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If You Are Using Melatonin for Sleep — Read This Before You Take It Again

If you are taking melatonin to help you sleep – STOP – and read this about potentially dangerous side effects!

A new study published in the Journal of the American Medical Association Dr. Jingen Li, Ph.D., of Beijing University of Chinese Medicine, has found that since 2018 Americans have been using melatonin as a sleep aid twice as much as in years previous and taking the supplement in more than the suggested dosage has a number of adverse side effects.

It is no secret that many more Americans are having trouble sleeping since the pandemic. And that means that many more are turning to melatonin to help get a needed good night’s sleep. Dr. Li’s study found that many are taking it in excessive amounts, probably because of the mistaken impression that being over-the-counter, it is harmless. 

The study evaluated adults who took melatonin at the recommended dosage of 5 milligrams per day (mg/d), as well as those who exceeded that dosage.

Although the overall use of melatonin in the US is still relatively low, the study does “document a significant many-fold increase in melatonin use in the past few years,” according to sleep specialist Rebecca Robbins, Ph.D., who is an instructor in the division of sleep medicine at Harvard Medical School, but was not involved in this study.

Dr. Robbins said that “Taking sleep aids has been linked to prospective studies with the development of dementia and early mortality. Melatonin is one such sleep aid.”

The study revealed that those who took melatonin in excessive amounts experienced several unpleasant side effects, including dizziness, stomach cramps, headaches, nausea, confusion or disorientation, depression, irritability, anxiety, low blood pressure, and tremors.

An older study that also appeared in JAMA suggested a link between mutations in the melatonin receptor sites and both insulin resistance and type 2 diabetes development. The study found that lower melatonin levels in the study participants may have been a precursor for type 2 diabetes. However, it could not establish direct causality.

When Dr. Richard Castriotta, a sleep medicine specialist at Keck Medicine of USC in Los Angeles, was asked what melatonin users should take away from Dr. Li’s study, he said, 

“Not much, except that the increasing use of melatonin, like any non-FDA-approved medication sold as a ‘nutritional supplement,’ increases the risk of untoward side effects from a ‘bad batch’ of unsupervised manufacture or extraction (e.g., L-tryptophan). In reality, low dose (1–3 mg) melatonin is safe and effective in certain circumstances in managing circadian rhythm disorders but is not a very good hypnotic.”

“In higher doses (6–12 mg),” Dr. Castriotta continued, it may be useful in REM behavior disorder and may play a role in cancer prevention/treatment.”

Currently, the Food and Drug Administration (FDA) does not regulate the manufacture of melatonin supplements. There is concern that the quantities of melatonin in OTC preparations may exceed what the label displays by up to 478%.

“This raises concerns about ‘overdoses,’ Dr. Castriotta said, “in other words flooding the body with levels that interfere with melatonin’s many important biological functions — and makes it hard to assess melatonin’s effect on sleep in a given patient, since the actual dose may vary substantially from tablet to tablet or at least bottle to bottle.”

But, it is not all bad news; evidence shows that melatonin has beneficial anti-inflammatory and antioxidant properties and may have other therapeutic potential. It is currently under investigation for its value in treating medical conditions unrelated to sleep.

The bottom line is, as with any medication or nutritional supplement, the responsibility rests with the consumer “to only use as directed.”

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