Melatonin levels decline gradually over the life-span and may be related to lowered sleep efficacy, very often associated with advancing age, as well as to deterioration of many circadian rhythms.
Regardless of whether it truly helps with sleep or not, Dr. Ramkissoon doesn't recommend taking melatonin long-term.
In people who are over 90 years old, melatonin levels are less than 20% of young adult levels. Different factors cause the decline in age-related melatonin production, including calcification of your pineal gland, which is very common, and issues with light detection due to eye conditions, such as cataracts.
The anti-aging effect of melatonin is exerted by upregulating the expression of silent information regulator 1/Sirtuin 1 (SIRT1), which reduces oxidative stress damage, decreases p53 activation, and inhibits the NF-κB pathway. Radiation can induce premature senescence through direct or indirect oxidative stress damage.
Topical melatonin is also important in a routine with an anti-aging focus, as it helps to protect against free-radical induced cell damage. Levels decrease with age, so using topical melatonin in your skincare routine can help supplement this natural depletion.
In the UK and most of Europe, it's classed as a medicine, not a health supplement and as such, requires a prescription. This is because melatonin is considered “medical by function” which means that it requires a drug licence.
Do not use melatonin if you are pregnant or breastfeeding or have an autoimmune disorder, a seizure disorder or depression. Talk to your health care provider if you have diabetes or high blood pressure.
In several clinical trials, melatonin was found to be well tolerated and not associated with serum enzyme elevations or evidence of liver injury. Despite wide scale use, melatonin has not been convincingly linked to instances of clinically apparent liver injury.
The possible dangers of using melatonin long-term
As with many hormones in our bodies, having too much or too little melatonin in your system long term can cause health concerns. The problem when taking a melatonin supplement is that since it's not a drug, there's no oversight or regulation by the FDA.
Furthermore melatonin has been shown to have valuable effects on cardiovascular health, blood pressure, and endothelial function and it might benefit patients with heart failure.
Stopping the use of melatonin
You should not get any harmful discontinuation or withdrawal effects if you stop taking melatonin. However, you may get your old symptoms back. If you are on a high dose, then the doctor may wish to reduce the dose slowly before stopping it completely.
Melatonin is generally regarded as safe for seniors by physicians and pharmacists because its side effects are mild, it's not habit forming, and it does not cause withdrawal symptoms if you stop taking it suddenly.
Melatonin is generally considered safe to take every night at doses between 0.5 mg and 5 mg. A safe starting dose of melatonin is between 1 mg and 5 mg for adults. More melatonin can cause side effects, particularly in older adults. For older adults, lower doses, such as 1 mg, are usually considered enough melatonin.
It's important to note that there isn't a “safe” dosage of melatonin. Generally, an adult dose is thought to be between 1 and 10 mg. Doses near the 30 mg mark are usually considered to be harmful.
Melatonin does tend to have less risky potential side effects than certain prescription sleep aids, Grandner says, but he adds that “melatonin is not a good alternative to prescription sleep medications. It does not work as a sedative and it is ineffective in most cases of insomnia.”
The NDPSC considered that insufficient information was available on the safety of melatonin to allow it to remain exempt from scheduling for human therapeutic use and that it should not be available without prescription.
French authorities are urging certain populations to avoid consuming food supplements containing melatonin after incidences of adverse effects were reported to the country's nutrivigilance scheme.
Natural alternatives to melatonin, such as magnesium, valerian root, l-theanine, chamomile, and passionflower, are all-natural remedies that have been used for centuries to promote relaxation and help people get a better night's sleep.
These results provide new evidence that melatonin stimulates the proliferation and type I collagen synthesis in human bone cells in vitro, suggesting that melatonin may act to stimulate bone formation.
Sleeping on your back
According to Dr. Vasyukevic, the supine position is the best position all around for prolonging youthful skin. Not only does it prevent wrinkles due to the lack of wrinkle-inducing friction, it also stops the skin from feeling the pressure of your face "folding" into the pillow.
They also showed that oral intake of estrogens reduces the nocturnal secretion of melatonin. The above observations indicate that low levels of estrogen after menopause should result in increased secretion of melatonin.