Can Melatonin Help With Multiple Sclerosis Symptoms?

Research shows that people who have multiple sclerosis (MS) have symptoms that are specific to melatonin levels in the bloodstream.¹

Melatonin is a naturally occurring chemical messenger released by the brain to facilitate sleep. Melatonin release is regulated by circadian rhythms. These rhythms are informed by several time cues, with the most important one being the availability of light in one's immediate landscape.¹

As a rule, healthy people have lower levels of melatonin in their bloodstream during the day. That is because melatonin is meant to be released into the body by the brain only as the day ends and the night begins. In the morning, as the sun rises, melatonin levels are also meant to drop off after a night's rest.

The relationship between MS and melatonin

To understand the link between melatonin's potential protective relationship to the brain in people with MS, we need to consider what we already know about MS. Here are 2 features of the MS disease process that seem to be connected to levels of naturally occurring melatonin levels in the brain:¹

• MS flareups tend to be seasonal, with more frequent attacks in the spring and summer
• MS typically occurs in people who live farthest from the equator, owing to a theory that vitamin D deficiency may be part of the root cause of MS

In both cases, available levels of melatonin in the bloodstream are shaped by time (seasonality) and location (climate).¹

Some interesting research shows that melatonin has a neuroprotective role in processes that can lead to demyelination and inflammatory response typical in MS. Simply put, the less melatonin a person produces can lead to a higher frequency of symptoms and even relapses.¹

It's been found in mouse models that melatonin can also stop the body from making destructive T cells and cytokines, which play an important role in inflammation and your immune system. People with MS are also shown to excrete more melatonin metabolite in the urine at night than people without MS. This suggests a relationship between melatonin metabolism and MS.¹

It appears that disrupted circadian rhythms (often experienced by people who work nights or have disrupted sleep-wake patterns for any reason) have been shown to increase one's risk for developing MS, as well.¹

Overall, MS and sleep disturbances share some common mechanisms related to circadian rhythms that seem to be related to problems with the body's natural melatonin availability.¹

Keeping your circadian rhythms in sync has been shown to have multiple benefits for overall health. Healthy circadian rhythms lead to healthy sleep, healthy digestion, and a healthy immune system, for instance. By sticking to a regular sleep-wake regimen, even someone with MS can enjoy a better overall prognosis.²

Can someone with MS use melatonin to their benefit?

Maybe.

In one 2022 study in mice, treatment with melatonin resulted in decreased symptoms and reduced flare-ups. However, there hasn't been enough research in humans to determine whether treatment with melatonin would be useful for people with MS, and if so, what a potential dosage and frequency might look like.³

In the case of someone encountering a relapse, the use of steroids to reduce symptoms and slow down disease progression has also been shown to reduce levels of available melatonin. On top of that, aside from reducing one's own ability to fight disease using one's own melatonin as a neuroprotective agent, steroid use is infamous for leading to insomnia. This further reduces available melatonin levels which could be helpful for preventing a flare-up.⁴

Fortunately, melatonin as a supplement can help reset disrupted circadian rhythms. If you fall into some inconsistent sleep-wake patterns, using melatonin at night can help you to achieve a rhythm "reset." This could be useful for those who are finishing up a course of steroids or in the case of cross-continental travel when jet lag (a kind of temporary circadian disruption) might lead to messed up sleep-wake patterns.⁴

Should you supplement with melatonin?

It's best to approach melatonin use under the guidance of a sleep doctor. Why? Researchers are still discovering details about the circadian system as well as the usefulness of melatonin as a prescribed treatment for any health concern.

Melatonin is not categorized as a drug by the US Food and Drug Administration (FDA). The bottles of synthetic melatonin sold at pharmacies are not regulated, meaning dosages may not be accurate. Some commercial products are offered at dosages that could cause your melatonin levels to elevate your blood melatonin levels beyond what is considered normal. Since so little is known about this supplement, it makes better sense to work with a healthcare professional if you want to go this route.⁵

One thing researchers do know: melatonin can interact with other medicines, so keep this in mind when considering its use.⁴

Sleep, MS, and melatonin

Problems with sleeping and daytime drowsiness are common for people with MS. However, if you struggle with sleep at night or have daytime fatigue, it might be just as useful to have a sleep study overseen by a board-certified sleep specialist first to rule out diagnosable sleep problems you might not be aware of.⁶

During that conversation, you can discuss whether melatonin is right for you. Keep your MS neurologist informed about your concerns as well. Remember, every person with MS has a different physiology, so "one size does not fit all" when it comes to treatments for MS symptoms.