While we’ve known about melatonin as an aid for sleeplessness, recent research has demonstrated it has enormous health benefits in many other arenas as well.
Melatonin Production
Produced in the pineal gland, melatonin is a naturally-occurring hormone that is triggered when the retina of our eyes discern darkness. It then diminishes when we are exposed to light – even artificial light. This is why jet lag, shift work, and blue screens (which signal the brain that it’s daylight) can negatively affect melatonin levels. Physiological production of melatonin in the human body ranges from between 0.1 mg and 0.8 mg per day. It’s found in multiple human tissues and fluids, including the brain, retina, lens, skin, GI tract, kidneys, thyroid, thymus, spleen, white blood cells, saliva, bile, amniotic fluid, urine, feces, breast milk, and more. Production of melatonin begins to decrease as early as our twenties and continues to decline through the fifties, when production levels out at approximately 0.3 mg per day. When you add in menopause and lifestyle factors such as late nights, poor sleep hygiene, and alcohol, it can drop even further.
Melatonin for Sleep
A meta-analysis of 19 studies looked at the use of melatonin for the treatment of primary sleep disorders and illustrated interesting data. The study involved 1683 individuals and found that melatonin had a statistically significant impact on reducing sleep latency (the time it takes to fall asleep) and increasing total sleep time. [1]
A 2017 review analyzed 12 studies and concluded that the use of melatonin is indicated in the following situations:
- Insomnia: 1-5mg 30 minutes before bed for those who experience difficulty falling asleep. Slow-release formulas, at the same dose, are effective for sleep maintenance issues.
- Regulating sleep in those who are blind
- Delayed Sleep Phase (a persistent shift in sleep-awake times later than social norms)
Beyond Sleep
In recent years, melatonin has been proven to have many other health benefits. It offers cellular protection against oxidative stress, it supports mitochondrial homeostasis, and it has modulating effects that impact both systemic and acute inflammatory states. It’s also been shown to offer cardiovascular and immune protection, support brain health, and reduce migraines and tinnitus. This is one powerful little hormone!
One study looked at long-distance runners who ran a 50km (31 mile) race and found that those who took melatonin had reduced oxidative stress and inflammation compared to the runners who didn’t take it. [2]
In a randomized, 12-week study, melatonin was compared with the medication, amitriptyline, and placebo in migraine sufferers. The results showed a 3mg dose of melatonin reduced migraine frequency at the same level of effectiveness as amitriptyline and was better tolerated. It is also reportedly effective as a therapy for primary headache disorders. [3]
Melatonin has demonstrated beneficial effects on the immune system, including some anti-carcinogenic properties. One study showed high-dose melatonin was effective in arresting tumor growth and improving quality of life markers. [4]
Dosing
Over the last twenty years, research has shown that using the lowest effective dose of melatonin is the best course of therapy (this is true for all hormones, of course). Too much melatonin can cause side effects, such as amnesia or a “melatonin hangover” the morning after, with grogginess and causing difficulty with falling asleep the following night. Too much melatonin can also produce vivid dreams or even nightmares. Since the body naturally produces between 0.1mg and 0.8mg of melatonin per day, physiologic dosing is best. Anything above this range is considered a pharmacologic dose. While physiological dosing is optimal for sleep, pharmacological dosing of 20mg was effectively used in the cancer research study.
So how much melatonin is too much? It seems to depend on biochemical individuality and the brand used as the bioavailability of any given product can play a significant part. Higher dose formulas are not necessarily better as melatonin is quickly broken down by the body and should be customized for each client. On average, most practitioners find that 1-3mg is effective on a daily basis and dosing should be individually determined.
For sleep difficulty, short-term, high dose, repeated low dose, or a sustained-release formula may be required depending on the root cause of disrupted sleep. Some studies show it can be taken up to 4 hours prior to bedtime and be effective. Other studies suggest that dosing melatonin for sleep requires a minimum of twelve hours of wakefulness for optimal efficacy.
For jet lag from eastbound travel, a preflight early evening dose of 3-5mg of melatonin for 1-3 days leading up to travel, followed by bedtime dosing for 4 days in the new time zone is effective.
For westbound travel, melatonin, at a dose of 3-5mg, can be used for 4 days at bedtime when in the new time zone.
Interesting note: there is no research showing that use of supplemental melatonin impacts receptor sites or feedback loops, which means melatonin is likely safe to take long term. Melatonin is inexpensive and easily accessible. With so many benefits, we should all be considering it more often with our clients.
- Ferracioli-Oda E, Qawasmi A, Bloch MH. Meta-analysis: melatonin for the treatment of primary sleep disorders. PLoS One. 2013;8(5):e63773. Published 2013 May 17. doi:10.1371/journal.pone.0063773
- Ochoa JJ, Díaz-Castro J, Kajarabille N, et al. Melatonin supplementation ameliorates oxidative stress and inflammatory signaling induced by strenuous exercise in adult human males. J Pineal Res. 2011;51(4):373-380. doi:10.1111/j.1600-079X.2011.00899.x
- Gonçalves AL, Martini Ferreira A, Ribeiro RT, Zukerman E, Cipolla-Neto J, Peres MF. Randomised clinical trial comparing melatonin 3 mg, amitriptyline 25 mg and placebo for migraine prevention. J Neurol Neurosurg Psychiatry. 2016;87(10):1127-1132. doi:10.1136/jnnp-2016-313458
- Lissoni P, Barni S, Cattaneo G, et al. Clinical results with the pineal hormone melatonin in advanced cancer resistant to standard antitumor therapies. Oncology. 1991;48(6):448-450. doi:10.1159/000226978
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FAQ
These frequently asked questions expand on the key clinical concepts covered in this article and provide additional context for practitioners considering melatonin in practice.
What is melatonin and how is it produced?
Melatonin is a naturally occurring hormone produced primarily in the pineal gland in response to darkness. Production is triggered when the retina detects reduced light exposure and decreases with both natural and artificial light. Melatonin is also found in numerous tissues and body fluids throughout the body.
Why do melatonin levels decline with age?
Melatonin production naturally begins to decline as early as a person’s twenties and continues decreasing through the fifties. Menopause and lifestyle factors such as poor sleep hygiene, late nights, alcohol use, shift work, and frequent exposure to blue light may further reduce melatonin production.
How effective is melatonin for improving sleep?
Research suggests melatonin can reduce the time it takes to fall asleep and increase total sleep duration. A meta-analysis of 19 studies involving more than 1,600 participants found statistically significant improvements in both sleep latency and total sleep time for individuals with primary sleep disorders.
Who may benefit most from melatonin supplementation for sleep?
Melatonin may be beneficial for several sleep-related situations identified in the research. These include:
- Difficulty falling asleep (insomnia)
- Sleep maintenance concerns using sustained-release formulations
- Sleep regulation in individuals who are blind
- Delayed Sleep Phase Syndrome
Appropriate dosing depends on the individual’s presentation and clinical goals.
What health benefits does melatonin have beyond sleep?
Melatonin supports far more than sleep regulation. Research cited in this article describes roles in protecting against oxidative stress, supporting mitochondrial homeostasis, modulating inflammation, promoting cardiovascular and immune health, supporting brain health, and helping reduce migraines and tinnitus.
How does melatonin support oxidative stress and inflammation?
Melatonin has demonstrated protective effects against oxidative stress while helping modulate inflammatory responses. In one study of long-distance runners completing a 50 km race, participants taking melatonin experienced lower levels of oxidative stress and inflammation than those who did not supplement.
Can melatonin help with migraine prevention?
Research suggests melatonin may help reduce migraine frequency. In a 12-week randomized trial, 3 mg of melatonin reduced migraine frequency similarly to amitriptyline while being better tolerated, and it has also been reported to benefit primary headache disorders.
What role does melatonin play in immune health?
Melatonin has demonstrated beneficial effects on immune function and has shown anti-carcinogenic properties in research. One study cited in the article found that high-dose melatonin was associated with arrested tumor growth and improvements in quality-of-life markers.
What is the recommended dose of melatonin?
The lowest effective dose is generally considered the preferred approach. Although the body naturally produces approximately 0.1–0.8 mg daily, many practitioners find that individualized doses of 1–3 mg are effective for routine use, while certain clinical situations may require different dosing strategies.
Can too much melatonin cause side effects?
Yes. Excessive melatonin dosing may cause unwanted effects, including morning grogginess, vivid dreams, nightmares, amnesia, and difficulty falling asleep the following night. Because individual responses and product bioavailability vary, dosing should be personalized rather than assuming higher doses are more effective.
How should melatonin be timed for sleep support?
Melatonin timing depends on the clinical situation. While many protocols recommend taking it about 30 minutes before bedtime, some studies suggest it may be effective when taken up to four hours before sleep, and other research indicates that at least twelve hours of wakefulness may improve its effectiveness.
How is melatonin used for jet lag?
Melatonin dosing differs based on travel direction.
Eastbound travel:
- 3–5 mg in the early evening for 1–3 days before travel, followed by bedtime dosing for four days in the new time zone.
Westbound travel:
- 3–5 mg at bedtime for four days after arriving in the new time zone.
Is long-term melatonin supplementation considered safe?
According to the research discussed in this article, supplemental melatonin has not been shown to negatively affect receptor sites or feedback loops. Based on this evidence, the article concludes that melatonin is likely safe for long-term use, though dosing should remain individualized.
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ABOUT THE AUTHOR
Margaret Floyd Barry, FNTP MRHP is owner and Executive Director of the Institute of Restorative Health. She’s a functional nutritionist, author, speaker, educator, and real food advocate. Through years of experience working with the most complex client cases, including reversing her own autoimmune condition, Margaret uses a powerful system for restoring health by addressing the root cause of illness.
Today, Margaret teaches fellow practitioners the same proven system she uses to get her clients life-changing results through the Institute of Restorative Health – a two-year comprehensive functional nutrition certification program for qualified health professionals. Margaret also runs Restorative Corporate Wellness, a team of Restorative Health Practitioners facilitating health transformations with corporate clients. She is the author of Eat Naked and its follow-up cookbook The Naked Foods Cookbook. She’s also the host of the Clinician’s Corner podcast, where she interviews some of the world’s top experts in the fields of functional health and nutrition.
