A problem that many people have these days is not being able to sleep properly at night. Some people can't sleep for hours after going to bed. For others, their sleep patterns are disrupted due to the time change when they travel abroad. At times like these, some people have heard of a pill called 'Melatonin'. So today, let's talk about what melatonin really is, how good it is to use, and what things we need to be careful about.
What exactly is Melatonin?
Simply put, melatonin is a hormone naturally produced by a small gland in our brain (the pineal gland). Its main function is to control our body's sleep-wake cycle. When it gets dark at night, our body's melatonin levels increase, signaling us to sleep. When it gets light in the morning, melatonin levels decrease, waking us up.
But the melatonin you can buy in pharmacies is a synthetic supplement that mimics this natural hormone. Many people use it to help with things like insomnia or jet lag.
But the most important thing here is that this is not a 'medicine' that cures, prevents, or diagnoses any disease. It is just a dietary supplement.
Things to tell your doctor before taking melatonin
Although melatonin is a dietary supplement, it is not suitable for everyone. It can cause side effects in people with certain medical conditions. Therefore, if you are considering using melatonin, you should definitely talk to your doctor. Especially if you have any of the conditions below, you should inform your doctor.
| Condition/Occasion | Why should you inform the doctor? |
|---|---|
| Diabetes | Melatonin can affect blood sugar levels. |
| Cancer, hormonal problems, immune system diseases | Melatonin may have an effect on these conditions and their treatments. |
| Liver disease | Because melatonin is removed from the body by the liver, it can be dangerous for liver patients. |
| Depression or other mental illnesses | Melatonin can alter mood and exacerbate existing symptoms. |
| If you are pregnant or expecting a baby | There is not enough data on the safety of melatonin during pregnancy and breastfeeding. |
| Other... (allergies, alcohol use, seizures) | It is essential to seek medical advice regarding the use of melatonin under any of these conditions. |
How exactly do you use this?
If you use melatonin, it is very important to do it correctly.
- Take this pill with a glass of water . Do not take it with food.
- This is usually taken an hour or two before going to bed .
- After taking melatonin, don't do anything other than getting ready for bed, because you'll start to feel sleepy.
- Some tablets are dissolvable or chewable, but some must be swallowed whole. So read the instructions on the box carefully , or follow your doctor's instructions.
- Never take more than the prescribed dose. If you forget to take a dose at the scheduled time, skip the missed dose. If it is almost time for your next dose, take that dose only. Never take a double dose to make up for a forgotten dose.
What if you give it to children?
Special care should be taken when giving melatonin to children. It is not recommended to give melatonin to children without a doctor's recommendation. Since children's hormonal systems are still developing, giving hormonal supplements like melatonin can have long-term effects. Therefore, if your child has sleep problems, be sure to see a pediatrician.
Things to consider when taking melatonin
Melatonin may make you feel drowsy or dizzy . Therefore, do not drive, operate machinery, or do anything that requires alertness after taking it. To reduce the risk of dizziness and falls, especially if you are an elderly person, do not get up suddenly from a standing position or from a sitting position.
Another dangerous thing here is that after taking melatonin, some people get out of bed and do various things without realizing it. For example, sleep-driving, cooking, eating, talking on the phone, etc. You won't remember any of this the next morning. This can be serious. If you find out that this has happened to you, call your doctor immediately. Also, don't take melatonin on the day you drank alcohol or took other sleeping pills. Doing so will increase the risk of these sleep-related activities.
The most important thing: Supplements like melatonin are not subject to strict quality control like medicines in our country or in many countries around the world. This means that we cannot give a 100% guarantee about their purity and dosage accuracy. Just because they are labeled as 'natural' does not mean they are always safe for people.
If you think you have taken more melatonin than you think, immediately call the National Poison Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other things that may interact with melatonin (Drug Interactions)
Melatonin can interact with other medications, supplements, or habits you are taking. This can increase side effects or change how well your medications work. So be sure to tell your doctor about all the medications, vitamins, and alcohol you take.
| Drug/substance type | Description and risk |
|---|---|
| Never take melatonin with these medications. | |
| Fluvoxamine, Ramelteon, Tasimelteon | These are also medications that affect sleep or mood. Taking them together can cause serious side effects. |
| Melatonin may interact with these things (seek medical advice) | |
| Alcohol and caffeine | Alcohol increases sleepiness, while caffeine can reduce the effects of melatonin. |
| Hormones, such as birth control pills and patches | It can affect the body's melatonin levels. |
| Some blood pressure medications (e.g. Nifedipine) | Melatonin can affect blood pressure. |
| Medicines that prevent blood clotting (e.g. Warfarin) | The risk of bleeding may increase. |
| Mental illness, seizure medication (e.g. Carbamazepine) | These medications may interfere with their effectiveness. |
| Smoking tobacco | Smoking can increase the rate at which the body breaks down melatonin. |
What are the side effects?
Like anything, melatonin can have side effects. Some are serious, some are common. Let's take a look at what they are.
| Side effects that should be reported to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Changes in mental status | Restlessness, agitation, increased depression, suicidal thoughts. |
| Side effects that should be reported to the doctor if they persist or are bothersome | |
| Feeling sleepy the next day | Excessive sleepiness that persists even after waking up in the morning. |
| Other minor effects | Headache, nausea, dizziness, bedwetting in children. |
Take-Home Message
- Melatonin is a dietary supplement that helps with sleep, not a medicine that cures a disease.
- Be sure to talk to your doctor before using melatonin, especially if you have other medical conditions.
- Avoid driving as melatonin can make you feel sleepy. Be aware of unusual behaviors such as sleepwalking.
- Since dietary supplements are not subject to strict controls like medications, buy from a trusted manufacturer.
- Never give melatonin to children without medical advice.
- Tell your doctor honestly about all the medications, vitamins, alcohol, and smoking habits you take.
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