A Boy Ate 180 Gummy Melatonins For Lunch. This Is What Happened To His Brain.
HB is a 14 year old boy, presenting to the emergency room disoriented.
His mother Karen, tells the admitting nurse that she noticed he was acting funny,
before she found him face down in the living room.
You see, HB was always at odds with his mother. When he was younger, HB’s dad would always make
jokes about mom. On the surface, the jokes seemed funny, if they weren’t a little mean,
but dad was serious-- he was fed up with Karen’s nonsense, and he wasn't going to take it anymore.
One day, dad told HB he was going out to buy some milk, and HB never saw his dad again.
The now single mom cared for HB, but things never seemed to be ok. HB was always
loud. Whether he was watching TV or screaming at his computer, Karen just found her son, annoying,
and it was time for her to do something about it. HB liked to eat candy. His mom believed all that
sugar was making him hyperactive all the time. And at the store one day, Karen came up with an idea.
She came across gummy melatonins. She was done dealing with HB’s crap--
"Time for some peace and quiet," she thought as she filled his bag of gummy candies,
with gummy melatonins. As HB was eating his candy, he thought they were more delicious than normal,
really soft with the perfect texture that felt so good on the way down,
as he proceeded to finish the entire bag for lunch, eating all 180 gummy melatonins.
Immediately after finishing the bag of what he thought was candy, HB felt good. But as the hour
passed, he started feeling dizzy, and lightheaded. Karen was happy that her son was quieter than
normal. She couldn’t remember what it was like to finally have some quiet around the house.
But she didn’t realize that he ate all 180 gummy melatonins until she looked at the candy bag and
found it empty. As she finds her son knocked out on the floor, she panics knowing that
this was her fault as she calls for 911 and he’s brought to the emergency room where we are now.
At examination, doctors noticed that HB seemed somnolent. He was confused
when they could get a response from him. Karen kept quiet to doctors about what had
happened because she knew she did something wrong but she wasn’t going to admit it.
She needed to find a way out of this because she didn't think that HB would eat the entire bag.
It’s not my fault, she thought. If only he wasn’t so loud all the time, she thought. HB didn't know
exactly where he was and why he was where he was, but they could find that out only when they could arouse
him. He could respond to commands, meaning his brain is still in tact, but something’s wrong.
Typically in the day time, when the sun is out and it’s bright outside, people aren’t sleepy.
Even if he’s responsive, the medical team do some more tests and when they prepare
to draw blood from him, Karen, feeling guilty that all of this was caused by her, tells the
doctors that she thinks HB accidentally ate 180 gummy melatonins
because they were somehow in his bag of candy. She definitely totally had no idea
how they got in there though, and this tells the medical team everything they need to know.
Melatonin is a hormone that’s released in the brain in response to an absence
of light. In normal function, your body naturally makes it everyday.
In the United States, around Thanksgiving time, there’s always a meme that eating
too much turkey at the holiday dinner will make you more sleepy than compared to eating other foods,
because turkey has an amino acid called Tryptophan. The meme’s true. In the brain,
tryptophan becomes serotonin, a major chemical in the brain used to send signals,
and it’s this serotonin that’s used to make melatonin. And American Thanksgiving
in November, it’s already dark outside by dinner time, putting all of this together.
At the midline of the brain, outside the blood-brain barrier,
attached to the roof of the third ventricle of the cerebrum is the pineal gland,
something that’s been referred to as the "Third Eye," and it's present in almost all vertebrates.
The pinealocytes, pineal gland cells, synthesize and secrete melatonin,
and it’s here when there’s an absence of light, that a major increase in activity of the enzymes
that convert serotonin to melatonin takes place. But what exactly, does melatonin do?
Melatonin in the brain is a signal to the body’s biological clock, something called
the circadian rhythm. It suppresses some nerves and mutes the signals they send being one of the
brain’s chemicals involved in sleep. Meaning if HB took a mega dose of it by eating 180 gummy
melatonins, then the sleep signal is very strong in his brain. It should make sense
why he’s somnolent and confused. HB has hypermelatoninemia. Hyper meaning high.
Melatonin referring to this chronobiotic hormone and -emia meaning presence in blood.
Are there bad things that are going to happen to him now because of this?
Unlike some gummy vitamins, and some other gummy supplements, melatonin is endogenous,
meaning that it’s naturally produced in the body during normal function.
Because it’s a signal for time based on daylight, when it’s not present and produced,
the body appears to run on a rhythm where the cycle is longer than 24 hours.
In people who are completely blind and can’t see light, this appears to be happening to them.
Children getting fed mega doses of melatonin is becoming more common now. Poison centers
across the US have logged more than a quarter of a million pediatric melatonin ingestions
between 2012 to 2021, with the number of calls increasing dramatically every year. For something like melatonin,
poison center calls aren’t going to be for small ingestions, they’re usually for what’s thought to be big
toxic ingestions, or amounts completely unknown. And the poison centers can only record the calls
that come in. Who’s going to record the kid who silently eats a whole bottle of gummy melatonins
and never tells anyone and just acts funny for a while after they did it? Maybe the kid never even
realized that what they ate were gummy melatonins. But it’s not just the calls that have increased,
kids going to the hospital in part related to melatonin megadose ingestions increased. In the
last 10 years, at least 2 kids have passed away in the hospital, who went in because
of melatonin megadose, if not for other things as well, the information there is not known,
and the measurements aren’t going to be clean, because you’re dealing with real people.
It’s not clear that it was 100% the melatonin only that did them in because, experiments and
studies show that we have never found the max dose of melatonin in animals, and in humans.
This should make sense— an endogenous substance, that’s not stored in the body, that’s vital for
chronobiotic function, would be one that shouldn’t be overtly reactive and toxic in a negative way
in the body, because you need to have it for normal function. But on the flip side, ingesting
mega doses of gummy melatonins for whatever reason, is well outside the realm of normal function.
Generally, if you talk to someone in medicine about melatonin supplementation, there’s a couple
thoughts that will come to their mind. First is that supplementation is not always reliable.
The advertised amount of active ingredient in any product has been known to vary widely even
amongst bottles of the same product. 5 milligrams might not actually give you 5 milligrams, and for
melatonin, in some cases, serotonin was also found in sampling of some melatonin supplements, which
could cause real toxic effects in kids eating whole bottles bringing us to the next point.
Melatonin is metabolized by the liver. If someone is supplementing with it, and they’re
taking medicines for other illnesses, and those medicines are metabolized by the liver too, well,
the liver only has so many spots available for drug breakdown, and this can become a
perfect setup for an interaction to occur, where either an inappropriately increased
or decreased amount of melatonin or the medicine will float around in the body, causing problems.
This can cause the disease to flare up because medicine in the body is too low,
or it can cause toxicity from too much medicine in the blood. Luckily for HB,
he was a healthy 14 year old who wasn’t taking any medicines so that wasn’t an issue.
Different people will react to melatonin differently. Some insist that they take
huge megadoses daily to “open their third eye.” Others will be knocked out the entire
night and have the wildest dreams of their life if they take 2 gummies instead of
1. Others will also say it’ll work the first few days, but if they keep taking it, it will
stop working. Whatever the case is, melatonin is a neurologically active hormone. Generally,
you don’t want to disturb the balance of these chemicals if you don’t have to.
In the medical world, feedback systems on hormones in humans is an important concept,
because hormones are chemical messengers used to communicate things from one part of the body to
another. If you administer, from an outside source, a lot of a hormone that the body is
supposed to make, the body will compensate the balance. If the hormone is secreted by a gland,
and the body detects an abnormally high amount of that hormone, because it was administered from
an exogenous source, over very long periods of time, years to decades, that gland can atrophy,
meaning when you are no longer supplementing that hormone from the outside, your body could have a
hard time making what it’s supposed to, because the gland has atrophied. For melatonin, we don’t
know if that happens, because we don’t have large populations of people reliably taking huge doses
everyday consistently. Even though we haven’t found a maximum dose of melatonin, this sudden
increase in pediatric melatonin ingestions might give us some more clues as to what’s happening.
HB’s case isn’t unique. Courts have put babysitters and daycare staff in
prison because those people gave kids inappropriate amounts of melatonin,
as one part of their mistreatment of these kids. Even if there’s a possibility that
melatonin in the big doses given to these kids might not be toxic, it’s still giving a
supplement to these kids without asking the parents, with a possibility that it could
have consequences or place undue risk that we don’t yet know about, bringing us back to HB.
Doctors counseled Karen and HB that there might not be immediate illness that will happen
from him eating 180 gummy melatonins, because he didn't have any other signs and symptoms when
examined. His sleep schedule and circadian rhythm might be disturbed for the next several days to
weeks, but they will have to let it play out and come back to the hospital if he has any other
problems. Karen learned her lesson in not treating her son like this. Because HB did not return
to the emergency room at a later day because of this, we can assume that he made a full recovery.
Thanks for watching. Take care of yourself and be well.