Melatonin: Is it safe for people who are immunosuppressed?

Posted by oceanone @oceanone, Mar 7, 2021

I greatly suffer from insomnia; I follow all the proper recommendations to improve my quality of sleep to no avail. I am 77 years old. Melatonin has been recommended to me by my doctor but I hesitate because I remember reading somewhere that Melatonin is not good for people who are immuno-suppressed such as myself. On Enbrel for my PSA. Anyone knowledgeable about this? Thank you!😊

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@oceanone
I believe there are a number of medications that may interfere with it. Contraceptives won't be an issue if you're a guy or a problem if a woman unless your trying for the Guinness book of world records. I heard something about not taking Tylenol/Acetaminophen. Don't know if other pain meds would be a problem. Also some Antidepressants. I believe that these drugs may increase the effects of Melatonin. However, I doubt your physician would recommend it if it would cause serious problems. I take a medication that isn't recommended to be taken with seizure meds I take because the seizure meds decreases the effectiveness of it so my doctor increased the new med and all is working fine. Although I did talk to a couple of Pharmacists before having it filled.
Melatonin is a very powerful hormone in smaller doses usually work best anyway. I would start with 1/2-1mg if you can find a dose that small. If it's effective fine but if not I'd ask your doctor for a referral to a sleep specialist.
I have insomnia but I don’t take anything for it, if I sleep fine if I don’t fine. I just figure when I need sleep I'll sleep. That protocol has been working fine for me. I'm curious what you do in the hours preceding bedtime?
Good luck,
Jake

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@oceanone I am post-transplant and on immunosuppressants and melatonin has been approved for me by my transplant team. If you do choose to take it, as Jake commented, start with a small dose. I started with 1mg. I would not go over 3mg at any point, higher doses tend to cause nightmares/sleep disturbances.

I saw a version of melatonin advertised that had extra ingredients, including some herbals and it claimed to help you sleep through the night. I asked my transplant department about that because melatonin does not get me through the night. They said no due to the herbals, but if I woke up in the middle of the night and couldn't sleep that I could take a second melatonin.
JK

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@oceanone, I moved your discussion to the Sleep Health group (https://connect.mayoclinic.org/group/sleep-health/). You may wish to read through some of the other discussions.
Here's some information about melatonin and sleep from Mayo Clinic:
- Melatonin https://www.mayoclinic.org/drugs-supplements-melatonin/art-20363071
I think these excerpts are more relevant to your situation:
"Insomnia. Research suggests that melatonin might slightly reduce the time it takes to fall asleep, but its effects on sleep quality and total sleep time aren't clear. Melatonin might be more beneficial for older adults who could be melatonin deficient."
"Immunosuppressants. Melatonin can stimulate immune function and interfere with immunosuppressive therapy."

As @contentandwell pointed out, she was cleared to take melatonin by her transplant team. So everyone is different. Oceanone are you taking immunosuppressants or do you have conditions that make you immuno-compromised?

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I am 79 and use melatonin er without problems. I am not immune compromised however.

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I'm not sure how Melatonin would help you IF you go to bed at the same time each night, and when it's dark. I'd first try a night mask, ear plugs, a good pain med (naproxin, aspirin, etc.).

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I was told I shouldnt take melatonin on a full time basis, is this true?

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@hmccarth5

I was told I shouldnt take melatonin on a full time basis, is this true?

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That’s my understanding too, @hmccarth5. Here’s what Mayo Clinic has to say
https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/melatonin-side-effects/faq-20057874
“Melatonin is generally safe for short-term use. Unlike with many sleep medications, with melatonin you are unlikely to become dependent, have a diminished response after repeated use (habituation), or experience a hangover effect.”

I’m happy the cooler weather is returning in my part of the country. I sleep so much better with cool air through the open window. What helps you sleep?

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I was taking melatonin to sleep due to PMR pain prior to diagnosis and starting prednisone. I continued to take it and was never pain free in my shoulders and neck. After adding 10 mg MTX daily two months ago the shoulder and arm pain became extreme. Just moving my right arm brought tears to my eyes. It hurt even when resting and not moving. I read that melatonin interferes with the effectiveness of prednisone so I stopped taking it. After just two days the pain is reduced by about 90%. None of my doctors ever mentioned this to me. I learned it from reading other PMR sufferers who experienced this. I am sleeping much better without the melatonin. Thanks to all of you who share.

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I meant 10 mg MTX weekly NOT daily!

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