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I've been searching through many news stories, most of which I've read before but today I came across something new! How Melatonin can be dangerous for people with Orthostatic Intolerance.

Study Shows Melatonin Supplements May Make Standing A Hazard For The Cardiovascular-challenged


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Thanks for the article biarrose. I had no idea. I take melatonin on an as needed basis. I feel sluggish in the morning but not if I take a very small dose. I wonder what dose they used in the study. Also, if they used healthy volunteers and they had abnormalities, I can only imagine what it might do to us.

There is a melatonin agonist that will be released soon, I hear. It will be by prescription. I bet it might cause the same effect.

I don't like sleeping pills or benadryl. Benadryl really does make my POTS worse by the way. What do others think of valerian root or other natural remedies? I might have to resort to warm milk at bedtime. It works for my small children.


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melatonin made me feel pretty dern woozy when i tried it this past year. i still woke up a bunch throughout the night, just felt "drugged" when i did. and after a bad crash about a week or so after starting it i scrapped it altogether.

a sleep doc mentioned to me about a new prescription melatonin...but it's already on the market i believe so perhaps it's something different.

re: natural remedies in general, in theory i'm all for them but in practice it's another story. the major issue that i have - as do some of my docs - is the fact that they're so unregulated that there's no way to really know what you are/aren't getting. i know that some have had luck with things & i'm not saying i don't ever consider/try options (i.e. the melatonin) but that's my biggest concern with them generally. that and that people tend to think they're "less" that "real" meds in terms of potential side effects, interactions with other meds/foods, potency, etc.

just my two cents...

:huh: melissa

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Hi Sunfish,

You expressed concern about natural remedies as not being able to know with certainty what is in them. Maybe I can shed some light on using natural remedies with confidence, or at least with discretion. I am an RN, worked for years in the regulatory side of the pharmaceutical industry, and also owned a health food store.

First, it's a myth that natural remedies are unregulated in the U.S. They are indeed regulated by the FDA and subject to the federal code of regulations. They are regulated differently from drugs, as they are not drugs, but they are regulated. To confirm for yourself, go to the the FDA website - www.fda.gov - and note in the left side box the scope of FDA-regulated products. Supplements comes under the first category of "food". IMO, the FDA has been remiss in their duties to we taxpayers, but that's another post entirely.

Second, many natural health manufacturers subscribe to either their own professional societies guidelines or to the FDA pharmaceutical manufacturing guidelines. Of course, there are plenty who subscribe to absolutely no guidelines at all.

How to tell? If a company makes any OTC (over the counter) products (you can tell these by an NDC number and an information box on the package that list "drug facts" - the layout will look similar to the information box on tylenol, tums, sudafed, etc.), then all of their manufacturing must be in compliance even for their supplement products. For example, Enzymatic Therapy makes a product called Air Power which is an otc (active ingredient is guafenesin), so they are in compliance with pharmaceutical manufacturing regs. Companies such as Nature's Way and Nature's Herbs also make OTCs so are in pharma compliance. Another company, Carlson, says on its packaging "Made in an FDA approved facility".

What does this mean? It means that if the label says 100 mg of licorice root, that in fact is in the bottle. It is tested for batch to batch consistency for active constituents, contamination by biologics (mold, bacteria, etc) and also for contamination by other products. That is, it is only licorice and nothing else. Since such companies have invested a lot of money in their manufacturing infrastructure - equipment, procedures, staff - and make themselves open to FDA inspection, they are also likely to choose appropriate top quality ingredients as well. What does that mean? Well, have you ever bought a cheap coffee vs a really good coffee? A flavorless green house tomato vs a really sweet garden grown variety? Same applies to herbs. BTW, homeopathy is an OTC in this country and therefore regulated as a drug.

My advice - buy only supplements from top quality suppliers and from manufacturers who are members of NNFA - the National Nutritional Foods Association. Investigate their quality procedures. Avoid supplements sold on tv, the internet (only) and out of someone's home. Advertising "quality" on a label or in written material is meaningless. Ask to see the documentation. I can't tell you how many manufacturer's reps tried to get me to carry their line by a lot of fast talk about quality. But when I demanded the procedural documentation signed off by their quality and regulatory staff, NOTHING. Documentation should either say that they're in compliance with the gmp (good manufacturing procedures) guidelines of the NNFA or the gmp guidelines of 21 CFR (code of federal regulations). It must be dated and signed by someone with authority in the quality group (eg, Joe Smith, VP Quality) and be on company letterhead.

If you have a chronic condition and plan to use supplements, I advise subscribing to a publication that the Journal of the American Medical Association called the "gold standard" of supplements - the Natural Medicines Comprehensive Databse published by The Pharmacist's Letter. (www.naturaldatabase.com) You can subscribe either just online (which I like best - continual updates) or buy the book. You can print off supplement fact sheets to take to your doctor which lists the action, interactions, contraindications, etc plus gives all the relevant references to the scientific literature. The layout is similar to the PDR, so docs find it easy to read. Almost all pharmacies now stock this reference, so if you're on meds and buying supplements, your pharmacist can help guide you.

Sorry this is so long, but hope it clarifies some issues. I'd be happy to answer any questions

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