At the Clinic Scenario #12: The Endocrine System

1. At the Clinic Scenario #12:The Endocrine System By: Jasmin Salazar Juan Carrillo

2. Scenario Number 12 Melatonin has been suggested as a possible aid for sleeping problems due to jet lag and rotating work schedules (shift work). It may also be involved in seasonal affective disorder (SAD). Explain how melatonin may affect sleeping.

3. What is melatonin? • A natural hormone that helps regulate the sleeping cycle. • It is made by your body’s pineal gland, small gland located in mid-brain. • It regulates the sleep-wake cycle by chemically causing drowsiness and lowering temperature • Usually it begins to release at about 9 p.m., and levels stay elevated for about 12 hours Pineal gland is inactive during the day, but when the sun goes down it begins to produce melatonin, which is released into the blood.

4. Why is it produced when it is dark? • Exposure to light stimulates a pathway from the retina to the hypothalamus. There, the supra-chiasmatic nucleus (SCN) initiates signals to other parts of the brain that controls hormones, body temp. and other functions that play a role in making us feel sleepy or wide awake • When it is light, the SCN instructs the pineal gland to suppress melatonin production, and when daylight fades, the SCN sends a signal to the pineal gland to start producing melatonin

5. Where else is melatonin found? • It is found in some natural foods like meats, grains, fruits, and vegetables. • It is legally sold as a dietary supplement (e.g., vitamins and minerals) • The effects of melatonin occur according to how much is consumed.

6. Melatonin as a Dietary Supplement • These supplements are sometimes used to treat jet lag or sleeping problems, treat season affective disorder, help to control sleep patterns for people who work night shifts, prevent/reduce problems with sleeping and confusion after surgery, reducing chronic headaches. • It is safe to be used in low doses for short and long term periods.

7. Side effects of deliberate use of Melatonin • Sleepiness • Lower body temperature • Vivid dreams • Morning grogginess • Small changes in blood pressure

8. Insomnia/ Jet Lag • Melatonin supplements can help people who have sleepless nights (insomnia). • Jet lag is a physical condition caused by the disturbance of our sleeping cycle and travel associated with sleep deprivation. • Studies conclude melatonin can prevent or reduce jet lag, but it must be used for several days. • Melatonin supplements will lessen the time it takes to fall asleep, reduce daytime tiredness, boost alertness during the day, and improve quality of life in people with primary insomnia

9. Seasonal Affective Disorder • Seasonal affective disorder is a type of depression you get during a specific season. -There are lower levels of melatonin due to a lack of sunlight, which is why SAD occurs in seasons with shorter days (fall, spring). -You may feel sad/ moody, crave carbs, gain weight, feel drowsy, lose interest in things. • Taking melatonin as a supplement when there are days with less light, will regulate the amount you sleep, which will lessen the depression.

10. Additional Uses • Melatonin supplements may help with sleep problems caused by menopause • Melatonin can slow the growth of certain breast cancer cells • Melatonin may promote sleep with children with ADHD or autism • Melatonin can block the growth of prostrate cancer cells • Melatonin may help alleviate Alzheimer’s disease by decreasing agitated behavior and confusion, and having a beneficial effect on memory

11. Precautions • Before taking melatonin supplements, always go to your doctor first. • If you take too much melatonin, it is going to disrupt your sleeping cycle even more • Additional side effects include stomach cramps, dizziness, headache, irritability, decreased libido, breast enlargement in men. • If you are taking it because of depression, sometimes it may make the depression worse; see doctor before use • Also be aware of how the melatonin supplements will interact with other drugs you may be taking