Is Melatonin A Sleep Aid Or Hormonal Nightmare?
Melatonin is a scheduled medicine. It is not only being used as a natural remedy for sleep issues. We are looking into the reasons why and finding out Melatonin’s other uses. Having your day becoming night and your hours all mixed up messes with your sleep patterns. Your natural production of Melatonin directly relates to light and the day’s cycle into night. But when you take a supplement, it kicks into action whatever the time of day. That’s why it’s the perfect solution to jet lag.
Does Melatonin Stimulate Your Body’s Natural Ability To Produce It?
Largely unregulated for years, melatonin has also been the go-to natural solution for sleep-onset insomnia (difficulty falling asleep). But dosage is important – without regulation, you could be taking too much or too little. The problem with taking too much is that it could cause your body to stop producing melatonin. Which in turn could cause you to develop a sleep disorder.
The pineal gland regulates melatonin in your body which is triggered by the suprachiasmatic nucleus. SCN – a small region in your brain responsible for controlling circadian rhythms. This in turn triggers the light receptors in your eyes. Synthetic light has a major effect on our circadian rhythms, effectively disrupting sleep cycles. We now know that taking too much melatonin will have a negative impact on your natural sleep-wake cycle.
Dr Graham Duncombe, health renewal functional doctor at the Skin & Body Renewal Group, explains. “ The duration of use is most important, and I don’t recommend using melatonin continuously for longer than three months. During this time, it is still a good idea to have some breaks, such as on a Saturday night, to avoid its suppressant effect.” Most health practitioners will agree. And integrated medical practitioner Dr Hema Kalan says, while it can be a short-term solution, it’s much better to look for and treat the root cause of sleep issues. And there are many, from obstructive sleep apnoea and musculoskeletal disorders to medication, vitamin deficiency and stress.
What Is Melatonin?
Melatonin is a hormone. The pineal gland regulates it and links it to your circadian rhythms. During the day, your pineal gland is inactive, but when the sun goes down, it begins producing melatonin. It then releases into your bloodstream. The levels of melatonin in your blood stay elevated for around 12 hours and begin reducing as the sun sets.
During the day, your melatonin levels are barely measurable. Natural melatonin levels peak at around midnight, so dosing should mimic this effect. Blue light causes a delay or inactivates melatonin. So phones and computers should have filter after sunset. However, it is advisable to keep away from screens at night.
Should Melatonin Be Given Under Prescription Only?
In March 2012, a number of changes were made to the schedules of the Medicines and Related Substances Act, 101 of 1965. One of these changes made melatonin a Schedule 2 medicine. Therefore, you can only obtain it with a prescription. Currently, the only legitimate use for melatonin is jet lag, at a dose of 6 mg daily. One of the reasons why we regulate melatonin is because people take far too much of the supplement.
But, what has happened to the variety of supplements that were available?
It’s not that easy to get hold of melatonin anymore, other than through Internet sites. However, these aren’t the best option. Some anecdotal reports suggest that a pharmacist will give you a limited supply of melatonin without a prescription if you say you need it for jet lag. This is not the case. You can get melatonin at your local pharmacy on prescription, but it’s better to use a compounding pharmacy.
Duncombe notes: “The advantage of compounding pharmacies is that they can compound a patient-specific dose and provide bioidentical melatonin with the least chemical additives.” He doesn’t recommend a slow-release formulation, as it won’t mimic your body’s natural biorhythms. It can even suppress cortisol and testosterone.
Does Melatonin Have An Effect On Breast Cancer?
The Cancer Association of South Africa (CANSA) says breast cancer is the most common cancer in women of all races, other than non-melanoma skin cancer. But, researchers are finding that Melatonin taken over a short period of time may be reducing the growth of breast-cancer tumours in some people.
Breast-cancer tumours grow in certain ways. Research is discovering that small doses of melatonin is actually assisting in stopping tumours in their tracks. According to the University of Maryland Medical Centre, studies are also showing that melatonin may strengthen the effects of some chemotherapy treatments used for breast cancer. In addition, a small study was done on women taking tamoxifen for breast cancer who weren’t getting any results. The addition of melatonin caused tumours to reduce slightly in 28% of the women in the study.
Further research is needed to establish whether melatonin supplementation should be used as a viable option for treating breast cancer. However, the research is looking positive. Duncombe says melatonin has an indirect effect on hormones and an anti-inflammatory effect. He also says it promotes the growth hormone and DHEA levels. He says it lowers excessive oestrogen levels. Kalan adds that interim results from studies on high doses of melatonin (50 mg daily) are promising for people with stage four breast cancer, prostate cancer and gastrointestinal cancers.
Is Melatonin Safe For Children?
The ADHD Support Group of Southern Africa indicates that between 5% and 10% of people in South Africa have ADHD. Doctors deem melatonin a scheduled medicine. But one study suggests the use of melatonin for children who experience insomnia because of ADHD.
Child psychiatrist Dr Fiona Schulte says: “Around 25% of children with ADHD report disturbed sleep patterns.
Particularly in the form of chronic sleep-onset insomnia. Insomnia, is a big problem in children with ADHD, even without being on methylphenidate (Ritalin). However, often the medication makes it worse.” Parents who find the hyperactivity- especially at night – difficult to deal with shouldn’t get too excited about a natural solution.
Schulte suggests: “A bigger concern clinically is that melatonin only promotes falling asleep. This means you can deal with the initial insomnia. But it has no effect on middle insomnia or early awakening. There is a lower effect with chronic use. You may need to increase the dose or have a ‘drug holiday’ and restart after a few weeks.”
During an interview with Science Daily, Prof David Kennaway, director of the Circadian Physiology Lab at the University of Adelaide in Australia, says the use of melatonin to treat children’s sleep disorders is “rather alarming.” He suggests there is “extensive evidence from laboratory studies that melatonin causes changes in multiple physiological systems, including; cardiovascular, immune, metabolic systems and reproduction in animals.” Its effects on children’s developing bodies is still unstudied.
“Melatonin is a scheduled medicine, but isn’t a safe option for children,” says Duncombe. He recommends rather looking for the cause of sleep difficulties and trying behavioural therapy. Schulte agrees, saying that “treatment with melatonin in children with ADHD is best reserved for children with persistent insomnia that is having a severe impact on daily functioning. Particularly in cases where there is an obvious phase-shift of the endogenous circadian rhythm.”
Melatonin Must Be Treated Cautiously
While melatonin is useful as a sleep aid and could possibly have positive effects on breast and other cancers. We should only use it carefully and only on a short-term basis. If you’re having trouble falling or staying asleep, the first steps should always be lifestyle intervention rather than medication or supplementation.