Many people are trying out melatonin supplements. Yet often are not getting the results they want, or are unsure exactly how to take it. There’s a science to taking melatonin – What dose? What time? What source? What formula? Knowing what to do for your own situation can be overwhelming. The last newsletter was all about our intrinsic melatonin rhythm. With that understanding, the next step is to understand exactly how melatonin works throughout the body. Then you can use those actions in a targeted way to support your personal health aims.
There are three general purposes to use melatonin supplements. The most commonly known, is using it as a hypnotic for sleep. The second purpose is as a ‘chronobiotic’ to shift the body clock for circadian rhythm disorders. Think jet lag, shift work, and people who are extreme night-owls or early birds. The third purpose is a broad category which includes all melatonin’s actions at the cellular level. This is a rich area of use, but yet is the least commonly known. Let’s dive into these three purposes, and explore a few of the many reasons
Melatonin as a Hypnotic
Hypnotic substances are ones that help us sleep. This is the purpose that often comes to mind first, yet there’s not a lot of research evidence for use. Taking 1mg to 3mg of melatonin within 30 minutes before bedtime is a well-established effective use for difficulty falling asleep at the beginning of the night. For sleep maintenance insomnia, using a time release formula may help. Here a person falls asleep easily at the beginning of the night, but wakes in the middle of the night. In this case, taking a time-release formula of 1 – 3mg right at bedtime is recommended. It will be active later in the night.
Chronobiotic Effects
The second way to use melatonin (which you probably haven't heard about) is to use it as a chronobiotic. A chronobiotic is a substance that signals to the body what time it is, just like our endogenous melatonin signals that it is night. Melatonin taken as a chronobiotic can actually shift your circadian phase somewhat. That’s the mechanism used for circadian rhythm disorders such as jet lag, shift work, delayed sleep wake phase and others. When using melatonin as a chronobiotic, it is taken away from bedtime, at a precise time to make the desired body clock shift. The right timing and dose is very exact, so it’s best to consult with a sleep specialist if you wish to use melatonin as a chronobiotic. Inexact use can produce the opposite effect, making you sleepy just when you don’t want to be, or causing a ‘paradoxical’ response. It’s likely because of it’s chronobiotic effect that melatonin taken for insomnia doesn’t get people the effect they wish.
Virtually the entire class of Circadian Rhythm Sleep-Wake Phase Disorders can benefit from melatonin supplements. Most of the research uses physiological dose of 0.5mg up to low pharmacologic doses of 3mg or at most 5mg. This would include:
- Delayed Sleep Wake Phase Disorder
- Advanced Sleep Wake Phase Disorder
- Jet Lag Disorder
- Shift Work Sleep Disorder
- Non-24-hour Sleep Wake Disorder
Indications for Other Sleep Disorders
There is a rare sleep disorder, REM Behavior Sleep Disorder (RBD), in which the normal REM sleep paralysis is not present. This means people act out their dreams, a danger to themselves and others. Melatonin has been helpful as part of a comprehensive treatment plan. RBD requires treatment by a sleep specialist, as it is a complicated disorder, which is associated with future development of Parkinson’s disease.
Melatonin Improves Cellular Health
The third way that melatonin supplements are used is for its’ actions at the cellular level. These mechanisms are very important and I anticipate are going to get a lot more attention over the next ten years or so. Exciting! As we discussed in the last newsletter, there is evidence that our melatonin levels are significantly suppressed by all the artificial light at night which we’re exposed to in our built environments. This may be part of the connection between the modern lifestyle and chronic disease.
Some of melatonin’s actions beyond sleep, beyond sleep and beyond circadian rhythms, include:
- It is one of the most powerful antioxidants. And we need antioxidants to help with anti-aging functions.
- It is a very powerful anti-inflammatory.
- It helps with our mitochondria, which is the powerhouse of the cell, creating our energy.
- It helps us keep strong bones. Many of these actions are important for longevity and anti-aging.
- It’s neuroprotective.
The medical research is actively investigating melatonin supplements as a treatment for a wide range of conditions, based on the above actions. Uses span from:
- central nervous system disorders such as migraines, autism and ADHD.
- immune conditions such as autoimmune disorders, and oxidative stress.
- cardiovascular diseases such as hypertension, metabolic syndrome, high cholesterol.
- reproductive disorders such as preeclampsia and PCOS.
- gastrointestinal disease such as ulcers and IBS.
- musculoskeletal disease osteopenia.
As ever, if you are interested in taking melatonin supplements, first consult with your licensed healthcare provider to learn if it’s right for you, and make sure there are no contra-indications for your use. You’ll also want professional advice to get the timing, dose, formula, and source right.
Stay tuned for the next Melatonin series when we’ll talk about all the considerations in choosing a melatonin supplement - dose, timing, formula, source and more.
Sleep well and dream big,
Dr. Catherine
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