melatonin : hello all. Today 13 July 2022 my... - Sleep Matters

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melatonin

StJulian1305 profile image
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hello all. Today 13 July 2022 my doctor has told me to read up about melatonin. Saying she was unable to prescribe melatonin, as it’s not available on the NHS. We, that’s her and I, are trying a program to help with my insomnia. Which I’ve suffered for many years. This is going to be a start asking for advice until I buy Melatonin, obviously through Amazon. As I’m not sure where to start to buy it and is it a safe place to buy it.

thank you

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4fishylady profile image
4fishylady

You can buy melatonin almost everywhere. It is OTC and comes in varying strengths. I have taken it for years, but lately seem to have a slight headache in the mornings. I have cut it in 2 or 4 pieces to see if it makes a difference. Some people have nightmares, but if you don't have any ill effects, it might help you. I also use Unisom, the doxalamine version, not the benedryl version. It helps me sometimes. It is an antihistamine, and safe, look it up.

StJulian1305 profile image
StJulian1305 in reply to 4fishylady

Thank you, what a minefield, I’m nervous of trying, but if I don’t try I won’t know.

kaliska0 profile image
kaliska0 in reply to 4fishylady

Technically it's a prescription med in the UK but that doesn't mean it isn't easy to get from overseas sources. The main concern is that majority of brands tested on store shelves in the US had up to 100 times the listed dose of melatonin. Most had at least double to 10 times as much. Melatonin is one of those things where less can be better than more. You used to never see it above 3mcg and in studies they rarely go over about 1mg because you start to get more negative effects on sleep quality. Having such inaccurate dosing of otc brands causes a serious problem for trying to use it effectively and makes it far more likely someone will have more problems than benefits. If you do buy it otc you want to make sure you get it from a quality supplement company and not just the most common name you see in stores or even on the internet.

StJulian1305 profile image
StJulian1305 in reply to kaliska0

A lot of absolutely brilliant information. That’s kind of you. It really helps 👏🏻👏🏻

Tortie2014 profile image
Tortie2014

Melatonin is safe; you can start really small. I take 1.5 - 3mg per night. You’ll know if you take too much - I get a hangover if I take too much. Good luck - I hope it works for you! I also like magnesium l-threonate- it helps a lot!

StJulian1305 profile image
StJulian1305 in reply to Tortie2014

Thank you very much.

Stilltrying2 profile image
Stilltrying2

Magnesium works better for me than melatonin.

kaliska0 profile image
kaliska0

I suggest trying valerian root instead or along with it. Melatonin does trigger sleep but it's purpose normally mostly ends there. Increasing the levels so they last throughout the night can commonly interfere with sleep quality. It always gets me stuck in a sort of half awake, half asleep state while never quite getting any real rest. Some have less negative impact from it than others and if you are really having trouble getting enough hours of sleep the increase in quantity is sometimes worth the reduction in quality depending on the person. For the most part people concentrate way too much on quantity and not enough on quality. 6hrs of sleep can be as restful as 12hrs of sleep and sleep aids often reduce quality so you need more than 8hrs to feel as rested as the average person without a sleep disorder. On sedatives I was sleeping 12-14hrs and still exhausted because it turned out I was getting only 5-10mins rem and a couple hours deep sleep when I need over an hour of rem and double the amount of stage 3-4 sleep.

Valerian root is less likely to get you stuck in shallow stage 2 sleep with less rem and not as much chance of waking in the middle of the night. It mostly impacts gaba. Gaba is what most common prescription sleep aids target but valerian root is less direct and nowhere near as strong with no addiction risk. Kind of like taking st john's wort for serotonin but you can't really increase gaba too much like you can when combining strong serotonin enhancing supplements or meds. Valerian can occasionally have some withdrawal when you stop taking it after using for several months with usually a mild increase in sleep issues or lower mood for a short time. I used it for several years and despite not being able to taper it (there weren't many options for dosage then) I did not have any real difficulty stopping it compared to some prescription meds that work similarly. It worked better and for longer than z-drugs (zopiclone, ambien, lunesta... ) for me. I have recently found it in liquid extracts for exact dosing if you are sensitive to it or tapering it off slowly when you want to stop taking it. I didn't find that the liquid extract I tried from a normally very reliable company was stronger than the dried capsules when using an equal dose. I had hoped it would be even more effective but it's not useful enough for my extreme level of insomnia to keep combining it with everything else I use.

Phosphatidylserine is a good one for some people. Different brands work for different people. It was well studied some years back for lowering cortisol and feelings of stress but that was before they quit using extracts from animal brains and switched to refining it out of plants. Some argue the studies are not accurate with the difference in source. When I bought it from the integrative health doctor I was seeing the person handling billing said she couldn't force herself to stay awake after taking it. I found it had a strong effect for 2 days, a mild effect for about another week, and then I didn't notice anything. I got some effects switching brands and then nothing again. I took it for a few more months just due to lack of it likely doing anything bad while potentially being helpful even if not noticeably so. Eventually when I ran out of powder again I decided to give up on it. If you try it get capsules and not packages of powder. It sticks to everything.

The otc first generation antihistamines like benadryl, chlor tabs(always forget the chemical name but brand names usually include the chlor part in their specific product name), or unisom are all sedating and may improve sleep by reducing an alerting neurotransmitter in the brain along with their antihistamine effects. Meclizine is also among that group of otc antihistamines but rarely gets included because it's mostly taken for motion sickness. I found it had some unique effects that improved my sleep without as much of the negatives like dizziness, reduced energy the next day, or dry mouth that is not uncommon with the others. It's actually the anticholinergic effect and not the antihistamine effect that has the most impact on making you sleepy. That's also what causes the decongestant effect and most side effects. It reduces all body fluids. Less mucous and also less saliva, less sweating, and impact on fluid and electrolyte balance or how dilated the blood vessels are as part of drying everything up so you don't have a stuffy, runny nose anymore.

Blocking choline is great for making you sleepy but can have too many negative effects the next day for many and is overall not good for brain function. You might have to test different ones to see how you react and it's best to take periodic breaks from any of these meds to let choline and the neurotransmitter it makes, acetylcholine, recover. Some only use them when they need to make extra sure they get good sleep that night, have to try to go to bed sooner than usual, or are temporarily having more sleep problems than usual. They will work better the less often you take them so are even better for specific situations instead of every night. Unisom in particular is a very strong anticholinergic for a non prescription med and why it tends to get labelled for sleep instead of for allergies but that makes it the most likely to have negative next day effects on your ability to think or a lack of motivation even if you don't experience most of the common physical side effects.

While there are tons of potential sedating supplements or non prescription meds for sleep the most important advice I can give because most people ignore it and won't mention it is to also look at things that help you wake up and at least stay mentally alert but preferably more physically active during the day. Make sure anything you take wears off by evening but raising alerting substances and energy production early in the day creates triggers to sleep later in the day. I've detailed some of it several times in some of my other posts of how substances like serotonin turn to melatonin and atp becomes adenosine or the rise and fall of cortisol, estrogen(for women), and dopamine from morning to night. More alerting substances early means they create more sleep inducing ones later or a bigger drop that makes you feel sleepier when you stop being active.

Most are familiar with what happens when you drink a lot of caffeine to stay awake and it wears off suddenly. You often crash and feel 10 times sleepier than you did before drinking it because of the more rapid and larger change in effect from alerting stimulants to the return of sleep triggering substances. Mainly the impact of adenosine. The same happens with many energy drinks, some supplements, and especially prescription stimulants or wakefulness promoting agents (modafinil).

Creating that same effect but in a healthier way can help you sleep. Sometimes even more so than night time supplements do. I always recommend starting with bright daylight at least in the morning but as much of the day as possible and then as dim as you can keep it for at least a few hours before bed. Light timers are suggested if you can't increase actual daylight exposure so the light period remains consistent every day. Turn on automatic blue light filters or dimmers on electronics if they have them.

Use supplements that improve energy but minimize or avoid ones that are based on stimulant like activity such as caffeine. You want things labelled for mitochondrial energy support or coenzymes such as coq10 with pqq. Some amino acids like carnitine and ribose have shown the most promise for improving both chronic fatigue or fibromyalgia daytime tiredness and the sleeping problems that tend to go along with them. Plus other basic things like b vitamins, especially b12 and thiamine(b1), can be both mildly energizing and improve sleep. They also help with the use of nutrients, elimination of harmful byproducts, and reduction in mild inflammation that may not cause symptoms worth treating but is a common hidden contributor to insomnia. There is a modified version of thiamine called sulbutiamine that binds multiple thiamine molecules together and many find it helps with daytime energy, anxiety, and sleep partially due to increasing serotonin. Personally I react too strongly to thiamine and have to take a partial dose or it keeps me awake and others react too strongly to b12 and have to cut the pills. Sublingual lozenges are the best for b12 since it's only absorbed in a limited part of the GI tract. It results in many having low levels despite the fact the body can store enough many people don't get signs of a deficiency for 5-15 years after avoiding all foods with any b12 in them. It's hard to test accurately for b12 and blood tests for levels are mostly useless by themselves.

I take b12 and folate lozenges a few days of the week, a thiamine tablet once a week, and then use electrolyte mixes that have added vitamins and less common minerals included daily as a lemonade or fruity drink depending on flavor I buy. Nutricost makes a good all in one electrolyte complex with b vitamins and a broader range of minerals than most. Another easy all in one source of the most useful vitamins, and coenzymes the body makes is freeze dried (not even low heat treated) liver capsules or if you don't mind the taste bulk powdered is cheaper. You could also just eat liver but that's not nearly as convenient and most don't want to eat a meal of liver daily. A bunch of studies used pureed beef liver and compared it to various high dose vitamins or vitamin complexes. The liver was much more helpful for a variety of health issues often targeted with vitamins or vitamin derivatives like retinols from vit A for skin conditions. Liver that is not heat dried contains still active enzymes and antioxidants the body normally makes to alter both vitamins and macronutrients (proteins, fats, and carbs). It promotes normal metabolic function and digestion that can improve causes of reduced sleep or energy for many people. Sleep and energy production really do go together. Both need to work right and both rely heavily on good nutrient intake, proper hormone levels, and a clear day to night difference to generate energy vs sleepiness at the correct time.

While anticholinergics are sedating and can be good for nighttime, I use choline supplements and racetams first thing in the morning. It's easier to wake up, I'm more motivated to be active, can concentrate better, and after they get used up by the body throughout the day I then feel more like ending whatever activity and going to bed. In the US racetams are not regulated and I use coluracetam as the most alerting in the morning and fasoracetam later in the day as somewhat calming. Most racetams are prescription in the UK except a few older ones. If it's available aniracetam is one of the best options of the older, well studied racetams for a not overly stimulating but still not sedating effect and tends to improve motivation and concentration. It's most often used by those with anxiety or people who want to increase their creative thought processes while listening to music, doing art, or to perform better at their typical daily job.

Merely improving nutrition and slightly altering diet with more overall protein and fat can be surprisingly helpful. Especially along with the addition of things like b vitamins. Processing proteins into useful body tissue, hormones, and neurotransmitters is their main purpose in the body. A few people actually do better on high carb diets and sleep better with a small meal of carbs before bed. Some can't have any food near bedtime to avoid digestive upset. It depends on the person but it's generally better to go with protein snacks and evening meals over carbs for the longer lasting energy and more stable glucose that leads to more stable cortisol.

Cortisol spikes higher when you are hungry, have a drop in blood glucose even if you don't really need more food, are in pain, cold, worried about things..... It's referred to as the stress hormone but it's actually very important for it to rise during the day. It is one of the main alerting substances that tells the body it's time to wake up and it impacts immune function to reduce inflammation, allergies, and over reactions by the body to irritants. However, you don't want to trigger spikes or high levels when they can keep you from sleeping or wake you up in the middle of the night. When daylight ends you want to avoid those things I listed that make it rise so don't go to bed hungry or thirsty, make sure you are a comfortable temperature, find relaxing activities to do that help lower cortisol, and try to get rid of any stressful thoughts if that's an issue. Also unless your doctor says otherwise try not to use steroid based inhalers, nasal sprays, or other treatments too close to bed. They mimic the effects of cortisol.

Writing things down even if you'll never show it to anyone can be a good way to get it out of your head if that's ever a problem when you are trying to sleep. Your subconscious still feels like you communicated what's bothering you and has this sense that the situation is over now even if you consciously know you didn't actually change the situation any. I use penzu online diary instead of writing because I type 100wpm and I can access it on any device that has a browser. It also makes a good place to quickly collect useful info. Copy over the entire text or links to posts, articles, or studies that had good info for looking back on later. I've also used it to record my blood pressure and heart rate over a couple weeks or the time I slept most nights between appointments to show to my doctor. At least until I got an oura ring that automatically tracks everything but bp 24/7 and includes sleep stages.

Occasionally looking back over 2-3 year old data has resulted in discovering the reason for a specific issue or trend. For example I always have more problems sleeping in spring and fall. Doctors kept suggesting changes in light but I have the whole house lit up with light therapy strength daylight spectrum strip lights on timers at the same time year round and it just didn't seem to match. I realized my oura ring shows my body temp bouncing around all over the place up to 6F different so it would swing between 33.6-40.1C from day to day throughout parts of spring and fall that had the most temperature fluctuations in weather even if I didn't go outside much. It's a common issue with chronic fatigue syndrome or fibromyalgia and I also have borderline low thyroid that most doctors ignore but one did try giving me low dose thyroid replacement hormones for awhile that actually helped my sleep some as well until my thyroid levels started remaining higher on their own.

Hormones are more important than even most doctors realize. Aside from cortisol, thyroid, and melatonin (that is important but often over exaggerated for sleep benefits) your reproductive hormones are a common contributor to the timing and quality of sleep. More so for women who have higher progesterone and more changes to both those levels and estrogen from morning to night. For women some quality bioidentical progesterone that is usually available without prescription in most countries can potentially work as well as sleep aids and may have some very good health benefits. It's best if you can get a doctor to check your hormones a few times during the month to see what they are doing and if you are among the many who have lower levels of progesterone or already have high levels. For men the reduced fluctuations and increased risk of negative effects when trying to raise reproductive hormones means it's harder to get doctors to check hormone levels and to improve them if not ideal even though it can contribute to insomnia for both genders.

I've been testing things for more than 15 years so I could just keep listing things all night long. After a year of experimenting with stopping birth control pills for one of the few times in my life and taking extra progesterone and some hormone altering supplements I found I got 1 week better sleep but 3 weeks worse sleep than when on hormonal birth control. I declared it a failed experiment, went back on birth control pills, and started investigating the fact infrared light was found to increase natural melatonin production and induces sleepiness. I spent several months accumulating some research, first hand accounts, and tested some NIR (near infrared) and invisible 850nm lights myself. I decided it's a useful addition to light therapy instead of only mimicking daylight and added an infrared light for 30mins on a timer after my daylight spectrum lights turn off. Research is currently somewhat limited on the ideal light spectrum or timing for sleep improvements so that's the best I've figured out so far for NIR. I continue to watch for any new research or self reports of it's usefulness or problems on various groups that cover a variety of sleep disorders and daytime fatigue problems. Some with extreme circadian rhythm disorders use only red light sources for hours every evening until bed to get their brain to recognize that day time is over.

Now I'm experimenting with exogenous (supplemental) ketones. I have been looking for a way to raise adenosine for years and ketones are one of those things that both increase ATP and then increase adenosine if you don't take too much and are active enough that it mostly gets converted from energy to sleep inducing. Initially ketone esters knocked me out cold several hours early. I kept falling asleep in my computer chair. After a few weeks the effect slowly faded and after a few months it still gave a daytime energy increase and my oura ring shows more rem at night. It still seems to improve how rested I feel but it quit helping with falling asleep earlier or making me feel sleepy at all. I'm taking a couple month break and trying again. There are some theories that it may be impacted by amino acid supplements. A certain level of activity is likely needed throughout the day in order to convert the ATP. Sugar is another variable. My blood sugar does not drop any from evening to morning despite lack of food if I use ketone supplements because the body prefers ketones as energy. That has some benefits if you want to avoid glucose drops when fasting or overnight but not reducing sugar intake any from normal might be serving as an extra source of energy to keep me feeling active when I should be tired. Further testing needed on that but at low doses it's harmless since your body will make the same ketone salt as are in supplements whenever you go too long without carbs or sugars and the sleep benefits from ketone supplements are fairly well documented.

StJulian1305 profile image
StJulian1305 in reply to kaliska0

Wow!! What great information. I will read this in the day time and study it. Also I’m going to show my GP. As you have given more goid advice than her. A big thank you

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