Melatonin: Difference between revisions

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[[File:Melatonin-sleep-tablets-OTC.jpg|alt=Two round white melatonin tablets next to a bottle of melatonin tablets.|thumb]]
[[File:Melatonin-sleep-tablets-OTC.jpg|alt=Two round white melatonin tablets next to a bottle of melatonin tablets.|thumb]]
'''Melatonin''', also sold under the brand name '''Slenyto''', is a hormone produced in the pineal gland which regulates sleep and wakefulness.<ref name="Hardeland2005">{{citation | author = Hardeland R | title = Antioxidative protection by melatonin: multiplicity of mechanisms from radical detoxification to radical avoidance | journal = Endocrine | volume = 27 | issue = 2 | pages = 119–30 | date = July 2005 | pmid = 16217125 | doi = 10.1385/ENDO:27:2:119 }}</ref><ref name="emc" /> It is involved in the synchronization of circadian rhythms, including sleep-wake timing, blood pressure and [[Temperature dysregulation|body temperature regulation]], cardiovascular efficiency and muscle strength, and many others.<ref name="Altun2007">{{citation |vauthors=Altun A, Ugur-Altun B | title = Melatonin: therapeutic and clinical utilization | journal = Int. J. Clin. Pract. | volume = 61 | issue = 5 | pages = 835–45 | date = May 2007 | pmid = 17298593 | doi = 10.1111/j.1742-1241.2006.01191.x }}</ref><ref name="hardeland2006">{{citation | vauthors = Hardeland R, Pandi-Perumal SR, Cardinali DP | title = Melatonin | journal = The International Journal of Biochemistry & Cell Biology | volume = 38 | issue = 3 | pages = 313–6 | date = March 2006 | pmid = 16219483 | doi = 10.1016/j.biocel.2005.08.020 }}</ref>
'''Melatonin''', also sold under the brand names '''Circadin Adaflex''', '''Ceyesto''', '''Syncrodin'''  and '''Slenyto''', is a hormone produced in the pineal gland which regulates sleep and wakefulness.<ref name="Hardeland2005">{{cite journal | author = Hardeland R | title = Antioxidative protection by melatonin: multiplicity of mechanisms from radical detoxification to radical avoidance | journal = Endocrine | volume = 27 | issue = 2 | pages = 119–30 | date = July 2005 | pmid = 16217125 | doi = 10.1385/ENDO:27:2:119 }}</ref><ref name="emc" /> It is involved in the synchronization of circadian rhythms, including sleep-wake timing, blood pressure and [[Temperature dysregulation|body temperature regulation]], cardiovascular efficiency and muscle strength, and many others.<ref name="Altun2007">{{cite journal |vauthors=Altun A, Ugur-Altun B | title = Melatonin: therapeutic and clinical utilization | journal = Int. J. Clin. Pract. | volume = 61 | issue = 5 | pages = 835–45 | date = May 2007 | pmid = 17298593 | doi = 10.1111/j.1742-1241.2006.01191.x }}</ref><ref name="hardeland2006">{{cite journal | vauthors = Hardeland R, Pandi-Perumal SR, Cardinali DP | title = Melatonin | journal = The International Journal of Biochemistry & Cell Biology | volume = 38 | issue = 3 | pages = 313–6 | date = March 2006 | pmid = 16219483 | doi = 10.1016/j.biocel.2005.08.020 }}</ref>


==Theory ==
==Theory ==
Many of melatonin's biological effects are produced through activation of melatonin receptors,<ref name="Boutin2005">{{citation |vauthors=Boutin JA, Audinot V, Ferry G, Delagrange P | title = Molecular tools to study melatonin pathways and actions | journal = Trends Pharmacol. Sci. | volume = 26 | issue = 8 | pages = 412–19 | date = August 2005 | pmid = 15992934 | doi = 10.1016/j.tips.2005.06.006 }}</ref> while others are due to its role as an [[antioxidant]],<ref name="Hardeland2005" /> with a particular role in the protection of nuclear and [[mitochondria|mitochondrial]] DNA.<ref name="Reiter2001">{{citation |vauthors=Reiter RJ, Acuña-Castroviejo D, Tan DX, Burkhardt S | title = Free radical-mediated molecular damage. Mechanisms for the protective actions of melatonin in the central nervous system | journal = Ann. N. Y. Acad. Sci. | volume = 939 | issue =  | pages = 200–15 | date = June 2001 | pmid = 11462772 | doi = 10.1111/j.1749-6632.2001.tb03627.x }}</ref>
Many of melatonin's biological effects are produced through activation of melatonin receptors,<ref name="Boutin2005">{{Cite journal |vauthors=Boutin JA, Audinot V, Ferry G, Delagrange P | title = Molecular tools to study melatonin pathways and actions | journal = Trends Pharmacol. Sci. | volume = 26 | issue = 8 | pages = 412–19 | date = August 2005 | pmid = 15992934 | doi = 10.1016/j.tips.2005.06.006 }}</ref> while others are due to its role as an [[antioxidant]],<ref name="Hardeland2005" /> with a particular role in the protection of nuclear and [[mitochondria|mitochondrial]] DNA.<ref name="Reiter2001">{{citation |vauthors=Reiter RJ, Acuña-Castroviejo D, Tan DX, Burkhardt S | title = Free radical-mediated molecular damage. Mechanisms for the protective actions of melatonin in the central nervous system | journal = Ann. N. Y. Acad. Sci. | volume = 939 | issue =  | pages = 200–15 | date = June 2001 | pmid = 11462772 | doi = 10.1111/j.1749-6632.2001.tb03627.x }}</ref>


Melatonin supplements or medication are commonly used for helping people get to sleep or stay asleep.<ref name=drugscom>{{Cite web|url =http://www.drugs.com/melatonin.html|title =Melatonin|access-date =2021-03-04|website=drugs.com}}</ref><ref name="emc"/>
Melatonin over-the-counter supplements or medication are commonly used for helping people get to sleep or stay asleep.<ref name="drugscom">{{Cite web|url = http://www.drugs.com/melatonin.html| title = Melatonin|access-date = 2021-03-04 | website = drugs.com}}</ref><ref name="emc"/>


==ME/CFS ==
==ME/CFS ==
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As a medicine, it is used for the treatment of [[insomnia]], however, scientific evidence is insufficient to demonstrate a benefit in this area.<ref name="Bra2015">{{citation | vauthors = Brasure M, MacDonald R, Fuchs E, Olson CM, Carlyle M, Diem S, Koffel E, Khawaja IS, Ouellette J, Butler M, Kane RL, Wilt TJ | title = Management of Insomnia Disorder [Internet] | date = December 2015 | pmid = 26844312 }}</ref> Melatonin is also used for [[sleep dysfunction]].
As a medicine, it is used for the treatment of [[insomnia]], however, scientific evidence is insufficient to demonstrate a benefit in this area.<ref name="Bra2015">{{citation | vauthors = Brasure M, MacDonald R, Fuchs E, Olson CM, Carlyle M, Diem S, Koffel E, Khawaja IS, Ouellette J, Butler M, Kane RL, Wilt TJ | title = Management of Insomnia Disorder [Internet] | date = December 2015 | pmid = 26844312 }}</ref> Melatonin is also used for [[sleep dysfunction]].


As a medicine, some forms of melatonin are licensed for use for Insomnia or sleep in children with ADHD.<ref name="emc"/>
As a medicine, some forms of melatonin are licensed for use for [[insomnia]] or sleep in children with ADHD.<ref name="emc"/>


==Costs and availability==
==Costs and availability==
In [[Canada]] and the [[United States]], melatonin is sold over-the-counter. In other countries, such as the [[United Kingdom]], it is only available with a prescription but may be legal to import for personal use.
In [[Canada]] and the [[United States]], melatonin is sold over-the-counter. In other countries, such as the [[United Kingdom]], it is only available with a prescription but may be legal to import for personal use.
==Dosage==
Typical doseage for melatonin is 1-5mg per night.<ref name="emc" />


==Risks and safety ==
==Risks and safety ==
Melatonin has not need studied in people with [[autoimmune disorder|autoimmune disease]]<ref name="emc">https://emc-prod-ukwest-wa.azurewebsites.net/emc/product/10024/smpc</ref>, however ME/CFS is not classed as an autoimmune disease at present despite the [[:Category:Immune signs and symptoms|immune symptoms]].<ref name="ICC2011primer">{{citation| last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers| last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande
Melatonin should only be used after doctor's advice in people with an [[autoimmune disorder|autoimmune disease],<ref name="emc">{{Cite web | title = Slenyto 5 mg prolonged-release tablets|website=electronic medicines compendium |access-date = Mar 4, 2021|url=https://emc-prod-ukwest-wa.azurewebsites.net/emc/product/10024/smpc}}</ref> however ME/CFS is not classed as an autoimmune disease at present despite the presence of some [[:Category:Immune signs and symptoms|immune symptoms]].<ref name="ICC2011primer">{{Cite journal | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref name="ICD11">{{cite web | title = ICD-11 - Mortality and Morbidity Statistics|url=https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f569175314 | last = World Health Organization | first = | authorlink = World Health Organization | date = 2020 | website = icd.who.int|url-status=|archive-url=|archive-date=|access-date=20 May 2020|quote=Diseases of the nervous system}}</ref><ref name="CDC-IOM-SEIDcriteria">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html | title = IOM 2015 Diagnostic Criteria {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|website=[[Centers for Disease Control and Prevention]] | date = Jan 27, 2021|access-date = 2021-02-25}}</ref>
| last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir
 
| last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas| last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick
===Side effects ===
| last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell
Melatonin side effects are usually mild, these can include:
| last7 = Staines | first7 = D | authorlink7 = Donald Staines| last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles
*[[Daytime sleepiness]]/tiredness
| last9 = Speight | first9 = N | authorlink9 = Nigel Speight| last10 = Vallings | first10= R | authorlink10= Rosamund Vallings
*[[Headache]]s
| last11 = Bateman | first11= L | authorlink11= Lucinda Bateman
*[[Stomach pain|stomach ache]]
| last12 = Bell | first12= DS | authorlink12= David Bell
*[[Nausea]]
| last13 = Carlo-Stella | first13= N | authorlink13= Nicoletta Carlo-Stella
*[[Dizziness]]
| last14 = Chia | first14= J | authorlink14= John Chia| last15 = Darragh | first15= A | authorlink15= Austin Darragh
*[[Irritability]] or restlessness
| last16 = Gerken | first16= A | authorlink16= Anne Gerken
*[[Dry mouth]]
| last17 = Jo | first17= D | authorlink17= Daehyun Jo| last18 = Lewis | first18= DP | authorlink18= Donald Lewis
*[[Dry skin|Dry]] or [[skin itch|itchy skin]]
| last19 = Light | first19= AR | authorlink19= Alan Light
*[[Pain]]s in your arms or legs
| last20 = Light | first20= KC | authorlink20= Kathleen Light
*Strange or vivid dreams
| last21 = Marshall-Gradisnik | first21= S | authorlink21= Sonya Marshall-Gradisnik
*Night sweats<ref name="NHS">{{Cite web | url = https://www.nhs.uk/medicines/melatonin/side-effects-of-melatonin/| title = Side effects of melatonin| website= NHS|access-date=2023-12-31}}</ref><ref name="drugscom"/>
| last22 = McLaren-Howard | first22= J | authorlink22= John McLaren-Howard
| last23 = Mena | first23= I | authorlink23= Ismael Mena| last24 = Miwa | first24= K | authorlink24= Kunihisa Miwa| last25 = Murovska | first25= M | authorlink25= Modra Murovska| last26 = Stevens | first26= SR | authorlink26= Staci Stevens
| title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners  
| date = 2012| isbn = 978-0-9739335-3-6
| url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf
}}</ref><ref name="ICD11">{{cite web|title=ICD-11 - Mortality and Morbidity Statistics|url=https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f569175314|last=World Health Organization|first=|authorlink=World Health Organization|date=2020|website=icd.who.int|url-status=|archive-url=|archive-date=|accessdate=20 May 2020|quote=Diseases of the nervous system}}</ref><ref name="CDC-IOM-SEIDcriteria">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/iom-2015-diagnostic-criteria.html|title=IOM 2015 Diagnostic Criteria {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|website=[[Centers for Disease Control|date=Jan 27, 2021|access-date =2021-02-25}}</ref>


==Notable studies==
==Notable studies==
*1996, [https://www.ncbi.nlm.nih.gov/pubmed/8842569 Dissociation of body-temperature and melatonin secretion circadian rhythms in patients with chronic fatigue syndrome]<ref name="melationincfs1996">{{Citation| issn = 0144-5979| volume = 16| issue = 4| pages = 327–337| last1 = Williams| first1 = G.| last2 = Pirmohamed| first2 = J.| last3 = Minors| first3 = D.| last4 = Waterhouse| first4 = J.| last5 = Buchan| first5 = I.| last6 = Arendt| first6 = J.| last7 = Edwards| first7 = R. H.| title = Dissociation of body-temperature and melatonin secretion circadian rhythms in patients with chronic fatigue syndrome| journal = Clinical Physiology (Oxford, England)| date = July 1996| pmid = 8842569}}</ref>
*1996, [https://www.ncbi.nlm.nih.gov/pubmed/8842569 Dissociation of body-temperature and melatonin secretion circadian rhythms in patients with chronic fatigue syndrome]<ref name="melationincfs1996">{{Cite journal | issn = 0144-5979| volume = 16 | issue = 4| pages = 327–337| last1 = Williams | first1 = G. | last2 = Pirmohamed | first2 = J. | last3 = Minors | first3 = D. | last4 = Waterhouse | first4 = J. | last5 = Buchan | first5 = I. | last6 = Arendt | first6 = J. | last7 = Edwards | first7 = R.H. | title = Dissociation of body-temperature and melatonin secretion circadian rhythms in patients with chronic fatigue syndrome| journal = Clinical Physiology (Oxford, England)| date = July 1996 | pmid = 8842569}}</ref>
* 2016, [https://www.ncbi.nlm.nih.gov/pubmed/27226183 Effect of melatonin supplementation on plasma lipid hydroperoxides, homocysteine concentration and chronic fatigue syndrome in multiple sclerosis patients treated with interferons-beta and mitoxantrone.]<ref name="melatoninms2016">{{Citation| issn = 1899-1505| volume = 67| issue = 2| pages = 235–242| last1 = Adamczyk-Sowa| first1 = M.| last2 = Sowa| first2 = P.| last3 = Adamczyk| first3 = J.| last4 = Niedziela| first4 = N.| last5 = Misiolek| first5 = H.| last6 = Owczarek| first6 = M.| last7 = Zwirska-Korczala| first7 = K.| title = Effect of melatonin supplementation on plasma lipid hydroperoxides, homocysteine concentration and chronic fatigue syndrome in multiple sclerosis patients treated with interferons-beta and mitoxantrone| journal = Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society| date = April 2016| pmid = 27226183}}</ref>
* 2016, [https://www.ncbi.nlm.nih.gov/pubmed/27226183 Effect of melatonin supplementation on plasma lipid hydroperoxides, homocysteine concentration and chronic fatigue syndrome in multiple sclerosis patients treated with interferons-beta and mitoxantrone.]<ref name="melatoninms2016">{{Cite journal | issn = 1899-1505| volume = 67 | issue = 2| pages = 235–242| last1 = Adamczyk-Sowa | first1 = M. | last2 = Sowa | first2 = P. | last3 = Adamczyk | first3 = J. | last4 = Niedziela | first4 = N. | last5 = Misiolek | first5 = H. | last6 = Owczarek | first6 = M. | last7 = Zwirska-Korczala | first7 = K.| title = Effect of melatonin supplementation on plasma lipid hydroperoxides, homocysteine concentration and chronic fatigue syndrome in multiple sclerosis patients treated with interferons-beta and mitoxantrone| journal = Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society | date = April 2016 | pmid = 27226183}}</ref>
 
==News articles ==
* 2023, [https://edition.cnn.com/2022/02/01/health/melatonin-overuse-wellness/index.html Using melatonin for sleep is on the rise, study says, despite potential health harms] - CNN


==Learn more==
==Learn more==
Line 56: Line 56:
[[Category:Potential treatments]]
[[Category:Potential treatments]]
[[Category:Non-benzodiazepine hypnotics]]
[[Category:Non-benzodiazepine hypnotics]]
[[Category:Hypnotics]]
[[Category:Sleep aids and hypnotics]]

Latest revision as of 22:35, December 31, 2023

Two round white melatonin tablets next to a bottle of melatonin tablets.

Melatonin, also sold under the brand names Circadin Adaflex, Ceyesto, Syncrodin and Slenyto, is a hormone produced in the pineal gland which regulates sleep and wakefulness.[1][2] It is involved in the synchronization of circadian rhythms, including sleep-wake timing, blood pressure and body temperature regulation, cardiovascular efficiency and muscle strength, and many others.[3][4]

Theory[edit | edit source]

Many of melatonin's biological effects are produced through activation of melatonin receptors,[5] while others are due to its role as an antioxidant,[1] with a particular role in the protection of nuclear and mitochondrial DNA.[6]

Melatonin over-the-counter supplements or medication are commonly used for helping people get to sleep or stay asleep.[7][2]

ME/CFS[edit | edit source]

Evidence[edit | edit source]

As a medicine, it is used for the treatment of insomnia, however, scientific evidence is insufficient to demonstrate a benefit in this area.[8] Melatonin is also used for sleep dysfunction.

As a medicine, some forms of melatonin are licensed for use for insomnia or sleep in children with ADHD.[2]

Costs and availability[edit | edit source]

In Canada and the United States, melatonin is sold over-the-counter. In other countries, such as the United Kingdom, it is only available with a prescription but may be legal to import for personal use.

Dosage[edit | edit source]

Typical doseage for melatonin is 1-5mg per night.[2]

Risks and safety[edit | edit source]

Melatonin should only be used after doctor's advice in people with an [[autoimmune disorder|autoimmune disease],[2] however ME/CFS is not classed as an autoimmune disease at present despite the presence of some immune symptoms.[9][10][11]

Side effects[edit | edit source]

Melatonin side effects are usually mild, these can include:

Notable studies[edit | edit source]

News articles[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 Hardeland R (July 2005). "Antioxidative protection by melatonin: multiplicity of mechanisms from radical detoxification to radical avoidance". Endocrine. 27 (2): 119–30. doi:10.1385/ENDO:27:2:119. PMID 16217125.
  2. 2.0 2.1 2.2 2.3 2.4 "Slenyto 5 mg prolonged-release tablets". electronic medicines compendium. Retrieved March 4, 2021.
  3. Altun A, Ugur-Altun B (May 2007). "Melatonin: therapeutic and clinical utilization". Int. J. Clin. Pract. 61 (5): 835–45. doi:10.1111/j.1742-1241.2006.01191.x. PMID 17298593.
  4. Hardeland R, Pandi-Perumal SR, Cardinali DP (March 2006). "Melatonin". The International Journal of Biochemistry & Cell Biology. 38 (3): 313–6. doi:10.1016/j.biocel.2005.08.020. PMID 16219483.
  5. Boutin JA, Audinot V, Ferry G, Delagrange P (August 2005). "Molecular tools to study melatonin pathways and actions". Trends Pharmacol. Sci. 26 (8): 412–19. doi:10.1016/j.tips.2005.06.006. PMID 15992934.
  6. Reiter RJ, Acuña-Castroviejo D, Tan DX, Burkhardt S (June 2001), "Free radical-mediated molecular damage. Mechanisms for the protective actions of melatonin in the central nervous system", Ann. N. Y. Acad. Sci., 939: 200–15, doi:10.1111/j.1749-6632.2001.tb03627.x, PMID 11462772
  7. 7.0 7.1 "Melatonin". drugs.com. Retrieved March 4, 2021.
  8. Brasure M, MacDonald R, Fuchs E, Olson CM, Carlyle M, Diem S, Koffel E, Khawaja IS, Ouellette J, Butler M, Kane RL, Wilt TJ (December 2015), Management of Insomnia Disorder [Internet], PMID 26844312
  9. Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012). "Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners" (PDF). ISBN 978-0-9739335-3-6. Cite journal requires |journal= (help)
  10. World Health Organization (2020). "ICD-11 - Mortality and Morbidity Statistics". icd.who.int. Retrieved May 20, 2020. Diseases of the nervous system
  11. "IOM 2015 Diagnostic Criteria | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Centers for Disease Control and Prevention. January 27, 2021. Retrieved February 25, 2021.
  12. "Side effects of melatonin". NHS. Retrieved December 31, 2023.
  13. Williams, G.; Pirmohamed, J.; Minors, D.; Waterhouse, J.; Buchan, I.; Arendt, J.; Edwards, R.H. (July 1996). "Dissociation of body-temperature and melatonin secretion circadian rhythms in patients with chronic fatigue syndrome". Clinical Physiology (Oxford, England). 16 (4): 327–337. ISSN 0144-5979. PMID 8842569.
  14. Adamczyk-Sowa, M.; Sowa, P.; Adamczyk, J.; Niedziela, N.; Misiolek, H.; Owczarek, M.; Zwirska-Korczala, K. (April 2016). "Effect of melatonin supplementation on plasma lipid hydroperoxides, homocysteine concentration and chronic fatigue syndrome in multiple sclerosis patients treated with interferons-beta and mitoxantrone". Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society. 67 (2): 235–242. ISSN 1899-1505. PMID 27226183.