Melatonin is a neuro hormone secreted by the pineal gland in the brain in response
to darkness. Hence the name for melatonin, hormone of darkness. Under normal conditions
the body releases melatonin at night in response to stimulus that affects our sleep wake cycle.
This is known as our circadian rhythm. Oral melatonin can also be produced synthetically
as a supplement that has long been used for the treatment of jet lag and insomnia, as well as for
shift workers, like nurses who need to stimulate their inner clock at times that are counter-
intuitive, to one's natural circadian rhythm.
We know that melatonin can help induce sleep and restore a normal sleep cycle,
but can an oral dose of melatonin help with anxiety? Let's talk about it.
The primary function of melatonin is to synchronize the circadian rhythm of the body.
Melatonin is secreted from the pineal gland in a circadian pattern controlled
by the endogenous circadian pacemaker in the brain called the suprachiasmatic nucleus.
The pineal gland is a very small gland shaped like a pine cone, and it is found deep in the brain.
Interesting that when the pineal gland was first discovered, it fascinated scholars
and philosophers from many cultures and was dubbed the third eye and the seat of the soul
by Rene Descartes and was conceptualized as a tranquilizing organ. Interestingly,
those who began researching the pineal gland suggested that its hormone product melatonin
could possibly be associated with longevity and that pineal gland dysfunction
and eventual failure is what initiates the aging process.
The suprachiasmatic nucleus modulates and coordinates circadian changes within the
body systems. This includes changes such as body temperature, endocrine functions,
blood pressure and sleep. Neurons within the super cosmetic nucleus
receive light information from what are known as melanopsin expressing retinal ganglion cells
from the retina through the retina hypothalamic tract, where axons make direct synaptic connection
with the suprachiasmatic nucleus cells. What you might not know about melatonin
is that this neuro hormone is also an incredibly potent free radical scavenger.
Another way to say this is that melatonin is a broad spectrum antioxidant. Antioxidants are
molecules in the body that fight what we know as free radicals, such as the hydroxyl radical.
The hydroxyl radical is a free, radical produced in the body
and is the most reactive species of oxygen. It has long been known that free radicals
can cause harm to the body. Especially if levels become elevated. These free radicals
have also been linked to multiple illnesses like diabetes, heart disease, and cancer.
Antioxidants can also be found in foods like fruits and vegetables,
other plant-based Wholefoods and several vitamins like vitamins, E and C. These are all effective
antioxidants. So where does melatonin fit into all of this? As we age melatonin,
production declines significantly. If we hypothesize that aging could be in part caused
by accumulated free radical damage, then melatonin may well play a significant role in the aging.
Scientists have been studying, whether this drop in melatonin could be prevented, and if so,
then perhaps the aging process could be delayed and this would include delaying
age-related degenerative conditions. It is well accepted among the scientific community
that free radical damage has been implicated in a number of neurodegenerative diseases.
The pineal gland also secretes many other neurotransmitters.
Serotonin as a precursor of melatonin synthesis is known to be released by Pinealocytes and
its receptor is also expressed in the pinealocytes. We know that serotonin
is one of the neurotransmitters associated with depression. From a clinical standpoint,
serotonin deficiency has several symptoms, including low mood and low sleep quality.
So when we put all of this together, what we start to realize
is that there may be a complex relationship between depression, sleep and circadian
rhythm. Before we discuss whether melatonin could help with anxiety. It's important to
clarify that not all anxiety is bad. Anxiety is our body's way of detecting possible danger
and alerting us to react to outside stimulus that could compromise our health or wellbeing.
If you are experiencing symptoms of anxiety that are affecting your ability
to cope with day tasks,. Or fulfill your commitments at work or at home,
seeking guidance from a trained healthcare provider would be the best course of action.
Anxiety is so complex that it can show up in many different forms.
In fact, there are 11 different types of anxiety and related disorders, and each of these disorders
has its own list of corresponding symptoms. Here's some of the more common physical signs
that generalized anxiety disorder can generate. You will note that irritability, muscle pain,
fatigue, and also sleep problems can all be symptoms of a generalized anxiety disorder.
A person who is experiencing anxiety may not be sleeping well or may have difficulty getting
to sleep. This can lead to poor sleep habits and a possible decrease in melatonin levels.
It is possible that in some cases, the body may not be producing enough melatonin. This can
cause sleeplessness trouble relaxing and general anxiety. Supplementing with melatonin for anxiety
therefore could potentially improve the quality of sleep and help to regulate circadian rhythm.
Practicing good sleep hygiene is also essential. This includes trying to go to bed at the same time
every night, reducing the use of devices that emit blue light within two to three hours of bedtime,
using a table lamp instead of ceiling lights to simulate the sun going down
and to train your body, to know when it's time to go to sleep.
We know that as a supplement exogenous melatonin has sleep inducing and temperature lowering
effects during what is known as biological daytime, and when taken at the right time,
it will essentially shift the phase of the human circadian clock.
As previously mentioned successful use of melatonin's chronobiotic properties has been
reported in other sleep disorders associated with abnormal timing of the circadian system.
There are some studies that suggest that melatonin exerts a sleep promoting effect
only when endogenous melatonin levels are low.
However, we can confidently say that melatonin has both sleep promoting, and circadian phase shifting
effects. But what do we know about melatonin and anxiety? In this prospective phase two trial
researchers sought to assess the effect of melatonin on circadian biomarkers,
sleep and quality of life in breast cancer, patients who were undergoing surgery for breast
cancer and thus likely to suffer from anxiety and sleep disruption. They analyzed 32 patients
with metastatic breast cancer and gave them each five milligrams of melatonin at bedtime.
For two months, they then analyzed their sleep and circadian rhythm , daily levels of cortisol
in the blood, and the expression of core clock genes in peripheral blood mononuclear cells.
They found the bedtime melatonin was associated with a significant improvement in a marker of
objective sleep quality, sleep fragmentation, and quantity, subjective sleep fatigue severity global
quality of life and social and cognitive functioning scales.
Morning clock gene expression was increased following bedtime melatonin intake. Melatonin
did not affect actigraphy measure of circadian rhythmicity or the diurnal cortisol pattern.
However, the researchers concluded that these results invite further investigation of melatonin
as a potentially useful therapeutic agent for improving sleep and quality of life
in cancer patients. There are now multiple studies, both in adults and children showing
that melatonin when given prior to surgery can help to reduce anxiety
and also act as a potent analgesic prior to surgical procedures.
So where does this leave us with melatonin as a supplement,
and what do we know about the possible side effects of supplementation?
Though the evidence on the use of melatonin solely for anxiety thus far is sparse, there is plenty
of evidence showing that melatonin when used in people who may suffer from difficulty sleeping,
due to different stressors, such as surgical procedures or a difficult
diagnosis could help to reduce anxiety levels and also help to produce an analgesic effect.
In some cases, Improving the quality of sleep in individuals who are likely to be
suffering from some level of anxiety could be beneficial. In general,
the safety of short-term use of melatonin is well-documented. Reports of side effects,
such as dizziness, headache, nausea, and sleepiness have been reported,
and it's important to note that this could potentially be an additive effect
when combined with other supplements or medications, which is why it's best to
speak with your pharmacist or healthcare provider before taking any new vitamin or supplement. In
addition to the possible additive sedation when paired with other medications or supplements,
melatonin is often contra-indicated if you have a history of seizures or are on medications like
blood thinners that could interact with this supplement, if you are considering melatonin,
it is generally recommended that you start with a low dose and take it about two hours before bed.
So should you consider melatonin for anxiety in general? Melatonin should
not be considered a go-to treatment or first-line recommendation unless there
are also sleep related anxiety issues. There is some evidence that lemon balm or chamomile
tea could be more beneficial for anxiety that is not sleep related or causing issues with sleep.
There are also different digital apps that can help patients deal with anxiety. And
of course there are prescription options that can be discussed with a healthcare
professional. What we do know is that melatonin can definitely help to improve sleep quality,
regulate circadian rhythm, and in some cases, ease negative feelings associated with anxiety.
Please ask a healthcare professional before starting or stopping any new medication or
supplement. I hope this was helpful. Thank you so much for joining me. Take care and stay healthy.