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Can Melatonin Help with Multiple Sclerosis Symptoms?

People who have MS experience symptoms which are specific to melatonin levels in the bloodstream.

Melatonin is a naturally occurring neurotransmitter released by the brain to facilitate sleep. Melatonin release is regulated by circadian rhythms, which are informed by several time cues, the most important one being the availability of light in one’s immediate landscape.

As a rule, healthy people have lower levels of melatonin in their bloodstream during the day 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 two features of MS disease process that seem to be connected to levels of naturally occurring melatonin levels in the brain:

  • 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).

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

It’s been found in mouse models that melatonin can also halt the formation of destructive T cells and cytokines, leading to an opposite effect: the formation of protective versions of these very same cell structures.

People with MS are also shown to excrete more melatonin metabolite in the urine at night than people without MS, suggesting a relationship between melatonin metabolism and MS.

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 amplify one’s risk for developing MS, as well.

Finally, adequate levels of melatonin have been shown to have an antioxidant effect in people with MS, as discovered in a patient study in 2014 where people with MS received dosages of the supplement to gauge its effectiveness in a controlled environment.

Overall, MS and sleep disturbances share some common mechanisms related to circadian rhythms that seem to be related to compromises in one’s natural melatonin availability.

Keeping one’s 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 multiple sclerosis can enjoy a better overall prognosis.

Can someone with MS use melatonin to their benefit?

Maybe.

In mouse studies, treatment with melatonin resulted in decreased symptoms and reduced flareups. 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.

In the case of someone encountering a relapse, the use of steroids (specifically, methylprednisolone corticosteroid treatment) 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, which further reduces available levels that could be helpful for mitigating a flareup.

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.

Should you supplement with melatonin?

It’s best to approach melatonin use under the guidance of a sleep physician. Why?

Neuroscientists and circadian biology researchers are still discovering the neurochemical basis of the human 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 FDA. The bottles of synthetic melatonin sold at pharmacies are not regulated; dosages may not be accurate. Some commercial products are offered at dosages that could cause your melatonin levels to elevate your blood melatonin levels to 1 to 20 times what is considered normal. While there are no reported cases of toxicity or overdose, so little is known about this supplement that it makes better sense to work with a healthcare professional if you want to go this route.

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

Also, keep in mind, a correct dosage taken at the wrong time of day can lead to more circadian rhythm disruptions, which previous research shows can put people with MS at a neurochemical disadvantage.

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.

These can include obstructive or central sleep apnea, nocturia (the frequent need to use the restroom at night), restless legs syndrome, or periodic limb movements of sleep.

During that conversation, melatonin as a treatment can be discussed for its appropriateness to your situation. Keep your MS neurologist enlightened about these 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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MultipleSclerosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. “Corticosteroid therapy exacerbates the reduction of melatonin in multiple sclerosis.” Dokoohaki S, Ghareghani M, Ghanbari A, Farhadi N, Zibara K, Sadeghi H. Steroids (2017 Dec): 128:32-36. Retrieved online on 29 Dec. 2017.
  2. Less vitamin D and melatonin bad for multiple sclerosis. Schwartz S. Science News. (2015 Sept 10). Retrieved online on 29 Dec. 2017.
  3. “The Link Between Melatonin and Neurological Diseases.” Chronobiology (2017 Aug 17). Retrieved online on 29 Dec. 2017.
  4. “Melatonin Acts as Antioxidant and Improves Sleep in MS Patients.” Adamczyk-Sowa M, et al. Neurochemical Research (2014): 1585–1593. PMC. Retrieved online on 29 Dec. 2017.
  5. “Modulation by Melatonin of the Pathogenesis of Inflammatory Autoimmune Diseases.” Gu-Jiun L et al. International Journal of Molecular Sciences (2013): 11742–11766. PMC. Retrieved online on 29 Dec. 2017.
  6. “Multiple Sclerosis, Melatonin, and Neurobehavioral Diseases.” Wurtman, R. Frontiers in Endocrinology (2017): 280. PMC. Retrieved online on 29 Dec. 2017.
  7. “Protocol for a randomized, double blind, placebo controlled, crossover trial of Melatonin for treatment of Nocturia in adults with Multiple Sclerosis.“ Delgado D, Canham L, Cotterill N, Cottrell D, Drake MJ, Inglis K, Owen D, White P. BMC Neurology (2017 Mar 27): 17:63. Retrieved online on 29 Dec. 2017.
  8. “Seasonality and autoimmune diseases: The contribution of the four seasons to the mosaic of autoimmunity.“ Watad A, et al. Journal of Autoimmunity (2017). Retrieved online on 29 Dec. 2017.
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Comments

  • DeniseC
    1 year ago

    Wow…but would it stop RLS? The urinary frequency was reduced by taking CBD Hemp oil but the RLS still bothers me. I thought that Vitamin B 3 converts to Melatonin so no need to bother getting additional tablets. Do MSers struggle converting the B3 or are they two different things.

  • TK Sellman moderator author
    1 year ago

    Good question, Denise.

    RLS (restless legs syndrome, aka Willis-Ekbom disease) is a movement disorder of sleep, so I don’t think melatonin supplementation would work to prevent these unpleasant experiences at bedtime, unfortunately. It’s better applied to the regulation of circadian rhythm function.

    Melatonin is a natural product of the pineal gland in the brain released when it is stimulated by changes (reductions) in light in the evening (and other time cues, like eating). It has a strong relationship with serotonin, as well.

    While most people can practice good sleep hygiene at bedtime and count on normal melatonin production, people with MS could benefit from a very small dose of exogenous (manmade) melatonin, according to some research (here’s one link to an abstract, but there are others: https://onlinelibrary.wiley.com/doi/full/10.1111/jpi.12442). This is due to the fact that a healthy circadian system can help your body to defend against all sorts of other problems, such as infection, insulin resistance, mood disorders, elevated blood pressure etc.

    I’m not sure about the conversion of B3 into melatonin, but I do know that many people with lesion activity can also have vitamin B deficiency which can both mimic MS or exist comorbidly with it. Only your doctor can tell you for sure what your situation is.

    Good luck, and hope you find a solution for that RLS, it is such a troublemaker!

    Tamara

  • ericawilson
    2 years ago

    Thank you for article. Very good information. I usually take a 3mg tablet of Melatonin before bed. Not every night, but when I know I will have trouble falling and staying asleep. Thanks again!

  • TK Sellman moderator author
    1 year ago

    Thanks for reading!

    Both my sleep doc and neuro recommend the very smallest dosage for melatonin, which I believe is 3mg.

    We tend to think “more is better” in our society, but that’s not the case with melatonin, it can reset your rhythms and lead to very vivid strange dreams if too much is taken, as well.

    It’s also not recommended for children unless under a pediatrician’s care.

    There is a ton of research on melatonin these days now that we have so much more knowledge about circadian rhythms (thanks to neuroscience), so we should know a lot more about the benefits of melatonin supplementation within the next few years.

    Best wishes,
    Tamara

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