Melatonin and multiple sclerosis

Are you a melatonin junkie? What level of evidence do you need to try it? #MSBlog #MSResearch

"Over the last few months we have had a run on melatonin queries; every second MSer in clinic asks about it. Why? Because of studies like the one below and some recent animal work. At the end of the day the answer is we need better evidence to recommend melatonin as a treatment for  MS. In short, we need class 1 evidence from randomised double-blind placebo-controlled trials. The issue in the UK is that you can't buy melatonin off the shelf, you have to order it via the web from US-based health supplement websites. Hence there is no guarantee of the quality of the product. Melatonin, or N-acetyl-5-methoxytryptamine, is a natural product and is produced by our pineal glands in response to reduced retinal light. It has been used for decades as a natural product to improve circadian sleep disorders, for example jet lag and sleep cycle reversal. If we want to prescribe melatonin in the UK for the latter we have to do it on a named patient basis. The other interesting aspect of the biology of melatonin is that it has some anti-oxidant effects. Whether or not these are relevant to MS in unknown; we need more data to assess this."



"I would be interested to know if any of you are using melatonin and why you are taking it. Thanks."



Epub: Adamczyk-Sowa et al. Melatonin Acts as Antioxidant and Improves Sleep in MS Patients. Neurochem Res. 2014 Jun 30.

Background: The relationship between the prevalence of MS and sunlight's ultraviolet radiation was proved. Oxidative stress plays a role in the pathogenic traits of MS. Melatonin possesses antioxidative properties and regulates circadian rhythms. Sleep disturbances in MS patients are common and contribute to daytime fatigue.

Objectives: The aim of study was to evaluate 5 mg daily melatonin supplementation over 90 days on serum total oxidant status (TOS), total antioxidant capacity (TAC) and its influence on sleep quality and depression level of MSers. 

Methods: A case-control prospective study was performed on 102 MSers and 20 controls matched for age and sex. The Kurtzke's Expanded Disability Status Scale, magnetic resonance imaging examinations, Athens Insomnia Scale (AIS), Beck Depression Inventory questionnaires were completed. Serum TOS and TAC levels were measured. 

Results: We observed higher serum levels of TOS in all MS groups, while after melatonin treatment the TOS levels significantly decreased. The TAC level was significantly lower only in mitoxantrone-treated group and it increased after melatonin supplementation. A strong positive correlation between T1Gd(+) number lesions and TAC level in interferon-beta-1A group was observed. AIS group mean score above 6 defining insomnia were observed in interferon-beta-1B-group, glatiramer acetate-group and mitoxantrone-group: 6.62 ± 2.88, 8.45 ± 2.07, 11.1 ± 3.25, respectively. After melatonin treatment the AIS mean scores decrease in glatiramer acetate-group and mitoxantrone-group achieving 5.25 ± 1.14 and 7.08 ± 2.39, respectively (p < 0.05). 

Conclusions: Finding from our study suggest that melatonin can act as an antioxidant and improves reduced sleep quality in MSers. 

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