Special Precautions & Warnings
Pregnancy and breast-feedingPOSSIBLY UNSAFE
Not enough is known about the safety of using melatonin when breast-feeding. It is best not to use it.
Children: Melatonin is POSSIBLY SAFE when taken by mouth as a single dose. It is POSSIBLY UNSAFE when taken by mouth or injected into the body in multiple doses in the short-term. Because of its effects on other hormones, melatonin might interfere with development during adolescence.
Bleeding disorders: Melatonin might make bleeding worse in people with bleeding disorders.
Depression: Melatonin can make symptoms of depression worse.
Diabetes: Melatonin might increase blood sugar in people with diabetes. Monitor your blood sugar carefully, if you have diabetes and take melatonin.
High blood pressure: Melatonin can raise blood pressure in people who are taking certain medications to control blood pressure. Avoid using it.
Seizure disorders: Using melatonin might increase the risk of having a seizure.
Transplant recipients: Melatonin can increase immune function and might interfere with immunosuppressive therapy used by people receiving transplants.
Side Effects Of Melatonin
Like any other dietary supplement, melatonin may cause side effects in some peoplepossible side effects include:
Dr. Bollu says drowsiness can mean either excessive sleepiness at night or grogginess the next day. He also adds that interfering with your bodys natural sleep cues may carry another side effect as well.
Taking a hypnotic medication regularly, on a nightly basis, would dampen your innate drive to sleep, explains Dr. Bollu, who adds that although we dont know for certain, this could also be true for melatonin. However, some research suggests melatonin may not dampen this drive in the same way that Ambien, for example, does. When your body recognizes more melatonin in the body, it begins to slow down its own production of melatonin over time. Therefore, short-term use of a melatonin supplement is preferred.
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What Is The Right Dosage Of Melatonin: How Much Is Too Much
Knowing how much melatonin to take is tricky, especially since some brands may recommend a dosage thats more than your body actually needs.
As you shop around, youll find that some melatonin supplements contain as much as 5 to 10 milligrams per serving.
Generally speaking, most people produce enough melatonin to sleep well. If you need a little extra to reset your sleep cycle, you probably dont need more than 3 mg. Some people sleep better with as little as 0.3 to 0.5 mg.
Melatonin needs vary from person to person. Since melatonin can have many effects on the body, like all drugs, it should be taken at the lowest dose possible, warns Dr. Jacobowitz.
With that being said, start with a low amount. If you still have problems sleeping, gradually step up your dose until you find an amount that improves sleep without causing side effects.
Less is more with melatonin to avoid sleep inertia. This is a common problem with some sleeping pills. Some people complain of a hungover or groggy feeling in the mornings due to remnants of the sleep aid remaining in their bloodstream.
This effect doesnt typically occur with melatonin, but it can happen if you take too much the night before.
Melatonin is also safe for children. And like adults, some children dont need a lot of the supplement to sleep better.
Again, start your child at a lower dose, and then gradually increase the amount of melatonin as needed. Talk to your doctor for advice on appropriate dosages.
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When To Steer Clear
Certain people should be more cautious about melatonin use, particularly if it triggers a negative reaction, including those with:
- Chronic insomnia. Having trouble falling asleep or staying asleep that lasts a month or more shouldn’t be managed with melatonin, according to the American Academy of Sleep Medicine and the American College of Physicians. These groups recommend other more proven remedies , noting that there is not enough evidence that melatonin is safe and effective for long-term use.
- Restless Legs Syndrome . The tingling or “creepy-crawly” feeling in the legs that often keeps people awake could be worsened by melatonin. The supplement can intensify RLS symptoms because it lowers the amount of dopamine in the brain, according to the Restless Legs Syndrome Foundation. If you’ve been diagnosed with RLS or suspect that you have the condition, talk to your HCP about lifestyle changes or medications that could help.
- Dementia. This progressive cognitive deterioration is often associated with insomnia, which can tax both patients and their caregivers. But melatonin may do more harm than good among those with dementia since the condition causes people to metabolize the supplement more slowly, resulting in daytime drowsiness. In people with moderate or severe dementia, melatonin supplementation may increase the risk of falls, according to 2015 guidelines from the American Academy of Sleep Medicine.
If you’ve been drinking alcohol, it’s also not safe to take melatonin.
Is Overdose Of Melatonin Safe
If someone is becoming too much dependant on melatonin supplements, there are bound to be certain disruptions in the circadian rhythms or the sleep-wake cycle. There might also be some other side effects which are harmful. Though a melatonin overdose has no proper definition, there can be serious effects of melatonin overdose. Some people may be more sensitive to 20 mg Melatonin while others may be not. Doses in this range might be harmful to the adults, let alone children.
The safest dose of melatonin would ideally be the lowest dose that helps in falling asleep without causing any side effects. A dose between 0.2 and 5 mg is considered to be safe, though a safe dose is always determined by age, body weight and sensitivity to the supplement.
What Happens If I Take Melatonin With Another Medication
According to the Mayo Clinic, taking melatonin should be safe for most people, though in some circumstances it can interact with other medications such as blood thinners, blood pressure medications, anticonvulsants, oral contraceptives and others. However, this doesnt mean the interaction will be dangerous, in some cases it may just inhibit melatonins ability to simulate drowsiness.
Before taking melatonin, be sure to discuss your current medications with your doctor to be sure its the right choice for you.
What Medications And Substances Does Melatonin Interact With
Melatonin may interact with several different types of medications, including:
- Blood-thinning medications. Taking melatonin with blood-thinning medication may increase your risk for bleeding.
- Epilepsy medications . Melatonin may make these medications less effective.
- Immunosuppressants. Melatonin can potentially interfere with immunosuppressive drugs.
- Diabetes medications. Melatonin use can affect blood sugar levels.
- Blood pressure medications. Blood pressure may get worse when melatonin is taken with these medications.
- Contraceptive drugs.Birth control pills may increase the risk of side effects from melatonin.
Because melatonin supplements can make you tired and drowsy, avoid mixing them with:
- other sleep aids
How Much Should You Take
The majority of studies have researched doses ranging from 0.3 mg to 10 mg as the safest and most effective dose. However, the ideal dose depends on age, weight, the problem youre trying to address, and any current medications that youre taking. Generally speaking, the ideal dose is the lowest dose possible that provides the desired effects. Most experts recommended starting at the lowest dose and slowly increasing until you get the desired effect.
If youre unsure which dose to start with, its best to talk to your doctor.
Is Melatonin Habit Forming
Melatonin is not considered to be habit-forming or cause dependencies. It is generally safe for short-term use. If you find yourself using it every day for longer than 2 weeks, its important to talk to your doctor about your symptoms to rule out underlying conditions causing problems with your sleep.
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Synthesis And Physiologic Role In Humans
Melatonin is an indole hormone, widely distributed in both plant and animal sources, such as human milk, bananas, beets, cucumbers, and tomatoes. Chemically, melatonin is N-acetyl-5-methoxytryptamine, a derivative of serotonin, which in turn is derived from tryptophan. Serotonin is first acetylated by N-acetyltransferase and then methylated by hydroxyindole orthomethyltransferase to form melatonin. Melatonin synthesis depends on intact beta-adrenergic receptor function. Norepinephrine activates the N-acetyltransferase and beta-receptor blockers depress melatonin secretion.
The enzymes of melatonin synthesis are activated and depressed, respectively, by darkness and light. Release of melatonin follows a circadian rhythm generated by the suprachiasmatic nuclei in response to daylight alterations.
Through melatonin release, the pineal gland maintains the internal clock governing the natural rhythms of body function. This apparent clock-setting property of melatonin has led to the suggestion that it is a chronobiotic substance that alters and potentially normalizes biological rhythms and adjusts the timing of other critical processes and biomolecules that, in turn, exert numerous peripheral actions.
What Are The Recommended Doses Of Melatonin
You can legally buy melatonin in any amount. You donât need a prescription in the United States. But you canât get melatonin over the counter in countries like Japan, Australia, the United Kingdom, and some parts of the European Union.
So far, experts havenât come up with a specific dose or timing for the supplement to help insomnia. Many studies look at doses from 0.1 to 10 milligrams of melatonin. But doctors believe that 2 to 3 milligrams are usually a good amount to start with.
If youâre an adult, you can usually take up to 8 milligrams per day for about 6 months. For kids, experts suggest about 3 milligrams daily for 3 months.
Itâs tough to tell exactly how much melatonin each person should take. Everyoneâs body may react differently to the supplement based on their:
- Health conditions
- Timing when they take melatonin
Studies have also found that sleep aid products may have more or less of the listed melatonin amount. Experts found that certain supplements may have anywhere from under 83% to over 478% of whatâs listed on the bottle label. This may mean that youâve taken more or less of the amount you believe you took. The reason for the poor quality control is that melatonin is considered a dietary supplement. This means that itâs not regulated by the FDA for its indication, potency, or purity.
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Yes You Can Overdose On Melatonin
Low doses of melatonin cause relatively few side effects, but it is possible to take too much, says Nicole Avena, PhD, an assistant professor of neuroscience at Mount Sinai School of Medicine in New York City.
Melatonin supplements are not regulated by the US Food and Drug Administration and therefore have no standardized dose. The typical dosage found in stores ranges from about one to five mg but can be found in doses as high as 10 mg.
Overdosing on melatonin can lead to side effects, including:
- Daytime sleepiness
What Medication Can Interact With Melatonin
Its important to know how other medicines may interact with melatonin. As a general rule of thumb, consult your doctor before taking any new herbs or supplements.
Melatonin can reduce the effectiveness of some prescription drugs, triggering possibly serious complications.
For example, you shouldnt combine an anticoagulant or blood thinner medication with melatonin. Melatonin can increase the risk of bleeding.
Melatonin may also increase blood pressure in people who take medication to control their hypertension.
Other drugs that may interact with melatonin include:
- Selective serotonin reuptake inhibitors
Also dont take melatonin if youve been diagnosed with an autoimmune disease, like lupus.
Autoimmune diseases are the result of an overactive immune system, and inflammation is a classic symptom on these diseases. Melatonin can stimulate immune system activity, increasing inflammation and exacerbating an existing disease.
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What Are Other Options For Getting Better Sleep
Melatonin may or may not help you head off to dreamland, but there are many things you can do to increase the chances of a good nights sleep. The healthiest way to fall asleep is to have a healthy sleep schedule that you can keep all seven days of the week, said Dr. Robbins. She recommends relaxing before bed, avoiding spicy foods at night, keeping the bedroom cool, wearing breathable PJs so your body temperature stays level, and going to sleep at about the same time every night.
After youve established a soothing sleep routine, be careful of blue light. Using devices such as laptops and smartphones in bed can lead to disrupted sleep, said Dr. Kouri. Take a break from all screens at least 30 minutes before you go to bed. This will help your natural melatonin production to help you get to sleep.
Melatonin supplements have mixed results, but are perfectly safe to try if youre curious. Just make sure to start at a low dose , avoid mixing with alcohol, and keep screens away from the bedroom.
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How Much Melatonin Is Too Much
It’s hard to say exactly how much melatonin is too much since there is no standardized dose, but it’s best to start with the lowest dose possible and work up from there, says Alex Dimitriu, MD, founder of Menlo Park Psychiatry and Sleep Medicine in Menlo Park, California.
There is no known lethal dose of melatonin and no reports of death from taking too much melatonin, Dimitriu says, but taking too much can disrupt your natural circadian rhythm and internal body clock, causing you to actually have more trouble falling asleep.
What the research says: Some studies have shown that cancer patients can benefit from large doses of melatonin ranging from 20mg to 1,000mg, but these doses are generally not recommended for those with no underlying medical conditions.
The effects of taking large doses of melatonin don’t appear to be lethal, Dimitriu says, but more research is needed to determine the long-term health implications of melatonin use and the effects of doses larger than 30mg.
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Melatonin Dose For Children
Broadly speaking, Dr. Goldman doesnt have recommendations for children when using melatonin. In most cases with teens or younger children, trouble falling asleep is a behavioral issue or it could be a sign of an underlying medical condition. In these cases, Dr. Goldman recommends working with a pediatrician or sleep medicine provider to diagnose the problem before using melatonin.
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Reasons To Be Cautious About Melatonin
Your sleep-deprived friends may swear by it and you’ve probably read about it online or seen it on drugstore shelves. But is melatonin all it’s cracked up to be, or are you better off just counting sheep to get some ZZZs?
First, the basics: Melatonin is a naturally occurring hormone in the brain that your body uses to help regulate your circadian rhythm. That’s the 24-hour body clock that, among other vital functions, tells you when to sleep and when to wake up each day.
Your body gradually starts making melatonin about two hours before bedtime, bringing on that familiar drowsy feeling, and production continues throughout the night. In fact, melatonin is often called the “Dracula of hormones” because levels rise when it gets dark outside. As sunrise approaches, levels begin to drop, letting you know it’s time to rise for the day.
Given melatonin’s essential role in the body’s internal clockworks, many people assume the supplement is safe. This may be one reason why it has become the fourth most popular supplement among U.S. adults, according to a National Health Interview Survey. Its use doubled between 2007 and 2012, as more than three million adults reported taking the sleep aid.
And it is true: Melatonin is generally harmless – at least if you take it for a short period of time.
Is It Ever Safe For Kids To Take Melatonin
Most of the reports in the CDC study were about kids age 5 or younger, and 99 percent of cases occurred at home. Given that, both experts said, the trend is likely a result of more parents purchasing melatonin supplements and storing them in places kids can reach.
“One year to 4 years those are the curious years,” Osterhoudt said. “Thats when children can now walk and climb and get into places that their parents werent ready for them to get into. So they find things and explore the world by putting things into their mouth.”
Since melatonin is considered a dietary supplement in the U.S., it does not require approval from the Food and Drug Administration and can be purchased over the counter.
Because of that lack of regulation, Osterhoudt said, “oftentimes the amount of melatonin in the products will be less or more than we think that were getting.”
There’s also a possibility of “other ingredients in the pill or the liquid that were taking that we are unaware of and that arent disclosed on the label,” he added.
That can make it difficult to determine how much melatonin a child has actually ingested.
There’s also still debate about melatonin’s effectiveness for kids and adults.
“It is thought that short-term use of melatonin can be helpful in treating people with sleep disorders or jetlag,” Osterhoudt said, though he added that “we could use more research on how supplementing these hormones over long periods of time might affect the body.”
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