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Melatonin: May Help More Than Just Your Sleep
Wednesday November 07, 2012
Julie Chen M.D.
huffingtonpost.com - Most of you have heard of melatonin before, but it's likely that you usually only hear about it in regards to insomnia or sleep issues. What you may not know is that it seems to play a role in other health concerns we frequently hear about, including cancers, hypertension, Alzheimer's disease, and Parkinson's disease, just to name a few.
Melatonin is a compound in our body that helps to regulate sleep as well as other physiological rhythms in our body. It is secreted by the pineal gland and is a hormone that is affected by light. Light suppresses levels of melatonin, while darkness helps to trigger our body to secrete more of this compound. What's interesting about melatonin is that its levels start to wane as we age and certain medications seem to alter its levels in our body as well.
While the long-term side effects of frequently altering our natural melatonin secretion is not completely well understood, there is some concern that long-term alterations to normal secretion patterns can have other negative health effects. That is why sometimes you may hear from the medical community about concerns for night workers and their overall health.
Because melatonin has antioxidant effects in our body, there is growing interest in its benefits for patients with neurodegenerative diseases such as Parkinson's disease or Alzheimer's disease.[1-3] There is even growing interest in using melatonin for stroke patients and those with high blood pressure.[1-4]
Early studies suggest that there may be some benefit from melatonin use in patients with cancer. Some of these studies suggest that patients on melatonin had better response to chemotherapy in breast cancer patients, and some of the side effects and anxiety associated with therapy were somewhat mitigated -- more so in the melatonin users compared to those not on melatonin.[7-12]
There was a meta-analysis of randomized, controlled trials using melatonin as adjuvant therapy or alone for cancer patients, and researchers found that there was a 34 percent relative risk reduction in death in the melatonin user group.
Another study looked at patients who had advanced cancer in the breast, lung, gastrointestinal tract, head or neck. When given chemotherapy either alone or with 20 mg/day of melatonin, there was a reduction in side effects of low platelet count, fatigue, mouth sores, heart complications, and neurotoxicity in the melatonin group, and higher rate of survival.[7-9],
There is even some indication that melatonin may be helpful with migraines. There was a study that looked at migraine sufferers who were given 3mg of melatonin about 30 minutes before bedtime every night for three months. Of the patients who finished the study, two-thirds of the patients seemed to have a 50 percent reduction, and the severity and duration of migraines were less severe.
While these early studies suggest some exciting benefits from regular melatonin therapy, I want to caution you from going out and buying large quantities or dosages of melatonin without first running the idea by your physician. The fact is that these are early studies and that further studies are warranted to help us really get a better understanding of melatonin's comprehensive role in our health. For now, if you are interested in trying out melatonin, make sure to ask your physician about it and whether it is right or safe for you.
Once you have the go-ahead from your doctor, the general rule on dosing is that for those of you looking for help with sleep, a dosage of about 0.5-3mg at bedtime is what you would need for insomnia or sleep issues. You may consider 5-6mg for time zone changes or jetlag but for daily usage, the lower dosages are ideal at about 0.5-3mg at bedtime.
For those looking for help in more complicated health issues such as migraines or cancers, make sure you get clearance from your treating physician first and make sure to take it separately from your prescription medications once you have the clearance to take it. The dosages for these therapeutic goals are usually higher at around 5-20mg. If you would like to utilize higher dosages, my recommendation is to first consult your physician but also seek the guidance of an integrative physician or naturopathic doctor.
While these early studies are truly exciting and indicate a potential wide array of health benefits, I am just as excited as you are to see further studies that will help to clarify more of the intricacies of therapeutic indications as well as safety and side effect profiles above and beyond what we currently already know.
1. Suzen S. Recent developments of melatonin related antioxidant compounds. Comb Chem High Throughput Screen. 2006 Jul;9(6):409-19.
2. Cardinali DP, Furio AM, Reyes MP. Clinical perspectives for the use of melatonin as a chronobiotic and cytoprotective agent. Ann NY Acad Sci. 2005 Dec;1057:327-36.
3. Srinivasan V, Pandi-Perumal S, Cardinali D, Poeggeler B, Hardeland R. Melatonin in Alzheimer's disease and other neurodegenerative disorders. Behav Brain Funct. 2006;2(1):15.
4. Reiter RJ, Tan DX, Leon J, Kilic U, Kilic E. When melatonin gets on your nerves: its beneficial actions in experimental models of stroke. Exp Biol Med (Maywood.). 2005 Feb;230(2):104-17.
5. Scheer FA, Van Montfrans GA, van Someren EJ, Mairuhu G, Buijs RM. Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension. Hypertension. 2004 Feb;43(2):192-7.
6. Cagnacci A, Cannoletta M, Renzi A, et al. Prolonged melatonin administration decreases nocturnal blood pressure in women. Am J Hypertens. 2005 Dec;18(12 Pt 1):1614-8.
7. Lissoni P, Barni S, Meregalli S, et al. Modulation of cancer endocrine therapy by melatonin: a phase II study of tamoxifen plus melatonin in metastatic breast cancer patients progressing under tamoxifen alone. Br J Cancer.1995 Apr;71(4):854-6.
8. Cos S, Gonzalez A, Martinez-Campa C, et al. Estrogen-signaling pathway: a link between breast cancer and melatonin oncostatic actions. Cancer Detect Prev. 2006;30(2):118-28.
9. Sanchez-Barcelo EJ, Cos S, Mediavilla D, et al. Melatonin-estrogen interactions in breast cancer. J Pineal Res. 2005 May;38(4):217-22.
10. Sainz RM, Mayo JC, Tan DX, Leon J, Manchester L, Reiter RJ. Melatonin reduces prostate cancer cell growth leading to neuroendocrine differentiation via a receptor and PKA independent mechanism. Prostate. 2005 Apr 1;63(1):29-43.
11. Mills E, Wu P, Seely D, Guyatt G. Melatonin in the treatment of cancer: a systematic review of randomized controlled trials and meta-analysis. J Pineal Res. 2005 Nov;39(4):360-6.
12. Lissoni P, Barni S, Mandala M, et al. Decreased toxicity and increased efficacy of cancer chemotherapy using the pineal hormone melatonin in metastatic solid tumour patients with poor clinical status. Eur J Cancer. 1999 Nov;35(12):1688-92.
13. Peres MF, Zukerman E, da Cunha TF, Moreira FR, Cipolla-Neto J. Melatonin, 3 mg, is effective for migraine prevention. Neurology. 2004 Aug 24;63(4):757.
14. Drake MJ, Mills IW, Noble JG. Melatonin pharmacotherapy for nocturia in men with benign prostatic enlargement. J Urol. 2004 Mar;171(3):1199-202.
15. Brzezinski A, Vangel MG, Wurtman RJ, et al. Effects of exogenous melatonin on sleep: a meta-analysis. Sleep Med Rev. 2005 Feb;9(1):41-50.
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