Melatonin is a hormone made naturally by the body that is associated with circadian rhythms and sleep. This substance is naturally occurring in plants, animals, humans and even microbes. In humans it is produced from tryptophan, an amino acid, by the brain’s pineal gland. Production of the hormone seems to be triggered by darkness and the onset of darkness, whereas it decreases in daylight. Many people now use artificially produced melatonin, or N-acetyl-5-methoxytryptamine, as a sleep aid. Some doctors believe that in a society where people are generally in “rush” mode, parents may become too reliant on using melatonin to shorten the time it takes normal children to fall asleep after a busy day. There are definite cases for its use, but also possible contraindications.
There have been some interesting studies. One, done at the University in Granada, Spain, shows that people who take melatonin better control potential weight gain, even without reducing their caloric intake. In another study, it has been shown to reduce levels of “bad” cholesterol (LDL) and increase the good type (HDL). Some studies have tested on female fertility with melatonin use. A Japanese study found that when women doing in vitro fertilization (IVF) take the sleep hormone, the quality of the egg is improved and success rates with the IVF treatment double.
The Mayo Clinic’s website has extensive information with seven separate pages dealing with background, evidence, dosing, safety, interactions and so on. It is thorough in a way as to possibly leave one wondering what, if any, the advice is. Essentially, the compound is described as well as what it does. Then there is a list of seemingly every possible condition ever studied with regards to melatonin, including, on the “Evidence” page, a letter grade (A, B, C, D or F) allocating a measure of how much scientific evidence there is to substantiate results.
The breakdown of the Mayo Clinic’s site shows conclusive benefit of melatonin use for children with autism and ADHD, and other neurological disorders, as a sleep aid. There is an apparent almost magical difference in the child’s quality of sleep, as well as the obvious benefits to the whole family. People with insomnia, whether children or adults, also benefit. Jet lag and sleep enhancement for any adult receives a “B” grade for melatonin use as proven by the evidence. Then there is a whole host of “C” grades, meaning: “Unclear scientific evidence for this use.” This list includes things from melatonin’s benefits on macular degeneration, Alzheimer’s/cognitive decline, anti-inflammatory, cancer treatment, benzodiazepine withdrawal (anti-anxiety medications), Chronic Fatigue Syndrome, depression, fibromyalgia, to even something as common as headaches and as unusual as restless leg syndrome or ringing in the ears.
The safety page reads like something out of a medical lawyer’s guide, as the list of negative things melatonin may cause is so extensive as to make one wonder if there is anything bad it does not cause, sort of the transverse of the sensation when reading the “C” grade list of how many things some think it helps. Possible side effects include but are not limited to (this is the ultra-brief version) abnormal heartbeat, bedwetting (in children), aggression, immune system changes, amnesia, delusions, decreased sperm count, hallucinations, headache, increased seizure risk (and this after having given a “B” grade for use in children with epilepsy), mood changes, nightmares, skin reactions and even psychotic symptoms.
After studying benefits, which are caged in cautious “maybes,” and side effects, a reader may come away confused. Yet the Mayo Clinic is not being purposefully abstruse or in any way irresponsible. One does not doubt the veracity of their information. The thing is, there may be too much of it.
In this day and age where it seems that legally every bit of information must be made available to the public, pharmaceutical commercials are parodied for the happy people presented on screen enjoying whatever benefit the drug incurs, while a long list of side effects, some fatal, is read on voice-over. How can a person know what to do?
One extremely important issue to consider is dosing. The dosing on the Mayo Clinic site, that medical establishment being akin to a medical bible for many, shows that there is a very diverse range when it comes to amounts given, varying by age as well as the disorder being treated. People who do not consult a doctor or pharmacist, but merely follow instructions on the bottle of this compound, run the risk of gambling. Too often this substance is bought by parents gambling on their children.
A neurologist from Toronto’s Hospital for Sick Children, Dr. Shelly Weiss, notes, as does the Mayo Clinic, that no clear benefits are shown in use with “healthy” children, meaning children who do not have a neurological disorder, sleep disorder, etc. She points out that supplements contain 25 to 50 times more melatonin than the body will produce each night.
Pediatrician Marvin Gans makes clear how uncomfortable he is with a society that doses normal children to speed up the occurrence of sleep. The predominant environment is one of speed, where everything must happen quickly. He says that to expect a child to go from play instantly into sleep is unrealistic. There is a fear too many parents give this substance to their children for their own convenience. As there are can be potential risks, pointed out by Dr. Weiss, including delayed development or late-onset puberty in children who take it over long periods, doctors warn against using it unnecessarily.
Except for children with ADHD, cerebral palsy, autism and other specific cases, parents should rely on good bedtime habits and sleep routines, and accept that even normal children need time for their own melatonin to kick in. As for what a normal length of time is? Check with sleep professionals, but twenty or thirty minutes would be within a normal range, with children of very fortunate parents falling asleep within fifteen minutes and perhaps less lucky parents’ having children who take 40.
Even with children who clearly benefit greatly from the use of melatonin, keep in mind professionals say no long-term studies have yet been done. Whatever long-term effects may occur in “normal” children can happen then for any child. As with anything medical, one should always carefully research and speak with a doctor, and a pharmacist, if possible.
Opinion by Julie Mahfood
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