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Recently, many major news outlets picked up a report on melatonin published in February 2022 in the Journal of the American Medical Association (JAMA). The news coverage seeded fears across the country that long-term use of melatonin is harmful; however, there are no further studies on long-term use that solidify this claim. Here, I have gathered the facts on the long-term use of melatonin.

Is Melatonin Safe for Long-Term Use?

In the JAMA article, the authors cited no new research on the possible health risks associated with supplemental melatonin. Instead, they reported on a few statistics, and made a few suggestions:

• There has been a rise of the use of melatonin in the US: from .4% of the population in 2000 to 2.1% in 2018.
• A small percentage of folks are taking more than 5 mg of melatonin daily.
• The amount of melatonin varies greatly within poor-quality OTC melatonin supplement brands. You may think you are taking 3mg, but the dose in the actual supplement may not match the label. The doses can differ significantly within these poor-quality suppliers.

They suggest getting a melatonin prescription to be sure of the dosage, or to get it from a reliable and trusted source (which, of course, is important when buying any natural supplement). They also suggest, due to the growing popularity of melatonin, to avoid long-term use at a dose higher than 5mg. While the media picked up this story as a warning against general long-term use, looking closer shows us that the dosage makes a big difference. If there was serious, conclusive evidence that melatonin was harmful, you would not be allowed to buy it in a grocery store.

Here is a current and long-standing statement from the National Center for Complimentary and Integrative Health (NCCIH) about melatonin’s safety:

“For melatonin supplements, particularly at doses higher than what the body normally produces, there’s not enough information yet about possible side effects to have a clear picture of overall safety. Short-term use of melatonin supplements appears to be safe for most people, but information on the long-term safety of supplementing with melatonin is lacking.”

Side Effects of Melatonin

A 2015 review reported by the NCCIH takes a look into the side effects of melatonin supplements. Multiple studies on short-term melatonin use were reviewed, with study participants ranging from healthy adults to surgical patients and critically ill patients. In these studies, only mild side effects were reported.

Some of the mild side effects include:

• Headache
• Dizziness
• Nausea
• Drowsiness

While these short-term side effects are mild, the review does state that melatonin’s possible long-term side effects are unclear. To put this research into perspective, we must also consider the dose of melatonin that these study participants are taking.

See also Is Melatonin the Same as Ojas?

Safe Dosages of Melatonin

It is important to consider that most of the research on melatonin is done with 3mg dosages before bed. Based on the research I cite below and my clinical experience, for most cases, I prefer to start with micro-dosing of melatonin in order to find the precise dose for each individual. Most folks find they get maximum benefits between .1 and .5 mg before bed. 

I use Low Dose Melatonin for supporting healthy sleep, mitigating age-related decline of melatonin production, and to reset the body’s circadian rhythms.   LifeSpa’s Low Dose Melatonin makes it easy to micro-dose, as one drop is a .1mg dose, and you can add drops to reach your desired effects without going overboard. For certain health imbalances that may require a higher dose, I also use LifeSpa’s Melatonin HP. This HP formula is a 5mg time-release dose that delivers 1mg at first, followed by 4mg throughout the night over a 6-hour period.

Why Does Melatonin Stop Working?

Melatonin may be one of the most misunderstood nutritional supplements. Pigeonholed as just a sleep hormone, the science tells the real story: it is a 3-billion-year-old molecule that is found in all living things, connecting biological clocks with nature’s circadian rhythms. Dysregulation of melatonin leads to circadian disruption, which is linked to a seemingly endless list of health consequences.  

While famous as a sleep support, not all who try melatonin before bed get the results they were hoping for. I commonly hear from my patients: ‘I tried it and it helped me sleep for a while, but then it stopped working’. This is not a case of typical tolerance, as seen with many drugs (when your body develops resistance to a substance over time, and higher doses must be taken to reach the same initial effect). Melatonin is a bit more complex.

While there is no evidence that the body builds typical tolerance or resistance to melatonin, other reports show that too high a dose of melatonin can have the opposite effect—waking you up and keeping you from sleep. Finding the precise dose for your individual needs is the key to getting the most results from your melatonin.

When It Comes to Melatonin, Less Is More

There have been decades of research on the safe supplementation of the “hormone” melatonin. A hormone supplement, by definition, means it will suppress the natural production of your own… The question is, will taking melatonin to deplete your natural production of it?  According to my podcast guest Paula Witt Enderby, Ph.D., a melatonin researcher from Duquesne University, melatonin is not classically a hormone. Taking melatonin does not suppress your natural production; in fact, it can encourage the body to make more of its own melatonin, helping reset the body’s circadian rhythms.

This helped explain the experience some of my patients had when they started taking melatonin. Initially, it helped them sleep, but over time they needed more and more—until it finally stopped working. If supplemental melatonin encourages the body to make more of its own, then it is easy to reach an internal concentration that is too high, which will disrupt circadian rhythms and effectively keep you awake. When you take a melatonin supplement, you will have the dose you are taking orally along with the amount you are now making within your body. When you start getting more than you need, the dose should be lowered and not raised.

See also Podcast Episode 063: Melatonin with Dr. Paula Witt-Enderby

Protocol for Microdosing Melatonin

This research suggests that the most common explanation for melatonin’s negative side effects and impact on sleep is that the dose is too high. One study found that micro-dosing melatonin at just .3mg resulted in the same sleep benefits as a higher dose of 1mg. Another study demonstrated that .5mg of melatonin restored balance to circadian rhythms as well as 5mg, suggesting once again that in certain circumstances, less can be as effective as a higher dose. Over time, opting for the lower dose instead of the higher dose will keep your body from getting more than it needs, reducing the risk of that paradoxical effect and worsening sleepless nights.

At LifeSpa, our Low Dose Melatonin is just .1mg for each drop. To mitigate the age-related decline in melatonin and to maintain healthy circadian rhythms, I suggest micro-dosing your melatonin.

An example protocol with Low Dose of Melatonin:

• Days 1-5: Take up to 1 drop about 30 minutes before bed
• Days 6-10: Take up to 2 drops about 30 minutes before bed
• Days 11-15: Take up to 3 drops about 30 minutes before bed
• Days 16-20: Take up to 4 drops about 30 minutes before bed
• Days 21-25: Take up to 5 drops about 30 minutes before bed
• Days 26-30: Take 6 drops about 20 minutes before bed

To Learn More About the Benefits and Science of Melatonin, Please Read all my Melatonin Articles!