Melatonin. What Is It and How Does It Work?

​We’ve all had those nights where we toss and turn and sleep seems far off. Many of us grab for melatonin supplements in hopes of warding off the dark nights of insomnia. Studies are not conclusive as to whether it helps sleep and whether long-term use is safe. What is melatonin? How does it work?
 
Melatonin is a hormone, a potent anti-inflammatory, an antioxidant which is used for other purposes than sleep. Because of its properties, melatonin is being used in cancer therapies, autoimmunity, post-COVID syndrome, Polycystic Ovary Syndrome (PCOS), infertility, bone health, gut health, and other disease states. Melatonin is released by the pineal gland in response to darkness. It regulates the circadian rhythm and circulates throughout the body and acts upon the “clock genes.”
 
The liver and kidneys rapidly metabolize melatonin within an hour when taken as a synthetic supplement so only fractions of it will stay in the bloodstream while sleeping. It is suggested in some studies to help with primary sleep disorders, decrease sleep latency and improve sleep quality compared to placebo. Yet it is important to remember that our endogenous melatonin being secreted by the pineal gland provides a steady state while sleeping (only with darkness) and slowly decreases within the last several hours prior to waking.
 
The mitochondria (small structures in a cell that are found in the cytoplasm — the fluid that surrounds the cell nucleus) regulate most of our melatonin most likely in relation to oxidative processes via an enzyme defense. The body’s way to protect itself and scavenge free radicals.  However, there is a threshold of protection the mitochondria can withstand and not become overloaded.
 
Melatonin declines with age sometime after puberty and precipitously after around age 50. Supplementation of only 0.3mg would be needed to replace levels; however, that amount may not cover a person’s need and you would need to assess each person, individually. Foods rich in melatonin include tart cherries, coffee, beetroot, asparagus, sprouted kidney beans, extra virgin olive oil, St. John’s war, feverfew, to name a few. These foods have a rich source of phytomelatonin; however, in very minute amounts.
 
Before rushing out to start melatonin, always think lifestyle first. To help induce natural production, darkness is necessary. Staying away from blue light, light within the environment, keeping a dark bedroom, or consider wearing an eye mask, are the first lines intervention. Of course, exercise, stress, fasting/eating, room temperature, sleep apnea, etc., are also significant to helping with sleep beyond what melatonin can do. Take home advice: love to like the darkness in your environment and begin tapering the lights about 2 hours before bedtime.  May you find darkness as a soothing and relaxing friend that will welcome melatonin.