Does Dr. Oz Vampire Hormone Advice Apply Toward Autism?

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Melatonin is sometimes referred to as “the Vampire Hormone” because it is a hormone that sleeps during the day and rises at night to provide people with a normal, restful sleep cycle. However, rather than making one feel rested and refreshed in the morning, taking an over-the-counter melatonin supplement can leave a person feeling drained in the morning as reported in an recent episode of The Dr. Oz Show. In addition, a guest expert on the show--among others--recommends against giving melatonin to children. But what about autistic children where research indicates supplemental melatonin may be the things dreams are made of for frustrated and worried parents of autistic children?

The following is a look at two views/concerns of supplemental melatonin use in both adults and autistic children.

On the Dr. Oz Show, Dr. Oz addresses the growing health problem of adults who are having difficulty sleeping may be compounding their sleep deficiency by taking melatonin supplements too often and in too high of doses that are leaving people exhausted and ill. According to special guest and sleep specialist Dr. Michael Breus Ph.D., part of the problem has to do with people believing that melatonin is a safe and natural sleeping pill or a safe and natural sleep aid as is often advertised on melatonin bottle labels.

“Here’s the problem—it’s marketed as a natural sleeping pill. It’s not a sleeping pill—it’s a sleep regulator. What melatonin does is that it kind of fakes your body out and makes you think that it’s nighttime,” says Dr. Breus. “It regulates your sleep, it does not initiate sleep.”

Another problem, explains Dr. Breus is that people often take the wrong dose at the wrong time, which further exacerbates a person’s sleep difficulties.

“The only amount of melatonin that you would really need—if you even need it—is approximately 1 mg, because that’s how much it takes to get your plasma concentrations levels up so that it’s up in your bloodstream and having that effect of kind of tricking your brain into thinking that it’s nighttime. Anything over that is overkill—period,” says Dr. Breus. When taking melatonin, he says that it should only be taken 90 minutes before bedtime to give it time to kick in and work.

Another problem with melatonin abuse is that consumers are misled by marketing into believing that because it is natural that it is safe and can be treated like any other supplement. He points out that melatonin is not a vitamin or some supplement, but that it is a hormone and he makes the point of that hormone replacement therapy (HRT) requires a doctor’s visit and a prescription, and so should melatonin since it is a hormone.

Dr. Breus states that cases where melatonin use may be appropriate for someone includes cases such as being a shift worker who needs to regulate their sleep time or someone who suffers from jet lag. But when it comes to children, he cautions viewers that melatonin is not appropriate.

“Nothing could be worse than giving a child melatonin at this point because we don’t know what can happen—that’s my biggest fear,”
says Dr. Breus. “I’m not saying that I know definitely things are going to happen here, I’m saying that we don’t know what’s going to happen.”

But what about melatonin for autistic children who often have difficulty in going to sleep?

As it turns out Dr. Breus is not alone in believing that children should not be given melatonin. Dr. David Clark—a board-certified Chiropractic Neurologist—who has lectured on learning/behavior problems such ADHD, Autism and Dyslexia, says that giving an autistic child melatonin is “a huge mistake.” He explains that melatonin has a type of push and pull relationship with cortisol where cortisol levels are high in the morning and low at night, whereas melatonin is low in the morning and high at night.

“Many kids have a sleep problem, but not because of a melatonin problem. The autistic child has a sleep problem due to cortisol problems…it could be a misfiring brain, it could be a gut infection, it could be food intolerance, it could be an autoimmune condition that is causing that. But giving a kid melatonin and not investigating those other factors, you are really doing your child a disservice. When you give a child melatonin…you are disturbing the normal cortisol rhythm and that can have some disastrous effects.”

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Dr. Clark explains that when some parents report seeing a benefit from giving their autistic child melatonin it is because melatonin acts as an antioxidant that can calm down inflammation in the brain; however, this fails to treat the real reason why the child has an inflammation to begin with. His point being that detective work is needed to see if an autistic child is suffering from other underlying causes such as a food intolerance or an autoimmune system dysfunction before turning to melatonin as a solution.

In a recent article published in the Journal of Autism and Developmental Disorders, researchers report positive results from a 14-week study where autistic children with sleep difficulties benefited from taking varying doses of melatonin before going to bed. Their data showed that in most of the autistic children studied, dosages at 1 or 3 mg was effective within week 1 of treatment, maintained its effects over several months, was well tolerated and safe, and showed improvement in sleep and behavior.

However, the data also showed benefits in some children only after taking doses as high as 6 mg nightly, which was a major point in The Dr. Oz Show—that most adults were over-medicating themselves by taking more than the recommended I mg per day for only a few days, and that the high doses were causing health problems. The fear of treating autistic children with melatonin voiced by Dr. Clark is that the pineal gland (the body’s natural source of melatonin) will atrophy and thus lead to a lifetime dependence on taking melatonin in these children.

According to an Autism Speaks news report about the study, researchers and physicians prescribing melatonin are aware that there may be a risk with autistic children taking melatonin and that more research is needed to find out what the long-term consequence(s) if any really do exist. Furthermore, physicians for and against the use of melatonin are in accord that it should be given only under direct medical supervision and not as an OTC drug a frustrated parent may be tempted to try:

Malow (an MD and the lead author of the study) cautions that families and individuals dealing with autism-associated insomnia should consult a physician rather than try melatonin on their own. “There are lots of causes for sleep disturbances,” she explains. “It is vitally important to first identify and treat any underlying medical condition.” All children enrolled in the study were first evaluated by a medical specialist for potential contributory conditions such as gastrointestinal disease or sleep apnea and received treatment if needed.

Apparently what can be gleaned from the views for and against supplemental melatonin is that for now it is biologically safe and that it may prove beneficial only under specific situations and conditions and that it should not be mistaken as a type of safe and natural sleeping pill. Furthermore, experts and physicians on both sides of the fence believe that melatonin should be administered only under the supervision of a medical professional. However, it is clear that not enough is known about its long-term effects on children with autism and whether it may really lead to a lifelong dependency that should be avoided.

If supplemental melatonin eventually proves to be harmful in the long run for autistic children, it will truly have earned its name as the “vampire hormone.” Parents with autistic children are advised to speak with their child’s physician before considering giving their child a melatonin sleep aid or other melatonin-containing product.

Image Source: Courtesy of Morgue File

References:

The Dr. Oz Show: “Why Melatonin May be Dangerous to Your Sleep”

You Tube Video: “Autism Mistake Melatonin”

Autism Speaks: “More Evidence that Melatonin Eases Autism-Associated Insomnia”

“Melatonin for Sleep in Children with Autism: A Controlled Trial Examining Dose, Tolerability and Outcomes”
Journal of Autism and Developmental Disorders Vol. 42, Number 8, pp. 1729-1737 (2012); Malow et al.

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