Melatonin for high blood pressure?

Melatonin is fascinating stuff.

In addition to its use as a sleep aid, melatonin exerts possible effects on cardiovascular parameters, including anti-oxidative action on LDL, reduction in sympathetic (adrenaline-driven) tone, and reduction in blood pressure.

Several studies document the blood pressure-reducing effect of melatonin:

Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension.

Melatonin reduces night blood pressure in patients with nocturnal hypertension.

Prolonged melatonin administration decreases nocturnal blood pressure in women.

Blood pressure-lowering effect of melatonin in type 1 diabetes.


But blood pressure may be increased when melatonin is added to nifedipine, a calcium channel blocker:

Cardiovascular effects of melatonin in hypertensive patients well controlled by nifedipine: a 24-hour study.


Effects on BP tend to be modest, on the order of 5-8 mmHg reduction in systolic, half that in diastolic.

But don't pooh-pooh such small reductions, however, as small reductions exert mani-fold larger reductions in cardiovascular events like heart attack and stroke. NIH-sponsored NHANES data (see JNC VII), for example, document a doubling of risk for each increment of BP of 20/10. The Camelot Study demonstrated a reduction in cardiovascular events from 23% in placebo subjects to 16.7% in subjects taking amlodipine (Norvasc) with a 5 mm reduction in systolic pressure, 2 mmHg drop in diastolic pressure. Small changes, big benefits.

Many people take melatonin at bedtime and are disappointed with the effects. However, a much better way is to take melatonin several hours before bedtime, e.g., take at 7 pm to fall asleep at 10 pm. Don't think of melatonin as a sleeping pill; think of it as a sleep hormone, something that simply prepares your body for sleep by slowing heart rate, reducing body temperature, and reducing blood pressure. (You may need to modify the interval between taking melatonin and sleep, since individual responsiveness varies quite a bit.)

I also favor the sustained-release preparations, e.g., 5 mg sustained-release. Immediate-release, while it exerts a more rapid onset of sleep, allows you to wake up prematurely, The sustained-release preparations last longer and allow longer sleep.

The dose varies with age, with 1 mg effective in people younger than 40 years, higher doses of 3, 5, even 10 or 12 mg in older people. Sustained-release preparations also should be taken in slightly higher doses.

The only side-effect I've seen with melatonin is vivid, colorful dreams. Perhaps that's a plus!

Comments (15) -

  • Jeanne Shepard

    5/10/2008 2:27:00 PM |

    I've hears that you can take melatonin too long, that is build up a tolerance.
    Any thoughts? I prefer it to other sleep aides, otherwise.

  • Anonymous

    5/10/2008 9:15:00 PM |

    After reading the article, I'm going to give melatonin a try.  Bought a bottle of 1mg tablets.

  • Michael

    5/10/2008 11:09:00 PM |

    I don't know if I have a weird body or something, but melatonin doesn't agree with me at all. It makes me a tiny bit groggy when I take it, but it turns me into a zombie the next day. Even small doses, like 1-2grams, basically makes me feel like I didn't sleep at all that night, and I feel crummy all day.

  • Jenny

    5/11/2008 11:33:00 AM |

    Dr. Davis,

    I have taken melantonin for many years and it helps me not only sleep, but get back to sleep if I wake up in the middle of the night.

    I've found a huge difference in the effectiveness of various company's pills. Trader Joe's for example, don't work for me at all. Schiff work very well.

    I was told years ago to take 1/4 of a pill for best results, and that is what I do. That works better than a larger amount for me.

  • Anne

    5/12/2008 1:10:00 AM |

    I have found melatonin to be very helpful. I go to sleep easily and I stay asleep. After I had bypass 8years ago, I was unable to sleep more than an 4-6 hours without Ambien. 8 months ago I started taking melatonin. It did not work right away, but after a few weeks I started to sleep very well and I have not had to restort to Ambien since. I take 3mg.

    I take 25mg metoprolol, a Beta blockers and found out that BB's decrease melatonin. Found this info through the internet, not my doctor.  

    My BP has been well controlled, even at night so I never checked to see if it went lower with melatonin.

  • Jeanne Shepard

    5/12/2008 3:24:00 AM |

    Jenny,

    Have you ever been told that you can't take it for a long period of time?
    I'd like to keep taking it, but was told not to.

    Jeanne

  • JohnN

    5/15/2008 2:01:00 AM |

    I have been taking melatonin for years and credit it with restorative sleep and general good health.
    Even so, my success rate is only about 70%. I discover that the amount of melatonin (in the blood) for a good night sleep (the desired effect) is a very small fraction of the oral dose that you can take. The difference is how the body (liver) metabolizes the substance. You really have to experiment to find the right dose for yourself; more is not better.
    For someone to try it for the very first time start at .1-.2 mg (a very small chunk of the tablet) and modify the dose accordingly.
    Do not think of it the same way as Ambien. It's best function is to ease you into sleep.
    Good luck.

  • Ann Theresa

    9/27/2008 1:59:00 PM |

    I am so hot at night that when I sleep, I wake up because of it.  I started taking my blood pressure upon waking and found it to be high.  160 or so over  90-95. I could feel the way my body felt. My blood pressure during the day is usually 115-120 over 70.  I knew I was peri menepausal, so the hormone thing was very suspect. After a lot of research, I decided to start taking 3 mg Melatonin. I checked with my doctor and he was catching up with me on his computer as we spoke.It was funny!  But anyway....I have been on these for about 3-4 weeks now and find that although I'm still warm when sleeping,  I am in a deeper sleep. My blood pressure now upon waking is about 123-125 over 82-83.  I have seen a significant improvement in lower blood pressure.  I will add that I have been walking daily and started taking a B complex also before bed.  I take my melatonin just before bedtime.  I have never had any problems with falling asleep. So the timing of use should be adjusted for when you need it.  I would much rather take this hormone than take the blood pressure medicine my doctor was so fast to offer.

  • Anonymous

    11/10/2008 7:54:00 PM |

    I swear by melatonin, and recommend the 5mg time release.  For me, it works best if I take it about 30 minutes before bedtime.  The time release eliminates the problems with waking up too early.

    The only time I have problems with feeling groggy is when I don't get enough sleep.  If you take it at midnight, then get up at 5 am, you're going to feel it.  If I know I'm not going to get at least 7-8 hours of sleep, I will skip the melatonin that night so I don't feel groggy.

    I have seen extreme differences in brands, so I think there is something to the comments about the quality of different manufacturers.

    I've never been told not to take it over long periods, but then I didn't ask a doctor about it.  I've noticed a slight tolerance if you take it all the time, so I sometimes will stop taking it for a while to break that cycle.

  • Improve Health Heart

    4/10/2009 3:43:00 PM |

    Hello.

    Your post looks quite interesting.. I never knew that Melatonin is a substance which has such uses.. I had heard of the term anywhere in any book but never took much interest in it..

    But your post spills out quite knowledgeable information definitely this much that it will hold my attention for a long long time..

    I also have a great interest in Heart related issue's and I have created a blog myself for it..

    I hope my posts will also help you gain some info..

  • Jonathan Byron

    4/22/2009 2:44:00 PM |

    There is some interesting research that suggests that melatonin is one factor that reduces insulin secretion at night.

  • TedHutchinson

    9/6/2009 6:26:07 PM |

    Oxidized-LDL and Fe3+
    /Ascorbic Acid-Induced Oxidative
    Modifications and Phosphatidylserine Exposure in Human
    Platelets are Reduced by Melatonin

    Abstract.
    Low-density lipoprotein (LDL) modifications and platelet activation are major risk factors for cardiovascular diseases. When platelets are exposed to oxidative stress, they become activated. Oxidized LDL (ox-LDL) and metal-catalysed oxidation systems such as Fe3+/ascorbic acid increase free radical production.
    We wanted to verify whether melatonin has a protective effect against oxidative modifications and phosphatidylserine externalization in platelets induced by ox-LDL and Fe3+/ascorbic acid.....snip.... These data suggest that melatonin may protect platelets from iron overload-induced and ox-LDL-induced
    oxidative modifications and also from the triggering signals of apoptosis activation, possibly due to its scavenger effect on toxic free radicals.

    The full text of both abstract and paper are the link above.

  • Serg

    7/21/2010 5:52:26 PM |

    This article regarding Melatonin for high blood pressure? is very interesting and useful, blood pressure may affect your sexual activity, and this not only happen to older people as I used to believed, young people can also be affected so you may need  to buy viagra to help yourself on those situations.

  • buy jeans

    11/3/2010 4:54:14 PM |

    I also favor the sustained-release preparations, e.g., 5 mg sustained-release. Immediate-release, while it exerts a more rapid onset of sleep, allows you to wake up prematurely, The sustained-release preparations last longer and allow longer sleep.

  • mike

    2/22/2011 11:37:17 AM |

    One such remedy that has gained popularity in recent years is melatonin. Melatonin is a growth hormone naturally produced by the pineal gland in your brain. Melatonin hormones are secreted at night or in the dark and helps regulate the sleeping cycle. It is believed that melatonin may help the body know when it is time to go to sleep and when it's time to wake up. These days, melatonin can be taken in pill form to treat everything from jet lag to insomnia. However, like with all medications, there is the potential for serious melatonin side effects if take with other medications.

    Reference:
    melatonin usage consider your age

    melatonin side effects

Loading
Does fish oil cause blood thinning?

Does fish oil cause blood thinning?

Omega-3 fatty acids from fish oil have the capacity to "thin the blood." In reality, omega-3s exert a mild platelet-blocking effect (platelet activation and "clumping" are part of clot formation), while also inhibiting arachidonic acid formation and thromboxane.

But can fish oil cause excessive bleeding?

This question comes up frequently in the office, particularly when my colleagues see the doses of fish oil we use for cardiovascular protection. "Why so much fish oil? That's too much blood thinning!"

The most recent addition to the conversation comes from a Philadelphia experience reported in the American Journal of Cardiology:

Comparison of bleeding complications with omega-3 fatty acids + aspirin + clopidogrel--versus--aspirin + clopidogrel in patients with cardiovascular disease.(Watson et al; Am J Cardiol 2009 Oct 15;104(8):1052-4).

All 364 subjects in the study took aspirin and Plavix (a platelet-inhibiting drug), mostly for coronary disease. Mean dose aspirin = 161 mg/day; mean dose Plavix = 75 mg/day. 182 of the subjects were also taking fish oil, mean dose 3000 mg with unspecified omega-3 content.

During nearly 3 years of observation, there was no excess of bleeding events in the group taking fish oil. (In fact, the group not taking fish oil had more bleeding events, though the difference fell short of achieving statistical significance.) Thus, 3000 mg per day of fish oil appeared to exert no observable increase in risk for bleeding. This is consistent with several other studies, including that including Coumadin (warfarin), with no increased bleeding risk when fish oil is added.

Rather than causing blood thinning, I prefer to think that omega-3 fatty acids from fish oil restore protection from abnormal clotting. Taking omega-3 fatty acids from fish oil simply restores a normal level of omega-3 fatty acids in the blood sufficient to strike a healthy balance between blood "thinning" and healthy blood clotting.

Comments (20) -

  • Marc

    10/26/2009 9:46:32 PM |

    Long time reader, first comment.
    Thank you for so freely sharing all the information.

    Marc

  • Daniel

    10/26/2009 11:02:46 PM |

    Thank you for this!  I have had this question for a long time given the number of things I take that "thin the blood."

  • Kevin

    10/26/2009 11:44:45 PM |

    As a veterinarian I've dispensed fish oil capsules for several years.  Some owners give so many that the dogs smell 'fishy' when seen for routine care.  The owner doesn't smell it since they're with the dog a lot.  The coats are gorgeous, something that doesn't often happen in Wyoming at 7000ft altitude.

  • Dr. William Davis

    10/26/2009 11:47:45 PM |

    Hi, Kevin--

    My two Boston terriers jump for their fish oil capsules, two every day!

    I'm glad to hear from a veterinarian that the coat sheen is indeed from the fish oil.

  • Rich

    10/27/2009 1:27:09 AM |

    Due to an afib episode a couple of years ago, I was taking 20 mg of warfarin per day, plus around 5000 mg of EPA+DHA, and never had bleeding issues.  

    My INR was always a stable 2.0.

    As I've not had an afib reoccurrence, I've replaced the 20mg coumadin with 325mg aspirin daily, and still take around 5000 mg EPA+DHA.  No bleeding issues with that combo either.

  • Catherine

    10/27/2009 3:55:32 AM |

    Glad this topic came up.
    Over the last 5 years, I've had to periodically eliminate my fish oil intake as I would start to bruise badly. My internist said she has seen this occasionally with fish oil and called it "capillary fragility." I bruise easily anyway, but it would really get bad with fish oil. So there must be some quality in fish oil that influences this.

    Then about 6 months ago I started a strong supplement change to help with my low bone density--already taking magnesium and calcium but added:
    Boron, K2, silica,pomegrantate juice, and BIG increase in vitamin D.
    I also increased omegas to 3,000 a day which I was not able to tolerate before.

    It has been over 4 months since I have had ANY bruise---which is just unheard of for me. I usually have 3-4 different bruises on arms/legs. So something in these supplements  strengthened my capillaries I guess, and I can now take high fish oil doses!
    Anyone else had a bruising problem with fish oil?

  • Dr. William Davis

    10/27/2009 11:04:59 AM |

    Hi, Catherine--

    Fascinating observation!

    I'll bet it has something to do with the vitamin D, more than anything else. Vitamin D seems to strengthen structural tissues in bones, muscle, heart valves, and perhaps capillaries and other small blood vessels.

  • trix

    10/27/2009 11:59:37 AM |

    Several years ago I bruised easily for a while and attributed it to taking garlic supplements daily.  I started taking Vit C and the bruising stopped.  I don't think it had to do with fish oil (in my case); I don't think I was taking fish oil at the time.

  • Daniel

    10/27/2009 9:37:33 PM |

    I too achieve rapid blood thinning when taking 2400mg of EPA/DHA per day. That's only 4 pharmaceutical grade capsules. Even after my vitamin d levels were normalized I still got bruising.

    I now take Vitamin K2 (MK-7 natto extract) twice a week and it's allowed me to bump my EPA/DHA up to 3600mg with no ill effects or bruising.

    It was either supplement or eat a lot of aged cheese, they both seemed to do the trick in my particular case.

  • Healthy Oil Guy

    10/27/2009 9:53:51 PM |

    Thank you for sharing this study with us.  It helps clarify whether there is a risk for blood thinning from taking fish oils.  This information may help individuals who are taking blood thinning medications and considering adding fish oils to their daily diet.

  • Dave

    10/28/2009 2:22:01 AM |

    Catherine,

    Without a doubt, your cessation of bruising was due to vitamin k2. I routinely take nattokinase, large doses of fish oil, curcumin, and other blood thinning agents, and if I don't take vitamin K2, I will begin bruising. (I also take high doses of Vitamin D). When I take K2, I have absolutely no bruising.

    Vitamin K2 has many clinical trials showing that it helps endothelium  integrity and elasticity.

    Also, grapeseed extract and pine bark extract (specifically oligomeric proanthcyanins) has the same beneficial effect.

  • Catherine

    10/28/2009 4:41:41 PM |

    Daniel,

    That's really interesting! There is a lot of research on K2's effect on strengthening weak bones. Bone fractures go down considerably when high doses of K2 are used (Japan is using K2 as osteoporosis treatment) BUT studies show it needs to be in conjunction with adequate calcium and Vitamin D---they work synergistically for bone strength.  So it makes sense that K2 and D could do the same with strengthening fragile capillaries. I am also taking the M7 natto form.

  • Catherine

    10/29/2009 12:01:36 AM |

    Dave,

    Thanks for sharing your experience with this, you've really confirmed it now for me.  I can't believe I have suffered with this for most of my life with no answers (tried high dose Vit C, grape seed, etc) and now within months on K2, there's no bruising and I can tolerate fish oil. Hope my bones are responding this well!
    This blog is so helpful....

  • Mina

    10/29/2009 12:21:31 PM |

    Thanks for posting this. The question recently came up in our office. I like your assertion that omega-3s restore the blood to normal and remove abnormal clotting. And to comment on a post above, our dog has a beautifully shiny coat and takes 2 pure EPA capsules each day!

  • Term papers

    1/26/2010 3:40:08 PM |

    I have enjoyed reading That During nearly 3 years of observation, there was no excess of bleeding events in the group taking fish oil. (In fact, the group not taking fish oil had more bleeding events, though the difference fell short of achieving statistical significance.

  • Viagra Online

    8/23/2010 6:41:39 PM |

    I've been drinking fish oil for many year and I don't have any chance in my body people use to said me that but I think it is just a rumor.

  • buy jeans

    11/3/2010 10:19:55 PM |

    I'm also especially gratified that a woman now holds our record. I'm uncertain why, but the ladies have been shy and the men remain the dominant and vocal participants in our program. Speak up, ladies!

  • moseley2010

    12/7/2010 2:37:16 AM |

    I haven't heard of this problem
    fish oil supplements. But now we know what to tell them when this sort of concern comes up. Fish oil or Omega-3 is really beneficial to health. It's just important that it comes from clean waters.

  • Jack

    3/12/2013 7:03:38 PM |

    What is an appropriate dose of fish oil for someone taking coumadin?

  • dorange

    6/15/2014 3:53:03 PM |

    Dr. Davis, when  person is taking Tamoxifen...
    (1) is it safe to take vitamin k2 or K1?
    (2) will fish oil have a role in preventing blood clots?

Loading