How to Master Your Melatonin and Optimize Your Sleep - with Dr. Deanna Minich | EP168

If it works in the plant to optimize its phytochemicals for the survival in that environment and then within us in our mitochondria. It just tells me that from a survival, longevity and aging perspective, it would behoove us to ensure that we had good levels of melatonin.

Hello everyone. I'm Dr. David Perlmutter. Welcome back to the Empowering Neurologist. This is going to be one of those Backed by Popular Demand episodes. We're going to again visit the notion of how we can use melatonin. What are the implications of its use, how safe is it, how effective is it, why would we use it, et cetera. You may recall we did another show about melatonin several months ago with Dr. Deanna Minich, and she is going to join us again today because there's been such an incredible response to wanting more information about this ever more popular supplement. Let me tell you a little bit more about Dr. Minich. Deanna Minnich is a certified functional medicine practitioner and a nutrition scientist, international lecturer, teacher and Author with over 20 years of experience in academia and in the food and dietary supplement industries. Throughout the years, she's been active as a functional medicine clinician, in clinical trials and in her own clinical practice as well. She is the author of six consumer books on wellness topics, four book chapters and 50 scientific publications. Her academic background is in nutrition science, including a master of Science degree in human nutrition and dietetics from the University of Illinois at Chicago and a doctorate in medical sciences from the University of Groningen in the Netherlands. For a decade, she was part of a research team led by Dr. Jeffrey Bland. He's been on our program many times, really the founder of functional medicine. So I'm very excited to learn more about melatonin today. So we're going to jump right in. Well, Deanna, welcome back to the program. It's so great to see you.

Good to be here with you talking about one of our favorite topics, melatonin.

In June of 2022 in JAMA, Journal of the American Medical association, there was a review that looked at. Let me read the top. The title is Trends in Use of melatonin supplements among US adults 1999-2018. And it really, I think, brought to our attention the fact that there's a heck of a lot more melatonin being used. So I wanted to break down what this is all about, why we use it. But you were kind enough to send me a list of some ideas about personalizing, optimizing and personalizing your melatonin usage, since I know so many of our viewers right now are using melatonin, myself included, at times. So I thought that'd be a good place to start. But actually, prior to that, I had a couple of questions I wanted to go through. And first, I think a lot of people are wondering, when we buy a melatonin supplement in the health food store online, where does that come from? What is the origin of that melatonin?

That's a great first question to get into, because as you and I know, being entrenched in the dietary supplement world, there can be a lot of. There's a whole spectrum of quality and different things to consider. So back in, I would say the late 1950s is when melatonin really came to light, so to speak, and people started looking at it as a supplement and bringing it in. And at that time, it was made from the pineal gland of animals. But it was outrageous because it took something on the order of like 2,500 pineal glands to get like 100 milligrams of melatonin. So that's not sustainable. It's not kind. And it's also just with viruses and prions, there could be all kinds of just untoward effects or safety issues. So what happened from that point on is that people figured out how to make melatonin very cheaply in a commercial way. And so. And I've actually dived into some of the patents to look at how melatonin is created commercially. And if you look at a lot of these processes, many times what they do is they start with a petrochemical source of some type, and then it's run through a series of reactions. So 99% of the melatonin on the market is synthesized from chemicals. There's a paper, you probably have seen it. There's a paper from 2018. And essentially these authors had identified 13 different contaminants that can be found in these synthetic melatonin supplements. So everything from thalamide types of derivatives or even formaldehyde derivatives. And so I think that that's. That's one piece of it. You know, most melatonin on the market is synthetic. It's got other things in there which can change the activity and then further on to that, because it is part of the supplement conversation, the packaging of melatonin counts. And most of the melatonin that's out there, it's in bottles. And so when we open up the bottle and then we start to expose the melatonin to things like air or even light it starts to degrade the melatonin. So that's why having, you know, blister packs, you know, single use, you know, we need to be thinking about all of that. And also, in full disclosure, I am chief science officer at Symphony Natural Health, which makes Erbatonin, which is a plant, melatonin. So it doesn't have a lot of those issues that I spoke about.

So there is melatonin in plants. There's. We know that I think walnuts and perhaps cherries are high in melatonin, relatively high, but certainly not high enough to think that you're going to eat walnuts and it's going to give you a slug of melatonin.

I actually did the calculations on that. I don't think I spoke about that last time. But so first of all, I think just to back up, because people want to know, like how much melatonin should they be taking? And there is a range. And if we just look at pineal gland derived melatonin, there's actually a curve, an endogenous curve. So children make about 1 milligram. And as we move into middle age, it is about 0.3 milligrams. And then as we move into our fifth and sixth and on up decades, you know, about 0.1 milligrams. So if we just backtrack the mathematics of that and say, okay, I'll just give myself as an example. I'm almost 53. What if I just want to get back to that 0.3 that I had when I was 35. So if we do the calculations. And the thing about plants that I love about plants is that in some ways they're unpredictable. Right? So if you just take a study where they actually measured the melatonin in a tart cherry, and then you take that study with its range and then do the calculation for the very physiologic amount of 0.3 milligrams, what you get is, and I've actually memorized this number, it's 2,718 tart cherries in order to get 0.3 milligrams.

And that will dramatically lower your uric acid as well, I might add. So but how does that, when you say that we have a certain level of melatonin, obviously declines with age, is that that's produced in the body in a 24 hour period.

It is produced primarily at night. So the most. So first of all, I think just again set the stage for the listeners. Melatonin is found ubiquitously so in every body compartment. More or less. We have some degree of melatonin. But the kind of melatonin that we're referring to here is the true endocrine neurohormone, melatonin, which is released from the pineal gland at night at the pinnacle of darkness, which is between 2 and 4am so during the day we don't have melatonin circulating, not from the pineal gland. That ramps up as it becomes dimmer and dimmer as we make our way through the day. So actually it's called dim light melatonin onset. So as it becomes dimmer and dimmer, our melatonin endogenously goes up from the pineal gland that starts to lower our core body temperature. It gets released systemically, goes into the systemic circulation and then starts to upregulate clock genes. And what was really interesting for me, just by way of, I continue to read the melatonin literature and the liver cells have a high number of these oscillating clock genes. So you having a focus in neurology, one of the things that I think about is liver detoxification, brain detoxification through the glymphatic fluid, all of which melatonin from the pineal gland is actually having this ripple through effect of at night.

So I mean, it's an interesting point then that this melatonin isn't just something people should be thinking about in terms of maybe it's going to help reduce the onset of the time it takes for me to fall asleep. That there are wide ranging issues in the body, in the hepatic cells, in the immune system, for example, that a lot of chronobiology focuses to some degree on the level of melatonin at night.

Yeah, and in fact, I was just looking at a study last night. It was an animal study in which they gave the animals melatonin in their drinking water during the day or at night. And they found that there was no effect of taking melatonin during the day. It was at night when these animals were drinking the water that they had a boost in their longevity.

So interestingly, the receptor then for melatonin may also not be as active during the day, despite the fact that here is this exogenously administered melatonin, still nothing happened beneficial, I think, from what you're saying, because maybe the receptor was less active.

Could very well be, you know, and that's again speaking about melatonin in the true endocrine way. We know that there are two melatonin receptors. So melatonin receptor 1 and then 2. There are three different nuclear receptors. And by way of thinking of all of the receptors, we can also have gene variants for those receptors. So when people say, oh well, you know, I'm taking 20 milligrams of melatonin, I just think about, you know, are we saturating and supersaturating our receptors to the point that we're not receiving the signal anymore? Which again is another reason for my advocacy for a lower dose of melatonin. Right. To kind of start there at that physiologic level to prime those receptors to work well.

So I think what you're saying then is maybe if I'm extrapolating that perhaps it's not the best idea to be. I don't mean reliant, but at least taking melatonin on an every, every night basis in terms of receptor sensitivity.

No, I, I'm, I would say, you know, to clarify that what I'm speaking to is when people take supraphysiological doses that could in essence super saturate the receptors, I think, you know, just a modest amount of 0.3 milligrams taken on a daily basis for an aging person to help with markers of antioxidant activity, anti inflammatory action, you know, a lot of those different features would be advised. You know, I think, you know, I was on a different podcast and his name, Dr. Dickin Weatherby, you know, as we were talking about melatonin, he said, you know, this sounds like melatonipause that people don't get their melatonin levels back. So the way I think of it is, you know, how do we again fill our gap with modest amounts that bring us back into just again smoothing that, that, that curve a bit, but not the high doses that may play into what you're speaking to, which might be the receptor activity. Right. So I, I don't think you would get that with a physiologic dose with what we normally produce, and then also taking that at night before bedtime, about an hour. So, you know, I think that there is a lot of nuance there.

Well, melatoninopause, I'm still stuck on that from a couple. You love that. It's a great book title. You need to get the URL and that, that should be.

You better make a note. You're right, I do. He gave me full permission to use it. So that was not my invention.

That was just absolutely. Hey guys, we're going to get right back to the podcast in just a moment, but I wanted to let you know that this podcast is being sponsored by Purity Coffee. This is the coffee I've been drinking for the past several years. Why? This is USDA certified organic, is third party, verified to be mold free and pesticide free. It's the product of what we call regenerative agriculture and it's a great tasting cup of coffee. Great way to start your day. They have a new product called Balance. And the advantage of Balance is it has only 30% of the caffeine of typical coffee. That's a real advantage if you want to have two or maybe three cups in the morning and you might otherwise get a little overly jazzed. I know what that's like. And maybe you might want to have a cup of coffee perhaps later in the afternoon, but you're fearful about the caffeine content. All of the bioactive components are still there. So this is Balance. And you can get this for a 30% discount on your first order by using the promo code Perlmutter and going to the link at the bottom of your screen. Let's get right back to our podcast. Let's go back to the light issue. We know that we wake up, we're exposed to light melatonin levels bottom out and but yet in the evening, we need our darkness, especially as it relates to the blue spectrum of the light that we are exposed to. So how about some just general recommendations for people to allow their pine needles to come online, make melatonin and allow us to at least derive benefit, first of all, from our endogenously produced melatonin.

I'm so glad that you're starting there because, you know, quite honestly, this whole foray into melatonin has changed even how I approach nutrition. And often what I'm saying now is we have an operating system. We're run by rhythms of light and dark. And if we don't get those right, then eating and sleeping and activity, I mean, those are all in my mind kind of secondary to, to being housed within this framework of light and dark. So, yeah, let's start by, you know, one of the first practices is making sure that you get bright morning light. So, and even if, you know, you know that I live in the Pacific Northwest and it isn't always so bright, but even cloudy days sure is.

In the summertime though.

Yeah, sure is. But, but all throughout the year we need to be doing that because getting the bright light in the morning first thing actually helps our melatonin production at night. So most people don't put that together as of that equation. Now at night, I think we have to Hack our environments a little bit better in the way of, you know, one of the things that I have done is just even change the dimness of my lights seasonally. So, you know, of course, the computer screen, like changing the dim, just changing the light intensity. Right. Changing your phone intensity. Now one of the things, I don't think I mentioned it last time, but I use an app. I use an app called Light Meter. It's free. And as our friend and colleague, Dr. Jeffrey Bland would always say, if you don't measure it, you don't change it. Right. So one of the things to get smart about the light in your environment is actually to measure it. So one lux is equal to seeing a candle flame about three feet away. So lux is a measure of light. And you want your bedroom, your sleeping room to be under one luxury. So it's got to be really low and you don't know what it's actually at unless you measure it. So if you open up the app, let's just say you download the app, you use the camera on the phone to actually just at the eye level, just kind of see what you're seeing and then it will give you a readout of the lux. So I'm intentionally in my home office where I have a big window in front of me. This gives me 5000 lux, which is what we would want because during the day we want a lot of light, but at night I actually have it now so that our sleeping room is under zero lux.

Can you repeat the name of the app?

It's called Light Meter. Light Meter, Lux app.

Got it. So you say we should have one lux or less in order to go to sleep at night.

Yeah.

So really, really dark.

Well, you know, you might be surprised. And again, unless you actually measure it, you don't know what it looks like. When I have 0 lux in my sleeping room, it's still a little bit grayish. It's not like has to be pitch black. You might be surprised. Now, you and I both have light colored eyes. This is another factor, personalization of our environments, people with light colored eyes. So that would be blue eyes, green eyes, and even light brown eyes. They're even more susceptible to the suppressive effects of artificial blue light. So there was one study in which they looked at that comparison and showed something like, you know, a 17% greater suppression. So for us, you and me, our light at night, we have to be particularly sensitive to what we've got in the way of electricity, light bulbs, screens, all of it. Because, you know, quite honestly, and I've been telling a lot of my functional medicine colleagues because I teach for the Institute for Functional Medicine, especially in the environmental health module. You know, many times we focus on plastic, we focus on heavy metals. And I just was talking with them not too long ago and I said, you know, what's really interesting is that artificial light at night, which goes by Alan as an acronym, is one of the most societally accepted endocrine disruptors. It doesn't just impact melatonin production, but because melatonin is connected to so many other hormones, we're impacting thyroid function, we're impacting sex, steroid hormones, and potentially into fertility, adrenal hormones. They're all impacted by artificial light at night. Not to mention.

This is really, really intriguing and very, very, I think, very important. In the intro, I made people aware of the fact that we were going to have this. We're really going to get into the weeds a little bit. But think about this then. Through the mechanism of melatonin production or suppression, artificial light at night can have wide ranging effects on other hormones and really significant parts of our physiology and certainly immune function as well.

Yes, absolutely.

And even metabolic issues like insulin sensitivity, glucose levels. You know, there's research, you'll probably talk about it, that shows that wearing these blue light, wearing blocking glasses has been shown to actually improve insulin sensitivity and glucose levels in people who've had issues with that.

Yeah. In fact, I. There's one study, it was a small study, I think it was done in Japan and they had men who were healthy, who had no metabolic dysregulation, wearing blue light blocking glasses two to three hours before bedtime for a month. And at the end of the study, they measured a number of different metabolic parameters. And what they found was that there were statistically significant changes in fasting plasma glucose and the HOMA score. And the HOMA score is a measure of insulin resistance, insulin sensitivity. So even if you're healthy and you've got no metabolic issues, wear the blue light blocking glasses. You know, I have them here, I'm not wearing them now because it's 10:30 in the morning and you know, I actually want blue light. I don't want to suppress it. But by the time it starts to get dimmer and dimmer, I have been consistently wearing and even traveling with my blue light blocking glasses as well as my, my Erbatonin. You know, just kind of, I've got my little composite of things that I need to ensure that I stay in rhythm wherever I'm at.

Well, hi, everyone, Dr. David Perlmutter here. We hope you're enjoying this content and if you would do so, go ahead and hit the like button. And if you're not already a subscriber to our channel, please consider doing so. We're really grateful to have you as part of our community. So let's get right back to the presentation. Well, it's 1:30pm Where I am and so I'm almost at my caffeine curfew, which is 2pm And I think we'll talk about that. You know, let's just jump into it. What the heck. You had mentioned that there's an interaction between caffeine and melatonin that we should be aware of. What do we do with that information?

Well, just like you mentioned your caffeine curfew, you know, we have to start.

And I didn't make up that term, by the way.

Well, no, but you, you mentioned it for yourself that after a certain point, you can't be having caffeine. First of all, we just know that caffeine can interfere with healthy sleep. And so caffeine and melatonin compete for a similar liver enzyme, for metabolism. So if you have caffeine or caffeinated beverages, coffee, whatever it is, even chocolate, too late at night, what can happen is you start to distort the metabolism of melatonin. You might lengthen it, you might shorten it. You know, again, it just kind of depends on your individual dynamics of that particular enzyme. You know, another thing that so many people ask me about as it relates to caffeine and the pharmacokinetics of melatonin is how do I even know if I have enough? So one of the things that I have done personally is I do supplement, right? I do take that 0.3 milligrams and I did the Dutch test. So when I just wanted to look at my urinary metabolite of melatonin, that's typically what is produced. It's not. You don't measure melatonin. You measure the bio transformed metabolite of melatonin and you measure it in the urine. So when I got my results back, and of course you have to realize that there could be many different factors which can play into the inaccuracy of that test. Like if I got bright light, I could have suppressed my melatonin, all of those things. But what I found was that my melatonin, at least my metabolism of it was in the sweet spot, which told me that most likely the dose I was taking is in the sweet spot for my pharmacokinetics, like how I'm metabolizing melatonin, the amount I'm taking. And you know, it works well for me in terms of sleep, but I don't just take it for sleep, I take it for other things.

Well, like what?

Well, because I am in my 50s and you know, one of the things I think that's sticks out in my mind, I don't know if you know who Brian Johnson is. And some of these other, of course I do, longevity, biohacking kind of people. I mean, they, they take melatonin. But one of the studies that really impacted me was a study done, I believe it was in 1988 and it was with animals. And it was taking two groups of animals, 10 in each group. And in one of the animal groups, they gave those animals melatonin in their water. And that was at night. Everything else was the same. Their diet was the same, the environmental conditions, the lighting, all of that was the same. And they tracked. And these mice that they, they had for the experiment were actually a bit older. So they weren't young mice, they were older mice. So kind of like me. And they, they had these mice over time and they tracked them until they died. And basically what they found was that the mice that had melatonin in their water at night had a 20% greater lifespan. So they lived something like 930 days versus like 752 some odd days. That has always stuck in my mind. So why do I take melatonin? It's not for the sleep. And I think for many people, they have pigeonholed melatonin, something so biodynamically complex into the singular action of sleep when we know that it's actually doing so many other things. So I'm doing it more for. Oh, by the way, in that study they also mentioned that the, the appearance of the mice looked different. So the mice who did not have the melatonin in their water, their posture became hunched over, they started losing their fur. They just didn't look healthy. They started to shrink in their body weight. And for the animals that had the melatonin in their water at night, and I keep stressing at night because there was another study where they gave melatonin in the water during the day and they did not see those, those aspects of longevity. So I thought that that was fascinating.

You mentioned antioxidant function as it relates to melatonin. How do we position melatonin in the panorama of our endogenous antioxidants and certainly. How do we look at it as a player in whatever we may be supplementing?

Well, some people would call it the master antioxidant. We've probably heard that for glutathione and other types of antioxidants. Here's the thing with melatonin. Melatonin is amphiphilic. And amphiphilic means that it's fat soluble and it's water soluble, which means that it can traverse through many different body organs, tissues. It can be in the brain, which is fatty. It can be in the blood, which is watery. So it's very unique in its antioxidant capacity. So one molecule of melatonin can, can scavenge up to 10 different free radicals, whereas with vitamin C, you might get a scavenging of like one to two very specific radicals. When you compare glutathione to melatonin, what you see is that melatonin can scavenge more in the way of the hydroxyl radical compared with glutathione. So, you know, there, there's. I don't want to say that it's just all about melatonin. Melatonin works as a team player and it can actually stimulate the production of glutathione and a number of different antioxidant.

Enzymes and it can actually salvage glutathione.

Correct.

But as a team player, what is the synergy between melatonin and vitamin D?

Yeah, that, that's really interesting. And again, you're aware of the review article that we published on. Is melatonin the next vitamin D? So what is the synergy? There was a study, I think this really nails it. There was a study in which they were looking at women. It was a smaller study, 70 some odd women, and basically showing that for women who had vitamin D insufficiency or deficiency, they also had an association with lower amounts of melatonin. When the vitamin D levels were corrected, melatonin levels seem to be improved. So we do need to be thinking about, I kind of see it like a triangle. Vitamin D, melatonin, magnesium. And so if we're overdoing vitamin D, you know, how do we stretch and change the magnesium? Because we need magnesium for the different hydroxylase enzymes to activate vitamin D. And then we're also kind of pulling on that connection over to melatonin. So to me, you know, when I think of sunlight, I'm thinking of vitamin D. I think most people do. We also need to be thinking about that darkness. Back to what you were saying. Before about darkness deficiency, that we're not getting the balance, we're getting the vitamin D. Perhaps. Perhaps that's still a big question. I think people are starting to get a bit more knowledgeable about that. But we also have to complement that with the, the, the melatonin, because I do think that they're working in tandem. You know, there's kind of this yin yang approach.

You know, it becomes really relevant when we recognize how pervasive, at least insufficiency by definition of vitamin D. How in our society, how that is. You mentioned something earlier that they found a Japanese study in which men who were metabolically intact were evaluated. And I was just, I was thinking at that moment, good luck in America trying to find adult men who are intact by all five measurements of metabolic syndrome. Good luck with that. You're going to have to search high and low to get your cohort because of how just generally metabolically compromised we are. Speaking of men versus women, you've made some comments that melatonin production, melatonin requirements, even melatonin supplementation, might well be looked at in terms of being gender specific.

Well, that is coming from two things. First of all, one of the things that I find really interesting, and I've had a conversation with Emily Ridbaum, who is a nutritionist who's really into preconception health. She's really bullish about melatonin. And we were talking about in terms of gender specificity or looking at maternal levels of melatonin. So what's really important for, I would say for men and women is melatonin is important for fertility. Right. So for the egg, for the sperm, they're, they're both important. But then as a woman is if she decides to nurse her, her baby, that's really important because the melatonin that is coming from the breast milk, which we do not find in formulas, by the way, is helping to. Actually, this was from an, an helping to modulate the gut microbiome of the infant, or in this case, since it's animals, the offspring. But essentially, you know, looking at the gut microbiome modulation of maternal supplementation of melatonin, also looking at potentially better sleep for the mother, better sleep for the infant. You know, so I think that that's really interesting. And in terms of like female male bioavailability, this is not my work. This is from a study in which they found that bioavailability of melatonin is actually lower in men than women. So that's, you know, by 50%. So why are women more Primed for the uptake of melatonin? I don't know. But, you know, there can be some hacks as far as, you know, how do you optimize that uptake? You know, how can you get that into the body? How do you personalize that melatonin curve throughout the night?

Well, you mentioned something I think really interesting, and that is the effect of breast milk melatonin on the developing microbiome and functionality of the microbiome in the infant. What about the rest of us? How does our own pineal gland produce melatonin affect our own microbiome?

You know, there is some more emerging work. It's kind of interesting because the gut actually produces is 400 times the amount of melatonin that the pineal gland does. But yet I feel like we know less about it. But what I find intriguing is that the gut derived melatonin is, it's doing a lot of things, or at least a lot of things are proposed. So what is it doing in relationship to the gut microbiome? Well, there were some inklings in the research to suggest that it may actually be changing the gut microbiome circadian or rhythm, or even its ability to produce things like short chain fatty acids. Now that's all very still preliminary. It's very cursory work. It's nothing definitive, it's nothing that we've seen this in people. But I think it's pretty interesting because melatonin produced in the gut can change gut motility, it can change gastric secretions, and there is this potential change of the gut microbiome modulation. And I kind of see that between two different compounds. I've been doing a lot of research as well on polyphenols and seeing how, you know, polyphenols together with melatonin seem to be having this connection to the gut microbiome as well as a chronobiotic effect. I mean, from a seasonal aspect of when we need certain things, those two feel like the drivers within nature to kind of get us back into that rhythm.

So what should somebody be thinking about if he or she is thinking, well, gosh, I saw this podcast, I've heard about melatonin. I think I might, it makes sense. I should be taking it. What is their next step? I mean, can everybody, or should everybody have a Dutch test determine what their baseline metabolism is, what their excretion is of melatonin metabolites? Or is there a more user friendly approach to getting started and following how a person is doing in terms of their supplement regimen?

Yeah, I would say to dive, right? I mean, so much depends on your age. You know, I think for most people in their middle age, they need to be looking at a very low dose supplement of melatonin, you know.

And what does that mean, low dose? What kind of.

Yeah, let's go back to that. So that 0.3 milligrams. And again I'm taking that from the curve of melatonin levels produced by the pineal gland. So again, I'm going back to what is traditionally formed from the pineal gland. It's at about 0.3 in middle age. So you know, some people say, well, I want just a little bit more, maybe you know, just about a milligram. But you know, I think low dose is a pretty good place to start. I also think that choosing a good quality supplement, like I was talking about Erbatonin, because there is a study in the molecules journal in 2021 where they actually took synthetic melatonin versus the erbatonin and did a series of tests. And what they found was that in looking at inflammation that the erbatonin was able to quell anti had had 646% Greater Anti Inflammatory activity. It could also scavenge more free radicals up to like 470%. And there was even they did a skin cell line looking at reactive oxygen species and it was able to quell 100% more of those radicals. So side by side, what I would say is if you're going to take melatonin, amplify the response. If you're a biohacker, an athlete, an aging person, you know, just side by side, make sure that you're getting other things naturally occurring in that plant. Melatonin. So what we know about erbatonin is that it contains lutein, zeaxanthin. And this is just natural because Erbatonin is made from alfalfa, chlorella and rice. And it's all made from those plants where they were in an environment to optimize the natural production of melatonin. So it's not an extract, it's just really bringing in the other things of the plants. So I would say to bring in something safe and packaged correctly like the Erbatonin.

Why do plants make melatonin?

Well, I know you and I had this conversation last time, right? We were talking about auxins and you know, the reason why plants make melatonin is actually the melatonin in the plant. It's very different than how we're using melatonin in Some ways, but it can stimulate the production of other phytochemicals, like even the glucosinolates, which I'm a huge fan of. So, you know, again, it's driving that photosynthetic process in the chloroplast, enabling it to, you know, optimize phytochemicals. So, you know, that really speaks to me in terms of, you know, if it works in the plant to optimize its phytochemicals for the survival in that environment and then within us in our mitochondria, it just tells me that from a survival, longevity and aging perspective, it would behoove us to ensure that we had good levels of melatonin.

Now, let's throw a little ringer in here, and that is that we change our dosage depending on the phase of the moon. You have to open up about that.

I just learned about that study not too long ago because I got very much into all of the rhythms, right? Like we've got the Circadian rhythm, the 24 hour rhythm, we have the circannual rhythm, which is the seasonal rhythm. And maybe, if you'd like, we could talk a little bit about how even the birthday that you have can predispose you to certain risks for certain autoimmune diseases, potentially because of the melatonin and vitamin D. But anyway, let's talk about the moon, which is another layer of rhythms. So there was a study, this is really intriguing because it was done in a sleep lab, so without the influence of things like the light of the full moon or even the sunlight, right? So these, these people came into the sleep lab and then they tracked them over time for just to look at their endogenous melatonin levels. And what was really intriguing is that four days before the full moon and four days after the full moon, their melatonin production just went like that. It just came down. So if you think about it, many people will say, and I've had this experience myself, where they don't sleep very well during the full moon. Some people don't know why that is, but they just don't see. And then they think, well, it's too bright outside. Or, you know, there could be all those reasons, but at least in this study, the variable of light was actually controlled for it and they still found a reduction of melatonin. So we may need to actually be thinking about not just as seasonal, and I'll actually be talking about that at the PLMI meeting in a few, in a week or so, but we may need to adjust our melatonin seasonally, when we have up and down levels, especially as it relates to vitamin D and melatonin and then even through the month, you know, so if you don't want to have like all of that, you know, mental chaos and be thinking about all of that, you know. You know, again, this is what I keep coming back to. Kind of like just the blue light blocking glasses, adjusting the light and dark, having the Erbatonin to kind of smooth the gap at that very low physiologic level, I think, you know, just starting there to accommodate for whether it's the lunar cycle, the circannul cycle, circadian rhythm. And David, I don't know if you want to talk about this, but this is another area of interest. I just made an Instagram post. I would also posit that melatonin could be seen as a molecule of consciousness. And the reason why I say that is because there is some talk in the psychoneuroimmune literature about seeing different levels of melatonin even in people who meditate. Now we're not talking like a one off meditation, like let me just sit there and meditate and I'll get my melatonin. In Seasoned meditators who have been meditating for, you know, a longer duration, like 10 years and more, what they find is that melatonin levels endogenously are higher than that of non meditators. And I also go back because, you know, my major was in biology, but my minor was in English lit. And much like, you know, your, your kids being an artist and you know, a medical doctor, I kind of like the juxtaposition of those two. And I think of even, you know, Rene de Car heart back in the 17th century, philosopher, mathematician, you know, the pineal gland was seen as the seed of the soul. So I kind of find that, you know, I, I'm starting to go bigger and broader thinking about, you know, do we really need all of these psychoactives? Do we really need to get into psilocybin and all of these things to have a higher consciousness? Or are we losing that sense of awareness, that sense of consciousness? Because certain of these molecules that would keep us in tune with nature and with our own self realization are declining if we're not attentive to those things. So I'm just putting that out there.

It's wonderful speculation, especially when you recognize what's going on with the biogenesis of melatonin in terms of its precursors, right? How that relates to other aspects of neurochemistry. You Know, I think back years ago, prior to mri. I'm really dating myself now. But when we only had CT scans and we would look between the hemispheres and there'd be this white dot on. On some scans, not all. And we would say, oh, that's simply calcification of pineal gland. Let's move on. It's nothing important. But one would wonder, I mean, the calc. The pineal gland does not calcify in everybody. And you wonder, really, vis a vis the conversation that you're hap. We're having right now if we could analyze those individuals with calcification versus those who have not experienced calcification in terms of various psychometric tests and determine if, in fact, there is something going on when the pineal gland, ostensibly because it's calcified, is losing its functionality.

Right?

Who knows?

Yeah. Yeah, absolutely. You know, that's another feature of a lot of the melatonin research, is looking at pineal gland calcification. And then people think, well, how do I find out? I mean, I would just say, you know, it is really interesting that that could happen, that it can become more hardened, more crystalline. You know, that might even mirror what could happen in the cardiovascular system. Right. So, you know, I think, again, just how do we become more resilient? One thing that we didn't touch on, but by way of you mentioning calcification, it made me think of it is just even stress, because there is this dynamic with cortisol and melatonin. And some people will say, well, Deanna, how do I really know if I need melatonin? And I asked them to tell me a little bit about their lifestyle, what they're up against. You know, I asked them to tell me their age. And, you know, all of those factors really do play in. And stress is a big one, because if we look at how melatonin is made, even in that little pineal gland, which, by the way, is the first endocrine gland to form in utero, even before the others. What we see is that, you know, the body makes melatonin from tryptophan, and tryptophan has to convert to serotonin, which then needs to convert to melatonin. And that pathway actually is very encumbered with nutrients. It's encumbered with lots of different enzymes, including a methyltransferase. And with methyltransferases, as we know, there can be genetic variants that tie into that. So there can be so much variability. And so the body delegates tryptophan very carefully 95% of tryptophan actually goes through the kynurenin pathway, which gives us nad. And I think you were talking on one of your Instagram lives not too long ago about NAD and IVs and, you know, just all of the talk about NAD. But, but anyway, the tryptophan, most of it will go towards energy. So when we're stressed, we're going to take even more of that tryptophan to run through that kynurenin pathway, right? We're gonna have less leftover to make melatonin and to even make serotonin. So I want everybody to be thinking about that because in this modern day, you know, whether it's toxicity, whether we're stressed, all of these many things stack up to aligning, to really needing to have just optimizing our melatonin levels. So we're going to be even at greater jeopardy maybe in our 20s. We're down to 0.3 milligrams, right? Like what our pineal gland can make just because of so many things fall short.

I think you bring up a very good point. And I think probably the biggest influence in terms of diverting tryptophan away from serotonin production and into kyaurenic, that whole kyanic acid pathway is inflammation. And, you know, we know that there's so much inflammation as a consequence of our metabolic mayhem, as a consequence of our elevated blood sugar, our levels of obesity, our levels, as mentioned, of stress, our lack of adequate restorative sleep. These things all contribute to ramping up our set point of inflammation, which directly impacts the biochemistry of, in this case, melatonin production by affecting dramatically its precursor, which is serotonin. We divert away from serotonin through this potentially brain toxic pathway, the kyaurendic acid pathway, via one of its metabolites that is certainly brain threatening. So, you know, these things all feed in. And I think that we didn't mention, but it's worth mentioning, mentioning that getting our metabolism back on track will allow us then to endogenously produce perhaps more physiologic levels of melatonin than we are currently doing. And this decay that we see with aging might well be somewhat explained by our risk of metabolic issues that are so prevalent. You know, I mentioned earlier that, you know, good luck finding a man in America. This study that was done in Japan, who's metabolically intact, 85% of American adults has at least have at least one component of the metabolic syndrome. So, you know, and those things are all ultimately harbingers of higher levels of inflammation, I. E. Ultimately going to compromise our ability to make melatonin via this kynurenic acid pathway, so, and translates into.

Neuroinflammation, you know, into your. Your particular sphere. Right. And then we see the issue with the glymphatic fluid exchan, that's not working so well. And we know that melatonin is important for the transport of a lot of those toxic amyloid peptides and hyperphosphorylated tau proteins. And so if somebody's inflamed, like you're speaking to, they already have that as a. They're inflammaging. Right. They're metabolically inflamed. And, you know, they've got type 3 diabetes, so to speak. And so now we've got issues with, with the brain and we start to set the stage metabolically for greater risk for dementia and neurodegenerative issues.

And it gets back to sleep and perhaps the role of melatonin in sleep, I mean, that's when you activate this system to purge your brain, the glymphatic system, during deep sleep. And I'm all about wearables. I'm going to tell you right now, as we speak, I'm going to tell you exactly what happened to yours truly last night. Okay? So my sleep last night, it was optimal. I've done better, but it was at an 89. But I spent 2 hours and 38 minutes, 32% of my night last night in deep sleep, which is when we activate the glymphatic system. So, you know, maybe we're not going to measure melatonin in everybody in terms of its metabolites, but people can get a wearable. I mean, there's so many wearables now that can give you that data as it relates to the quality and quantity of your sleep. I happen to wear an aura ring, but there are several of them out there now. And that gives you an inference, especially the sleep onset part. How long did it take you to fall asleep?

Right.

Last night? For me, six minutes.

So, and that's actually what melatonin helps with, is that sleep latency.

That's right.

Right. Yeah, yeah.

Let me get to something that I think people are talking about as it relates to this sleep latency being reduced by melatonin. I think many of us have experienced that we fall asleep even more quickly if we take melatonin. But there is a discussion about rebound, about people then two or three in the morning, if they take melatonin, they might wake up how common Is that. And what can we do about it?

I think you have to look at when you take melatonin, the personalized kinetics of it. So for some people, they might be a fast metabolizer, they may need to take it with a little bit of fat. So something like I. I have a colleague who takes his Erbatonin with a fish oil, and that helps kind of just create that natural, kind of a slower release. Right. And also potentially getting into the brain better. Sometimes I think that when people are waking up at that, you know, it is kind of that time of the night, like the 3am Wake up. I know somebody else who. She and her family have a a.m. wake up thread. Like, they all wake up at 2am so why is that? Well, you know, there could be a lot of other things too, because melatonin production naturally is high at 2am There could be. And especially if somebody just happens to have a higher toxic load, they might be having more activity at the level of the glymphatic fluid. Right. There could be certain things that could get more disruptive and there's a greater shift metabolically at that time. And I know that, you know, I'm married to an acupuncturist, and he and I have these conversations all the time. And even within Chinese medicine, and this is in scientific literature as well, there are certain organ breakouts of hours. Right. So between one and three is liver time. So, you know, when I would tell him that, he's just right.

Yeah.

So, you know, we think of when I think of, like the time somebody's waking up when it's one to three, I think of liver toxicity, I start thinking of, like, what is, you know, maybe melatonin is actually riling things up to kind of get things out. And because there is more activity now, there's no science to suggest that somebody waking up at 2 2am is going to be more toxic and, you know, has. Has greater levels and all of that. And their, their liver health is, you know, being amplified and, you know, being worked with. But I, I think. I think we need to be looking at that from a personalized perspective and working on things like metabolic detoxification in tandem with sleep. That to me would flag. Perhaps we need to do more and even during the day to help with that nighttime release.

Yeah, I think it's just important for people to grasp that sleep and nighttime is not when everything shuts down. We have this sense that everything's turning off and it shuts down at night. And that gets back even before traditional Chinese medicine to Ayurvedic medicine, that it's really only a 12 hour day and that it repeats itself. So what goes on at night that you can look upon 1 or 2am as being just like 1 or 2pm when the sun is very high and fire is active, Pitta is active. And that what is the center of fire in Chinese medicine? As you mentioned, it's the liver. And that's when things are happening. Now we know that the brain is actively consolidating memory and detoxifying itself in the middle of the night. Why we need sleep. I did a podcast yesterday and they said, what's the one thing on the top of the list that you would want to modulate in people to help reduce their risk for Alzheimer's? I said, sleep better. Restorative sleep.

Yeah.

And you know, they were looking for the magic supplement or, you know, perhaps exercise. But it is sleep. Who knew?

Yeah, we need that. And I think that for so long it's been heralded as like almost a badge of honor if you can go without sleep. And like, oh, you know, I only need four to five hours.

Yeah, right. And we all did that, you know, especially during residency.

Yes.

When. And you know, you're making life and death decisions the next day and you didn't sleep because you were up all night in the emergency room. That's a good person to be making those decisions, that's for sure.

You know, I want to just mention to you, you know, because I love this area and I like what you're saying about sleep too. You know, this idea of the darkness. Right. You know, there are even. I don't know if you've seen these online, but there are darkness retreats where people just go. And for, you know, like a few days they're just in complete darkness. And you know, I've been kind of looking at there. There's one particular retreat center in Oregon that I keep looking at. And you know, they watch and monitor the people when they come out just in terms of their, their senses, just like how so many things change. And I would just encourage people like you're mentioning sleep. You know, this darkness deficiency idea is, is huge. You know, I was on a panel with people with, from NASA and other types of organizations really concerned about the ecosystems on the planet, concerned about, you know, just what we're doing with all of this toxic light. And perhaps we can't sleep well because we've got this bombardment of all of this artificial light. I mean, if you look at the planet Earth from afar, it just looks like a huge lit up globe. We're not in darkness as a planet. So that just makes it, I think even more difficult to find our slumber. To find.

And I would say sound too. You know, one thing that I'm very taken by with my Apple Watch is it'll alarm. It'll send me an alarm if there's too much ambient noise. And you know, this is. Your Apple Watch will do that. And you will be surprised. I mean even if you're driving your car and the windows open and that sound is happening, you'd be surprised at all of the ambient noise at high levels that we're exposed to. Yeah, it's bad for your hearing in the long run, that's for sure. But it's also very stressful. It's also getting to exactly what you talked about. I find that in the summertime where we go is incredibly quiet to the extent that it takes several days to get used to the fact that there's not all this noise around us. And it absolutely heightens your senses and I think it's extremely healing. And I totally hear what you're saying about light as well, you know, especially from monitors and televisions and things. I'm in a studio right now with bright lights and you know, and that's why I don't do these recordings, you know, very late in the day because I know it affects me.

Yeah, no good. You know, and I think it's so important to get the word out. And I thank you for having me back to talk about this because I feel like, you know, we talked about melatonin as a centerpiece here, but there's something bigger and broader. It's, you know, we're human beings that are misaligned to natural rhythms and we really need to find our way back, you know, step by step. Whether it's blue light blocking glasses, melatonin supplement, you know, whatever it is. We need to find our way back to nature. We need to hear the frogs and see the stars.

Evolutionary environmental mismatch that, you know, here our evolution, our genes have created a physiology that is just not lining up with our environment in so many ways. The foods we eat, the light to which we are exposed, the sounds, the, the, the, you know, the real consequences of our everyday lives. Not to mention, and then I'm going to mention. Why do people say not to mention then you know, I'm going to mention.

You know, that they're going to mention it.

It's so meaningless. But the, just the toxic exposure in the forms of air pollution now that there's so much smoke. And people think, well, air pollution is bad, sure, but it's the unseen, you know, these PM2.5 particles that are you ubiquitous now around us. So much worse with fire smoke. That is not really part of what our physiology is geared for. So I think it's really, there's a lot to be said about, you know, Lauren Cordain's original work in terms of the Paleo diet, that we're trying to live a life that gets back into sync with our genetics and, you know, certainly understanding chronobiology, circadian rhythms, the role of melatonin as you have so wonderfully elucidated, I think this is really a centerpiece and it is relatively easy to get back on track as it relates to this one very important piece of the puzzle, and that is establishing a better diurnal chronobiology via understanding melatonin. So thank you very much.

Oh, it's been a delight. Thanks for all of your great questions and your comments.

Wonderful. Always good to see you. And I will not see you in Seattle in a couple of weeks. I just got home from that area. But I hope to see you. I'll see you in February, I'm sure, in New York.

Sounds great. All right, wonderful. Thanks so much. Take care. Bye. Bye.

Well, more enlightenment, isn't it, on the use, safety considerations as we might use melatonin becoming an ever popular, ever more popular supplement these days. I hope you found this information interesting and certainly helpful as it relates to your choice in using melatonin or not in your supplement protocol. I'm Dr. David Perlmutter. Thanks for joining me here on the Empowering Neurologist. And we'll be back soon. Bye for now. Sam.