Melatonin for IBS and GERD: A Closer Look at Its Potential Benefits

Benefits of Melatonin- More Than Sleep

Melatonin has gained a lot of traction in recent years, especially as a part of the treatment of COVID-19 due to its anti-inflammatory properties. There have been some studies that have identified melatonin as a possible treatment in symptom management of GERD and even IBS. 

Understanding Melatonin: 

Our bodies produce melatonin in a small part of our brains, the pineal gland. It is made with the help of the amino acid tryptophan and the neurotransmitter serotonin to help regulate the sleep-wake cycle, also known as the circadian rhythm. Our bodies naturally produce melatonin in response to natural light, with higher melatonin amounts produced during the nighttime (which is why we are sleepy at night). Melatonin helps your body know when it’s time to sleep and when it is time to wake up.

Most people associate melatonin with sleep, as it can make you drowsy. Even though melatonin is made in a part of the brain, it can also be produced within our gastrointestinal tract. In fact, it is estimated that melatonin in the gut is created 400 times the amount of melatonin in the brain. It is also found in larger quantities in the gut than in the blood. 

Melatonin’s Wide-ranging Benefits:

Melatonin has several functions and potential benefits: 

1. Maintain the body’s sleep-wake cycle
2. Maintain core body temperature
3. Act as an antioxidant to fight off damaging free radicals/oxidative stress
4. Help reduce inflammation
5. Protect against GERD and help treat stomach ulcers
6. Potential to help relieve the severity of IBS symptoms
7. Has neuroprotective benefits- potential to reduce risk of Alzheimer’s and dementia
8. Increase mood
9. Cardiovascular protection- improved cholesterol, lower blood pressure
10. Protect against diabetes 
11. Potential to boost fertility

Melatonin and GERD Management: 

Melatonin, when in higher concentrations within the gut, may help promote GI motility via increasing gastrin levels and by strengthening the lower esophageal sphincter or LES (the doorway between the esophagus and stomach). Melatonin might assist in the regrowth of protective cells lining the digestive system and could also help decrease harmful effects caused by oxidative damage in the digestive tract.

More specifically, several studies have identified that melatonin supplementation of 3 mg per day in people diagnosed with GERD had similar symptom improvements compared to 20 mg per day omeprazole. Furthermore, research suggests that taking melatonin in conjunction with proton pump inhibitors may alleviate GERD-related symptoms. 

In individuals with an H. pylori infection or a gastric or duodenal ulcer, a study found that taking 5 mg of melatonin twice daily for 21 days resulted in no ulcers. This is believed to be due to melatonin's positive impact on strengthening the lower esophageal sphincter (LES) tone and its antioxidant effects in the digestive tract. Moreover, melatonin has been found to raise the levels of gastrin in the blood, adjust the acidity of stomach acid, and decrease the production of stomach acid. 

Melatonin and IBS Relief:

Yes, you heard right; melatonin may also help to reduce the severity of IBS-related symptoms. Several studies have shown the positive effects of melatonin supplementation in individuals with irritable bowel syndrome by reducing overall IBS severity and IBS pain severity and improving quality of life. Melatonin deficiency has been found to be more common in individuals with IBS-D or diarrhea-predominant IBS.

Although one small study found melatonin supplementation may impact the colonic transit time, which could exacerbate symptoms in those with IBS-C or constipation-predominant IBS, other placebo-controlled studies have found that melatonin supplementation has been effective at reducing IBS-C symptoms, including an improvement in both pain and constipation symptoms.

Boosting Melatonin Naturally:

Maximize Melatonin Intake with Food:

Explore melatonin-boosting foods in your diet, such as tart cherries, goji berries, eggs, milk, fish, and nuts like almonds and pistachios. According to a review on melatonin bioavailability in foods, nuts, tomatoes and peppers, the skins of grapes, cherries, and strawberries, balsamic vinegar and ironically, coffee, among the foods listed that contain the high concentrations of melatonin. 

Optimize Sleep for Better Health:

Enhancing the quality of your sleep is key to overall well-being, and adopting a few simple habits can make a significant difference. Prioritize your sleep by minimizing screen time at least two hours before bedtime and aiming for a solid 7-9 hours each night. Research highlights the negative impact of increased exposure to blue light from screens on sleep quality and circadian rhythms, so consider putting away phones and turning off the TV well before bedtime. 

Engaging in calming activities, such as reading a book, can contribute to relaxation before sleep. Recognizing that melatonin production peaks between 2 am and 4 am, aligning with deep sleep cycles, underscores the importance of getting plenty of rest. Additionally, limiting caffeine and alcohol intake before bedtime not only improves melatonin production but can also be beneficial for those dealing with GERD (Gastroesophageal Reflux Disease). These simple adjustments can go a long way in optimizing your sleep for better health.

Considerations for Melatonin Supplementation:

Considering melatonin supplementation for sleep? Consult your doctor for the correct dosage, generally starting low and adjusting as needed. Caution is advised, particularly with children, as melatonin overdose is possible. Limited evidence exists on the safety of higher dosages over extended periods. 

If you're using other sedative medications, discuss potential interactions with your healthcare provider before adding melatonin to your routine. Prioritize safety and personalized guidance for a well-informed approach to melatonin supplementation.

1. _{Asher, A., Shabtay, A., Brosh, A., Eitam, H., Agmon, R., Cohen-Zinder, M., Zubidat, A. E., & Haim, A. (2015). "Chrono-functional milk": The difference between melatonin concentrations in night-milk versus day-milk under different night illumination conditions. Chronobiology international, 32(10), 1409–1416.}
2. _{Bang, C. S., Yang, Y. J., & Baik, G. H. (2019). Melatonin for the treatment of gastroesophageal reflux disease; protocol for a systematic review and meta-analysis. Medicine, 98(4), e14241.}
3. _{Celinski, K., Konturek, P. C., Konturek, S. J., Slomka, M., Cichoz-Lach, H., Brzozowski, T., & Bielanski, W. (2011). Effects of melatonin and tryptophan on healing of gastric and duodenal ulcers with Helicobacter pylori infection in humans. Journal of Physiology and Pharmacology, 62(5), 521.}
4. _{Chen, K., Zeng, B., Zeng, B., Sun, C., Cheng, Y., Su, K., Wu, Y., Chen, T., Lin, P., Liang, C., Hsu, C., Chu, C., Chen, Y., Yeh, P., Wu, M., Tseng, P., & Hsu, C. (2023). The efficacy of exogenous melatonin supplement in ameliorating irritable bowel syndrome severity: A meta-analysis of randomized controlled trials. Journal of the Formosan Medical Association, 122(3), 276–285.}
5. _{Faghih Dinevari, M., Jafarzadeh, F., Jabbaripour Sarmadian, A., Abbasian, S., Nikniaz, Z., & Riazi, A. (2023). The effect of melatonin on irritable bowel syndrome patients with and without sleep disorders: a randomized double-blinded placebo-controlled trial study. BMC gastroenterology, 23(1), 135.}
6. _{Faridzadeh, A., Tabashiri, A., Miri, H. H., & Mahmoudi, M. (2022). The role of melatonin as an adjuvant in the treatment of COVID-19: A systematic review. Heliyon, 8(10), e10906.} 
7. _{Grivas, T. B., & Savvidou, O. D. (2007). Melatonin the "light of night" in human biology and adolescent idiopathic scoliosis. Scoliosis, 2, 6.}
8. _{Lu, W. Z., Song, G. H., Gwee, K. A., & Ho, K. Y. (2009). The effects of melatonin on colonic transit time in normal controls and IBS patients. Digestive diseases and sciences, 54(5), 1087–1093.} 
9. _{Malekpour, H., Noori, A., Abdi, S., Abbasinazari, M., Mahboubi, A., & Ghamsari, M. A. (2023). Is the Addition of Sublingual Melatonin to Omeprazole Superior to Omeprazole Alone in the Management of Gastroesophageal Reflux Disease Symptoms: A Clinical Trial. Gastrointestinal Tract.}
10. _{Meng, X., Li, Y., Li, S., Zhou, Y., Gan, R., Xu, D., & Li, H. (2017). Dietary sources and bioactivities of melatonin. Nutrients, 9(4), 367.}
11. _{Minich, D. M., Henning, M., Darley, C., Fahoum, M., Schuler, C. B., & Frame, J. (2022). Is melatonin the “Next vitamin D”?: A review of emerging science, clinical uses, safety, and dietary supplements. Nutrients, 14(19), 3934.}
12. _{Prosapio, J. G., Sankar, P., & Jialal, I. (2023, April 6). Physiology, Gastrin. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.} 
13. _{Siah, K. T., Wong, R. K., & Ho, K. Y. (2014). Melatonin for the treatment of irritable bowel syndrome. World journal of gastroenterology, 20(10), 2492–2498.}
14. _{Silvani, M. I., Werder, R., & Perret, C. (2022). The influence of blue light on sleep, performance and wellbeing in young adults: A systematic review. Frontiers in Physiology, 13.} 
15. _{Suni, E., & Suni, E. (2023, October 18). Melatonin and sleep. Sleep Foundation.}