PD, Stroke Prevention and Recovery With Melatonin

[chartist]

As though dealing with PD isn't bad enough, PwP are thought to have an increased risk for stroke and a poorer outcome than non PwP, according to the following article :

academic.oup.com/qjmed/arti...

Previously I've written about some of the health benefits of melatonin and that list is growing. To add to the list I would like to discuss the potential of melatonin to help prevent stroke and also to help those who may have already had a stroke, with their recovery process and avoiding another one. There are many studies regarding this important subject and it is important because I think many people who have suffered a stroke feel that the chance for recovery is nil, but melatonin offers hope in this process for improved recovery as well as prevention. After reading the links below, I think you will at least consider that there definitely is hope for a better recovery post stroke as well as preventing a stroke from ever occurring in the first place or limiting the damage level that would normally occur without melatonin's protective activities already in play. Melatonin is not the only tool in trying to reach that goal, but it is an important one!

Is There a Genetic Link?

Some families seem to be genetically inclined toward strokes as discussed in the following link, so in that case, this article may offer hope in terms of warding off that genetic factor or even for people who have not been living the healthiest lifestyle for years who may be more prone to have a stroke.

ncbi.nlm.nih.gov/pmc/articl...

When are Strokes Most Prevalent ?

The colder months of winter and spring is stroke season, but this varies depending what report you read, but more than an average number of strokes occur in this timeframe, so getting prepared as is practical may be a good health idea. Strokes are also more likely to occur between the hours of 8:00 am and 12:00 pm. and even the day of week plays into the stroke scenario. Even gender and ethnicity can play a part.

ahajournals.org/doi/full/10...

What Are The Main Causes or Contributing Risk Factors For Strokes?

Multiple factors can cause or contribute to the different types of strokes. Obviously uncontrolled high blood pressure can be a major contributing factor as can age, genetics, ethnicity, gender, diabetes, high cholesterol, heart disease, previously having had a stroke or mini stroke(TIA) and obesity are common contributors, but there are others, such as Parkinson's disease and more.

nhlbi.nih.gov/health-topics...

What Are The Different Type of Strokes?

cdc.gov/stroke/types_of_str...

How Can The Common Sleep Aid Melatonin Help?

Melatonin is a very interesting molecule and when it comes to strokes, melatonin should definitely be included as a major component of any prevention or treatment plan because of its many health effects in humans and animals. Melatonin is highly protective of the brain and major organs such as the heart, lungs, kidneys, liver, skin and eyes. Below I will link to studies and articles which will explain how melatonin can work in a very positive way to manipulate the body through multiple pathways to improve the health status of individuals at high risk for a stroke and possibly prevent a stroke from ever occurring or in helping to repair some of the damage caused by a stroke.

The following study highlights many of the methods of action of melatonin that can help prevent an ischemic stroke, a stroke that occurs from a blockage in the artery that supplies oxygen rich blood to the brain. This study aims at the antiinflammatory activity of melatonin in terms of stroke prevention.

ncbi.nlm.nih.gov/pmc/articl...

These next studies discuss how melatonin can offer protection and possibly reparative actions after a hemorrhagic stroke. As mentioned above in "different types of strokes" this is the type where an artery in the brain leaks blood or ruptures allowing the blood to spill into the brain which puts excessive pressure on brain cells which damages these brain cells as opposed to an ischemic stroke(the most common type @ 87% of strokes) where a blockage in the artery that supplies blood to the brain becomes clogged preventing the oxygen rich blood from reaching the brain.

pubmed.ncbi.nlm.nih.gov/281...

ncbi.nlm.nih.gov/pmc/articl...

The following studies discuss how melatonin can be of potential use before and after ischemic stroke. Again, ischemic stroke represents 87% of stroke cases, so these are important studies in terms of more closely illustrating the value of melatonin as a prophylactic treatment as well as a therapeutic treatment for stroke. These studies highlight melatonin's ability to cross the blood brain barrier (BBB), readily enter all tissues of the body, enter into the cerebrospinal fluid (CSF), exert all of its direct and indirect potent antioxidant abilities, effectively reduce elevated inflammatory levels, activate the Nrf2/KEAP1/ARE pathway which will also increase the total antioxidant capacity (TAC), protect brain cells, protect neurons, protect mitochondria against damage and death caused by excessive oxidative stress, inflammation and apoptosis or programmed cell death, inhibit neuroinflammation, among many other health promoting methods of action that melatonin utilizes in areas of the brain affected by stroke.

frontiersin.org/articles/10...

journals.tubitak.gov.tr/med...

europeanreview.org/article/...

pubmed.ncbi.nlm.nih.gov/316...

pubmed.ncbi.nlm.nih.gov/314...

journals.sagepub.com/doi/10...

ncbi.nlm.nih.gov/pmc/articl...

In the following studies, the discussion turns toward how melatonin can effect some of its protective activities in stroke through its highly potent antioxidative actions. It is worth noting here that excess oxidative stress as noted in patients before and after a stroke can cause elevated inflammatory levels and these elevated inflammatory levels can cause further elevated oxidative stress levels in a continuous cycle which is very damaging to the brain cells, neurons and mitochondria. In long term high dose and very high dose studies, melatonin (HDM & VHDM) in humans and animals, melatonin has shown the ability to return elevated oxidative stress levels and elevated inflammatory levels back to healthy control patient status and this is a very important aspect about HDM as healthy control levels are what we want for good health in all areas of the body.

journals.sagepub.com/doi/10...

pubmed.ncbi.nlm.nih.gov/275...

In the following study, the ability of melatonin to actively work as a therapeutic against stroke related dementia is discussed.

ncbi.nlm.nih.gov/pmc/articl...

The following abstract discusses the role of melatonin in obesity as it relates to stroke. It mentions how obesity can be an aggravating factor in stroke and how melatonin can apply its protective effects in both disease states via its potent antiinflammatory effects.

pubmed.ncbi.nlm.nih.gov/331...

The following study highlights melatonin's role in improving cognitive impairment caused by stroke and some of melatonin's methods of action for utility in this purpose.

pubmed.ncbi.nlm.nih.gov/302...

The following two studies describes melatonin's application as a brain protectant against ischemic stroke injury via inhibition of endoplasmic reticulum stress.

ncbi.nlm.nih.gov/pmc/articl...

pubmed.ncbi.nlm.nih.gov/281...

Conclusion

There are plenty more studies about the benefits that melatonin can offer in terms of prevention and or treatment of stroke, but I am interested in highlighting this potential more so that people can understand the value of melatonin for this purpose and discuss it with their doctors to see if melatonin is something that may be compatible with their current regimens as a prophylactic or as a treatment in the case of someone who has already had a stroke or for people who fall into the "high risk categories for stroke".

Sadly, despite all the studies, there are very few doctors and neurologists who are recommending melatonin to their patients for this purpose as doctors lean toward the prescription medications which really haven't shown the same kind of effects that melatonin has for this purpose.

Sometimes, we have to be our own best advocate when it comes to our health. My personal approach is that I take melatonin, firstly because of its very good safety profile which shows that, compared to prescription meds, you are more likely to get other health benefits from the use of melatonin as opposed to potential serious side effects associated with some of the prescription medications used for stroke treatment. Blood thinners do not seem to be the answer to the problem , though they do help. In that line of thinking, melatonin has blood thinning qualities and much more to offer. Secondly, since melatonin mainly seems to confer health benefits well beyond just helping to prevent or treat stroke, I would like to put myself in a position to take advantage of those potential health benefits which melatonin has shown the ability to provide in multiple areas of human and animal health as shown in studies.

I have been taking HDM for years and as of the past 2 1/2 months have been at 106 mg+ of three different types of melatonin every night in pursuit of better sleep, health and as a prophylactic against such things as stroke, heart disease, age related macular degeneration, excess inflammation, excess oxidative stress, liver damage, kidney damage, osteoporosis, memory decline, lung issues, skin issues, among many others as suggested by hundreds of studies on the many health benefits associated with melatonin.

I am not a doctor so I can not recommend that anyone do what I am doing or give advice on dosing. I can only explain as best as I can, what I am doing and explain why I am doing it.

The bottom line for this post is that I share the message of what studies show about melatonin's ability to potentially improve health outcomes when it comes to stroke prevention and treatment.

Art

[faridaro]

Melatonin is such a vast subject - thank you Art for giving us another important aspect of it!

[chartist in reply to faridaro]

You're welcome Faridaro!Stroke can be such a devastating disease where you can end up completely dependent on others or worse yet, dead! If melatonin can help prevent or help recovery, I'm thinking that would be very important!

Art

[Despe]

Art, thanks for another excellent and informative post on Melatonin! Its benefits are endless.

I imagine total intake counts, too. How many milligrams one can take to realize benefits? My husband can only take 2-3mg, more than that makes him sleepy the next morning. Dr. Mischley had recommended him 10mg.

[chartist in reply to Despe]

Hi Despe,

Thank you!

Yes, I am aware of his inability to push his dose higher which precludes him from ever testing HDM via the oral route, but there is still the possibility of the studies that used suppository melatonin and intravenous melatonin which produced "no melatonin hangover" even in the early days of those multiyear studies. Obviously those type of studies are not plentiful, but that is what they reported, so imo, I would say that HDM may be an option for him at some point in the future if an HDM study shows even more benefit than the 10 mg melatonin/ PwP study earlier this year

[Despe in reply to chartist]

Art, are Melatonin suppositories available over the counter?

[chartist in reply to Despe]

Yes, they are, but they are very high dose of 200 mg and 400 mg in the little I have looked for them, there could possibly be lower doses available. The 400 mg dosing is likely used for very fast progressing diseases such as ALS or stage 4 cancers. I have not tested them yet, so I can not comment on the study claim of no melatonin hangover.

Art

[Despe in reply to chartist]

Wow! Thank you.

[chartist in reply to Despe]

You're welcome Despe!

Art

[Hikoi]

Art can you clarify for me if you have Parkinsons?

[chartist in reply to Hikoi]

Hikoi,

I do not have PD.

Art

[rebtar]

What are the three types of melatonin you take?Are melatonin suppositories available?

My (functional medicine) doc recently sent me an article on the potential benefits of melatonin for PD. I will look back for the links you’ve posted. I’d be interested in your thoughts about dosage that might be beneficial, or is that still a “anyone’s guess” sort if thing?

[chartist in reply to rebtar]

Hi Rebtar,

I explained in the original post about the three forms I am currently taking, unless you are asking about what brands? The one that contains B-6 is from Sam's Club and I used that one as part of my "In Pursuit of Restful Sleep" post because the B6 can be additive for sleep. The 12 mg dissolvable sublinguals are from Carlson and those were from when I was testing Dr. Neel's Covid-19 protocol because he said he was using sublinguals and at the time he did not explain why. I later found out that Dr. Neel used the sublinguals in case he ever had to treat one of his patients on a ventilator. I was also testing them because I had heard a report that they were more effective than immediate release. I did not find any noticeable difference in my testing. The third one is just a generic immediate release 10 mg capsule.

I've written quite a bit about melatonin and PD and I would have spent my time writing something else if I did not strongly feel that the science suggests that melatonin should be a very good match at trying to quell, neutralize, ameliorate as well as repair a very large number of damages attributed to the disease process, of which there are many.

An HDM/PwP study is what is needed to prove or disprove this idea relatively quickly. From all the studies I have read including studies that were years in length of HDM in humans, I suspect that the optimal dose range is going to be between 1 mg/kg BW ~ 2 mg/kg BW which is still significantly below stage 4 cancer dosing used by Dr. Shallenberger in his patients. His dose that he gives to all of his patients without cancer is close to the 2 mg/kg BW dose I mentioned above. Imo, these are doses that I would use if trying to treat a specific disease. I think as the research expands, the main difference between the 1 mg/ kg and 2 mg/kg will be that the 2 mg/ kg will achieve the same results faster than the 1 mg/kg. I have only tested 2 mg/ kg for a short period myself. My current dosing is above 1 mg/kg.

I have not, to date, seen or heard of another single molecule that has shown the multitude of effects in ameliorating the damages being done in this disease process, so melatonin sits squarely at the top of my list in terms of a potential treatment as opposed to treatment of symptoms alone.

One drawback that may be an issue with HDM alone is that the effects that might be beneficial in PD are likely occurring mainly at night with minimal effects during the day and I suspect this is why HDM has taken 6 months to a year to reach redox equilibrium and inflammation reduction down to healthy control levels. With that thought in mind I have been looking at other supplements that could be used during the day to avoid disrupting circadian rhythms while using HDM at night. The idea being that similar targeting as melatonin has shown, could also be effected during the day by the other supplements to cut the time to redox equilibrium down by more than half and allowing positive effects to be seen in as little as a month or even less. Toward that end I am looking at 3 of which one of them could be the daytime equivalent of melatonin in trying to significantly slow or stop disease progression while all 4 supplements have shown qualities that could potentially repair some of the damage caused by the disease process with the idea that the total effects could very significantly improve quality of life in PwP and stop or slow disease progression.

At this point, this is just me thinking out loud, but based on studies, I feel I am on the right track and am not currently prepared to stop.

Art

[Despe in reply to chartist]

Art, you are an amazing friend to PwP. Please let us know the three supplement you are looking at which could potentially repair some of the damages caused by PD along with Melatonin.

[gaga1958]

Thanks so much for all the research you do and your willingness to share your knowledge. Looking forward to hearing about the daytime supplements when you share your findings....... “I am looking at 3 of which one of them could be the daytime equivalent of melatonin in trying to significantly slow or stop disease progression while all 4 supplements have shown qualities that could potentially repair some of the damage”.

Sounds interesting.

Thanks again

[chartist in reply to gaga1958]

You're welcome!The main thing that is needed is an HDM/PwP study of good length to add to what the 10 mg melatonin/PwP study showed. The other supplement during the day would merely be to improve on the results of such a study.

Art

[pdpatient]

@chartist, I second @despe in applauding your efforts to help the Parkinsonian community with such exhaustive research. Thanks for the information and your support.

I will just ask you for one favor. Would you be willing and so kind as to list links to your " master posts" such as this one in your profile? It would be a good source of reference for everyone interested and a good start for the newcomers to the forum.

Shout-out to @mbanderson, @park_bear and @gwendolinej for their useful insights aa well.

[chartist in reply to pdpatient]

Thank you for saying so!

As far as linking to what I have written recently, probably the easiest way to look at those posts is to just click on my icon(the blue B1 capsule) and then the word "Profile" which will show that I only have 20 posts that I currently have up and you can just select the one you want to read. I try to delete posts as I feel they have run their course or are no longer relevant so that I can stay around 20 posts to make it quick and easy to browse the titles as quickly as possible.

There is no "easy way" that I am aware of to find the posts that I wrote when I was known as forum member "easilly/Art" 2 to 4 years ago. I can access them, but it is harder to find those posts. There were a few good posts in that group such as the borax post for arthritis and osteoporosis and I plan to update that one with some new information that may make it more applicable to more people. Eventually I plan to transfer them into my chartist account, but it is not a high priority at this point. Here is a link to a typical post that I would write when I was known as "easilly":

healthunlocked.com/parkinso...

I guess if I were to update that post, I would add that vitamin D is also useful in the fight against Covid-19.

Art

[Summertime1212]

Thanks for your thorough post. I get wild dreams if I take more than 1 mg of melatonin. Do you have any solutions for that?Thanks

[chartist in reply to Summertime1212]

I know for the melatonin hangover, the injections and suppositories are supposed to not have that issue, but they did not say if that also prevented the vivid dreams that some people have with melatonin.

Art

[Farooqji]

Thanks

[chartist]

Another new study abstract adding confirmation to the idea that melatonin is useful in stroke prevention and recovery which is very important for PwP given the fact that PwP are at increased risk for stroke. Melatonin appears to work toward this end via multiple methods of action including antioxidative stress, radical scavenging, antiinflammatory effects, antiapoptotic effects and pro neurogenesis activities.

pubmed.ncbi.nlm.nih.gov/338...

Art

[Millbrook]

Thanks Art for all the research. My husband has atrial fibrillation managed now by flecanide and concor. This was brought on by anxiety over his BCG treatment. He now takes 20 mg of melatonin every night. The highest dose I got to was 60 mg and I had hoped to see his nocturia improve but it did not so I scaled it back to 20 mg. He just started taking Xatral and his nocturia has improved within the first week though urologist had said improvement will be seen 4-6 weeks. With concor heart rate is also reduced below 60.

I was afraid that too high a dose may make his heart rate go lower and did not dare mention the dose to his cardiologist. I only said can he take melatonin - -and he says yes and probably thought I am one of those supplement dummies. I would like to get him up to 60 mg again because a fib has stroke risks.

[chartist]

This new (RCT) study (Oct. 2022) adds further confirmation to the early use of melatonin in people who have had a stroke, to improve outcomes :

pubmed.ncbi.nlm.nih.gov/362...

Here is a relevant quote :

' All patients completed the 5-day treatment period, and no serious adverse event was observed. While on day 5, the neurological status and stroke-related functional disability were comparable in both groups, on days 30 and 90, melatonin treatment resulted in a higher reduction in the median NIHSS and mRS score than placebo. Moreover, the overall changes in the NIHSS and mRS scores through a three-month follow-up assessment were significantly greater in the melatonin group than in the placebo group. The analysis of NIHSS scores distribution on day 90 showed a significant difference between the study groups in favor of the melatonin treatment. '

These study findings would have been even more interesting had they used melatonin for the full 90 days of the study period instead of just the first 5 days of the study. They only used 20 mg daily dosing of melatonin for 5 days, but a higher dose arm of the study would also have been useful and more informative.

I think an important aspect of this study is the early use of melatonin after a stroke.

Art