Melatonin: Shedding Light on the Hormone of Darkness

WHAT IS MELATONIN?

Melatonin is a natural hormone released by the pineal gland in your brain. It’s the only recognised hormone made by the pineal gland and is secreted in response to darkness. It comes from serotonin, made from tryptophan through a series of enzymatic processes. Other areas in your body produce melatonin (extra-pineal sites), like your gut and retina. The significance of their contribution to the total melatonin in your body is yet to be determined. Melatonin is also called the sleep hormone. Its role is to help synchronise your sleep-wake cycle with night and day and regulate your circadian rhythm. As a consequence, it optimises the transition to sleep and quality rest. Peak blood levels of melatonin happen from 2 am to 4 am. It’s near undetectable during the daytime. As you grow older, melatonin production in your pineal gland decreases.

Melatonin produced in your body is termed endogenous melatonin. It can also be made externally (exogenous melatonin) and is available as a prescribed medicine or dietary supplement in some countries. Both endogenous and exogenous melatonin affects different cells in your body, most notably your hypothalamus and retina. These interactions promote sleep and prevent wake-promoting signals. Countries like New Zealand, Australia, the United Kingdom, Japan, Canada, and the European Union generally require a melatonin prescription to obtain it. In the United States, melatonin is available as a dietary supplement, and you can buy it without a doctor’s prescription. It’s available as a tablet, capsule, liquid, or transdermal patch.

There have been some exceptions in New Zealand and Australia in recent years. In 2019, melatonin was approved as an OTC medication for New Zealanders aged 55 and above who have insomnia. Since June 2021, melatonin has been available for Australians in the same circumstances. This OTC availability in both countries is only for short-term treatment and must be verified by the pharmacist. All other cases in both countries require a prescription. Special authority and funding can be obtained from the government in a handful of instances where melatonin is beneficial (children with neurodevelopmental delays).

SOME FAST STATISTICS ON MELATONIN USE

1. In the United States, melatonin use increased four-fold, from 0.4% in 1999 - 2000 to 2.1% in 2017 - 2018 among adult men and women based on a national survey of more than 55,000 respondents.
2. More than 71% of melatonin supplements on the market contain varying melatonin levels ranging from 83% less to 478% more than the concentration declared on the label. It would be best to consult your doctor first before taking melatonin.
3. According to an article published in the British Journal of Pharmacology in 2021, melatonin prescribing increased approximately ten times from 2% to 19.9% per 1,000 people from 2008 to 2019 in England.
4. A study published in the European Journal of Paediatric Neurology in July 2022 found that child psychiatrists were the most common prescribing medical specialists for melatonin at 55% of all prescriptions in Stockholm, Sweden, from 2016 to 2019. The sample group for the study included 9,980 people (aged 0-25 years old). Only 20% have a diagnosis of sleep disorder.
5. Based on a survey of 1,050 Australians, 37% of participants admitted to using pharmaceuticals to help them sleep. Fourteen percent of them used melatonin. What’s even more worrisome is that 44% of younger Australians (18 to 30 years old) in that survey admitted that they’re dependent on pharmaceuticals to have a good night’s sleep (26% sleeping pills, 18% melatonin).

USES OF MELATONIN (WITH PRESCRIPTION) INCLUDE THE FOLLOWING:

1. Insomnia. People diagnosed with insomnia can potentially benefit from taking melatonin. According to research, melatonin can facilitate the time it takes for people with insomnia to fall asleep. It’s especially suitable for older adults who may be deficient in melatonin.


2. Jet lag, also called jet lag disorder, is a kind of circadian rhythm sleep disorder. It happens when you travel (by plane) across more than two time zones. Your body’s circadian rhythm (internal clock) needs ample time to adjust to the new time zone you’re in. Melatonin can shorten symptoms of jet lag, like daytime sleepiness and improve alertness.


3. SWSD, or shift work sleep disorder, is a type of sleep disorder that usually affects people who work outside the 9 am to 5 pm schedule. This schedule goes against your body’s natural internal clock. Melatonin may help in attaining quality daytime sleep among shift workers.


4. Children with sleep disorders. A handful of research studies have indicated that melatonin can contribute to the treatment of sleep issues among children with disabilities. Children with attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), asthma, and atopic dermatitis may benefit from melatoni


5. Blind people with circadian rhythm disorders.

Other Health Benefits of Melatonin. Numerous studies have documented other bioactivities of melatonin aside from improving sleep quality and duration.

1. Antioxidant
2. Anti-inflammatory
3. Melatonin boosts both innate and adaptive immunity
4. Anti-cancer
5. Anti-diabetic
6. Cardioprotective

CAUTIONS WITH MELATONIN

Melatonin taken orally is generally safe. There are some minor side effects and possible interactions with other medications or supplements to be mindful of. This is especially important if you are taking other medicines that can cause drowsiness or if you are taking warfarin (as it may alter the INR). Always discuss with your doctor prior to starting melatonin especially if you have underlying health conditions.

DISRUPTORS OF MELATONIN PRODUCTION

It’s natural that melatonin production and release decrease with ageing. Other factors and medical conditions that can affect its production include:

WHAT YOU CAN DO TO BOOST NATURAL PRODUCTION OF ENDOGENOUS MELATONIN

1. Let there be darkness. Umm, we don’t mean evil darkness here, okay? We want to state that to get some sleep, you need to dim down or completely turn off the lights in your bedroom. Make it easy for your pineal gland to release melatonin without impediments. Dial down artificial light, especially blue light at night. Devices that emit blue light include TVs, laptop screens, and smartphones. Blue light messes up melatonin production and release.


2. Let there be light, sunlight. Don’t worry. We’re not trying to confuse you. It may seem like going in the opposite direction, but getting some sunlight helps establish your brain's day and night internal clock. In response to sunlight, your body produces serotonin. Serotonin has a vital role in the production of melatonin. It’s a melatonin precursor.


3. Load up on tryptophan-rich foods. The essential amino acid tryptophan is required for the smooth production of melatonin, as well as crucial enzymes that convert tryptophan to serotonin and then to melatonin. Also needed in these enzymatic reactions are some minerals (zinc, magnesium) and vitamins (folate, vitamin B6, vitamin B12).



Some foods rich in tryptophan include:

1. Milk is the single largest source of tryptophan, especially full-fat milk. It’s no wonder Mum made you a mug of warm milk before bed.
2. Yoghurt
3. Tuna, chicken and turkey
4. Cheese
5. Chocolate
6. Oats
7. Nuts like almonds, pistachios, and cashews
8. Seeds such as pumpkin seeds, hemp seeds, and chia seeds
9. Bread
10. Fruits like bananas, apples, and prunes
11. Kumara


4. Melatonin-rich Sour Cherries. Are you familiar with sour cherries (Prunus cerasus)? You should be if you want a natural way of boosting melatonin production. Sour cherries or Montmorency cherries have been known to provide health benefits such as reducing inflammation, strengthening the immune system, improving memory, decreasing muscle soreness, and preventing certain types of cancers (in studies on mice). Research has also indicated that they also promote sleep. The juice of these cherries is known as tart cherry juice.



Tart cherries naturally contain melatonin. There’s ample evidence that drinking tart cherry juice boosts melatonin in the body. In addition to melatonin, tart cherries also contain tryptophan. Data from a randomised, double-blind study published in the European Journal of Nutrition suggested that consumption of tart cherry juice in the form of a supplement (juice concentrate) improves sleep quality and duration among healthy men and women. The study also indicated that it might also be of benefit to people having difficulty falling asleep. Alternatively, tart cherries are conveniently available as supplements in the form of capsules that contain skin extracts from the berries. They provide a more concentrated and convenient form of consumption.




Other foods that contain melatonin include:

1. Eggs, fish
2. Grapes, strawberries, goji berries
3. Vegetables like peppers, mushrooms, and tomatoes
4. Seeds such as mustard seeds and soybean seeds
5. Medicinal herbs, including St. John’s Wort (Hypericum perforatum) and Huang-Qin (Scutellaria biacalensis)


5. Griffonia simplicifolia is a small shrub found in West Africa. Practitioners of traditional African medicine use it to treat various illnesses like anxiety, depression, headache, weight loss, and insomnia. Seed extracts from this shrub contain a lot of 5-hydroxytryptophan (5-HTP), an immediate precursor of serotonin and melatonin. At the time of this writing, there’s still limited research to support its claims to promote quality sleep. It’s available as a supplement in the form of capsules.


6. Take a warm bath before going to bed. Studies have shown that a warm bath one to two hours before bed helps you fall asleep quicker, you can add some epsom salt to help support sleep.

Endogenous melatonin is a natural hormone produced by the pineal gland in your brain. It helps regulate your body’s internal clock and sleep-wake cycle. There are some natural ways to boost your body’s production of melatonin. If you have difficulty getting quality sleep, schedule a consultation with your doctor before taking melatonin. Exogenous melatonin is generally safe when taken short-term. Its use as an adjunct in the prevention and treatment of various diseases shows excellent potential. Further advances and benefits of its use will surely pop up in the coming years. The hormone of darkness seems to shine with much light.