Many parents have questions about the use of melatonin supplements for children who have difficulty sleeping. It is very easy to get wrong information off of the internet, and even many doctors are ill-informed about the use of dietary supplements, and they themselves sometimes fall prey to the idea of, “well, it’s natural, so it must be safe.”
In the case of melatonin, this is not necessarily the case. I advocate the use of caution and restraint with regard to the use of melatonin for children. Let’s take a look at the facts.
Melatonin is a chemical secreted from an area in our brains known as the pineal gland. Once released, it enters our bloodstream where it can often behave as a hormone, acting on different parts of the body. Although melatonin is now understood to have a wide variety of effects on our bodies, it is perhaps best known outside the medical community for its influence on our so-called circadian rhythms and sleep cycles.
When melatonin begins to circulate in increased amounts in our bodies, it can help regulate the sleep-wake cycle by triggering drowsiness, decreasing appetite, lowering body temperature, and acting to trigger other physiologic changes associated with sleep. Daylight helps regulate this cycle: photoreceptors in our eyes, in response to daylight (or more specifically, in response to a particular type of blue light that’s found within daylight) signal the brain to decrease release of melatonin. At nighttime, without the influence of daylight to keep melatonin levels at bay, larger amounts of this substance can be secreted, carrying the potential to lead to increasing drowsiness. It should be noted, however, that recent research has begun to suggest that melatonin actually has a much smaller effect on our sleep/wake cycle than previously predicted.
Despite the general pop culture belief that taking melatonin supplements (often used in doses of 2-3mg) will help cure insomnia and sleep-related disorders, the actual data is far less conclusive. A 2006 study for instance, failed to show a benefit for using melatonin to treat secondary sleep disorders – i.e. sleep issues triggered by jet lag, shiftwork, etc. Furthermore, the FDA has not approved the use of melatonin as a drug, instead categorizing it as a dietary supplement. This means that that the bottle of melatonin on sale behind the counter in a convenience store lacks the rigorous safety testing or regulation as, for instance, the bottle of aspirin sitting next to it.
Not only is the safety of long-term use of melatonin uncertain, there are also some definite (and significant) side effects that are already known about this supplement. For instance, melatonin can disrupt with our sexual functions, by interfering with the portion of the brain that secretes luteinizing hormone and follicle-stimulating hormone. These hormones are critical in both men and women for regulation of sperm production, ovulation, libido, and other sexual functions. Other known side effects of melatonin use can include nausea, irritation, and potentially dangerous drops in blood pressure.
Of great concern to me is the phenomenon of hormonal down regulation. Simply stated, when you supplement the body’s hormones either long term or in excessive amounts, your body becomes desensitized to that hormone, and possibly begins to stop producing it on it’s own. This is what is happening when I hear parents say “We started Johnny on 2mg of melatonin and now we’re up to 6mg! It works great! He’s been on it for years now, he can’t sleep without it. It’s totally natural, so it’s fine!” This is an example of how long term, over supplementation of melatonin can have an adverse effect on the body’s natural chemistry.
Should you decide to use melatonin as a sleep aid for your child, use the lowest dose possible, and for the shortest period of time possible. I would consider this the last resort before pharmacological intervention. As a well informed parent with all the facts in front of you, you will make the the best choice for your family.
So – what are “essential fatty acids”? What’s the buzz about Omega 3’s?
First, let’s take a step back and explain what fatty acids themselves are. Fatty acids in general are basic molecules used in lots of different places in our bodies. They can be used for instance, as energy and fuel sources, as structural components in cells and proteins, and to assist in digestion, in addition to many other uses. Our bodies can make lots of these fatty acids on their own, but some types have to be acquired from the environment in foods that we eat. These are what we call Essential Fatty Acids.
Essential fatty acids exist in a few varieties, but so far only two are currently thought to be required for humans. These are the omega-3 and omega-6 fatty acids. Omega-3’s are perhaps the most commonly known, and this is what we’ll be looking at for the rest of this discussion.
Omega-3 fatty acids fall under the category of polyunsaturated fatty acids, or PUFAs. There are actually three separate types of omega-3 fatty acids seen in human physiology. The first, alpha-linolenic acid, or ALA is found in plants. Sources of this type of omega-3 fatty acid include seeds such as chia, flax and soybeans (the full list is much longer).
The other two forms of omega-3 fatty acids are found in marine sources. Docosahexaenoic acid (DHA) is often seen in cold-water fish, such as salmon, tuna, bluefish and sardines. Eicosapentaenoic acid (EPA) is found in fish as well, including cod liver, herring, salmon, and mackerel. While these acids can of course be ingested by eating fish, they are also available in a variety of supplemental products, such as fish oil gelatin tablets.
Many studies show that omega-3s can be beneficial in the treatment of chronic health complaints including asthma, depression, cardiovascular disease, ADHD, and autoimmune diseases, such as fibromyalgia and rheumatoid arthritis.
So what role do omega 3-fatty acids play in the treatment of pain and disease, or in overall health maintenance?
"All these diseases have a common genesis in inflammation," says Joseph C. Maroon, MD, professor and vice chairman of the department of neurological surgery at the University of Pittsburgh School of Medicine. Omega-3's reduce the inflammatory process in the body that leads to many chronic conditions.
Studies from the University of Michigan show that fish oil significantly diminishes the production and effectiveness of various prostaglandins, naturally occurring hormone-like substances that can accentuate inflammation and thrombosis.
In another controlled study of the anti-inflammatory effects of Omega-3s by Dr. Maroon, the results showed that compared to ibuprofen, omega-3 EFAs demonstrated equivalent effect in reducing arthritic pain. Sixty percent of the participants in the study reported improvement in their pain levels, and no side effects were reported. Omega-3 EFA fish oil supplements appear to be a safer alternative to NSAIDs for treatment of nonsurgical neck or back pain.
In short, Omega-3 fatty acids have the effect of reducing inflammatory processes in the body. They are a beneficial supplement for management of chronic pain and certain diseases, and are also a valuable tool in preventative wellness care. I recommend choosing a high quality fish oil, tested for purity and free from contaminants, such as Standard Process Cod Liver Oil, or Tuna Omega 3 Oil. As always, consult with your healthcare practitioner before adding any new supplements, and feel free to contact me with any questions!
Allison Blaisdell, MSTOM, Lic.Ac. is a licensed acupuncturist and herbalist in private practice at Fitchburg Acupuncture, and also at Massachusetts General Hospital. She offers Acupuncture, Hypnosis, Nutritional Response Testing, and Frequency Specific Microcurrent, as well as online holistic health coaching and consultation. Her mission is to educate and empower her patients to achieve their best possible health.