This hormone is manufactured
from serotonin and involves synchronization
of hormonal secretions relating to our
sleep-wake cycles. It is stimulated by
darkness and suppressed by light. This
supplement can be beneficial for those
who suffer from insomnia, a common complaint
of those who suffer from fibromyalgia.
Melatonin
and Fibromyalgia
Preliminary evidence indicates that melatonin, a
molecule that is endogenously produced, may be effective
in treating the pain associated with fibromyalgia.
Although melatonin is commonly known as a sleep aid
(sleep/wake problems are common in fibromyalgia sufferers),
it has a variety of other beneficial effects that
may account for its potential benefits in the treatment
of fibromyalgia.
Note: Melatonin should not be used for long term
supplementation. Those who suffer from depression
and are taking certain prescription medication are
advised against taking melatonin.
Melatonin and Insomnia
Although results are still controversial, studies
suggest that melatonin supplements help induce sleep
in people with disrupted circadian rhythms, such as
those suffering from fibromyalgia, jet lag, poor vision,
and those with low melatonin levels. In fact, a few
studies suggest that when taken for short periods
of time (days to weeks) melatonin is significantly
more effective than a placebo, or “dummy pill,”
in decreasing the amount of time required to fall
asleep, increasing the number of sleeping hours, and
boosting daytime alertness.
In addition, at least one study suggests that melatonin
may improve the quality of life in people who suffer
from insomnia, a common symptom of fibromyalgia sufferers.
Although research suggests that melatonin may be modestly
effective for treating certain types of insomnia,
few studies have investigated whether melatonin supplements
are safe and effective for long term use.
Melatonin, Anxiety, and Depression
Those with fibromyalgia are very familiar with the
anxiety and depression that can accompany this condition.
A recent study of postmenopausal women, who commonly
have fibromyalgia symptoms, found that melatonin alleviated
both depression and anxiety.
Additionally, other studies have shown that people
who suffer from major depression or panic disorder
have low levels of melatonin. Healthy individuals
with mild episodic depression and patients who have
Seasonal Affective Disorder, (SAD -- a mild depression
that correlates with fall and winter -- periods of
light-phase shortening) also have lower than normal
melatonin levels.
Furthermore, experimental studies show that melatonin
causes a surge in the chemical serotonin, which helps
alleviate symptoms of depressive illness, including
major and mild depression and SAD. Melatonin should
be used with caution in people with depression and
should be appropriately timed with light therapy and
sleep-phase changes. Disruption of normal circadian
rhythm by poorly timed melatonin administration may
worsen depression.
Possible Interactions
If you are currently being treated with any of the
following medications, you should not use melatonin
without first discussing it with your doctor.
Antidepressant Medications
In an animal study, melatonin supplements reduced
the antidepressant effects of desipramine and fluoxetine.
More research is needed to determine whether these
effects would occur in people. In addition, fluoxetine
(a member of a class of drugs called selective serotonin
reuptake inhibitors or SSRIs) has led to measurable
depletion of melatonin in people.
Antipsychotic Medications
A common side effect of antipsychotic medications
used to treat schizophrenia is a condition called
tardive dyskinesia, a movement disorder of the mouth
characterized by a constant chewing motion and darting
action of the tongue. In a study of 22 people with
schizophrenia and tardive dyskinesia caused by antipsychotic
medications, those who took melatonin supplements
had significantly reduced mouth movements compared
to those who did not take the supplements.
Benzodiazepines
The combination of melatonin and triazolam (a benzodiazepine
medication used to treat anxiety and sleep disorders)
improved sleep quality in one study. In addition,
there have been a few reports suggesting that melatonin
supplements may help individuals stop using long-term
benzodiazepine therapy. (Benzodiazepines are highly
addictive.)
Blood Pressure Medications
Melatonin may reduce the effectiveness of blood pressure
medications like methoxamine and clonidine. In addition,
medications in a class called calcium channel blockers
(such as nifedipine, verapamil, diltiazem, amlodipine,
nimodipine, felodipine, nisoldipine, and bepridil)
may decrease melatonin levels.
Use of Beta-Blockers (another class of high
blood pressure medications including propranolol,
acebutolol, atenolol, labetolol, metoprolol, pindolol,
nadolol, sotalol, and timolol) may reduce melatonin
production in the body.
Blood-Thinning Medications, Anticoagulants
Melatonin may increase the risk of bleeding from anticoagulant
medications such as warfarin.
Interleukin-2
In one study of 80 cancer patients, use of melatonin
in conjunction with interleukin-2 led to more tumor
regression and better survival rates than treatment
with interleukin-2 alone.
Nonsteroidal Anti-inflammatory
Drugs (NSAIDs)
NSAIDs such as ibuprofen may reduce the levels of
melatonin in the blood.
Steroids and Immunosuppressant
Medications
People should not take melatonin with corticosteroids
or other medications used to suppress the immune system
because the supplement may cause them to be ineffective.
Tamoxifen
Preliminary research suggests that the combination
of tamoxifen (a chemotherapy drug) and melatonin may
benefit certain patients with breast and other cancers.
More research is needed to confirm these results.
The Benefits of Melatonin
Melatonin is a neurohormone that is naturally produced
in humans by the pineal gland, a cone shaped structure
in the brain. It is a favorite of travelers, as it
governs the body's circadian rhythms, helping to regulate
our sleep cycles. Melatonin is also a potent antioxidant.
This sublingual form is absorbed directly into the
bloodstream, via the blood vessels under the tongue
and in the cheeks, bypassing the liver and allowing
for quick entry into the system.
How It Works
Melatonin is secreted by the pineal gland in the
brain that helps regulate other hormones and maintains
the body's circadian rhythm, as mentioned above. The
circadian rhythm is an internal 24-hour time-keeping
system that plays a critical role in determining when
we fall asleep and when we wake up. Darkness stimulates
the production of melatonin while light suppresses
its activity. Exposure to excessive light in the evening
or too little light during the day can disrupt the
body’s normal melatonin cycles. For example,
jet lag, shift work, and poor vision can disrupt melatonin
cycles. In addition, some experts claim that exposure
to low-frequency electromagnetic fields (common in
household appliances) may disrupt normal cycles and
production of melatonin.
Melatonin also helps control the timing and release
of female reproductive hormones. It helps determine
when menstruation begins, the frequency and duration
of menstrual cycles, and when menstruation ends (menopause).
Many researchers also believe that melatonin levels
are related to the aging process. For example, young
children have the highest levels of nighttime melatonin.
Researchers believe these levels diminish as we age.
In fact, the decline in melatonin may explain why
many older adults have disrupted sleep patterns and
tend to go to bed and wake up earlier than when they
were younger. However, emerging research calls this
theory into question.
In addition to its hormonal and sleep actions, melatonin
has been shown to have strong antioxidant effects.
Preliminary evidence suggests that it may also help
strengthen the immune system.
Other Uses
Insomnia
Although results are still controversial, studies
suggest that melatonin supplements help induce sleep
in people with disrupted circadian rhythms (such as
those suffering from jet lag or poor vision or those
who work the night shift), and those with low melatonin
levels (such as some elderly and individuals with
schizophrenia). In fact, a recent review of scientific
studies found that melatonin supplements helped prevent
jet lag, particularly in people who cross five or
more time zones.
A few studies suggest that when taken for short periods
of time (days to weeks) melatonin is significantly
more effective than a placebo, or “dummy pill,”
in decreasing the amount of time required to fall
asleep, increasing the number of sleeping hours, and
boosting daytime alertness.
In addition, at least one study suggests that melatonin
may improve the quality of life in people who suffer
from insomnia and some experts suggest that melatonin
may be helpful for children with learning disabilities
who suffer from insomnia.
Although research suggests that melatonin may be
modestly effective for treating certain types of insomnia,
few studies have investigated whether melatonin supplements
are safe and effective for long term use.
Osteoporosis
Melatonin has been shown to stimulate cells called
osteoblasts that promote bone growth. Since melatonin
levels may be lower in some older individuals such
as postmenopausal women, current studies are investigating
whether decreased melatonin levels contribute to the
development of osteoporosis, and whether treatment
with melatonin can help prevent this condition.
Menopause
Melatonin supplements may benefit menopausal women
by promoting and sustaining sleep. Peri- or postmenopausal
women who use melatonin supplements to regulate sleep
patterns should do so only for a short period of time
since long term effects are not known.
Depression
A recent study of postmenopausal women found that
melatonin alleviated both depression and anxiety.
Other studies show that people who suffer from major
depression or panic disorder have low levels of melatonin.
Healthy individuals with mild episodic depression
and patients who have Seasonal Affective Disorder,
(SAD -- a mild depression that correlates with fall
and winter -- periods of light-phase shortening) also
have lower than normal melatonin levels.
Experimental studies show that melatonin causes a
surge in the chemical serotonin, which helps alleviate
symptoms of depressive illness, including major and
mild depression and SAD. Melatonin should be used
with caution in people with depression and should
be appropriately timed with light therapy and sleep-phase
changes. Disruption of normal circadian rhythm by
poorly timed melatonin administration may worsen depression.
Eating Disorders
Melatonin levels may play a role in the symptoms of
anorexia. For example, abnormally low melatonin levels
may cause depressed mood in people with this condition.
However, researchers do not know whether supplementation
will change the course of the disease. Some researchers
speculate that low melatonin levels in people with
anorexia may indicate who is likely to benefit from
antidepressant medications (a treatment often used
for eating disorders).
Rheumatoid Arthritis
Melatonin levels are lower in patients with rheumatoid
arthritis than in healthy individuals without arthritis.
However, when arthritis patients were treated with
the anti-inflammatory medication indomethacin, melatonin
levels returned to normal. The chemical structure
of melatonin resembles indomethacin, so researchers
suspect that melatonin supplements may work similarly
to this medication for people with rheumatoid arthritis.
However, this theory has not been tested.
Attention Deficit/Hyperactivity
Disorder (ADHD)
Although melatonin supplementation does not appear
to improve the key behavioral symptoms of ADHD, it
may be effective in managing sleep disturbances in
children with this condition.
Epilepsy
Preliminary research suggests that melatonin reduces
the number of seizures in certain animals and may
reduce seizures in people with epilepsy. However,
not all experts agree with these findings. In fact,
some researchers are concerned that melatonin (1 to
5 mg per day) may actually induce seizures, particularly
in children with neurologic disorders. Since this
research is in the early stages, some experts suggest
that doctors should administer melatonin only to a
select group of people who suffer from seizures that
cannot be controlled by any other type of therapy.
Sunburn
A few small studies suggest that gels, lotions, or
ointments containing melatonin may protect against
redness (erythema) and other skin damage when used
alone or in combination with topical vitamin E prior
to exposure to UV radiation from the sun.
Viral Encephalitis
Although melatonin has not been scientifically evaluated
for use in treating human encephalitis (inflammation
of the brain), some studies suggest that this supplement
may protect animals from serious complications associated
with the condition and even increase their survival
rates. In one study of mice infected with Venezuelan
equine virus (a type of organism that causes viral
encephalitis), melatonin supplements significantly
lowered the presence of virus in the blood and reduced
death rates by more than 80%. More studies are needed
to determine whether similar treatment may offer the
same protection to people with viral encephalitis.
Heart Disease
Low blood levels of melatonin are associated with
heart disease, but it is not clear whether melatonin
levels are low in response to having heart disease
or if low levels of melatonin cause people to develop
this condition. In addition, several animal studies
suggest that melatonin may protect the heart from
the damaging effects of ischemia (decreased blood
flow and oxygen that often leads to a heart attack).
However, researchers are unclear whether melatonin
supplements may help prevent or treat heart disease
in people. More studies are needed before scientists
can draw any conclusions.
Possible Interactions
If you are currently being treated with any of the
following medications, you should not use melatonin
without first discussing it with your doctor.
Antidepressant Medications
In an animal study, melatonin supplements reduced
the antidepressant effects of desipramine and fluoxetine.
More research is needed to determine whether these
effects would occur in people. In addition, fluoxetine
(a member of a class of drugs called selective serotonin
reuptake inhibitors or SSRIs) has led to measurable
depletion of melatonin in people.
Antipsychotic Medications
A common side effect of antipsychotic medications
used to treat schizophrenia is a condition called
tardive dyskinesia, a movement disorder of the mouth
characterized by a constant chewing motion and darting
action of the tongue. In a study of 22 people with
schizophrenia and tardive dyskinesia caused by antipsychotic
medications, those who took melatonin supplements
had significantly reduced mouth movements compared
to those who did not take the supplements.
Benzodiazepines
The combination of melatonin and triazolam (a benzodiazepine
medication used to treat anxiety and sleep disorders)
improved sleep quality in one study. In addition,
there have been a few reports suggesting that melatonin
supplements may help individuals stop using long-term
benzodiazepine therapy. (Benzodiazepines are highly
addictive.)
Blood Pressure Medications
Melatonin may reduce the effectiveness of blood pressure
medications like methoxamine and clonidine. In addition,
medications in a class called calcium channel blockers
(such as nifedipine, verapamil, diltiazem, amlodipine,
nimodipine, felodipine, nisoldipine, and bepridil)
may decrease melatonin levels.
Use of Beta-Blockers (another class of high blood
pressure medications including propranolol, acebutolol,
atenolol, labetolol, metoprolol, pindolol, nadolol,
sotalol, and timolol) may reduce melatonin production
in the body.
Blood-Thinning Medications, Anticoagulants
Melatonin may increase the risk of bleeding from anticoagulant
medications such as warfarin.
Interleukin-2
In one study of 80 cancer patients, use of melatonin
in conjunction with interleukin-2 led to more tumor
regression and better survival rates than treatment
with interleukin-2 alone.
Nonsteroidal Anti-inflammatory
Drugs (NSAIDs)
NSAIDs such as ibuprofen may reduce the levels of
melatonin in the blood.
Steroids and Immunosuppressant
Medications
People should not take melatonin with corticosteroids
or other medications used to suppress the immune system
because the supplement may cause them to be ineffective.
Tamoxifen
Preliminary research suggests that the combination
of tamoxifen (a chemotherapy drug) and melatonin may
benefit certain patients with breast and other cancers.
More research is needed to confirm these results.
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http://www.umm.edu/altmed/articles/melatonin-000315.htm
Curr Pain Headache Rep. 2007 Oct;11(5):339-42. PMID:
17894923 [PubMed - in process]
