Understanding the World: Should We Take Melatonin for Health Benefits?
Trying to Make Sense of Conflicting Evidence and Opinion
Note: This essay was prepared with the research assistance and ghostwriting capabilities of ChatGPT 4.0. This unfortunate LLMAI was not harmed in the process, although from time to time I had to beat it about the head and shoulders with a stick.
Author's Preface
My daughter informed me that melatonin might have protective effects for stroke victims or even after a stroke has occurred. This prompted me to start taking it. I wasn’t sure how much or how often to take it, but I had previously tried melatonin as a sleep aid and found that it didn’t seem to improve the quality of my sleep. In fact, it left me feeling groggy when I took a higher dose, so I had abandoned its use.
After my daughter mentioned that there was evidence suggesting melatonin might aid in recovery from a stroke—particularly relevant since I had experienced several strokes in the back of my brain, in the cerebellum—I decided to give melatonin another try, though I was uncertain about the appropriate dosage. I had also been struggling with sleep after spending five weeks in the hospital, where the noise and confusion disrupted my sleep patterns. Coupled with the typical issue of having to wake up to urinate in the middle of the night, only to struggle to get back to sleep, I decided to increase my melatonin intake slightly.
As a result, my sleep seemed to stabilize. Whether this was due to the melatonin or not, I can’t be certain. However, my sleep returned to a more normal pattern—sometimes good, sometimes not, but overall fairly consistent. I continued taking melatonin with the hope that it might help in my recovery from the strokes.
Then, I stumbled upon a video by neurologist Andrew Huberman. While I didn’t watch the video, I noticed in the text surrounding it a claim that melatonin should not be taken because it could be harmful. Although I didn’t follow up on the video, the idea that melatonin might be harmful stuck with me.
Around the same time, I came across another claim by a medical expert suggesting that melatonin is the most powerful anti-inflammatory substance in our bodies, surpassing even antioxidants and other supplements. I found this intriguing, as I hadn’t previously encountered the notion that melatonin had such significant anti-inflammatory properties. This led me to continue using melatonin. However, given Huberman’s caution and the conflicting claims, I realized that I needed to look into the matter more deeply.
After several months of using melatonin, I decided to employ ChatGPT to help me with the research. I’m well aware of the issues present in scientific, medical, and nutritional research, having written extensively on these topics from an informed layperson’s perspective. My goal is to understand the pros and cons of melatonin, to discern who is saying what regarding its effects, and to examine the evidence supporting or refuting claims of its efficacy, as well as the possibility that it may be detrimental. This essay is my attempt to explore these questions with the assistance of ChatGPT, and here’s what I found.
Introduction
Melatonin, a hormone produced by the pineal gland, is primarily known for regulating sleep-wake cycles. As such, it has become a popular supplement, particularly among those seeking to improve sleep quality or combat jet lag. However, melatonin's potential benefits extend beyond sleep regulation, with emerging research suggesting it may possess anti-inflammatory and neuroprotective properties. Despite these promising claims, the scientific and medical communities remain divided on the safety and efficacy of routine melatonin supplementation.
This essay aims to explore the conflicting evidence surrounding melatonin, presenting both the supportive and critical views of various experts. By examining the quality of research, the variability in individual responses, and the broader implications for health, we seek to answer the critical question: Should melatonin be taken for its health benefits, or could it pose hidden risks? Given the inherent uncertainty and conflicting opinions among healthcare providers and experts, this essay will also address the challenge of making informed decisions when the available guidance is so often contradictory.
Melatonin’s Role in the Body: Natural Functions and Supplemental Use
Melatonin is integral to the body's circadian rhythm, rising in the evening to promote sleep and falling in the morning to aid wakefulness. Beyond sleep, melatonin is involved in various physiological processes, including immune function, antioxidant defense, and blood pressure regulation (Reiter, 1993).
Supplemental melatonin is widely used for its potential to improve sleep, particularly in cases of circadian rhythm disturbances like jet lag or shift work. Research has shown that melatonin can be effective in these specific contexts, helping to realign the body's internal clock (Zhdanova, 2005). However, its role as a sleep aid for the general population remains debated.
Proponents of Melatonin: Anti-Inflammatory and Neuroprotective Benefits
Supporters of melatonin supplementation emphasize its potent anti-inflammatory and neuroprotective properties. Dr. Russell Reiter, a leading researcher in melatonin studies, has highlighted its ability to reduce oxidative stress and protect against neurodegenerative diseases and stroke. According to Reiter, melatonin’s antioxidant capacity makes it a valuable tool in preventing and mitigating damage in the brain and cardiovascular system (Reiter, Tan, & Galano, 2014).
Dr. David P. Cardinali further supports melatonin's use, particularly for sleep disorders and as an adjunct therapy in conditions like Alzheimer’s disease. He argues that melatonin's safety profile is well-established, even at relatively high doses, making it an attractive option for long-term use (Cardinali et al., 2002).
Critics of Melatonin: Potential Risks and Concerns
While melatonin's benefits are well-documented, there are significant concerns regarding its routine use. Dr. David Kennaway has expressed reservations about the safety of long-term melatonin supplementation, particularly in children. He warns that melatonin could disrupt natural hormone production and that its effects are not fully understood in the context of long-term use (Kennaway, 2015).
Similarly, Dr. Andrew Huberman, a neurologist and researcher, has cautioned against high doses of melatonin, particularly for those without specific circadian rhythm disorders. Huberman argues that over-the-counter melatonin supplements often exceed the body's natural production, potentially leading to hormonal imbalances and altered sleep architecture (Huberman, 2021).
Dr. Steven Lockley from Harvard Medical School also critiques the widespread use of melatonin as a general sleep aid. He points out that while melatonin can be effective for certain disorders, its benefits for most people are limited. Lockley advocates for alternative approaches, such as light therapy, to address sleep issues more effectively (Gandhi et al., 2015).
Variability in Response: The Challenge of Predicting Outcomes
One of the critical challenges in the debate over melatonin is the variability in individual responses. While clinical trials provide statistically significant average effects, they often obscure the wide range of individual variability in outcomes. This variability is a common issue in medicine, where treatments that work well for some may be ineffective or harmful to others.
Genetic factors, underlying health conditions, and lifestyle all contribute to how individuals respond to melatonin. For example, differences in melatonin metabolism can lead to variations in effectiveness and side effects (Burgess & Fogg, 2008).
In clinical practice, doctors often resort to a trial-and-error approach, adjusting doses and changing medications based on patient responses. Unfortunately, this approach is not without risks. The process of finding the right treatment can be subjective and prone to errors, leading to instances of iatrogenic illness—illness caused by medical intervention. In fact, iatrogenic illness is a significant concern in modern healthcare. In the United States alone, medical errors are estimated to cause hundreds of thousands of deaths each year, making it one of the leading causes of death (Makary & Daniel, 2016).
The prevalence of iatrogenic illness highlights a critical issue in the healthcare system. While medical treatments can be life-saving, the process of diagnosing and treating conditions often involves a high degree of uncertainty and variability in patient responses. This uncertainty can lead to adverse outcomes, including incorrect diagnoses, inappropriate treatments, and harmful side effects. The sheer number of iatrogenic cases underscores the importance of cautious and well-considered approaches to medical treatment, including the use of supplements like melatonin.
Summary
Melatonin is a hormone with well-established roles in sleep regulation and emerging potential as an anti-inflammatory and neuroprotective agent. However, the conflicting evidence and opinions regarding its use illustrate the broader challenges faced by individuals trying to navigate medical and health-related decisions. With experts disagreeing and the prevalence of iatrogenic illness underscoring the risks of medical intervention, individuals are left in a difficult position when trying to determine the best course of action for their health.
It is essential to recognize that consulting a healthcare provider, while often recommended, does not necessarily provide clear answers. Healthcare providers, like the experts in the field, are subject to the same uncertainties, biases, and limitations in knowledge. Thus, while they can offer guidance, their advice should be considered within the broader context of conflicting opinions and the inherent uncertainty in medical science.
Ultimately, the decision to use melatonin should be made with an understanding that there is no definitive answer. The best approach may involve careful consideration of the available evidence, an awareness of personal health needs, and an acceptance of the inherent uncertainties involved in medical decision-making. As research continues to evolve, our understanding of melatonin's full range of effects—both positive and negative—will hopefully become clearer, allowing for more informed and safer use of this intriguing but controversial supplement.
References
Burgess, H. J., & Fogg, L. F. (2008). Individual differences in the amount and timing of salivary melatonin secretion. Journal of Pineal Research, 44(1), 29-36. https://pubmed.ncbi.nlm.nih.gov/18725972/
Cardinali, D. P., Brusco, L. I., Liberczuk, C., & Furio, A. M. (2002). The use of melatonin in Alzheimer's disease. Neuro Endocrinology Letters, 23(1), 20-23. https://pubmed.ncbi.nlm.nih.gov/12019347/
Huberman, A. (2021). The Huberman Lab Podcast: Dr. Andrew Huberman on sleep, melatonin, and neuroplasticity. https://hubermanlab.com/
Kennaway, D. J. (2015). Potential safety issues in the use of the hormone melatonin in pediatrics. Journal of Paediatrics and Child Health, 51(6), 584-589. https://onlinelibrary.wiley.com/doi/abs/10.1111/jpc.12840
Gandhi, A. V., Mosser, E. A., Oikonomou, G., & Prober, D. A. (2015). Melatonin is required for the circadian regulation of sleep. Neuron, 85(6), 1193-1199. https://doi.org/10.1016/j.neuron.2015.02.016
Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. BMJ, 353, i2139. https://doi.org/10.1136/bmj.i2139
Reiter, R. J. (1993). The melatonin rhythm: Both a clock and a calendar. Experientia, 49(8), 654-664. https://doi.org/10.1007/BF01923947
Reiter, R. J., Tan, D. X., & Galano, A. (2014). Melatonin: Exceeding expectations. Physiology, 29(5), 325-333. https://pubmed.ncbi.nlm.nih.gov/25180262/
Zhdanova, I. V. (2005). Melatonin as a hypnotic: Pro. Sleep Medicine Reviews, 9(1), 51-65. https://pubmed.ncbi.nlm.nih.gov/15649738/