LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

melatonin

Melatonin Shines Again for the Most Dangerous Seizures

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Seizures are very, very bad for the brain. Status epilepticus is the term for uncontrolled, unstoppable seizures.

Very often, these patients end up in the emergency room pumped full of sedatives just to stop the seizures. The damage to the brain under status epilepticus is even worse than that which occurs with single seizures.

Not to belittle the ongoing damage to is occurring in the brain of epileptics during the interictal (in between seizures) period. Few epileptics are educated on this little tidbit. Most fear the dreaded SUDEP (sudden unexpected death in epilepsy), although the likelihood of any epileptic passing from SUDEP is very small.

The bottom line is that anything that can be done to protect the epileptic brain is a very good thing, whether having seizures or not. This is not to be confused with controlling seizures, since none of the anti-epileptic drugs actually work at protecting and improving brain health.
Which brings us to this particular study. While it is a mouse study, this is not the first time that research has demonstrated that melatonin can help to protect the brain.

In the study, researchers looked to see if melatonin could protect the brain during status epilepticus, arguably the worst-case scenario in an epileptic. Here’s what they found:

  • Melatonin use was able to reduce seizure activity
  • Melatonin reduced the brain cell damage in certain areas of the brain (CA1 area of the hippocampus and piriform cortex).
  • Melatonin decreased the hippocampal serotonin (5-HT) levels.

For something as simple as melatonin, these are some pretty important effects. As a brief primer, the pineal gland deep in the brain releases melatonin once sunlight stops hitting the eyes. Melatonin and serotonin are on the same metabolic pathway derived from the amino acid tryptophan. When sunlight is present, the pathway stops at serotonin. Once darkness arrives (and we are not exposed to blue light) the pathway continues to melatonin.

Interestingly, depression is closely associated with epilepsy. It would not be unreasonable to assume that the tryptophan to serotonin to melatonin pathway is somehow affected, making the supplementation of melatonin a very reasonable recommendation in any epileptic.

In our office, we start with .5 mg, a very small dose. Most patients mistakenly start themselves at much higher dosages.

Influence of melatonin on glucose tolerance and insulin sensitivity – (04-09-01)

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Influence of melatonin on glucose tolerance and insulin sensitivity

I’ve always been a little nervous about using any type of hormone replacement therapy be it estrogen, growth hormone, testesterone, insulin or melatonin. Precursers to these hormones may generally be considered safer because the body may only convert into the active hormone that which it needs. Melatonin was viewed as the “anti aging hormone of the week” several years ago after some studies in mice showed lower levels in aged mice when compared with younger mice. This study suggests a effect of meltonin on decreasing our bodies ability to use glucose efficiently.

Synergy : Clinical Endocrinology 54 (3), 339-346

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Melatonin for Chronic Whiplash Syndrome – (01-24-02)

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Melatonin for Chronic Whiplash Syndrome

I must admit that this seems like quite a novel approach, even coming for a nutrition-oriented physician that treats whiplash patients frequently. A certain percentage of whiplash patients will experience a syndrome, sometimes referred to as post-concussive syndrome; a constellation of symptoms including fuzzy thinking, diffuse headache and poor sleep. I do know that sleep is an essential part of the healing process, and that patients in severe pain to not usually sleep well. This approach may end up being another tool in the toolbox of effectively treating patients after trauma.

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Melatonin in Patients with Reduced REM Sleep Duration – (01-21-04)

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Melatonin in Patients with Reduced REM Sleep Duration: Two Randomized Controlled Trials

I usually hesitate to use melatonin in most cases, and would prefer valerian root and/or snacks high in tryptophan (bananas, sunflower seeds) as a first line approach. I view melatonin as a powerful hormone that has the ability to impact many aspects of physiology. However, in patients on a weird sleep schedule (midnights, travel) I have found it to work very well. Considering how many patients I see that have been given Ambien or some other such drug to sleep, the fact that melatonin induces REM sleep and Ambien doesn’t this should be a no-brainer.

JCEM — Abstracts: Kunz et al. 89 (1): 128 –

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Obstructive Sleep Apnea: Can Sleep Disturbance Cause Seizures?

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Recent studies have linked sleep apnea and chronic headaches. Since migraines and seizures have similarities, can obstructive sleep apnea cause seizures?

Sleep is absolutely vital to the health of your brain.  During sleep, while our conscious mind may not be alert, this does not mean that our brain is inactive during this time. Far from it.

But sleep is not important because it allows your brain to relax, but rather because processing and healing occurs during sleep that we do not yet fully understand.  It is clear that lack of sleep is a strong trigger for those suffering from migraines and seizures.  For this reason, getting a good night’s sleep is essential for good brain health.

This task is not always as easy as it sounds for several reasons:

  1. In today’s stressed out world, chronic stress throws off normal cortisol rhythms, leading to higher cortisol levels at night, making sleep nearly impossible.
  2. Sleep apnea, both obstructive and central, make restorative sleep impossible.
  3. Our use of medications to help us sleep disrupts normal sleep patterns, potentially being linked to over half of a MILLION deaths per year.

As mentioned earlier, sleep problems have already been linked to chronic headaches and this particular study follows along these same lines as it relates to seizures.  Researchers looked at an epilepsy center and evaluated those patients with seizures for the presence of obstructive sleep apnea and found:

  1. Patients with epilepsy had a much higher incidence of OSA compared to the general population (15.2% vs. 4.41%)
  2. If patient’s seizures were well controlled, then older men with a higher seizure frequency were even more likely to suffer from obstructive sleep apnea.
  3. In those who did not have good seizure control (medically refractory), those with diabetes and snoring had a higher risk of obstructive sleep apnea.
  4. Treatment of obstructive sleep apnea with a CPAP machine in refractory epilepsy patients improved their seizure control.

Clearly there is a link between sleep problems and seizure control.  I would not be surprised at all if the hormone melatonin plays a pivotal role here.  Numerous studies over the years have linked melatonin with protecting the brain and helping with seizure control.  Sleep disturbances can be caused by a problem with melatonin production (or the timing of melatonin production) and, conversely, sleep problems can lead to altered production of melatonin in the brain.

The bottom line is that sleep is critical for normal brain health.  Whether you suffer from chronic headaches or uncontrolled seizures, sleeping has to be brought under control naturally.

The long term solution to sleep problems is stress management and exercise. Few things will restore a healthy sleep pattern as well as these two. In the short term, natural compounds like valerian root may be effective on an individual basis to calm the brain enough to allow sleep to occur naturally.

Melatonin, the hormone mentioned earlier, may also help to restore normal sleep patterns. Typical starting dosages are .5 mg an hour or so before the desired bedtime.

If you have had sleep disturbances in the past, how did you manage them?

MODERATE AMOUNT OF SUN EXPOSURE DAILY IS PART OF HEALTHY LIFESTYLE – (08-14-03)

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Past exposure to sun, skin phenotype, and risk of multiple sclerosis

With sun exposure being villified in today’s society due to the perceived increased risk of all sun exposure on melanoma, there will be lowered vitamin D and melatonin production. Here we may see a glimpse of some of the skeletons in the closet of sunlight avoidance. While I’m not advocating lying for hours on the beach coating in Crisco, a moderate amount of sun exposure on a daily basis is part of a healthy lifestyle.

bmj.com Abstracts: van der Mei et al. 327 (7410): 316 –

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PROTECT BRAIN FROM EFFECT OF OXIDATIVE STRESS – (12-09-04)

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NEUROPROTECTIVE ROLE OF MELATONIN IN OXIDATIVE STRESS VULNERABLE BRAIN

In doing some research on how to protect the brain from this onslaught of oxidative stress, I was somewhat surprised to find articles on the ability of melatonin to increase the enzymes responsible for quenching free radicals such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase. Live and learn, I guess. Entrez PubMed –

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MELATONIN USAGE MAY AID NEURODEGENRATIVE DISORDERS – (12-29-04)

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Pro-oxidant activity of aluminum in the rat hippocampus: gene expression of antioxidant enzymes after melatonin administration

Maybe I’m just looking, but it seems like there’s been an awful lot of research on melatonin lately. I had previously just considered melatonin as a sleep aid, and did not consider it as an antioxidant. However, with the current literature supporting an oxidative stress/mitochondrial dysfunction etiology for seizures, Alzheimer’s, Parkinson’s and other neurodegenerative disorders, I have begun to look at melatonin in a much different light with great therapeutic potential.

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