Natural sleep aid over the counter

There are many natural sleeping pill products with melatonin combined with herbs and nutrients for sedation. Many claim to help you fall asleep and stay asleep without the side effects common to prescription sleeping pills. Some are effective, others are not.
Natrol, Melatonin, Time Release, 5 mg, 100 Tablets
Now Foods, Melatonin, 3 mg, 180 Lozenges

Functions and benefit of melatonin hormone:

Sleep aid, benefit for insomnia treatment
Some individuals like to take melatonin taken an hour or so before sleep on an empty stomach, others like to take a small amount several hours before bedtime. Best way to find out the ideal melatonin dose and time of use is through trial and error. Use may reduce body temperature and increase REM sleep quality.
   Parents should consider banning smartphones, tablets and laptops in their children's bedrooms at night: The bright light of these devices may lower levels of melatonin. Most teens use at least one high-tech device in the hour before bedtime, Journal of Clinical Endocrinology & Metabolism, 2015.

I have chronic insomnia and can I use melatonin 3 mg nightly for several months to overcome it?
    This is a decision you and your doctor need to make, as a general rule I suggest most people not take this sleep hormone supplement more than 2 or 3 times a week.

I am not sure how much Melatonin I should take. I take one and a half mgs every other night, as I assume I should not take it every night. I also don't know whether I can always take this or have to stop at some time.
   As a general rule I prefer using 1 mg or less and no more than two or three times a week.

Jet lag relief and treatment
Nightly doses of melatonin hormone, at 0.5 to 3 mg, taken a few hours before bedtime at the new destination for a few nights may be helpful in reducing symptoms of jet lag, especially if the travel is in an Eastern direction and several time zones have been crossed. It's very difficult to know exactly the dosage of melatonin that would be effective. There is a wide range of individual response to melatonin. As a rule, a higher dose of melatonin would be taken the more time zones are crossed while traveling eastward.

Alzheimer's disease patients
Melatonin and bright-light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease.
J Am Geriatr Soc. 2008. Department of Physiological Nursing, University of California at San Francisco, California, USA.
One group received 1 hour of natural morning light exposure Monday to Friday for 10 weeks and 5 mg melatonin, another group had natural light therapy alone. Control subjects received usual indoor light. Light treatment alone did not improve nighttime sleep, daytime wake, or rest-activity rhythm. Light treatment plus melatonin increased daytime wake time and activity levels and strengthened the rest-activity rhythm.

Anti-aging potential and longevity
We won't know for sure for many years to come if melatonin has anti-aging benefits and it will help increase longevity, nor will we know in the near future the ideal dosage, timing, and frequency. In the meantime, a low dose of melatonin such as 0.1 to 0.5 mg a few nights a week, particularly for those who suffer from insomnia, seems reasonable. The positive influence on deep, restorative sleep could alone account for a longer life span. It's probably a good water and fat soluble antioxidant.

Ever since melatonin became available over the counter in 1994, it has created a lot of controversy. To my knowledge, thus far, there have not been any published studies to indicate that this hormone has caused any serious harm. In fact, more research continues to be published regarding its benefits. A study published at the University of Rajasthan in Jaipur, India investigated the influence of low-dose chronic administration (0.10 mg/kg body weight/day for 3 months) against age-induced oxidative stress in mice tissues, namely brain, liver, spleen and kidney. Sixteen-month-old mice were supplemented with melatonin for three months and then autopsied (at the age of 19 months). The results indicated that it was able to significantly reduce the age-induced decline in the body's natural antioxidant system. The researchers state, "These findings indicate that low-dose chronic administration of melatonin acts as a free radical scavenger and anti-aging agent."

Antioxidant
In laboratory studies, melatonin has been found to stimulate natural antioxidant systems in addition to offering protection to the DNA present within cells. Its ability in inhibiting oxidative damage has been tested in a variety of neurological diseases where free radicals have been suspected as being in part causative of the condition. Thus, melatonin has been shown to reduce amyloid protein toxicity of Alzheimer's disease, to reduce oxidative damage in some types of Parkinson's disease, to reduce brain injury when exposed to low blood or oxygen flow, and to lower brain damage due to a variety of toxins.

Asthma
Melatonin Improves Sleep in Asthma: A Randomized, Double-blind, Placebo-controlled Study.
Am J Respir Crit Care Med. 2004.
Melatonin has sleep-inducing activity and reportedly affects smooth muscle tone and inflammation. The aim of this study was to evaluate the effect of melatonin on sleep in patients with mild and moderate asthma. Twenty-two consecutive asthmatic women were randomized to receive melatonin 3 mg or placebo for four weeks. Melatonin treatment significantly improved subjective sleep quality, as compared to placebo. No significant difference in asthma symptoms, use of relief medication was found between groups. We conclude that it can improve sleep in patients with asthma.

Autism
Children with autism may sleep better if they use this natural sleep aid, but it is best to avoid its regular use.

Blood pressure, hypertension, hypotension
This sleep aid is helpful in those who have hypertension, and can be taken together with blood pressure lowering medications.

Prolonged melatonin administration decreases nocturnal blood pressure in women.
Am J Hypertension. 2005.
In a randomized double-blind study, 18 women, 47 to 63 years of age and with normal BP or treated essential hypertension, received a 3-week course of a slow-release melatonin pill (3 mg) or placebo 1 h before going to bed. In comparison with placebo, melatonin administration did not influence diurnal BP but did significantly decrease nocturnal systolic, diastolic BP without modifying heart rate.

Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension.
Hypertension 2004.
We conducted a crossover trial in 16 men with untreated essential hypertension to investigate the influence of acute (single) and repeated (daily for 3 weeks) oral melatonin (2.5 mg) intake 1 hour before sleep on 24-hour ambulatory blood pressure. Repeated intake reduced systolic and diastolic blood pressure during sleep by 6 and 4 mm Hg, respectively. The treatment did not affect heart rate.

Cancer, may have anti-tumor abilities, could it be used for prevention purposes?
There's been quite a few studies with melatonin and cancer, most of them done in Italy. Most of the cancer studies have shown benefits using 10 to 40 mg of melatonin nightly. However, much is yet to be learned about this approach, and hardly any oncologists in the US are familiar with the use of melatonin as an anti cancer agent. Therefore, at this point, the use of melatonin for cancer is still experimental. However, since certain forms of cancer are ultimately fatal in many cases, it may be worthwhile to try melatonin.

Five years survival in metastatic non-small cell lung cancer patients treated with chemotherapy alone or chemotherapy and melatonin: a randomized trial.
J Pineal Res. 2003.
The present study was performed to assess the 5-year survival results in metastatic non-small cell lung cancer patients obtained with a chemotherapeutic regimen consisting of cisplatin and etoposide, with or without the concomitant administration of melatonin 20 mg/day orally in the evening. The study included 100 consecutive patients who were randomized to receive chemotherapy alone or chemotherapy and melatonin. Both the overall tumor regression rate and the 5-year survival results were significantly higher in patients concomitantly treated with melatonin. In particular, no patient treated with chemotherapy alone was alive after 2 years, whereas a 5-year survival was achieved in three of 49 (6%) patients treated with the combination. Moreover, chemotherapy was better tolerated in patients treated with melatonin.

Biomodulation of cancer chemotherapy for metastatic colorectal cancer: a randomized study of weekly low-dose irinotecan alone versus irinotecan plus the oncostatic pineal hormone melatonin in metastatic colorectal cancer patients progressing on 5-fluorouracil-containing combinations.
Anticancer Res. 2003.
The efficacy of weekly low-dose irinotecan in pretreated metastatic colorectal cancer patients may be enhanced by a concomitant daily administration of the pineal hormone melatonin.

Men who have higher levels of this sleep hormone are thought to have a lower risk for prostate cancer.

Indian J Dent. 2014. Potential role of melatonin in prevention and treatment of oral carcinoma. Melatonin, a hormone secreted mainly by pineal gland has been found to have antioxidant and anti-inflammatory properties in the oral cavity where it reaches through saliva. These properties have been found to be beneficial in certain oral pathologies including periodontal diseases, herpes viral infections and Candida, local inflammatory processes, xerostomia, oral ulcers and oral cancer.

J Med Life. 2014. Melatonin and cancer. Melatonin plays an important role in cancer (tumor growth and metastasis) through different pathways and may have therapeutic significance.

Q. How much and how often should a person take melatonin pills in order to reduce or prevent cancer occurrence?
   A. The role of melatonin supplements in cancer prevention has not been tested in humans enough for us to know for certain how much to take and how often. I prefer not to exceed 1 mg three nights a week.

Dream enhancement
This could lead to vivid, enjoyable and memorable dreams or, on the flip side, vivid nightmares. Melatonin enhances REM sleep. Any dose over 0.5 or 1 mg is likely to make dreams very intense. People report nightmares more frequently on high doses of 2 to 5 mg.

Endometriosis
Melatonin could be of benefit in endometriosis.

Hair growth
Melatonin may be of benefit in hair growth.

Hormone system influence
Tests on Japanese quail showed the hormone regulates a sexual pathway believed to be involved in seasonal breeding patterns. Writing in the Proceedings of the National Academy of Sciences, researchers at Hiroshima University in Japan studied melatonin's effects on a brain hormone called gonadotropin-inhibitory hormone, or GnIH. They removed all melatonin-producing organs from the birds -- the eyes and the pineal glands - and found GnIH levels fell. When they gave the birds melatonin, levels of GnIH went back up. This is important because GnIH has been found to have the opposite effect to the key hormone that primes the body for sex -- gonadotropin releasing hormone, or GnRH. In birds, switching off GnRH causes the gonads -- the testes and ovary -- to shrink as part of the birds' yearly cycle. In humans, GnRH brings on puberty.

Immune system
The details are fuzzy in humans, but in cell culture and animal studies melatonin hormone has immune stimulating or enhancing capabilities at least in the short term. Whether long term use as a pill provides such benefits remains to be determined. The effect on the immune system is complex.

Irritable bowel syndrome
Melatonin improves bowel symptoms in irritable bowel syndrome patients who have sleep disturbances. Administration of melatonin 3 mg for two weeks reduces abdominal pain and bloating, while reducing rectal pain sensitivity.

Influence of melatonin on symptoms of irritable bowel syndrome in postmenopausal women. It can be used as part of the treatment of IBS, particularly in patients with constipation-predominant IBS. Endokrynol Pol. 2013.

Migraine headache reduction
More research is needed to determine whether melatonin is useful for migraine treatment and to find the appropriate melatonin dose and timing. Those with migraine in the meantime can use a mg of melatonin 2 or 3 nights a week. Neurology. 2004 Aug 24.

Prostate help and BPH, frequent nighttime urination
Melatonin Pharmacotherapy for Nocturia in Men With Benign Prostatic Enlargement.
J Urol. 2004.
A total of 20 men with urodynamically confirmed bladder outflow obstruction and nocturia were entered into a randomized, double blind, placebo controlled crossover study assessing the effect of 2 mg controlled release melatonin at night. There were 7 men (35%) with detrusor overactivity and 10 (50%) had nocturnal polyuria. Melatonin and placebo caused a decrease in nocturia of 0.32 and 0.05 episodes per night. Daytime urinary frequency, International Prostate Symptom Score, relative nocturnal urine volume, maximum urinary flow rate and post-void residual were unaffected by treatment. Melatonin treatment is associated with a significant nocturia response rate, improvement in nocturia related bother and a good adverse effect profile. However, it is uncertain whether the observed changes in this study are clinically significant.

Prostate Cancer
In experimental studies -- animal studies and prostate cancer cell lines -- it's been shown that melatonin has an inhibiting effect on prostate tumor growth. Sarah Markt, M.P.H., doctoral candidate, department of epidemiology, Harvard School of Public Health, Boston. analyzed data from a 2002 to 2009 study of Icelandic men and used urine samples from participants to measure melatonin levels and linked them to cancer and death registries. The men also answered a questionnaire about sleep patterns. Men with sleep troubles had significantly lower levels of the chemical 6-sulfatoxymelatonin -- a breakdown product of melatonin -- compared to men who reported no sleeping issues. Although the study found an association between melatonin levels and prostate cancer risk, it did not prove a cause-and-effect relationship. Jan 19, 2014, presentation, American Association for Cancer Research meeting, San Diego.

Sexual function
Bright light exposure, especially in the morning, stimulates the pituitary gland to produce leutinizing hormone. This results in increased levels of testosterone and inhibition of melatonin production by the pineal gland. Decreased plasma melatonin is thought to lead to reduced serum prolactin – and high prolactin has been linked to sexual dysfunction.

Surgery and operations
Saudi J Anaesth. 2013. Melatonin in perioperative medicine: Current perspective. jkMelatonin, a new addition to the armamentarium of anesthesiologist, has some unique properties that are highly desirable in routine peri-operative care. Available clinical data show that preoperative melatonin is as effective as benzodiazepines in reducing preoperative anxiety with minimal action on psychomotor performance and sleep wake cycle. It may be considered as a safe and effective alternative of benzodiazepines as preoperative anxiolytic. It may have opioid sparing effect, may reduce intraocular pressure, and have role in prevention of postoperative delirium.

Tinnitus ear ringing problem
There may be an association of low levels of melatonin in those with the ear ringing problem of tinnitus.

Melatonin side effects, safety, adverse events, toxicity
Melatonin has side effects, but much less so that pharmaceutical sleeping pills. Long-term safety is not known, however melatonin thus far appears to be very safe in the short term. Vivid dreams and next day morning grogginess are common melatonin side effects on dosages greater than 1 mg. Prolonged use may have an influence on sex organs and reduce libido in some users. Most pharmaceutical sleeping pills are associated with memory loss, but this does not happen to be a melatonin side effect. Overdose is not likely to be dangerous since research shows extremely high amounts are not fatal as pharmaceutical sleep drugs would be. Those with high blood pressure can use melatonin without a major contraindication since it may slightly lower blood pressure.

Clin Drug Investig. 2015. Safety of Melatonin in Humans. The aim of this review was to present and evaluate the literature concerning the possible adverse effects and safety of exogenous melatonin in humans. In general, animal and human studies documented that short-term use of melatonin is safe, even in extreme doses. Only mild adverse effects, such as dizziness, headache, nausea and sleepiness have been reported. No studies have indicated that exogenous melatonin should induce any serious adverse effects. Similarly, randomized clinical studies indicate that long-term melatonin treatment causes only mild adverse effects comparable to placebo. Long-term safety of melatonin in children and adolescents, however, requires further investigation.

My step daughter is 15 years old and has been taking melatonin for 7 years a few times a week. She takes 2.5mg every night. Her mother took her to a sleep physician who prescribed it. She sometimes has trouble getting to sleep, usually because of her imagination and the number of "hstories" going around in her head. We find that when she has written the stories down, or had a lot of exercise outside, and adequate food during the day, she sleeps well. Her mother wants her to go to sleep every night at 8pm the same as her 5 and 7 year old half siblings, so gives her the melatonin pill. I am concerned about the long term side effects, especially after reading your website. She is small for her age, about 44 kg. She is almost always very groggy in the mornings, has vivid dreams, irregular periods (even after 18 months), and recurrent thrush. She is an intrinsically happy child, but increasingly has low moods and low self esteem.
   It's difficult to say whether the long term use of melatonin supplement is causing these problems, but it is possible.

Randomized, double-blind clinical trial, controlled with placebo, of the toxicology of chronic melatonin treatment.
J Pineal Res. 2000.
The objective of the present study was to assess the toxicology of melatonin 10 mg administered for 28 days to 40 volunteers. The following measurements were performed: polysomnography, laboratory examinations, including complete blood count, urinalysis, sodium, potassium and calcium levels, total protein levels, albumin, blood glucose, triglycerides, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL), urea, creatinine, uric acid, glutamic-oxalacetic transaminase (GOT), glutamic-pyruvate transaminase (GPT), bilirubin, alkaline phosphatase, gama-glutamic transaminase (GGT), T3, T4, TSH, LH/FSH, cortisol, and melatonin serum concentrations. Analysis of the polysomnography showed a statistically significant reduction of stage 1 of sleep in the melatonin group. No other differences between the placebo and melatonin groups were obtained. In the present study we did not observe any toxicological effect that might compromise the use of melatonin at a dose of 10 mg for the period of time utilized in this study.

Researchers at the University of Lodz in Poland. evaluated the effects of melatonin administration on sleep and routine blood chemistry in 14 women aged from 64 to 80 years. Melatonin 2 mg was given at 7 pm nightly for 6 months. Before and after melatonin treatment blood samples were taken in the morning after an overnight fast. The total blood count, glucose, total cholesterol, LDL, HDL, and triglycerides were measured. Thirty-six percent of those on melatonin had an improvement in general sleep quality. Treatment did not influence significantly either total blood count, glucose or blood lipids levels. On the basis of this preliminary study, it seems that elderly individuals should be quite safe if they use melatonin one to three times a week at a dose of 0.1 or 0.5 mg.

I am 49 years old and have been taking 3mg of melatonin nightly at 8 pm. I have been experiencing heart palpitations or fluttering like feelings. Is it possible for this to be a side effect of taking 3mg nightly? I started taking it because I wake up in the middle of the night. I am groggy in the mornings, but I sleep all night. I went to my primary doctor and we had setup an appointment for a cardio specialist, however, I have since cancelled that appointment. I stopped taking the melatonin and my heart skipping a beat situation halted completely in two days. My heart went from skipping a beat every hour, to 3 occurrences of skipping a beat for that entire day, to nothingy.
    I consider anything greater than 1 mg taken nightly for more than a few weeks in a row to be of high dosage. I have only rarely had feedback of heart rhythm disturbances as a possible side effect of melatonin supplement use.

Testimonials, long term use
I am currently taking 1mg of melatonin almost every night and have been for nearly 5 years. I am 45 years old. I have not noticed any side effects.

I have been taking 3 mg nightly for more than ten years and it has been a godsend because I cannot stay asleep through the night without it. I'm in my mid-sixties and sleep 7 to 8 hours most nights. I use no prescription medicines and am lucky to be in relatively good health. I haven't noticed any ill effects from this chronic use.

Autoimmune disease
I would like to know if melatonin is dangerous for people who have Hashimoto. In your book "Mind Boosters" Copyright 2000, you do not mention the fact that it might not be advisable for people with an auto-immune disease, but I have read it in a number of other resources. What is your opinion?
    I did mention this concern in my book Melatonin: Nature's Sleeping Pill, back in 1995 since not much was known about this supplement at the time, but since then I have not seen much human research that indicates this pineal hormone supplement to be dangerous in cases of autoimmune conditions. A large body of research has defined melatonin as a remarkable molecule with multiple effects on the immune system with complex intracrine, autocrine and paracrine regulatory loops. In brief, I don't suspect the use of this hormone supplement once or twice a week to have a major effect on an autoimmune condition.

I'm a supplement buyer for a Natural foods store. I have recently made myself very sick with melatonin. My research has led me to information about this hormone being contradicted in people with autoimmune disease like thyroid Hashimoto's, rheumatoid arthritis, Lupus erythematosus, MS and so on. I took melatonin at least 3 to 5mg every night for 8 months. I was perimenopausal but have since gone through the change. Melatonin lowered all my hormones and screwed up my thyroid as well. Also tanking sexual desire, yuck! My immune system took a kick and I have symptoms of rheumatoid arthritis, swelling and pain in my hands and feet. I'm now waiting to return back to normal. My immune system needs to calm down.
    I will await studies regarding the role of this natural sleep hormone with autoimmune conditions before deciding on its role with these conditions. Occasional use of melatonin in children or adults is very safe. When I wrote the melatonin book in 1995, some studies had mentioned that melatonin enhanced immune function and thus this required that a caution be placed in the book that those with autoimmune conditions should be careful its use. However, since then, there haven't been any significant mentions of its influence on autoimmune conditions. It would appear at this point that the use of 1 mg of melatonin a couple of times a week should be fine for those with rheumatoid arthritis, and more frequent use should not interfere in those who have osteoarthritis.

Melatonin dosage and frequency guidelines, why you should not take it every night
It's best not to take a high dose melatonin product on a nightly basis. The following are some of my concerns:

Tolerance develops in some people when melatonin is used every night. After a few weeks some find that melatonin is not inducing or maintaining sleep as well as it did in the past. To avoid the creeping up of tolerance, melatonin should be used at most every other night, or preferably every third night. The dose should be the lowest amount that works, such as 1 mg or less. Some users find that a dose as little as 0.3 mg taken around 8 pm can induce sleep. It is ok to occasionally take a high dose such as 3 to 5 mg if needed, for instance jet lag or shift work changes. Melatonin is not toxic at high doses when used infrequently. New research suggests a low dose of melatonin at 0.3 mg taken earlier in the evening may be as effective as a higher dose taken closer to bedtime.

Tiredness, low mood, or fatigue can develop when people use melatonin every night, especially in doses more than 2 or 3 mg. Some people feel sleepy or groggy the next day with the urge to take naps.

We still don't know the long-term effects on the immune and hormonal systems of chronic melatonin use. Also, high doses of melatonin used nightly without breaks could possibly interfere with optimal sex drive and have an untoward influence on gonads (see study below).

In l998 Walter Pierpaoli and William Regelson's book The Melatonin Miracle persuaded me to take this natural hormone supplement for eye protection. They advocate increasing dosage with age and at 75 to 5mg which I was then. I had been taking 6mg daily until five years years ago when my Opthalmologist said I had cataracts forming so I increased the dose to 9mg daily. At 82 I enjoy a full sex life and sleep well with dreams but no vivid ones or nightmares or cataracts. The salient point in your Melatonin question and answers is 'melatonin affects different people differently' After eight years daily dosage I am enjoying still a full and healthy life.

I've been taking melatonin for about 6 weeks with great success. I take a combination of the lozenge type and the time released. I've found that I can take it every 4 days because of the carry over effect. The results have been wonderful. Then suddenly last week, out of the blue, it seemed like the melatonin just stopped working. It seemed to have the opposite effect upon me, rather than putting me to sleep, I was awake all night. Now I'm back where I was at the beginning with my sleep problems. Do I just need a break from the melatonin for a couple of weeks?
   Tolerance could have developed. Taking a break for 2 weeks followed by using it less frequently is an option.

Q. I've been taking melatonin for almost 3 weeks. Is it safe to take every night? Im 27 years of age. It helps a lot. But my concern is that does it have a bad side effects on me? What if i stop using it? Does it affect my body?
   A. I prefer taking it no more that 3 times a week and at a dose of less than 2 mg. Sometimes taking a smaller amount, such as 0.5 mg, several hours before bed, on an empty stomach, works better than taking a high amount, such as 3 mg, an hour or two before bed. However, each person is different and it may take trial and error to figure out the best dosage and timing. It would also be helpful to take a full week off every month or two.

Should one take the regular melatonin pills, sublingual melatonin or the time release version?
Most of the melatonin presently on the market is the regular 3 mg pill. You may want to cut this pill into a fifth or even a tenth and use this dose your first night, about an hour or two before bed. Alternatively, you can also purchase melatonin pills at 1 mg or sometimes even lower dosages are sold. If this low dose is effective, then you may keep using it as needed for sleep. If you don't feel any effect, then take a little more the following nights.
   If your main problem is falling asleep, then try the sublingual form (also available in liquid form), in the range of 0.3 to 1.0 mg, about an hour or two before bed. However, some people wake up in the middle of the night, or early morning, feeling alert. Most of these people would want to sleep a couple of hours longer. Melatonin has a short half-life and therefore is metabolized very fast and will be out of the body soon. This explains why many people wake up early.
   In order to stay asleep longer, a good option is slow-release melatonin, which is released consistently throughout the night. Slow-release (also known as sustained, time or controlled-release) melatonin will likely become more popular in the future. Another form that is useful is melatonin tea. The tea is drunk about an hour before bed. One company has added half a mg of melatonin to their tea bag.

Children, use by a child
The use of melatonin for a child appears to be safe as long as melatonin use is kept to no more than 2 times a week and a dose of 0.5 mg or less. Further research with melatonin and children will tell us if more frequent use is appropriate or safe.

Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: a randomized placebo-controlled trial.
J Am Acad Child Adolesc Psychiatry. 2003.
A randomized, double-blind, placebo-controlled trial was conducted in a Dutch sleep center, involving 62 children, 6 to 12 years of age, who suffered more than 1 year from idiopathic chronic sleep-onset insomnia. Patients received either 5 mg melatonin or placebo at 7 pm. Melatonin treatment significantly advanced sleep onset by 57 minutes, sleep offset by 9 minutes, and melatonin onset by 82 minutes, and decreased sleep latency by 17 minutes.

Combination with other supplements
I was hoping you could tell me if there is any type of synergistic effect (positive or negative) of taking melatonin, GABA and Valerian root together before bed?
    Much depends on the dosage, extract potency of the valerian root product, and the timing. It would be best to first try each one by itself so you have a better understanding how each one works separately. The effects could be different depending on how many hours before bed these supplements are taken and whether they are taken with or without food. But, as a general rule, it is possible that the benefits could be positive as a combination.

Use with alcohol
Are there any side effects to mixing alcohol and melatonin? Sometimes I may have a beer or two and then later take the natural sleep aid when bed time approaches. Does alcohol lessen the effectiveness? Strengthen it?
    Alcohol helps induce sleep, however, there is often a rebound effect a few hours later with waking up in the middle of the night with difficulty falling back asleep. I think one drink of alcohol combined with one mg of melatonin should be safe, but two or more drinks along with more than 1 mg may interfere with clarity of thinking or induce vivid dreams. However different people respond differently.

Sleep Research studies
MIT scientists confirm that melatonin is an effective sleep aid for older insomniacs and it appears that only a small dose (about 0.3 milligrams) is necessary for a restful effect. Taken in that quantity, melatonin not only helps people fall asleep, but also makes it easier for them to return to sleep after waking up during the night. However, most melatonin products on the market range between 1 to 5 mg. At this high dose, tolerance can develop and the melatonin receptors in the brain become unresponsive. Thereafter, this natural sleep hormone supplement becomes less effective.
   When I first wrote my book Melatonin: Nature's Sleeping Pill back in 1995, I cautioned users to keep at a low dose. I recommended that people not take more than 1 mg on a regular basis even though the most common dosage on the market at that time was 3 mg. It appears now that a third of a mg works better in the long run.  Back in 1995 I had personally noticed tolerance within a few days of taking 3 mg nightly. I also experienced some of the side effects of high dose melatonin, which include wonderful psychedelic dreams, but also nightmares. In addition, I felt tired and sleepy in the mornings. I know feel comfortable recommending 0.2 to 0.5 mg a few nights a week. Melatonin is best absorbed on an empty stomach. If you can only find the 1 mg product, just take about a third of it. As to the ideal time of use, it can range from 3 to 4 hours before bed to 1 hour before bed. The higher dosages of 1 to 5 mg may be used occasionally for jet lag.

Questions & Answers
I can lie awake most of the night and never fall asleep. I will eventually fall asleep sometime after 4 a.m., but awaken around 8:30 a.m. and not be able to sleep anymore. I'm trying to find the correct time and dosage for taking the melatonin. I started out with a 1 mg. of the regular type of melatonin and found it didn't do anything. I increased it to 3 mg. and found I do fall asleep, but it's usually around 2 a.m. I've been taking it at different times of try and figure out what the best time to take it. I've taken it between an hour to an hour and a half before going to bed with the same results. Sometimes I don't realize I've been asleep until I wake up and remember some of the dreams I've had. Is that normal with melatonin? If I fall asleep, say around 2 a.m., I'll sleep until 7:00 or so, then am able to fall asleep until about 8:30, when I get up. I would like to be able to fall asleep earlier. I've read about the different types of melatonin; sublingual, time released, and the regular (which I take). Should I try a different type of melatonin or try taking it earlier in the evening, say around 7 or 8 at night, then more closer to bedtime?
   Melatonin, unlike pharmaceutical sleeping pills, is not consistent in providing sleep. You have to try by trial and error which dosage of melatonin works for you and how many hours before bed is best. For instance, in some people, a third of a mg taken 3 to 4 hours before bed works better, whereas for others, 1 to 3 mg taken an hour or two before bed is best. The problem with the higher amount of melatonin is that it causes vivid dreams. Also, I prefer to use melatonin no more than 2 or 3 times a week in order to avoid potential tolerance. I prefer the sustained release, others prefer sublingual melatonin.

I have been taking melatonin for several years before bedtime (usually a 3mg dose a couple times a week).  First, I’ve noticed that I’ve had to increase the dosage initially from 1 mg to 3mg over the course of about a year to maintain its effectiveness.  I’ve read you website and you recommend not taking more than 3mg – which I generally do not.  I have a question regarding negative side-effects of melatonin on sex-drive and fertility (for males).  I once asked a doctor (who said he was a specialist in sleep disorders) about the side effects of taking melatonin.  He made some off-the-cuff comments about melatonin being fine to take if you don’t mind going sterile after a few years.  I thought he was joking, but noticed in your website that you mention reduced sex-drive and some other ambiguous effects on reproduction/fertility.  Is there any evidence to back this up?  I have noticed a correlation with reduced sex-drive (including intensity of orgasm) when I take high or frequent doses of melatonin but am not sure this is not just related to general aging (I’m 39 now and have been taking melatonin since about my early 30’s).  Are things like sperm count and sperm viability affected?
   We have not come across any specific long-term studies regarding the role of melatonin in male sexuality or fertility. Anecdotal reports have suggested that there may be a libido decrease in some users with long term melatonin use but this is difficult to confirm. The dose of melatonin may influence each person's response. A few rodent studies indicate that low dose melatonin actually enhances sexuality. Since we don't have a full understanding of chronic melatonin use and libido in men, a good option is to stop melatonin use for a month or two in order to see if libido returns. Please keep us up to date on your response.

If your own body produces melatonin daily on its own, how can it be harmful if you take it daily? Is taken by mouth different from that which your own body produces?
   The body usually produces only a small fraction of the melatonin that may be ingested by pill. And, it produces it gradually  throughout the evening and night as opposed to a sudden ingestion of a 3 mg pill and quick spike in the bloodstream. Although the body produces a number of different hormones and substances, this does not mean that indiscriminate use of high doses of these hormones is safe, the body usually has developed a fine balance and upsetting this balance can sometimes get us into trouble.

I take 100 milligrams of 5-HTP daily. How safe is it to also take milligrams of melatonin at night? I am going through menopause and the melatonin helps with the night sweats and sleeping and the 5-htp helps throughout the day. Thank you for your website, very informative.
   Thank you for your email, but this is a personal type question that we can't say if it is safe or not for you. We do suggest reading the cautions on each of these supplements as presented on the website.

What I have noticed about melatonin, since I have been taking it, is that the higher the dosage the greater the benefits. I have initially taken 3mg, but with no real results. I decided to increase the dosage cautiously every week and after 30mg daily I noticed a REMARKABLE improvement in my physical conditions and mood. I decided to do that after reading your interview with Dr. Walter Pierpaoli in the final section of your book called: "Melatonin Nature's Sleeping Pill". I have not since then increased the dosage. But this small incident "proved" to me that the key lies in the dosage ! I got the same kind of benefits with vitamin C after increasing the dosage considerably. This may be a very important information or not. I'll leave it to you and your colleagues in the scientific field, "the brains", to decide what to do with this information. Thank you very much for writing the book Melatonin Nature's sleeping Pill.
   There may be certain benefits with supplements that occur at higher dosages, but the potential side effects can increase dramatically when these high dosages are continued.

I have chronic lymphocytic leukemia and Type 2 diabetes. Would it hurt me to take melatonin for one week to get my sleeping habits corrected?
    Short term use of melatonin for sleep should be fine but I don't know what kind of effect, beneficial or harmful, melatonin use would have with long term use.

Buy Melatonin 3 mg and 1 mg per pill
There are two popular products, 1 mg and 3 mg. it is difficult to extract enough melatonin from fruits or other sources. It is much easier to make it synthetically, and hence it is made in a laboratory as opposed to extracting from food or animal products.

Buy Melatonin supplement 1 mg, 3 mg

Dosage: I prefer using 0.3 to 1 mg two to three hours before bed on an empty stomach and no more than twice a week.