Natural Does Not Always Equal Safe
by Don Drake, Connelly Law Offices, Ltd.
"Welcome to June, everyone! It's the transition month from spring to summer, and typically, a time when sleep disorders tend to pop up with the time change, the hot and humid weather, longer hours of daylight, summer fun, add whatever cliche you like," said certified elder law Attorney RJ Connelly III. "Given these changes, we thought it would be a suitable time to discuss sleep disruptions and the use of melatonin to treat them and why, like all supplements, we need to heed some warnings."
We have written in the past about the use of nighttime prescription medications for sleep (such as Ambien, Edluar, Intermezzo, Zolpimist, and Sonata) and over-the-counter sleep aids (such as Unisom, Zzzquil, Sominex, Tylenol PM, diphenhydramine, etc.) and the dangers they pose, but what about those who decide on the all-natural route by taking melatonin products? After all, how bad can something natural be? But as Attorney Connelly said, natural products like melatonin can present with dangers, too.
The Importance of Sleep
Doctors call sleep an essential function of the human body. It is needed to restore the organs and provide the mind with a recharge. Research shows that those who have a healthy sleep pattern also have less illnesses and can fight off viruses better than those who do not. If the brain is deprived of sleep, an individual has difficulty concentrating, thinking, making appropriate judgments, and processing memories.
For most adults, seven to nine hours of sleep are needed, and children and teens need more, especially if they are under five years of age. As most of you know, good luck getting in seven to nine hours as family issues, work stressors, and even medical conditions can interfere with this. A lack of an adequate amount of sleep can be the beginning of a sleep disorder, caused by a disruption in our circadian rhythms, and for many who struggle with this, they seek help in the form of melatonin.
Circadian rhythms are 24-hour cycles that are part of our body’s internal clock, constantly running in the background carrying out the processes of the body, much like our phones have programs and apps running in the background. Different systems of the body follow different rhythms and these rhythms are synchronized with a master clock in our brains. This clock is activated by the length of the day and other environmental cues which is why these rhythms are tied in with the day and night.
When everything in the body is running appropriately, the circadian rhythm is good, leading to a restful and restorative sleep. But if these rhythms are thrown off, sleep problems begin and can lead to insomnia. These rhythms also influence physical and mental health.
What is Melatonin
Melatonin is a hormone that occurs naturally in the body and is used to regulate our circadian rhythms. Our bodies begin to make this hormone about two hours before bedtime which leads to that drowsy feeling and continues throughout the night to keep us asleep. This production is not necessarily caused by the time, but by the darkness outside.
The pineal gland, located deep in the brain, is the producer of this hormone. When the sun goes down and dusk begins, the pineal gland goes to work and increases melatonin levels, telling your body it's time to rest. As the sun rises, the gland begins to slow down the production of this hormone and the body starts to wake up.
So, given that our own body produces this hormone, most people assume it is safe since it is natural. Because of this, melatonin has become the fourth most popular over the counter supplement in the United States and between the years of 2007 and 2012, its use doubled with more than three million adults using it as a sleep aid. And with the pandemic and stress, reports are that the use of this product has skyrocketed. In general, the use of melatonin is harmless, but it is intended to be used for an abbreviated period as long-term use can result in problems which we will discuss and can result in serious interactions with medications being used for pre-existing conditions.
Where Do Melatonin Supplements Come From?
Supplements, in general, come in two forms - natural and synthetic. If you are taking "natural" melatonin supplements, these come from animals. Using "natural" products are preferred by health-conscious people, but because over the counter products are not regulated by the Food and Drug Administration (FDA), they may be impure and subject humans to viruses from the animal from which it is sourced.
"Synthetic" melatonin is man-made, using chemicals that simulate the molecular make-up of natural melatonin. When adults have sleep problems, using melatonin products raises the levels of the hormone in the body triggering the body to have a better and more restorative sleep. But as mentioned earlier, they are best used in the short term, for those experiencing insomnia, jet lag, sleep phase disorder or shift work sleep disorders.
Melatonin is also helpful for those experiencing certain physical and mental health issues including:
Alzheimer's disease and other dementias (but with caution)
Pre-surgical or post-surgical anxiety
These supplements are available in liquid, pill, chewable and gummy form.
This is not a concern as the body cannot build up a tolerance to it or cause withdrawal symptoms since it is produced naturally, unlike other sleep aids. However, some can experience side effects when using this supplement including:
Some can, but rarely, experience serious side effects such as:
Excessive bleeding in those with clotting disorders
Those with autoimmune diseases should not use this product. More concerning however, are the interactions with other drugs that melatonin use may have.
Drug Interactions and Melatonin
The Mayo Clinic has published a list of drugs that may interact with melatonin and this list should be heeded. They include: