It only comes out at night, often called the Vampire Hormone. Secreted by the pineal gland, mysterious in it’s own right. You can get carried away with all the mystical and esoteric metaphors tied to the pineal gland. Early scientists believed this gland to be the seat of the soul, our third eye. Can you guess which hormone I am referring too? Okay, one more clue, sure to give it away. It is one of the most commonly sold supplements used to help induce sleep.
Yes, melatonin is always listed as one of the top 5 remedies to help with insomnia. Even with all it’s popularity, I do not recommend taking it. There are many who have asked me about it, and I almost always recommend against it. We do not sell it our office. But I suspect many of these same individuals currently have a bottle in their cabinet and take it anyway. I get it; it’s touted as such a good sleep supplement on the internet! I have a very similar situation regarding fish oil supplements. We do not sell or promote omega 3 fish oils either. But that discuss is for another day.
Plus, I do not dispense or recommend nutrition based on a “good for” mentality. Trying to match a symptom to a remedy is a paint-by-number-nutritional-approach. You need a better way and fortunately there is a better way. I want to know (and you should too), the underlying metabolic, and or neurologic imbalance driving the conversation. Back to our sleep discussion.
Lately, I have had a few patients presenting with a sleep issue that we have not been able to effectively resolve. While digging deeper into the topic of insomnia, I revisited the clinical use of melatonin. Firstly, melatonin supplementation will in some individuals, help induce sleep. Which of course is why it is so popular. But unfortunately, there are many side effects that often happen without any suspicion from the user. They just know they are sleeping better and do not know that other nefarious metabolic changes are occurring. Here are a few.
Morning grogginess and decreased body temperature. You might say, “So what, I can just drink an extra cup of coffee and dress warmer….I need my sleep!” I guess that’s sort of an answer. But the grogginess is happening because certain brain receptors are becoming desensitized. Over time, as they become unresponsive, this leads to the development of a more insidious sleep issue. The decreased body temperature is due to thyroid function becoming depressed. In other words, melatonin can cause a functional hypothyroid.
Too much melatonin increases estrogen and prolactin levels which can cause anxiety and other symptoms too long to list. It can increase epinephrine which drives the flight and fight response, and causes insomnia and stress. Other known side effects are fatigue, exacerbation of migraines, and constipation. There are numerous other changes to our hormones and immune system directly related to melatonin abuse. Read the symptoms of hyperprolactinemia, it will concern you. So for me, it just seems too dangerous to use without some narrow clinical guidelines to wrangle in the risks.
Well, now I think there are some. I stumbled across a study published in the Journal of Clinical Endocrinology & Metabolism detailing the use of melatonin for insomnia. This study showed that dosages of 3 mg did improve sleep, but also significantly reduced body temperature. Also, it showed that melatonin supplementation as low as 0.1 mg also improved sleep but without the side effects. Apparently, the level of melatonin increases rapidly between the hours of 9 and 11 pm. If someone is deficient, then a dose as small as 0.2 to 1.0 is all that is needed.
So here are some guidelines for the safe and effective use of melatonin for sleep support. Start with 0.25 to 0.5 mg at bedtime. If you wake up in the middle of the night, try another 0.25 to 0.5 mg dosage. If you still have a problem going to sleep, then try 1.0 mg before bedtime. But that would be your maximum. If you still have a sleep problem, then it is being caused from some other issue other than a lack of melatonin.
I thought about what most health seeking individuals do when looking for a melatonin supplement. They go to Amazon. Convenient and 2 day shipping….a great business model for buying things. But I do not recommend using that model for addressing your health issues. What does the Amazon vendor know about your specific needs? What do they even know about health?? To prove my point, I went to Amazon and searched on melatonin. The first page had melatonin products for children and adults with dosages ranging from 3 to 12 mg per capsule. That's up to 100x over the physiological dosage!
Starting this week, I will have available in my office a melatonin supplement from a reputable manufacturer. It is a liposomal spray for faster absorption and the dosage per spray is 0.5 mg. I am suggesting you start with a ½ spray to deliver 0.25 mg. Just ask me about it.
There is much more to discuss on the issue of sleep. Autonomic nervous system imbalance, metabolic alkalosis, excess histamines, hypothyroid, low progesterone levels, excess free radicals, circadian rhythm out of sync…. and the number one reason is psychological in nature. Emotional distress, worry, and anxiety. But remember, psychological upheaval is often secondary to other metabolic patterns of imbalance.
I would go on, but I don’t want to put you to sleep.
PS. Or do I?
PSS. Next time.