Melatonin: Balancing the Stress-Hormone Attack with a Way to Relax
In this series, we’ve explored the havoc that can result when our hormones are thrown out of sync. These chemical messengers are potent and regulate almost all bodily processes. So, the downstream effects of any imbalance in them can seriously affect our mind and physiology.
In Part I of the stress-hormone attack, I discussed the stress hormone, cortisol. Although it is essential for optimal functioning, when it gets too high, it alters our other hormones, especially progesterone. This shift occurs because when our body is under threat, or appears to be, it prioritizes our survival over reproduction and recovery.
Thankfully, we can help to re-adjust cortisol levels by implementing lifestyle practices, stress relief tactics, dietary interventions, and aromatherapy, herbs, and supplements within a naturopathic and functional medicine protocol.
Another way we can nourish our body’s ability to de-stress is through cortisol’s counterbalancing hormone, melatonin. Whereas cortisol keeps us on point, melatonin helps us to relax and wind-down. The relationship between these two key chemical messengers is vital for harmonizing our wakefulness with our rest.
With approximately 1 in 5 (about 17%) Americans reporting to be on sleeping medications in 2020, it is essential to find some alternative approaches to assist with the ability to unplug at night. This is especially true considering that hypnotics are meant to be used only for short-term and have some scary side effects.
Supporting melatonin may be one way to help us fall asleep naturally, while offering side benefits. This is because melatonin also plays a role in regulating many biochemical pathways that can be altered by stress.
In this post, I will cover everything you ever wanted to know about cortisol’s trusty sidekick. Topics include:*
- What melatonin is
- What melatonin does
- Clinical studies on the benefits of melatonin
- What influences melatonin
- How melatonin works
- What occurs when melatonin and cortisol are deregulated
- Functional medicine tests for assessing the melatonin-cortisol relationship
- How to balance melatonin naturally with naturopathic and functional medicine
- FAQs about supplementing with melatonin
*This post is based on one of my publication on Rupa Health with some additional information and my clinical experience.
What is The Relationship Between Melatonin and Cortisol?
Before getting into melatonin, let’s review exactly how it is linked cortisol.
To stay alert, our body needs cortisol. For this reason, cortisol levels in the blood tend to be highest in the early morning (around 8 a.m.) and decrease slightly in the evening and into the early sleep phase.
Melatonin has the opposite schedule. It is released after sunset and peaks between 2-4 a.m., decreasing into the day.
Therefore, cortisol and melatonin are on opposing ends of our day-wake cycle, known as our circadian rhythm or chronobiology. They are the “yin and yang” hormones, balancing each other. If one is off, like all hormones, so is the other.
What is Melatonin?
Melatonin (N-acetyl-5-methoxytryptamine) is classified as both a hormone and an antioxidant. It belongs to the indolamine family of neurotransmitters, along with serotonin. Both are synthesized from an essential amino acid, tryptophan. Humans, plants, and microbes all make melatonin and it can also be ingested from various dietary sources.
Although it is produced in pineal gland, an endocrine gland located in the brain, it is also produced in other places throughout the body. These include within our bone marrow cells, white blood cells, mast cells (immune cells), and skin (epithelial) cells. Surprisingly, our gut is one of our main producers of melatonin. It makes approximately 400x the amount of melatonin than the pineal gland!
Melatonin is also present in most bodily fluids and it has receptors located throughout our whole body (e.g., brain, spleen, adrenal glands, kidneys, fat cells, heart, reproductive organs, and others). This provides evidence that melatonin’s effect on our health is much more than its impact on our circadian rhythm. Furthermore, it also indicates that our sleep-wake cycle influences many bodily and cellular functions.
What Does Melatonin Do?
Melatonin has various vital functions in the body. These include:
- influencing on our sleep-wake cycle
- acting as an antioxidant, protecting cells and tissues from damage
- mitochondrial homeostasis
- gene regulation in reproduction
- modulation of inflammation and the immune response
- gut and digestive health
- regulating body temperature and body mass
- bone health
- neurodevelopment
Clinical Studies with Melatonin
Some clinical trials have found melatonin to be beneficial in those who struggle with maintaining blood pressure, polycystic ovarian syndrome (PCOS), certain cancers, jet lag, and sleep disorders.
Furthermore, Cochrane reviews from 2015 and 2020 found melatonin to be effective for relieving anxiety, even when compared with benzodiazepines. Other studies also suggest that melatonin alterations may occur in other mental disorders.
According to one paper, stress-induced diversion of production from tryptophan can increase synthesis of kynurenine, an inflammatory metabolite associated with depression. This is at melatonin’s, serotonin’s, and niacin’s expense. This altered pathway could help to explain the link between mood problems and sleep disorders, as well as melatonin’s additional impact on the brain.
For example, recent findings report that melatonin could help regulate memory formation, neural signaling, and synaptic plasticity in the hippocampus (memory center) and other brain regions that stress disrupts.
Additionally, one older study evaluated the effects of melatonin on sleep and mood disorders in older adults. It was found that melatonin worked better than a placebo pill for improving sleep and decreasing symptoms of depression and anxiety.
I have used melatonin in my practice with perimenopause and menopausal women for alleviating their hot flashes and sleep issues. This is based on melatonin’s role in brain support, hormonal influence, and favorable findings from several studies for these indications.
What Influences Melatonin?
Factors that influence melatonin production include:
- Age
- Health status
- Nutrition
- Light
- Computers and LED/fluorescent light
- Medications
- Lifestyle (shift work)
How Does Melatonin Work?
Melatonin is often called the “hormone of darkness.” This is related to its production being stimulated by the absence of light. Light exposure is transmitted from the retina to the pineal gland which downregulates its synthesis.
Melatonin is also produced locally in the skin from sunlight, along with vitamin D. This is likely for its antioxidant protection from sun damage.
Effects of an Unbalanced Relationship Between Melatonin and Cortisol
Our natural rhythm is often disturbed from excess levels of stress and resulting higher cortisol levels. This leads to lower amounts of melatonin which can disrupt our ability to fall asleep and cause daytime sleepiness. Circadian deregulation can also result in brain processing issues, such as decreased alertness and problems with memory and decision-making.
To compound the loss of the physical and hormonal benefits of sleep, low levels of melatonin also results in suboptimal antioxidant support, immune modulation, and gut-healing properties. These reasons help to explain why high-stress levels can cause systemic inflammation and lowered immunity.
Functional Medicine Labs to Test for Melatonin and Cortisol
Clinicians may wish to measure markers of melatonin and cortisol to determine imbalances and evaluate the next course of treatment.
The tests for melatonin can be viewed in more detail on my Rupa publication. They include:
- A melatonin profile
- A Rhythm + CAR (Cortisol Awakening Response) Test
- The CAR Profile
How to Balance Melatonin Naturally: A Naturopathic and Functional Medicine Approach to Melatonin
A naturopathic and functional medicine doctor should take a comprehensive approach to balancing both melatonin and cortisol. Genetics, increased inflammation, toxic exposures, and lifestyle factors such as sleep habits, physical activity, diet, and stress, should all be considered.
Diet
Melatonin is present in the diet via many plant and animal foods. It is found in various vegetables, fruits, nuts, seeds, grains, oils, and spices. Tart cherries are one of the most abundant sources.
Tryptophan-rich foods can also be consumed, due to its conversion to serotonin and then melatonin. However, for some individuals with genetic variations in the enzymes involved, this process may not be efficient.
Furthermore, excessive quantities would have to be ingested to reach the physiological dosage of .3 mg. That being said, it can’t hurt to include these foods in the diet to strengthen melatonin turnover.
Vitamin B12
A few human clinical trials have suggested that vitamin B12 supplementation could impact secretion of melatonin and lead to better sleep.
Blue-Light-Blocking Glasses
Several studies have found that blue-light-blocking glasses can help to prevent the melatonin-suppressing effects of light during hours of darkness. The benefits of these glasses have been studied in those with insomnia, Delayed Sleep-Wake Phase, and healthy adults.
Modulating Cortisol
Naturopathic and functional medicine interventions including (1) regulating lifestyle practices and decreasing stress, (2) enhancing nutrition, and (3) using aromatherapy, herbs, and supplements, can all help to balance cortisol. Indirectly, this can support optimal levels of melatonin.
Summary on Melatonin and It’s Relationship to Cortisol
Although melatonin is known as the “sleep hormone,” and cortisol as “the stress hormone,” they do so much more. Both are key regulator hormones in the body and have a wide range of far-reaching effects. Besides their impact on our sleep-wake cycle and stress-related processes, their balance is essential for many physiological processes.
Balancing melatonin and cortisol by regulating lifestyle processes, decreasing stress, and supplementing, when appropriate, can optimize health and benefit many body systems.
Have you ever used melatonin or tried to balance it?
Will you consider this option now?
If so, please read the FAQs below first.
FAQS About Melatonin:
How Much Melatonin Should I Take?
There is no standard dose for melatonin.
In research, dose ranges from approximately 0.3 to 5 mg per day.
The smallest dose possible for effects is recommended.
For Sleep: Physiologic doses of 0.3 mg is the amount that has been suggested for addressing sleep disorders.
For Nervous System Balance: 300 mg have been used in studies for certain neurodegenerative conditions.
How Long Does Melatonin Supplementation Last?
Melatonin levels even out to baseline between four to eight hours after taking a 1-5 mg oral dose.
Side Effects
Common side effects of melatonin include headaches, dizziness, nausea, and feeling drowsy.
Safety of Melatonin
Melatonin can potentially interact with some medications, including heart medications and immune suppressors. (This is mostly at high doses.)
Furthermore, melatonin is a hormone, so taking it long-term has the potential to influence its natural production and impact other hormones. Some evidence also shows it could influence growth hormone secretion. This is why some physicians are cautious in using it with children. That being said, there have been studies demonstrating efficacy and safety for youth and most of the concerns in children recently were due to accidents involving overdosing.
Although melatonin is generally safe and non-addictive, please be sure to monitor it with your physician and do not overdose.
Naturopathic Medicine and Holistic Resources for Hormonal, Mood, and Digestive Support
- Free resources and more education on essential oils and mind-body wellness are available to you here.
- An Integrative Mental Health and Stress Resource Guide.
- Tools for coping with isolation and separation.
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References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436856/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571539/
https://consumer.healthday.com/sleep-2659296304.html
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https://www.mdpi.com/1422-0067/23/1/471
https://www.verywellmind.com/how-sleep-affects-mental-health-4783067
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571539/#B15-nutrients-14-03934
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242161/
https://www.medicinenet.com/hypnotics_drug_class_side_effects/article.htm
https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571539/
https://link.springer.com/article/10.1007/BF03324897
https://onlinelibrary.wiley.com/doi/10.1111/j.1600-079X.2007.00540.x
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571539/
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009861.pub2/full
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009861.pub3/full
https://pubmed.ncbi.nlm.nih.gov/33969545/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571539/
https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/melatonin-side-effects/faq-20057874
https://www.healthline.com/nutrition/melatonin
https://www.mdpi.com/2076-3425/10/4/219
See all the additional references in the original article on Rupa Health here.
Disclaimer: This material is for information purposes only and is not intended to diagnose, treat, or prescribe for any illness. You should check with your doctor regarding implementing any new strategies into your wellness regime. These statements have not been evaluated by the FDA. (Affiliation link.)
This information is applicable ONLY for therapeutic quality essential oils. This information DOES NOT apply to essential oils that have not been tested for purity and standardized constituents. There is no quality control in the United States, and oils labeled as “100% pure” need only to contain 5% of the actual oil. The rest of the bottle can be filled with fillers and sometimes toxic ingredients that can irritate the skin. The studies are not based solely on a specific brand of an essential oil, unless stated. Please read the full study for more information.
Thanks Pixabay and Canva.