Melatonin And Dysautonomia

[shadesofgrey49]

I found a journal article about how melatonin reduces the sympathetic nerve responses to orthostatic stress in humans.

This was particularly alarming to me because I've been dependent on melatonin (and lots of it) to sleep for about four years.

Has anyone else ever heard of this?

http://jp.physoc.org/cgi/content/full/551/3/1043

[firewatcher]

There is a good summary of this on the main page of this site. For some, melatonin makes POTS worse. For me, it has been a good thing. It lowers both my HR and BP. There are as many variables in responsiveness to melatonin as there are types of POTS and symptoms. I think for those who are hyperadrenergic or have severe migraines, melatonin would work well. If you have used it successfully for four years, I would not worry too much if at all.

Dosage is also important, I know several people who have to take 6+mg to see any difference, but I only need 1.5 mg.

Another thing to take note of is that Beta Blockers eliminate all natural melatonin from your system.

[lloppyllama]

I am on beta blockers and melatonin, so that is interesting that beta blockers get rid of the natural melatonin, it makes a huge difference for my sleep. I am not going to worry about it...I will ask my doc, but as long as they thinks its ok, I will too. Thanks for sharing though, good to know!

[firewatcher]

I have NEVER, and I mean NEVER slept as well as when I took melatonin about 3 hours after taking my Inderal. I had to stop my night-time dose of Inderal because of bradycardia and have not slept as well since then. My sleep doc said that it made perfect physiological sense: get rid of your natural melatonin and then put it back at exactly the right time.

I have a delayed melatonin onset (circadian) disorder, so by putting it back at the correct time I slept great!!!!!

[Rachel]

I've been taking melatonin for about a year and a half now. I can't sleep without it. I haven't noticed any adverse effects from the melatonin.

This has all been supervised by multiple doctors, so I'm not concerned.

Rachel

[shadesofgrey49]

I'm worrying that my melatonin ingestion brought on my POTS symptoms. Is that possible?

[firewatcher]

I'm worrying that my melatonin ingestion brought on my POTS symptoms. Is that possible?

I wouldn't think so, but if it's that simple, stop the melatonin for several weeks and see!! Man, I'd love a fix like that!

[shadesofgrey49]

Seriously. Wouldn't that be nice?

But I guess the specialists would have figured that out by now...

[Rachel]

I'm worrying that my melatonin ingestion brought on my POTS symptoms. Is that possible?

I had POTS for about 12 years before I even started taking melatonin.

If you're concerned that it melatonin may not be good for you, you can always try going without it for a while, and definitely check with your doctor.

[juliegee]

I tried melatonin once and had the worst headache of my life. I wonder what dose I took? Can anyone recommend a good starting dose?

[MelissaCrystal]

Melatonin changed my life, but not in the way most people would think ;p

I've been chronically ill since 6th grade, but I never knew it was Dysautonomia until I had a horrible reaction to Melatonin and couldn't function the next day. I looked it up on Wikipedia, and low and behold--POTS and Dysautonomia! That's when I started going to specialists to find out if I had it, and turns out I do.

Yayyyy, melatonin, thanks for making me really sick =) I'd probably be labeled a hypochondriac and living with my mom if it wasn't for that discovery.

[Lenna]

Julie,

For as starting dose, my son's doctor told him to take 3 mg. After a couple of weeks, he increased it to 6 mg. I routinely take 3 mg.

If it gave you a headache, I would start with an even smaller dose and work up very gradually.

Lenna

[Rachel]

Julie,

I take 3mg each night. This is the dose my doctor recommended. 3mg tablets are the easiest to find in the stores. If you had a headache from melatonin in the past and want to try it again, perhaps a dose of just 1 or 1.5 mg would be the best place to start.

Rachel

[MelissaCrystal]

Does Melatonin actually make some of you guys feel better?

I'm worried, because yes, Melatonin is the only thing that puts me to sleep, but I'd never ever take it again because I get lasting effects from it that can last for up to 2 days--makes me feel extremely tired, weak, low BP, dizzy, and trouble breathing. I hope none of you guys are making your symptoms worse than they are. =( I know things effect everyone different, but I was taking Melatonin for a while without realizing it was the cause of my horrible POTS episodes. It's exactly like my POTS episodes, which was confusing, but it was definitely the melatonin that was causing it.

[firewatcher]

Does Melatonin actually make some of you guys feel better?

I'm worried, because yes, Melatonin is the only thing that puts me to sleep, but I'd never ever take it again because I get lasting effects from it that can last for up to 2 days--makes me feel extremely tired, weak, low BP, dizzy, and trouble breathing. I hope none of you guys are making your symptoms worse than they are. =( I know things effect everyone different, but I was taking Melatonin for a while without realizing it was the cause of my horrible POTS episodes. It's exactly like my POTS episodes, which was confusing, but it was definitely the melatonin that was causing it.

Melissa,

Melatonin will lower your BP and HR, so if you have orthostatic hypotension, it WILL make it worse. When you say that it is the only thing that puts you to sleep...how much do you take and when (immediately before bed)? Have you tried other sleep medicines (Ambien, Lunesta, Sonata...)? Have you seen a sleep doc? If you have a circadian rhythm disorder then melatonin is the only thing that will help you sleep, you are just making it naturally at the wrong time and then adding too much by using the supplement. My sleep doc pointed out that artists and computer programmers are notorious for having circadian timing problems. If you stay up till you are sleepy (1-3am?) and then go to bed, do you get to sleep OK? Is it really hard to get up in the morning?

Melatonin and it's action are not fully understood by scientists. It does much more than just tell your body when to sleep. It acts directly on the hypothalamus (center of control for the ANS), but it also effects many other systems. As exquisitely sensitive as our systems are, it makes sense that anything that effects our nervous systems will be magnified and change our symptoms.

For everyone else, I'd like to climb on my soapbox here for a second:

Melatonin and ALL the OTC supplements ARE DRUGS!!!!!

Just because you can get them without a prescription does not mean that they are harmless, or that you need them! Many of these have mechanisms of action that are not understood. Many (MSG, melatonin, GABA, 5-HTP) act directly on the brain and nervous system.

Use them cautiously and under your doctors supervision.

We don't react to anything like "normal" people do, so we can totally screw ourselves up by following the advice of "normal" people. Listen to your body, it isn't going to lie to you.

OK, I'll get down now.

[Rachel]

Melissa,

I am much worse without melatonin.

[MelissaCrystal]

Does Melatonin actually make some of you guys feel better?

I'm worried, because yes, Melatonin is the only thing that puts me to sleep, but I'd never ever take it again because I get lasting effects from it that can last for up to 2 days--makes me feel extremely tired, weak, low BP, dizzy, and trouble breathing. I hope none of you guys are making your symptoms worse than they are. =( I know things effect everyone different, but I was taking Melatonin for a while without realizing it was the cause of my horrible POTS episodes. It's exactly like my POTS episodes, which was confusing, but it was definitely the melatonin that was causing it.

Melissa,

Melatonin will lower your BP and HR, so if you have orthostatic hypotension, it WILL make it worse. When you say that it is the only thing that puts you to sleep...how much do you take and when (immediately before bed)? Have you tried other sleep medicines (Ambien, Lunesta, Sonata...)? Have you seen a sleep doc? If you have a circadian rhythm disorder then melatonin is the only thing that will help you sleep, you are just making it naturally at the wrong time and then adding too much by using the supplement. My sleep doc pointed out that artists and computer programmers are notorious for having circadian timing problems. If you stay up till you are sleepy (1-3am?) and then go to bed, do you get to sleep OK? Is it really hard to get up in the morning?

Melatonin and it's action are not fully understood by scientists. It does much more than just tell your body when to sleep. It acts directly on the hypothalamus (center of control for the ANS), but it also effects many other systems. As exquisitely sensitive as our systems are, it makes sense that anything that effects our nervous systems will be magnified and change our symptoms.

I could never use it for my circadian rhythm because I couldn't take it regularly--got too tired all the time-- for me it actually works instantly...I start to get drowsy and my BP lowers a bit which really tires me out (or makes me weak). For some reason my nervous system is just typically stubborn and doesn't react to any SSRI's, sleeping pills, numbing agents, sedatives, and anesthesia. I bet a lot of the people on the forums can relate--ugh, so annoying. They don't react to most things, but then every once in a while I find something that it overreacts to--like vicodin, pain killers of all kinds, some depressants, pot, and alcohol.

Never ceases to amaze me how backwards out nervous systems can get---and how POTS people can be polar opposites but with the same base issue. Hopefully someday we'll figure it out =p

[firewatcher]

For some reason my nervous system is just typically stubborn and doesn't react to any SSRI's, sleeping pills, numbing agents, sedatives, and anesthesia. I bet a lot of the people on the forums can relate--ugh, so annoying.

Melissa, no kidding!

Every surgery or procedure I have ever had I have been hard to knock out! I remember every operating room I've been in and the really surprised looks on the faces of the surgeon and the nurses! Every time it's the same: "why are you still awake, didn't they give you...?"

I think I've been through every sleeping pill ever made! I also have NO tolerance for alcohol (everything gives me a headache, except whiskey and tequila...margaritas anyone? )

If you react that strongly to melatonin, try a smaller dose. Maybe even those dissolving wafers, they are the smallest dose. If you are that sensitive, you may even try light therapy, it also works directly on the hypothalamus and may give you more energy and swing your circadian rhythm back in line. DON'T try Rozerem if melatonin works that well, it's super-melatonin.

[ramakentesh]

Im starting to think that melatonin could be an interesting indicator in terms of whether a patient's primary problem is sympathetic excess (in which melatonin should help by dampening sympathetic nerve activity) or whether it is another issue (blood pooling, partial denervation and compensatory tachycardia and sympathetic overflow).

I wonder whether melatonin dampens both the sympathetic and parasympathetic systems? Perhaps the sympathetic overacitivty in some patients is caused by partial denervation resulting in hypersensitivity of remaining receptors? In these patients they may appear to be hyper, yet when treated with something that dampens sympathetic activity, may feel worse.

It could also even more confusingly be that we could cycle from one state to the other, so what helps sometimes may not at other times. Or our sympathetic systems could be fine and its just our parasympathetic systems with a problem (suggesting a combined alpha/beta blockade and mestinon treatment protocol).

I think the answers are coming out with these kinds of observations.

I regularly email my doctor and have a friend who emails other researchers with these kinds of information from patients. I get the feeling they are rarely interested, but the answer is in there somewhere.

Edited July 7, 2009 by flop

[firewatcher]

Ramatentesh,

Melatonin is a potent ANS relaxant for me. Within an hour after taking it, my HR and BP will drop dramatically (not a problem since I am tachycardic and hypertensive when upright!) I feel much calmer after I take it. My sleep doctor is very into the circadian rhythm thing and has pointed me in that direction already and I have read that delayed sleep phase disorder patients not only have a delayed melatonin onset, but much lower levels of melatonin in their systems. Again its all the ingredients for brain chemistry soup here: melatonin also regulates ADH (vasopressin) and has direct interactions with serotonin and the other neurotransmitters as well as partial regulation of menstrual cycles.

I really wish I could see the picture that's on the outside of this puzzle's box, the pieces seem to fit together in too many different ways...

[tinkerbella]

i used to use it until i found that it can bring out an underlining autoimmune disease. none of my docs knew this as my ana kept climbing and climbing.

i now use cal. and vit d in the middle of the night when i wake to lull me back to sleep.

i don't have the article but found it by googling melatonin.

i'll never take it again and it did help me sleep. I just don't need one more thing and yes, firewatcher i'm with you. OTC SUPPLEMENTS ARE DRUGS and people pop them like candy. if one helps maybe 2 will do better. oh, and forget to tell the doctor. that's a big no no.

blessings and

bellamia~

[jjb]

I have been taking melatonin for years. It works better than any sleep med I have taken with fewer side effects.

I also have circadian rhythm disorder.

I do think though that melatonin does worsen my dys symptoms and I have been trying to get off of it.

For the circadian rhythem issues, I find light therapy to be very helpful.