🩺  Conventional Medicine

Melatonin works (in the short term). Three things to consider:

(1) Studies show the actual amount of melatonin varies greatly between brands and even within the same brand. The amount is significantly greater or less than the amount on the label. And you never know what bottle you’ve got even if you buy the same brand every time. So it’s best to use a pharmaceutical grade melatonin if you can.

(2) We don’t like to give to patients under 3 years of age because the sleep difficulties are almost always behavioral.

(3) Most of my own patients who use(d) melatonin continually increase the dose as time goes on to get the same effect and then eventually say it “stopped working.” That was over years.

🌿  Integrative/Functional Medicine

Melatonin ok for rare occasions but not regular use. Here’s how melatonin works.

Melatonin is made in the pineal gland. It releases melatonin in two ways.

(1) The first is norepinephrine which stimulates the release of melatonin. Norepinephrine is easily converted to epinephrine by cortisol (stress hormone). So if you are stressed, norepinephrine will be depleted and thus little melatonin will be released.

(2) The second is the suprachiasmatic nucleus (SCN). When the SCN receives photons (light, particularly blue light) it remains active and tell the pineal gland to stop releasing melatonin.

The treatment then for better sleep is to reduce stress/excitement and turnoff all blue light 3 hours before bed. The idea is that the sunset is red and prepares us for sleep by releasing melatonin. Blue light is not naturally present in the evening or at night. So blue-blocking glasses are a perfect compromise if you don’t live in a cave. Put the glasses on 3 hours before bed and the body should have enough melatonin naturally to fall asleep.

How is melatonin made? Tryptophan is converted to serotonin and serotonin is converted into melatonin. I don't like to mess with little kids' melatonin levels directly because I don't want to mess with the natural feedback loops of serotonin.

🔮 Hippie Medicine

Some believe the pineal gland is our third eye and is the gateway to higher creativity (lucid dreaming, etc). The pineal gland actually has retinal tissue and the same physical wiring to the brain’s visual cortex. In the end, I believe we should protect the pineal gland and honor this gland through meditation and other spiritual avenues.