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Doctors' Answers to "Frequently Asked Questions" - Melatonin

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Melatonin toxicity
Question: What is a safe level and what is considered a toxic level for oral ingestion of melatonin?

Answer: No signs of toxicity yet. Strangely enough, no one knows the best or potentially toxic dosages. We haven't seen any toxicity and there are plenty of people taking in excess of the recommended dosage. There is research in progress on its sleep effectiveness and some on dosage, but not enough (no money in it).

Question: I have been hearing about melatonin, but I am not sure what it is supposed to do. Is there some information that I could get to give me a better understanding of what this is and what it is supposed to do. My husband and I have been taking this for about a week, and I have heard everything from sleeping aid to adding years to your life. I don't believe in miracle drugs but I do have sleeping problems. I was taking a medication for about 3 years called amitriptyline (10 mg at bedtime), but it makes you gain weight and I became worried about it being addictive so I quit taking it. Is Melatonin at all like that?

Answer: Melatonin is a hormone produced by your pituitary. In lower animals, like birds, it is very important in establishing sleep/wake cycles, migrations, and fertility(seasonal dependent). The activity in humans is less clear. There has been a lot or research on this hormone and it does appear helpful in inducing sleep in some people and also Restless Leg Syndrome on occasion. In my experience about 30% of patients have some improvement. There appear to be minimal or no side effects(to date). More data is surfacing on its ability to decrease cancers and increase longevity. This has been done mainly in rats and they are a tough model for aging. However, this hasn't stopped advocates from pushing dosing for longevity. Whether it has this effect in humans is unclear. I advocate it for my patients as an adjunct in sleeping and also, for time changes (really seems to help more than sleep to change ones sleep cycle). I know of no side effects worth mentioning. The jury is still out on other effects and some of my patients take it for this reason, with the lack of side effects, I think this is OK, but it is not my recommendation. However, I tend to be conservative regarding medications of any sort. Amitriptyline is not addictive (used for an antidepressant initially, also for sleep disorders and pain control). Other things that help sleep is avoidance of caffeine, chocolate, and especially alcohol (decreases stage IV sleep) in any amount.

Question: My sister has been giving melatonin to her 3 and 4 year old son and daughter without a doctorÝs permission. Both are normal, healthy children and she does this because they supposedly "sleep better". I am worried about the side affects of these self prescribed medicines. She gives them a teaspoon each before bedtime. Any information you have will be greatly appreciated, and we're prepared to take action to protect the children if necessary.

Answer: Melatonin itself is not even researched in adults. There doesn't appear to be any particular problems in adults, but there is no answer in children.

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