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Melatonin, a Sleep Hormone with Many Uses: Part 1

Throughout my career, I have used melatonin as a consistent sleep aid for helping people struggling with insomnia. It’s fairly cheap and with the right dose, I think it’s effective in a majority of folks that try it. Side effects are uncommon, although vivid dreams or feeling tired and sluggish with too high a dose can happen. 

While melatonin is primarily thought of as a sleep aid, it has a lot of additional potential uses. I thought it would be interesting to compile some of the latest studies on melatonin’s non-sleep benefits.

Melatonin has been shown to be helpful for: 

• Alzheimer’s disease
• Irritable Bowel Syndrome
• Migraines
• Tinnitus
• Diabetes and Blood Sugar Problems
• Cancer
• Heart Disease
• Fibromyalgia

Alzheimer’s

Alzheimer’s disease commonly presents with sleep difficulties. There’s currently a discussion in the research if poor sleep is one of the contributing factors in the development of Alzheimer’s disease (Ning 2019). Interestingly, melatonin may be protective against Alzheimer’s dementia. Melatonin has a multitude of effects that can benefit Alzheimer’s including (Shukla 2017): 

• Downregulating production of plaques and tangles in the brain
• Improving blood sugar handling, which could reverse the insulin resistance in the brain found in Alzheimer’s
• Repairing our cellular energy factories (mitochondria) 
• Reducing brain inflammation
• Increasing brain cell production

Melatonin has been shown to improve cognitive function and sleep in a clinical trial of people struggling with mild to moderate Alzheimer’s (Wade 2014). It was especially helpful in Alzheimer’s patients that struggled with insomnia.  

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome is a common gastrointestinal problem that includes frequent abdominal pain and diarrhea or constipation. Diet can play a role in treatment (Altobelli 2017), although I remember being surprised when I stumbled upon a vein of research describing melatonin as a potential treatment option.

Most people think of melatonin as a sleep hormone produced by the pineal gland in the brain. However, there’s more melatonin produced in the gastrointestinal tract than in the brain. Unlike melatonin produced for sleep, melatonin in the gut isn’t produced in response to darkness, it’s produced most strongly in response to eating (Konturek 2007). Gut melatonin appears to help decrease intestinal damage through its antioxidant and anti-inflammatory mechanisms. It also helps regulate the rhythmic contractions of the gastrointestinal tract involved with digestion.

In clinical trials for irritable bowel syndrome they typically dosed 3 mg melatonin at bedtime and found that melatonin decreased abdominal pain, improved gastrointestinal motility and improved sleep (Siah 2014). While melatonin is not a cure for irritable bowel, it is safe enough to consider as adjunctive support in patients, especially if they have sleep disturbances. 

Migraines

Migraines can be debilitating for migraine sufferers. Many of the standard treatments are not overly effective, or they have uncomfortable side effects (Gooriah 2015). Melatonin is generally considered a well-tolerated sleep aid (Xie 2017), yet one of its ancillary benefits appears to be for migraines. It’s not used for treatment of an active migraine, but rather it’s used for prevention. In a clinical trial, comparing melatonin to sodium valproate, a standard drug used for migraine prevention, melatonin worked just as well with significantly less side effects (Ebrahimi-Monfared 2017). In the study, patients were on an additional migraine treatment medication (either nortryptiline or propranolol) with the sodium valproate or melatonin, so this study was looking at melatonin as an add-on treatment. 

Another clinical trial compared melatonin 3 mg to amitriptyline, another drug used off-label for migraine treatment. Identical to the previous trial mentioned the melatonin worked just as well with fewer side effects (Goncalves 2016). Other review studies looking at the evidence overall, have come to the conclusion that melatonin is safe and effective for preventing migraines (Rosenberg 2016). Treatment is typically daily dosing before bed. With the problems associated with conventional approaches, melatonin is an interesting alternative to consider for migraines. 

Tinnitus

Tinnitus is a condition where a person hears ringing or other noises in the ears that are not actually present. While the condition is not usually serious, it can be very annoying, significantly decreasing a person’s quality of life. 

Underlying tinnitus there is often excess free radicals in the inner ear and hearing loss or damage (Pawlak-Osinska 2018). Melatonin is a potent antioxidant which can counter free radicals and studies using it for treating tinnitus have shown benefits. One study compared melatonin 3 mg at bedtime to sertraline, an antidepressant medication that has been shown to decrease tinnitus symptoms. The melatonin outperformed sertraline, significantly decreasing severity of tinnitus at 3 months (Abtahi 2017). Another study utilized melatonin on its own or combined with a local steroid. Both treatments were statistically beneficial, although the combined treatment was more effective (Albu 2014). A recent review article came to the conclusion that melatonin is a treatment option to consider for helping treat tinnitus (Hosseinzadeh 2019)

This concludes part 1…If you want to read more the article is continued in Part 2

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