I don't know. I fell asleep before I could figure it out. Yeah. Okay, so the deal is in the literature it is

Who Might Benefit Most from Melatonin

[03:40] is very varied. Some articles say it doesn't work, some articles say it does. Now in some subpopulations, I think there is some evidence to support it. Okay, I'd say one. One subpopulation. Oh sorry, I know you're trying, sorry. Yeah, I'd say three I guess. Older individuals. Yes. Okay. And or older

[04:00] individuals with different conditions like cardiovascular disease, dementia, or Parkinson's. Because as we age we actually make less melatonin, so you are melatonin deficient. So like our other supplement videos, obviously if you're vitamin C or vitamin D deficient or melatonin deficient, you replace that, the function of melatonin and your bodily function is going to be improved. That makes sense to me. Right, and that

Timing, Dosage, and Formulation: What Studies Suggest

[04:20] There is some good evidence to support that. And then also there is some evidence to support the use of a sustained release preparation. So that's a preparation that you take that gradually releases a little bit of melatonin over time as opposed to the instant release much more common type of supplement you would take. There's some evidence

[04:40] to show that those work better than the instant release. Did they say why they thought that was? No. Interesting. This was a scoping review that I, one of the articles that I looked at. That and another article I found that said one of the differences between all the articles that they reviewed is the timing. Do you take it right before you go to sleep? Do you take it an hour before, two hours before?

[05:00] in addition to how many milligrams you take. And this one article, after looking at a bunch of articles, hypothesized that if you took four milligrams about three hours before you go to sleep, that's the ideal way to do it. That's not a randomized controlled trial. That's not proven by any means, but that was the conclusion of that review article.

[05:20] And that's interesting because they say that our body's melatonin starts about two hours before we go to sleep, especially this is one of the reasons why you should have a regular sleep kind of pattern or strategy because about two hours before that's when our body starts to make more melatonin to tell you that you're getting ready to go to sleep. And this is also why they say to dim the lights at this time, avoid

Effectiveness for Insomnia and General Use

[05:40] exposure to blue light which very specifically reduces or stops the production of melatonin and confuses your body. So they say yeah about two hours and the dosing is yeah certainly all off the charts. I read by a bunch of experts saying start really really low like even 0.2 milligrams but yeah I think it varies and that's the trouble with looking at the research. What about Joe or Jane average?

[06:00] So when you're treating insomnia, I would say the consensus appears to be that it is not a good treatment for insomnia, which is your ability to either fall asleep or to stay asleep. Some of the research shows that you can fall asleep slightly faster, but that this is not an appreciable benefit. And then it does not measure the quality of sleep.

[06:20] your sleep as well. So even if you do get to sleep, it doesn't show that melatonin puts you deeper or you get more REM sleep or more restful sleep. Right. Yeah. Now, if you are thinking of taking melatonin, there are some side effects that you should be aware of. Right. Okay. And they're quite a broad things, common things and obvious things that you might expect to, you know,

[06:40] tiredness in the day, feeling sleepy in the day. Especially if you take too much or the dose is not accurately controlled by that supplement company. Right. Nausea, dizziness. Those are things that you would expect. Some surprise side effects are that can interfere with some of your other medications, your blood thinners, your diabetes medication.

Side Effects, Drug Interactions, and Usage Caution

[07:00] anti-depressants as well. That goes in with the mood change. You can have mood changes on this stuff. So there are some significant side effects. So you really want to check with your primary care physician, your healthcare provider before you start taking it. Which it doesn't say in the store when you're going to buy these right beside your vitamin C

[07:20] and your vitamin D. But this is, in my opinion, more than just a supplement. Totally agree. I think it's like a drug. Okay, so you said maybe for the older folks who produce less, there's two other populations that I think you're going to get to that may benefit or there's reasonable evidence to say because their circadian rhythms are specifically disrupted,

[07:40] that this hormone would help you. Yeah, some have supported you some shift workers. Okay, imagine you're coming home at like one or two in the morning. So your body's like, what the heck? Or at seven in the morning after you shift and now you're trying to go to bed, fly it out, your body's very confused. So it can help reset that circadian rhythm. And for short term use to overcome jet lag.

[08:00] Yeah, they say if you go across more than five time zones, seems to be the threshold for where it works that obviously you leave in the morning and you get there and it's still in the morning if you're going certain directions. So that can help reset that for you. I never get adjusted. I just stay all wonky until I get home. That's probably because your trips are too short. Probably.

[08:20] to take longer vacations. And whenever you're using melatonin it should and this is pretty well I saw in most articles is short-term use this is not something you want to be using for months or years this is something you're considering using for days just to get your body reset. That's why the jet lag and

Use in Kids and Associated Concerns

[08:40] shift workers might benefit. And there are actually specific types of sleep disturbance that are specifically related to called N-phase sleep cycle disturbance. So they say that it's good for that group as well. What about for kids, Paul? Because during the pandemic and as anxieties increase in our society, generally a lot more kids are having trouble sleeping and a lot of parents are saying, I need my kid to get some sleep. I'm going to give them some

[09:00] What are the thoughts on kids taking melatonin? So I'm not a pediatrician. No. However, I don't even play one on TV. No. I do know that it is used a lot in the pediatric population, especially in children with ADHD and other activity disorders. It is used a

[09:20] lot. But it has never been studied. But I could not find a good randomized controlled trial showing it works in that population. I think it became used a lot in that population because it's over the counter supplement, it's not a prescription medication. The side effects aren't are fairly rare and you can get very

[09:40] doses. You can get small doses of this or large doses of this. I think that's why, even though there's never been a good study to show, hey, this should be used in the pediatric population. But the other concern is because melatonin has other functions. So when you take melatonin or when your body starts making more melatonin to go to sleep, it actually reduces your gastric acid secretion, it increases your lower esophageal tone to reduce

[10:00] reflux, it actually reduces your insulin production and also increases your growth hormone. So if you start taking supplements, this actually could lead to a reverse cycle where you actually make less growth hormone. So this is the concern with kids because so many other things are happening and they're still growing that it is certainly not recommended for children. On the flip side, it is considered an antioxidant as well. Yes, yeah.

How to Naturally Boost Melatonin Through Sleep Hygiene

[10:20] How can we boost your own memory?

[10:40] Is there any way to boost our own melatonin? That's sleep hygiene. This is your best bet. Sleep hygiene, I think we've made a video about this before about the things you can't be used to. We'll put a link to it. Start to relax, dim the lights, stop the noises, avoid the blue light. And then they say the morning sunlight for whatever reason because near-infrared spectrum light actually increases melatonin production.

[11:00] And you can get that at a time when the UVA and UVB radiation is lower. You don't have to go midday. So that morning sunlight is a way to reset. And it makes sense too. You wake up, your body sees the sunlight and says, OK, it's time to be awake. I got to get through my day before we had clocks and other things to tell us how much time is. So do you use a melatonin with the sunlight? Yes, sorry. It's good for you. I mean, to reset your circadian rhythm. Yeah, it helps your recess.

[11:20] But there are the triggers that do make your body make melatonin. The sunlight sort of suppresses it, dimming the lights, starting to relax, starting to calm down. That helps increase your melatonin, which can help you get to sleep. Or this video will put you to sleep. Now you know. If you like this video, please like it.

[11:40] to our channel. And remember, you are in charge of your own health. We'll see you next time.