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Melatonin Melatonin Bioidentical HRT and Anti Aging

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The Carlton Clinic
Richard Snouffer, MD
1713 Hamric Dr. East, Suite B
Oxford, Alabama  36203

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Melatonin -- Sweet Dreams, and More


Melatonin is secreted by the pineal gland, buried deep within the brain.  The pineal gland secretes melatonin in response to total darkness.  Melatonin production does not begin until at least 1 hour is spent in total darkness.  Even a brief flash of light is enough to stop melatonin production.  For this and other reasons, complete darkness is advisable for proper sleep hygiene and health. 

Deficiency of melatonin production produces irritability, hypersensitivity and “jet-lag” like symptoms.  Melatonin deficiency has been shown to induce premature aging in rats. 

The melatonin system is the only sleep aid that produces natural sleep, without disturbance of the natural sleep cycles, the amounts of sleep spent in stages III and IV or a disturbance in REM sleep.  ALL other sleep medications, (i.e. sedatives, relaxants, etc.) disturb the sleep cycles and REM sleep, leading to reduced sleep quality.

Melatonin is also a powerful anti-oxidant and a potent free-radical scavenger, destroying even the most reactive and destructive free-radicals, the “hydroxyl radicals.” 


The risks of melatonin HRT are miniscule.  If you take too much melatonin or you don’t schedule enough time for sleep, you can wake up groggy, or have a difficult time awakening at the time you want to.  This can be solved in many cases by taking the melatonin 1 hour earlier at night.  If grogginess persists, then reducing the dose usually solves this problem.  Melatonin can also cause one to have more vivid dreams.  This may be good or bad, depending on the dream.  However, this is almost always temporary, lasting 2 weeks at most and usually 1 week or less.

Occasionally, patients are exceptionally sensitive to melatonin.  These patients may still get the benefit of melatonin HRT by lowering the dose. 

Occasionally, melatonin will have no discernable effect on people.  This only happens in 1 out of 10 patients.  Melatonin, because of its anti-oxidant and immune system enhancing properties, still benefits these patients.

About 1 in 100 patients have the opposite reaction to melatonin and it will keep them awake.  This usually occurs in people who are “night owls” or who are used to working night shifts.  These people too can still benefit from melatonin’s anti-oxidant effects as above.  They just take a low dose upon awakening.


Melatonin has been found to improve sleep pattern, as well as depth and quality of sleep.  Better sleep means improved immune system function which leads to a higher quality of life.  Melatonin is an energizer and a mood enhancer.  Melatonin improves the immune system by increasing the number of Natural Killer Cells.  Melatonin can be used to reset the body’s circadian rhythms.  This can help to overcome “jet lag” much more quickly than by conventional means.  Melatonin has also been shown to lower blood pressure and to decrease the incidence and magnitude of migraine headaches and cluster headaches in many patients.  Melatonin use is also noted to improve the morning Fasting Blood Glucose levels of diabetics. 

Melatonin and Anti Aging

Production and effectiveness of this hormone naturally decrease with age.  Replacement aids in restoring the functions of melatonin, but the dosage often needs to be increased with age because of the decrease in effectiveness.  Fortunately, there are no side effects to melatonin therapy with this increase, as side effects (mostly grogginess and it being harder to awaken in the morning) are associated with too much melatonin FUNCTION, not with levels of the hormone itself.  Since melatonin is also a powerful anti-oxidant, these increasing doses are probably more beneficial to the body than its function as a sleep aid alone might suggest.

Melatonin has a reputation for being a poor sleep aid.  This is every bit as unfortunate as it is untrue!  The problem stems from the fact that melatonin is available as an over-the-counter sleep aid.  These OTC preparations vary in terms of potency and absorbability (how much gets into your body to produce its benefits).  This leads to uneven results.  Furthermore, the OTC version of melatonin comes in 3mg preparations, yet the effective dose can commonly be anywhere from 1 mg all the way up to 30mg.  This means that few people have tried an effective dose of the OTC version (even if it was well absorbed) because, who, on their own will experiment until they are taking 10 pills a night?  Occasionally, the required dose can be up to 100mg for rare individuals.  However, do not exceed the normal maximum of 30mg per night without your doctor’s recommendation.

It must also be pointed out that other hormone deficiencies may also interfere with sleep, particularly in women.  If a woman is deficient in progesterone, for example, replacing melatonin alone may not result in good sleep, even at adequate doses.  In cases like these, good sleep will often not be obtained until all of the relevant hormones are optimized.  A doctor experienced in Anti Aging medicine should be well-versed in optimizing the levels of all of the relevant hormones, and should be consulted for sleep problems that seem not to respond to adequate doses of melatonin.

The Carlton Clinic has the compounding pharmacy start with pharmaceutical grade melatonin for quality, and has it micronized for absorbability.  This gives the patient the best absorption for maximum gain with this form of HRT.  It is also put in a sustained release formulation to last throughout the night.  Once the patient’s individualized dose (that produces good sleep in a reasonable amount of time without early morning grogginess) is determined, the next prescription will be made for that number of milligrams to restore one-pill convenience.

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The Carlton Clinic
1713 Hamric Drive East, Suite B
Oxford, Alabama  36203