The Hemp Connection [Search results for melatonin] 

I was recently asked my opinion about whether or not biotin supplementation would help hair loss. Here's a bit of commentary, plus information about melatonin, another supplement that has been studied.

As with any supplement, it's only going to help if you are indeed deficient in that particular nutrient. There are many reasons you could be deficient in biotin. One of the most relevant to PCOS, is the use of medications valproic acid and carbamazepine. These are seizure medications, also used to treat bipolar disorder and migraine headaches, that have been reported to cause or exacerbate PCOS. So if you've ever been on those medications, you may want to consider supplementation.

If your diet has been out of balance in any way (severe dieting, overeating, eating disorder, cutting out entire categories of food (gluten-free, paleo, vegan, etc.) with a focus on what to eliminate rather than on how to be complete, you may be at risk for biotin deficiency.

It's certainly not going to hurt, and it might help. The dose reported in the literature is 5 to 10 mg per day. However, keep in mind, if your hair loss is primarily related to high testosterone levels and you do not adhere to your complete recommended protocol, biotin will not fix what those problems are causing. It's not a miracle cure.

The best food source of biotin is Swiss chard. Which I was happy about because one of my favorite quick meals is a Swiss chard frittata…I actually planned on making one tonight before knowing this. Nice coincidence!

The other supplement I'm a little more versed in, is melatonin. You all know I'm a big fan of sleep, almost more than diet, for its power to heal. About a year ago, I was poking around in PubMed and found the abstract below, specifically looking at using melatonin to treat androgenic alopecia, which is specifically the type of hair loss you all have. I was coming out of a pretty stressful personal period myself, and had started to notice that my hairline was receding…not fun to look at! So I figured I'd try it myself before writing about it. What I do, is take a melatonin pill, dissolve it in my hand with a few drops of water, and then massage it into my skin with coconut oil. Simply using water didn't work, it needed a carrier. I've noticed that my hair is gradually starting to grow in again. It's not thick and lush, by any means, but it IS growing some hair back.

A caveat here, it won't happen in a week, and you have to be consistent with application. If you're going to flake out about it…don't bother even starting. It's taken almost a year to see a difference. But if you're committed and willing to be persistent, it's definitely worth a try.

Here's the article.
Fischer TW, Burmeister G, Schmidt HW, Elsner P. Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial. Br J Dermatol. 2004 Feb;150(2):341-5.

BACKGROUND: In addition to the well-known hormonal influences of testosterone and dihydrotestosterone on the hair cycle, melatonin has been reported to have a beneficial effect on hair growth in animals. The effect of melatonin on hair growth in humans has not been investigated so far.

OBJECTIVES: To examine whether topically applied melatonin influences anagen and telogen hair rate in women with androgenetic or diffuse hair loss.
METHODS: A double-blind, randomized, placebo-controlled study was conducted in 40 women suffering from diffuse alopecia or androgenetic alopecia. A 0.1% melatonin or a placebo solution was applied on the scalp once daily for 6 months and trichograms were performed to assess anagen and telogen hair rate. To monitor effects of treatment on physiological melatonin levels, blood samples were taken over the whole study period.

RESULTS: Melatonin led to a significantly increased anagen hair rate in occipital hair in women with androgenetic hair loss compared with placebo (n=12; P=0.012). For frontal hair, melatonin gave a significant increase in the group with diffuse alopecia (n=28; P=0.046). The occipital hair samples of patients with diffuse alopecia and the frontal hair counts of those with androgenetic alopecia also showed an increase of anagen hair, but differences were not significant. Plasma melatonin levels increased under treatment with melatonin, but did not exceed the physiological night peak.

CONCLUSIONS: To the authors' knowledge, this pilot study is the first to show that topically applied melatonin might influence hair growth in humans in vivo. The mode of action is not known, but the effect might result from an induction of anagen phase.

Castro-Gag M, Pérez-Gay L, Gómez-Lado C, Castiñeiras-Ramos DE, Otero-Martínez S, Rodríguez-Segade S. The influence of valproic Acid and carbamazepine treatment on serum biotin and zinc levels and on biotinidase activity. J Child Neurol. 2011 Dec;26(12):1522-4. Epub 2011 Jun 3.

Wolf B. EditorsIn: Pagon RA, Bird TD, Dolan CR, Stephens K, editors. Biotinidase Deficiency. SourceGeneReviews [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2000 Mar 24 [updated 2011 Mar 15].

Zempleni J, Hassan YI, Wijeratne SS. Biotin and biotinidase deficiency. Expert Rev Endocrinol Metab. 2008 Nov 1;3(6):715-724.

You may know of melatonin as a potent sleep aid. So much so, that if you took melatonin and you did not experience an enhanced ability to sleep, you stopped taking it.

Did you know, melatonin is a very powerful antioxidant as well? Some of the benefits of this compound relevant to PCOS include:

--lowered blood pressure
--improved memory
--reduced adrenal gland activity and cortisol secretion
--reduced cortisol response to stress
--reduced blood glucose, insulin levels, and insulin response to a glucose load
--reduced cholesterol and triglycerides
--reduced testosterone levels
--increased progesterone synthesis
--slows gastric emptying (which can help you to feel fuller, longer)

That's a lot of stuff! And it's not just not sleeping well that interferes with melatonin metabolism. So does fasting and starvation…which includes any kind of radical diet, including the medically supervised ones and the HCG ones. Melatonin levels in all three types of eating disorders, anorexia, bulimia, and binge eating disorder, are disrupted. Obesity suppresses normal melatonin daily rhythms. Omega-3 deficiency reduces melatonin synthesis and total tissue levels.

Vitamin deficiencies such as B12, zinc, and magnesium, can interfere with good melatonin status. When I read that, I immediately thought of the many vegetarians reading this blog, as those are common deficiencies when vegetarian eating is not proactively balanced.

Normal melatonin metabolism may be dependent on physical activity.

Medical problems associated with a melatonin imbalance include: affective disorders, Alzheimer’s disease, arthritis, asthma, autism, bipolar disorder, cervical cancer, chronic fatigue syndrome, cluster headaches, congestive heart failure, coronary artery disease, Cushing’s syndrome, depression, diabetes, duodenal ulcer, epilepsy, fibromyalgia, hypertension, idiopathic pain syndrome, lung cancer, metabolic syndrome, migraine headaches, obesity, obsessive-compulsive disorder, panic disorder, Parkinson’s disease, polycystic ovary syndrome, pre-eclampsia, premenstrual syndrome, schizophrenia, seasonal affective disorder, sleep apnea, and ulcerative colitis.

I'm well aware that many people reading this blog are looking for a magic supplement to erase the need for making healthy lifestyle choices. If you choose to supplement with melatonin, it likely will not hurt you, and it may help you to restore normal sleep patterns, but it will never replace the power of regular, adequate sleep. Just sayin'.: )

If you've never used melatonin before, and you decide to start, you may want to try it on a night when it's not essential that you be up and functioning early the next day. It can have a paradoxical reaction in some people.

And, if you happen to be a professional pilot, the FAA advises against using melatonin while on duty. It certainly wouldn't hurt on your days off, especially if you've been on some grueling red eye flights, just beware of this disclaimer while officially on duty.

I have an extensive list of references I've collected from which this blog post was derived. If you would like them you can contact me directly.

Bottom line, if you don't value sleep, your body is going to have a really, really, really hard time being healthy.

I just finished reading a list of new research on the hormone melatonin. This is the hormone that helps you feel sleepy at night. It is also one of the most powerful anti-aging compounds in the body. I've got quite a few things to share over the next few posts, hopefully to reinforce the importance of getting enough sleep. When you don't, your body is out of balance and hormones start to act wacky!

Today I'd like to talk about endometriosis, something I've had myself since a teen and something I wouldn't wish on anyone.

Researchers created an artificial state of endometriosis by implanting endometrial tissue on the abdominal walls of a group of rats. After 4 weeks, a portion of these rats were given a daily dose of melatonin. At the end of the study, the volume of the artificially implanted tissue was measured, and the melatonin/no melatonin groups were compared. Tissue volume actually shrunk in the melatonin-treated rats. Anti-oxidant activity also increased in the rats receiving melatonin.

The risk in presenting information like this is that the first thing most people ask when reading studies like this, is how much melatonin they should be taking. That's not my point. If you're struggling with disorders related to melatonin imbalance…the very first thing you should be asking yourself is how much attention you pay to sleep hygiene.

Are you getting enough sleep?

Do you recognize the importance of adequate sleep for overall health, or do you tend to consider the little amount of sleep you get as an indication that you're harder working/better than others?

Do you minimize your alcohol intake? Are you judicious with your caffeine intake?

Do you get physical activity on a regular basis?

If you can answer"yes" to all of these questions, a melatonin supplement is something you may want to consider…used judiciously. If you can't, these are the lifestyle areas you should work on first.

We have a difficult time respecting the importance of balance, but it's pretty much a non-negotiable thing. We either work toward achieving it, and improve our health, or we ignore it, and we stay stuck in a place where we just don't feel the absolute best that we can.

Güney M, Oral B, Karahan N, Mungan T. Regression of endometrial explants in a rat model of endometriosis treated with melatonin. Fertil Steril. 2008 Apr;89(4):934-42. Epub 2007 Jun 19.

I've become fascinated with sleep. How much we need it. How little we value it. And what happens to our health when we don't get it. Sometimes I wonder if we should be obsessed with sleep and not worried about what we eat.

Now the two worlds have collided!

It has been found that melatonin is a component of some vegetables. Some Japanese researchers gave a group of women high amounts of six specific vegetables. Another group of women was asked to avoid these same vegetables during the same time period. The women who consumed the vegetables had higher amounts of melatonin by-products in their urine.

Melatonin, as you know from reading this blog, is a sleep enhancing hormone and a very powerful antioxidant.

Of course, the very first thing most people will ask on reading this, is"what vegetables?"

I don't think the power in this study comes from the melatonin content of the vegetables. Melatonin is a highly unstable compound and it would be challenging to have it stay intact in a compound that is harvested, stored, chopped, and cooked before eating.

What may be happening here, is that vegetables are great sources of antioxidants. And since melatonin appears to be the ultimate antioxidant, it is called to duty when other antioxidants are in short supply and cannot do their job. If your melatonin is on cleanup duty, it can't be used to help you sleep!

The melatonin in the urine, I'm guessing, came from the fact that melatonin was allowed to function as melatonin, and not changed as it was used as an antioxidant.

So…the strategy appears to be, to eat as many different vegetables as you can in order to have maximum antioxidant power. And that will give you a better chance at getting a good night's sleep.

I know that it's difficult not to yawn if you see someone else yawning, so on behalf of helping you feel sleepy, here's a wonderful blog a friend told me about yesterday!
It's called Cute Things Falling Asleep.

Oba S, Nakamura K, Sahashi Y, Hattori A, Nagata C. Consumption of vegetables alters morning urinary 6-sulfatoxymelatonin concentration. J Pineal Res. 2008 Aug;45(1):17-23. Epub 2008 Jan 15.

I'm really big on sleep…and the fact that Americans just don't seem to want to admit that they need it…is a huge part of their problems with weight, hormones, and mood disorders. So over the past 6 months, I've been reading as much as I have time to read, about melatonin, the hormone that makes you sleepy. Turns out it's a huge anti-aging chemical, and if you aren't sleeping enough, it can cause a lot of serious problems.

Here's one interesting issue I ran across that might be of specific interest in PCOS. (I've noticed in the past few years that the number of women with PCOS I've helped, who are on sleep medications, has slowly and steadily been creeping upward.)

OK, keep in mind, this study was done on pigs, but it will give you the general drift.

Embryos (in petri dishes) exposed to melatonin developed more quickly than those without melatonin. And, unlike their non-exposed counterparts, the melatonin embryos also seemed to be protected against heat stress. Too much melatonin affected embryo development as well. So my point is not that you should supplement with melatonin, but that you should keep your own melatonin levels in balance with healthy sleep habits.

Remember, it's not just about getting pregnant. It's about staying pregnant and having a healthy baby. If your sleep habits are"off" now, that may have some important consequences later. And not just to you. One of the most important things you can do to balance your hormones is to develop a habit of adequate sleep and regular sleep hours.

I remember when I worked in the Silicon Valley, as the nutritionist at Apple Computer's corporate headquarters, people would come in to talk about their diet and literally brag about how few hours of sleep they were getting. I don't know where they (we) got this idea that not sleeping is somehow cool, or that it is a sign of a good work ethic, or that we somehow are superior when we don't. The truth is, it's about the absolute worst thing you can do for your health, to not value sleep. (When people would say,"I average 3-4 hours of sleep a night!"…I would think to myself…"Do you always regularly broadcast that you're not good to yourself?")

Just because you're not awake when you're sleeping…doesn't mean nothing important happens while you do it!

Rodriguez-Osorio N, Kim IJ, Wang H, Kaya A, Memili E. Melatonin increases cleavage rate of porcine preimplantation embryos in vitro. J Pineal Res. 2007 Oct;43(3):283-8.

As you can see in recent posts, we're getting very happy results with our nutrition/supplement protocol. If you've decided to try IVF, some of the concepts we promote might help you as well.

In a study of 18 women undergoing IVF treatment, it was found that the lower their melatonin levels, the higher the levels were of certain damaging oxidative chemicals.

An additional 115 women who had failed IVF were divided into two groups: 56 received melatonin supplementation and 59 did not. Melatonin supplementation improved the success rate of the IVF procedure.

In an additional study done in mice, eggs were incubated with a highly oxidative substance for 12 hours. The result was that egg quality suffered. By adding melatonin, this deterioration in quality was blocked.

The researchers concluded, "oxidative stress causes toxic effects on oocyte maturation and melatonin protects oocytes from oxidative stress. Melatonin is likely to improve oocyte quality and fertilization rates."

There are a couple of important consideration here.

1. When you deprive yourself of sleep, you deprive yourself of naturally produced melatonin. It damages eggs and reduces fertility.

2. You can choose to supplement to offset the damage and increase your chances of fertility, but keep in mind that if your melatonin levels are low, your body is telling you that you are out of balance. You may be able to correct part of the balance with a supplement, but it's a health risk to assume that a pill has taken care of the problem. Best to work on prioritizing sleep. After all, if you're soon going to have a baby in the house, you're going to need it!

Tamura H, Takasaki A, Miwa I, Taniguchi K, Maekawa R, Asada H, Taketani T, Matsuoka A, Yamagata Y, Shimamura K, Morioka H, Ishikawa H, Reiter RJ, Sugino N. Oxidative stress impairs oocyte quality and melatonin protects oocytes from free radical damage and improves fertilization rate. J Pineal Res. 2008 Apr;44(3):280-7.

You all are must be sooooooooooooooooooooooooooo tired of hearing me talk about the benefits of sleep. But I work with a sleepless population and it takes a few times to present my case before I make my point. I figure if I hammer at this from as many different angles as I can, and present as many examples of how poor sleep quality can interfere with your health, at least one of my examples will hit home and inspire you to consider your sleep habits and choices.

This doesn't bode well for Jay Leno and David Letterman…unless they team up with TiVo for advertising!

Women whose eggs had been examined and found to be of poor quality had those eggs examined by researchers. It was found that levels of chemicals indicative of oxidative stress were higher in those eggs than they were in the eggs of women whose eggs had been determined to be of good quality.

Taking this one step further, 18 women with low quality eggs were divided into one of three groups and given one of the following 3 regimens: (1) 3 mg melatonin per day, (2) 600 mg vitamin E per day, or (3) 3 mg melatonin AND 600 mg vitamin E per day. Oxidative stress markers were reduced in all three scenarios.

And THEN…in the final phase, 115 women who had not become pregnant with in vitro fertilization (IVF) were divided into two groups. The first group received 3 mg melatonin per day and the second group received no supplement. Melatonin significantly improved the rate of fertilization.

The researchers concluded that oxidative stress (which is what happens when you stress all day and don't sleep well all night), damages the quality of eggs. They also concluded that melatonin supplements can help improve fertilization rate.

Just a note--take melatonin if you want, but don't lose sight of the big picture. If you backed yourself into a corner because you weren't managing your stress and sleep, a pill may not be the complete solution to the entire problem.

Tamura H, Takasaki A, Miwa I, Taniguchi K, Maekawa R, Asada H, Taketani T, Matsuoka A, Yamagata Y, Shimamura K, Morioka H, Ishikawa H, Reiter RJ, Sugino N. Oxidative stress impairs oocyte quality and melatonin protects oocytes from free radical damage and improves fertilization rate. J Pineal Res. 2008 Apr;44(3):280-7.

If you've ever dieted, and you have trouble sleeping…there may be a reason. Keep in mind, this study was done on rainbow trout, but there is still a message in it for humans. Three groups of trout were studied with regard to their melatonin (sleep hormone/antioxidant) levels and cortisol (stress hormone) levels. The three groups were defined as fed fish, fish that were fasted for 7 days, and fish that were fasted for 7 days then refed for 5 days.

Melatonin levels were disrupted in fasted fish. If you were human, this would likely mean if you were on a strict fasting/dieting protocol, you were probably having trouble sleeping as well.

Interestingly, nighttime serotonin levels were higher in these fasted fish. Melatonin is made from serotonin, so I would presume that what the body tries to do when you're not eating well is to keep you alert and thinking about getting some food. It does that by hanging on to serotonin and preventing its conversion into melatonin. That's a survival mechanism.

So if you're dieting and you're awake at night with cravings? That's a normal response. Don't obsess about what's wrong with you, don't surf the Internet looking for what to do about your cravings. In this kind of situation, you're thinking about food because you need it. Get some.

As far as cortisol, dieting reduced levels and they stayed low after refeeding. You could argue that this is a benefit of dieting…except for the fact that if you're cutting yourself short on melatonin, you're aging yourself more quickly than you should. There are plenyy of ways to reduce melatonin levels without dieting that don't cut your life short on the back end.

By the way, since I write so much about sleep I thought I should mention…I love naps. The long afternoon kind where my cats curl up with me, and I wake up with a little bit of drool on my pillow. I don't feel guilty at all. I completely buy into the idea of"beauty sleep"--sooooo much cheaper than all those anti-aging potions on the infomercials!

Ceinos RM, Polakof S, Illamola AR, Soengas JL, Míguez JM. Food deprivation and refeeding effects on pineal indoles metabolism and melatonin synthesis in the rainbow trout Oncorhynchus mykiss. Gen Comp Endocrinol. 2008 Apr;156(2):410-7. Epub 2008 Jan 8.

If you've ever dieted, and you have trouble sleeping…there may be a reason. Keep in mind, this study was done on rainbow trout, but there is still a message in it for humans. Three groups of trout were studied with regard to their melatonin (sleep hormone/antioxidant) levels and cortisol (stress hormone) levels. The three groups were defined as fed fish, fish that were fasted for 7 days, and fish that were fasted for 7 days then refed for 5 days.

Melatonin levels were disrupted in fasted fish. If you were human, this would likely mean if you were on a strict fasting/dieting protocol, you were probably having trouble sleeping as well.

Interestingly, nighttime serotonin levels were higher in these fasted fish. Melatonin is made from serotonin, so I would presume that what the body tries to do when you're not eating well is to keep you alert and thinking about getting some food. It does that by hanging on to serotonin and preventing its conversion into melatonin. That's a survival mechanism.

So if you're dieting and you're awake at night with cravings? That's a normal response. Don't obsess about what's wrong with you, don't surf the Internet looking for what to do about your cravings. In this kind of situation, you're thinking about food because you need it. Get some.

As far as cortisol, dieting reduced levels and they stayed low after refeeding. You could argue that this is a benefit of dieting…except for the fact that if you're cutting yourself short on melatonin, you're aging yourself more quickly than you should. There are plenyy of ways to reduce melatonin levels without dieting that don't cut your life short on the back end.

By the way, since I write so much about sleep I thought I should mention…I love naps. The long afternoon kind where my cats curl up with me, and I wake up with a little bit of drool on my pillow. I don't feel guilty at all. I completely buy into the idea of"beauty sleep"--sooooo much cheaper than all those anti-aging potions on the infomercials!

Ceinos RM, Polakof S, Illamola AR, Soengas JL, Míguez JM. Food deprivation and refeeding effects on pineal indoles metabolism and melatonin synthesis in the rainbow trout Oncorhynchus mykiss. Gen Comp Endocrinol. 2008 Apr;156(2):410-7. Epub 2008 Jan 8.

Blood platelets are blood components that are important for blood clotting function. Platelet levels are very important to balance--if you don't have enough, you will have a difficult time stopping bleed from a cut or scrape. Too many, and you may have trouble with blood clots, which can block blood flow. Depending on where these blockages are, they can cause heart attacks, strokes, and thromboembolism.

Inflammatory diseases like PCOS are associated with changes in platelet function. In fact, women with PCOS do have problems with"sticky blood"--that is, blood that forms clots too easily. This aspect of PCOS is not weight dependent--you can have the same problem if you are lean as a woman who has weight to lose. Some of the changes in your clotting function are a function of the disease and likely would exist without any medical intervention. Other changes may be due to medications you are being prescribed. Birth control pills promote platelet activity, while metformin, decreases it.

Did you know that the same lifestyle choices inCYST promotes for weight loss, better fertility, healthier skin, and every other aspect of PCOS, is also good for healthier platelets?

1. Omega-3 fatty acids promote healthy blood clotting function. They also help to promote better melatonin balance. Melatonin is an important compound to platelets; it helps them to be less"sticky".

2. Physical activity improves circulation. Blood that is not moving is blood that has a tendency to coagulate. The more physically active you are, the less opportunity you have for platelets to collect and decide they should stick together.

3. As I just mentioned, melatonin is important to platelet function. If you're prioritizing sleep, you're giving melatonin a chance to do its job. Deprive yourself, and you give platelets the go-ahead to congregate. Melatonin is so important for platelet function, some researchers believe it may be a therapeutic supplement in people with heart disease, with similar functions to aspirin and Plavix. Who knew, a little bit of extra shut eye might be equally as powerful?*

*Any medication you have been prescribed for the purpose of altering how your blood flows and clots should not be discontinued without the consent of the physician who prescribed it. This could be a deadly choice. For anyone who is interested, I do have research I found describing some of the benefits of melatonin supplementation in heart disease. I'm happy to share it. Please share with your physician and discuss before making any changes.

If you're on any medication for blood thinning or platelet management, consider making some simple changes in your overall lifestyle that may have far-reaching benefit.

Luque-Ramírez M, Mendieta-Azcona C, del Rey Sánchez JM, Matíes M, Escobar-Morreale HF. Effects of an antiandrogenic oral contraceptive pill compared with metformin on blood coagulation tests and endothelial function in women with the polycystic ovary syndrome: influence of obesity and smoking. Eur J Endocrinol. 2009 Mar;160(3):469-80. Epub 2009 Jan 12.

Dereli D, Ozgen G, Buyukkececi F, Guney E, Yilmaz C. Platelet dysfunction in lean women with polycystic ovary syndrome and association with insulin sensitivity. J Clin Endocrinol Metab. 2003 May;88(5):2263-8.
Rajendran S, Willoughby SR, Chan WP, Liberts EA, Heresztyn T, Saha M, Marber MS, Norman RJ, Horowitz JD. Polycystic ovary syndrome is associated with severe platelet and endothelial dysfunction in both obese and lean subjects. Atherosclerosis. 2009 Jun;204(2):509-14. Epub 2008 Sep 17.

Amowitz LL, Sobel BE. Cardiovascular consequences of polycystic ovary syndrome. Endocrinol Metab Clin North Am. 1999 Jun;28(2):439-58, viii.

Kebapcilar L, Taner CE, Kebapcilar AG, Sari I. High mean platelet volume, low-grade systemic coagulation and fibrinolytic activation are associated with androgen and insulin levels in polycystic ovary syndrome. Arch Gynecol Obstet. 2009 Aug;280(2):187-93. Epub 2008 Dec 24.

d-Chiro inositol is an extremely popular supplement with women with PCOS. I've heard some fantastic stories about it helping when nothing else seemed to make a difference.

That being said…

…I ran across a very interesting study published this past summer. It has to do with myo-inositol, another member of the same family that does not convert well to the d-chiro form in women with PCOS.

In this study, two groups of women undergoing in-vitro fertilization (IVF) were evaluated for pregnancy outcome with two different supplement protocols. One group received myo-inositol plus folic acid, the other received these two supplements as well as melatonin.
Each group produced a similar number of eggs, but the women receiving the melatonin had a greater percentage of mature vs. immature eggs (i.e., better egg quality). Though the fertilization rate was equal in both groups, actual pregnancy rates tended to be better in the women receiving melatonin.

********BEFORE YOU RUN OUT AND BUY YET ANOTHER SUPPLEMENT!!!*********
Take a look at your sleep hygiene! Are you keeping regular sleep hours? Or are you up late at night reading, watching TV, surfing the Internet?

Melatonin is the sleep hormone. There are many aspects of PCOS that are associated with not sleeping well, including insulin resistance and weight gain.

Supplements do their best work in a well-balanced environment. One that is balanced nutritionally, emotionally, physically (with exercise), and with regards to sleep.

Create your own melatonin naturally, with more attention to sleep and rest. As with some of our success stories, you might be surprised at what happens when you focus on the little things rather than on the name of the supplement.

Rizzo P, Raffone E, Benedetto V. Effect of the treatment with myo-inositol plus folic acid plus melatonin in comparison with a treatment with myo-inositol plus folic acid on oocyte quality and pregnancy outcome in IVF cycles. A prospective, clinical trial. Eur Rev Med Pharmacol Sci. 2010 Jun;14(6):555-61.

Yesterday I shared some great news from an Italian research group about myoinositol for improving fertility. In the process of corresponding, they sent me a series of articles from their lab. One of their most recent investigated the combination of myoinositol and melatonin in fertility treatment.

Here's how it looks like the story goes.

Ovulation is an inflammatory process Yes, the process of releasing an egg, and giving life, is pro-inflammatory. It takes a lot of energy to do this, and as that energy is metabolized, it's oxidizing tissue around it.

Melatonin is one of the most powerful antioxidants we have You know, if you think about this the way Mother Nature does, it makes sense that we'd want to roll over and sleep all cuddled up after sex. It is her way of protecting that fragile egg from all of the stresses of the day.

The research I read yesterday was about INOFOLIC PLUS, an Italian proprietary blend of inositol, folic acid, and melatonin. Forty-six women who had previously undergone in-vitro fertilization (IVF) and failed, used this supplement daily for 3 months before undergoing another IVF procedure. They also continued to take INOFOLIC throughout the entire IVF cycle. This study, by the way, did NOT focus on women with PCOS, merely women who had failed IVF.

Here are some of the results of the second IVF in which the supplement was used:
--Higher number of embryo transfers
--Higher embryo quality
--Where all of the subjects had failed with their first IVF the first time, 13 (28%) became pregnant during the study, 4 miscarried.

What is remarkable about this study is that the average age of these women was 39 years, an age where fertility is starting to become difficult even without a diagnosis of infertility.

The supplement is not perfect, but it shows promise for helping women for whom other strategies have failed. It seems to be a great combination of compounds for peeling off the layers of inflammatory/oxidative damage have inflicted on reproductive systems…talking your ovaries down out of the tree, so to speak. What it seems to do, is both create a higher quality egg and then protect it from the ravages of oxidation long enough for it to meet a sperm, conceive, and create an embryo.

Ahhhhhh…just love the power we have within ourselves to create healing solutions!

As I mentioned yesterday, unfortunately, INOFOLIC is not available in the United States. However, there is an important bottom line message here that cannot be ignored.

When you're not eating enough antioxidants, not delegating, working too hard, not sleeping well, not managing your stress, the melatonin Mother Nature given you to protect your eggs, may likely be channeled into fighting other damages those lifestyle choices have promoted.

Not trying to shake the eFinger at you here, it's just becoming apparent from listening to so many of your stories that when we don't take good care of ourselves, the effects can stick around for a very long time. And when we do things in an effort to eat well but don't do our homework first (such as eating vegan but not making sure all nutrients are still adequate in the diet or panicking and going on a crash diet in order to get pregnant, or overexercising as the only way to manage stress), they can hurt us in the long run.

If you start to think about your choices as"What can I do to not unnecessarily use my own antioxidant power so it can be there for that egg?"…perhaps making some of those choices you've been reluctant to take on, might become easier to embrace.

Unfer V, Raffone E, Rizzo P, Buffo S. Effect of a supplementation with myo-inositol plus melatonin on oocyte quality in women who failed to conceive in previous in vitro fertilization cycles for poor oocyte
quality: a prospective, longitudinal, cohort study. Gynecol Endocrinol. 2011 Apr 5. [Epub ahead of print]

VITTORIO UNFER1, EMANUELA RAFFONE2, PIERO RIZZO2, & SILVIA BUFFO3

We've just passed the winter solstice, which means for those of us north of the equator, we're at our darkest. It's easy to want to hunker down, stay inside, and eat comfort food. But if you're prone to carbohydrate cravings and depression this time of year, a little bit of proactive choosing can help you to avoid weight gain and hormone imbalances that are common this time of year.

Even if you live in a warm climate like Los Angeles, or Phoenix, like I do, winter has profound effects on how you feel. In Los Angeles, because it sits so close to the border of the time zone, days end very early. On New Year's Day, the sun will set over LA at 4:54 PM! For those of you who like to exercise after work, this makes it hard to get out in the sun.

Every little bit of sunlight you get helps to keep your internal clock set, and helps to keep your body from converting too much serotonin to melatonin. Normally melatonin levels are high when we're supposed to be sleeping, but in the winter, especially in our modern culture, we're awake and aware that our serotonin levels are low. It's that drop in serotonin that provokes carbohydrate cravings, promotes depression, and makes us sluggish, not wanting to get out and be active.

If you can walk an errand in the middle of the day, if you can move your favorite reading chair to the window, if you can move your workout to the outdoors from the gym, all of those things can add up to help reduce the effects of melatonin.

If you're in Anchorage, where the sun is currently setting at just before 4 pm, or if you're stuck inside in LA because of the torrential rain, consider an ultraviolet light box. It's a contraption that helps to generate outdoor light indoors, that can be set up near your reading chair or desk. There are portable travel versions for anyone reading this whose sleep patterns and melatonin levels are chronically out of balance because of the demands of their job. Here is an example of a device I found on the Internet. http://www.litebook.com/light-therapy/jet-lag.asp

It's important to understand that melatonin imbalances are becoming recognized as triggers for other hormone imbalances, and can affect the severity of your PCOS.

Enjoy the video, I thought it might inspire you to get outside and let some sun shine into your life!

This post is interestingly timed, given what I wrote a few days ago about the importance of melatonin in maintaining fertility. The chemical pathways for both melatonin and niacin get their start with the amino acid L-tryptophan.

When a strong pro-inflammatory process is predominant, and the body wants to make more melatonin, it may do so at the expense of having enough ingredients to also make niacin…perhaps explaining why large doses of niacin have been found helpful to correct the lipid abnormalities associated with inflammation.

I've blogged before that people who eat more vegetables do sleep better and this may be one reason why. It gives your body what it needs to fight inflammation so that melatonin can be used to help you sleep!

For both vegans and omnivores, niacin is relatively easy to find. Mother Nature likely designed it that way because it's so important for fighting inflammation. The times you're most likely to get into trouble is if you're a chronic restrictive eater/dieter, or you're eating primarily processed carbohydrates.

See how you do with your niacin foods this week — it will be good for reducing inflammation, promoting sleep, and with the PCOS Diva's menus, pretty darn tasty!

liver, heart and kidney
chicken
beef
fish: tuna, salmon
milk
eggs

avocados
dates
tomatoes
leaf vegetables
broccoli
carrots
sweet potatoes
asparagus
nuts
whole grain products
legumes
saltbush seeds
mushrooms
brewer's yeast
Vegemite (from spent brewer's yeast)

Here is some interesting information from the world of sleep research that may have pertinence to those of you trying to conceive--and avoid miscarriage.

Even though we consider exercise to be a healthy behavior, technically, it is a stress. One of the types of stresses it induces, is thermal stress, or a rise in body temperature.

In this study, it was found that injecting melatonin helped to reduce the level of stress hormones found in the goats' blood samples. As melatonin levels rose, so did immune activity.

What does this mean to you?

1. If you're overexercising, your chronically (even if marginally) elevated blood pressure may be causing you to use your melatonin to restore balance. It may be interfering with your ability to get a good night's sleep.

2. Women whose melatonin levels are imbalanced have been found to be able to conceive, but to have trouble implanting the embryo.

3. Even if you're not overexercising, but you're not managing your stress, you may be channeling your important sleep hormone into a function that keeps it from being available for important reproductive-related functions.

4. Diet and exercise are important…but even more important is BALANCE in your life!

5. If you find that emotionally you cannot cut back on your exercise, let us help you. Sometimes the underlying reason has a very workable solution when addressed with the guidance of a trained professional.

Bottom line, it's important to exercise, but to not overdo it. And be sure that you're not compromising in the sleep department because you have underestimated the value of what happens while your eyes are closed.

Sejian V, Srivastava RS. Pineal-adrenal-immune system relationship under thermal stress: effect on physiological, endocrine, and non-specific immune response in goats. J Physiol Biochem. 2010 Aug 17.

Awhile back, a good friend of mine who is an airline pilot shared with me that despite the fact that pilots must pass routine and rigorous physicals, most live only about 10 years after retirement…and currently the mandatory retirement age for airline pilots is 60!

I've been interested ever since in why a demographic of individuals who meet our current definition of"healthy" may not necessarily be so. My ulterior motive, of course, is to keep my friend around as long as possible, but in the process of studying about sleep and health, I continue to find some really interesting things relevant to PCOS.

Such as the relationship between shift work and breast cancer. The connection here is that women with PCOS are more prone to cancer in estrogen-sensitive tissues.

Researchers have known for a long time that women who work shift jobs, such as nurses, are more prone to breast cancer. Now, research is emerging to suggest that melatonin physically suppresses the growth of breast cancer cells. Melatonin exerts its effect in numerous ways, from suppressing receptor genes, reducing the activity of proteins that regulate tumor growth, changing genes, inhibiting cell reproduction. The study I'm referring to in this post literally referred to melatonin as an"antiestrogenic" compound.

So 'splain me something, Lucy. Why is it, when I go to the Susan Komen Race for the Cure website…that the keywords"sleep" and"shift work" bring up nothing? Seems to me that the Breast Cancer 3 Day Walk would be more relevant…and preventive to those who participate…if it was a Breast Cancer 3 Day Slumber Party!

Srinivasan V, Spence DW, Pandi-Perumal SR, Trakht I, Esquifino AI, Cardinali DP, Maestroni GJ. Melatonin, environmental light, and breast cancer. Breast Cancer Res Treat. 2008 Apr;108(3):339-50.

I recently did a consultation with a young woman with a history of PCOS who was working with a reproductive endocrinologist to assist her with conception. I explained to her that even though she had chosen this route of treatment, nutrition could still be important to her overall success. Here is an important reason why.

Homocysteine is a marker of inflammation when elevated. High homocysteine levels can also interfere with brain development and promote congenital malformations in the developing fetus.

In a study done on rats in which elevated homocysteine levels were induced, the use of melatonin, a powerful anti-inflammatory/antioxidant, helped to reduce the incidence of learning disabilities seen in the offspring of rats with high homocysteine levels.

I cannot recommend the use of melatonin supplements during pregnancy as this is a preliminary study. However, I do know that the dietary pattern you see discussed on this blog is one that is correlated with reduced homocysteine levels. And…you know how much I talk about the importance of adequate sleep. If supplemental melatonin ends up to be beneficial, you can't deny that paying attention to your sleep patterns is a natural way to encourage the same outcome.

So we're not here just talking about how to get pregnant. It doesn't stop there, not at all! If you're going to go through all the expense and trouble to become pregnant, we want to be sure that once you get there, your pregnancy and the baby it produces are equally healthy.

Baydas G, Koz ST, Tuzcu M, Nedzvetsky VS. Melatonin prevents gestational hyperhomocysteinemia-associated alterations in neurobehavioral developments in rats. J Pineal Res. 2008 Mar;44(2):181-8.

The more I read about melatonin the more I think I should have majored in sleep instead of nutrition. Just ran across a research abstract reviewing the many effects melatonin, our sleep hormone, has on hair health.

In addition to being a potent antioxidant, which means it destroys compounds that promote the many symptoms of PCOS, melatonin reduces apoptosis, a process which kills cells in the body.

It's really important to value your sleep. Not getting it is not a sign of drive…or superiority…or success…or a glamorous lifestyle…losing sleep is something you do that accelerates aging and promotes all the nasty things you've come to hate about PCOS. Those of you who are losing hair to your PCOS…should take this very seriously!!!

Fischer TW, Slominski A, Tobin DJ, Paus R. Melatonin and the hair follicle. J Pineal Res. 2008 Jan;44(1):1-15.

I hope you all are not tired of my drumming into you the importance of sleep! This time, I want to look at a study about menopause. A 7 1/2 year study (which really is long and not common to see), discovered that administering melatonin delayed the events of menopause.

If you think of melatonin as one of the body's most powerful (potentially THE most powerful) antioxidant, this makes sense.

What does this have to do with PCOS? My personal feeling is that seeing all the symptoms of PCOS in the age demographic I've watch those symptoms drift down to means I'm seeing old people walk around in young peoples' bodies. I've been in this field for 26 years now, and when I first started out, it was rare to see anyone with insulin resistance or diabetes who was younger than the age of 40.

Fast forward to 5 years ago when I worked with a 9 year old girl. Not only was she insulin resistant, but she was complaining of joint pain that sounded like arthritis, hair loss, and memory problems at school. That's when the lightbulb went off for me. In at least a few cases, it seems as though PCOS is what happens when diseases of old age creep into the reproductive system.

The way we live, which is hard, fast, and with the expectation that pills and procedures can make up for those choices, eventually catches up with us. Pay attention to a few simple things which involve better balance and self care…and we can put off some of the yucky parts about having more birthdays under our belts.

The good news is, if you decide to take action, much of this can reverse. I received an excited phone call not too long ago from a colleague who's been through my PCOS training. She told me that the last 5 clients who she'd advised regarding their infertility had all become pregnant. One of them had failed with in vitro fertilization and was beginning to resign herself to the possibility that she'd never have kids.

My colleague's caveat: The clients who succeed are the ones who are willing to do the work.

We had a discussion about how being a dietitian working in reproduction is really a challenging proposition. Practically everyone else who offers a solution is the one who does the work, while the patient is relatively passive. It can create the impression that fertility is something you can have, if you have enough money to throw at the best experts out there.

Pay someone else to do the work? Do some work yourself? We've really got a hard sell.

But when I received this phone call I literally had chills. All this studying, writing, promoting, training, stressing over how we're going to get this program to take hold…for those five new lives, is completely worth it.

Trust me, it took me awhile to admit to myself, and I do this for a living, that I could improve on my own habits. But as I've realized how much better I feel, I've become very protective of my sleep. I'm rarely even awake anymore to watch the evening news. And when I miss my sleep, I can really see what it does to my body. I'm spacy, moody, stiff, I crave sweets, and I am lethargic. I'm not nearly as creative or productive.

I've also started imposing a rule on myself, if I don't have a good night's sleep, I don't work out the next day. I do go for a walk, but I focus on stress management and I try to time my activity so that I can get some ultraviolet light and hopefully correct my sleep clock. But I've learned, at least for myself, that when I push it, and expect to be able to work long hours AND exercise AND socialize, etc., etc., etc., something always gives.

Maybe that's the good part of having more birthdays under my belt…some wisdom has funally sunk in.

Diaz BL, Llaneza PC. Endocrine regulation of the course of menopause by oral melatonin: first case report. Menopause. 2008 Mar-Apr;15(2):388-92.

It's not something many PCOS practitioners think to ask during an assessment…but it's one of my first. That is, how well you sleep. Most women with PCOS are exhausted. They can't sleep at night and it's all they want to do all day. We did an informal survey a few years ago that surprised the sleep specialists I showed it to. Fully 85% of women with PCOS reported insomnia, sleepwalking, night eating, fibromyalgia, and/or early morning waking. We didn't even include obstructive sleep apnea, the sleep disorder most often associated with PCOS. What's going on? Melatonin, the chemical we tend to associate with making us sleepy, is also an extremely powerful antioxidant. It makes you sleepy so you slow down and rest while it does its main job…scrubbing up and cleaning up oxidative damage that has happened during the day. If you're under a lot of oxidative stress, it tends to want to kick in at odd hours…during the day. It's your brain's way of telling you that you need to slow things down, because it's gotten behind on the cleaning chores. When you are sleepy during the day, you are likely under stress. And if you have used up your melatonin stores during the day in an attempt to clean up the junk, there may not be enough to make you sleepy enough to fall asleep. What's a PCOS girl to do? --work on stress management --make sure your sleep hygiene practices are impeccable: turn off all digital equipment after 7:30 pm, keep the shades drawn to protect yourself from outdoor light, turn the alarm clock to face the wall so the light will not interfere with your hormones. Yes, you can take melatonin, and I've recommended it from time to time. But it's a bandaid solution. Your true answer is to start pulling yourself back into balance.