This article is medically reviewed on August 20, 2021 by:
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Who is at risk of melatonin overdose?
Did you know that melatonin is the primary hormone responsible for the quality of our sleep?
Many people may mistake this hormone for melanin: the pigment in hair, skin, and eyes that gives them dark color. However, the two compounds have nothing to do with one another.
Talking about melatonin, its production in the body increases with the evening darkness in order to control our sleep-wake cycle, or the so-called Circadian rhythm. 
That being said, many factors can impact the effective production of melatonin, the two main ones being poor dietary choices and prolonged exposure to blue light (type of light emitted from electronic devices like phones, TV, computers, etc.)  
The impaired production of melatonin and experiencing sleep disorders is only one reason why people may supplement with this hormone in the form of capsules, pills, or liquid.
Dr.Naghmeh (Pharmacist) says:
In addition to improving sleep, because melatonin acts as an antioxidant, it can also affect many other health conditions. Studies have shown that melatonin may improve eye health, reduce symptoms of seasonal depression, and even improve conditions of low thyroid function
Other benefits of prescribed melatonin supplementation may include improved symptoms of jet lag, insomnia, stress, ADHD, and others. 
However, self-guided or unsupervised supplementation may lead to melatonin overdose, which is associated with various adverse effects and health risks.
This article will guide you through the symptoms of melatonin overdose, as well as the methods used for diagnosis, risk factors, and treatment methods.
Let’s get started!
Dr.Naghmeh (Pharmacist) says:
In a study, 96 percent of women who had taken melatonin reported a total disappearance of morning depression, which is typical of peri menopause and menopausal women. It is very important to mention that these findings do not suggest people should start to take melatonin without consulting their physicians or pharmacists.
However, not all melatonin supplements are created the same. Melatonin is a hormone, and because it is, hormones must be USP pharmaceutical grade. It's really important to keep in mind that the Food and Drug Administration (FDA) doesn't regulate the safety or effectiveness of supplements the same way that it monitors drugs.
Two forms of melatonin exist in the general market. One is the natural form which comes from the pineal gland of animals, and may pose a risk to humans because it can be contaminated with animal virus. Synthetic melatonin is safer because it is free from biological contaminants.
There are also newer vegan, plant based, Natural slow release melatonin available now on the market.
Shopping for supplements can be incredibly challenging as a consumer , and pharmacists are the first line of accessible health care providers that can guide you in choosing the right one.
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According to the Mayo Clinic, the most common melatonin overdose symptoms include  :
- Short lasting depression
- Mild anxiety
- Abdominal cramps
- Reduced alertness
- Low blood pressure
Furthermore, a 2020 article in the Sleep Advisor suggests that melatonin supplementation and overdose may lead to the following side effects and health risks  :
- Daytime sleepiness
- Hormonal changes and imbalance
- Stomach issues
Considering that, the source also claims that over-the-counter melatonin supplements have been banned for sale in a number of countries, including Canada, Japan, Australia, UK, and some European Union countries.
That being said, melatonin is considered generally safe for supplementation and is unlikely to lead to withdrawal symptoms, according to the Mayo Clinic. 
Don’t miss out: How to Sleep Better at Night? [ 5 Steps to Improve Sleep ]
Diagnosing melatonin overdose can be tricky, as it’s sold freely (and treated like a supplement- not like a medicine) in many countries like the US, and patients may take uncontrolled doses of the hormone. 
In the US particularly, melatonin supplements (either prescribed or OTC) are not regulated by the FDA, which may increase the risk of product contamination or the presence of ingredients that are not listed in the ingredients list. 
If you recognize symptoms of melatonin overdose (from the previous section) and you supplement with the hormone, consult your healthcare provider or pharmacist immediately to get an accurate diagnosis and changes in your supplementation plan.
Who is at risk of melatonin overdose?
According to the NHS, melatonin is mainly prescribed to people over 55 years old, yet, it is also occasionally prescribed to younger adults and teenagers.  That being said, the source emphasizes the fact that melatonin might not be suitable for everybody. Here are the patient groups who are at risk if supplementing with melatonin:
- Patients with liver or kidney problems
- Patients allergic to synthetic melatonin or have had an allergic reaction to other medicines in the past
- Patients with autoimmune conditions (e.g., lupus, rheumatoid arthritis, multiple sclerosis)
Furthermore, The National Centre for Complementary and Integrative Health suggests that other patients groups that should be careful with melatonin supplementation include  :
- Pregnant and breastfeeding women
- People with dementia (who are often older adults)
- People who take other medicines or supplements
Related: Magnesium: Health Benefits Could It Be Dangerous?
What you may not know is that melatonin supplements can also interact with other medicines. This may not only increase the risk of overdosing with the hormone but may trigger additional health risks  :
- Anticoagulants, antiplatelet drugs, herbs: combination with melatonin supplementation may increase the risk of bleeding
- Anticonvulsants: their effect may be limited by melatonin supplementation in children with neurologic diseases
- Blood pressure drugs
- CNS depressants: may have additional sedative effect
- Diabetes medication: may cause blood sugar fluctuations
- Contraceptive drugs: might lead to more pronounced side effects of melatonin
- Cytochrome P450 1A2 (CYP1A2) and cytochrome P450 2C19 (CPY2C19) substrates
- Fluvoxamine: it may increase melatonin levels in the body
- Immunosuppressants: melatonin may improve immune function
- Seizure threshold lowering drugs: risk of seizures may increase
If you are taking any of the above-mentioned medicines, consult your healthcare provider or pharmacist before reaching for supplements containing melatonin.
Find out more: Vitamin and Mineral Supplements That (Don’t) Work Together
Evidence suggests that a lot is still unknown in terms of melatonin overdose and the suitable methods of treatment.  The available information suggests that the majority of patients can be treated at home or in an emergency department. Treatment methods for melatonin overdose include:
- Decontamination procedures
- Aggressive gastrointestinal decontamination (only after ingestion of very large doses)
- Gastric lavage (rarely)
- Activated charcoal
The treatment of this overdose condition should be directed by a health professional and should be under a doctor’s supervision to prevent complications and additional health risks.
The NHS has provided some guidelines for coping with the side effects of melatonin supplementation  :
Sleepiness and tiredness during the day: Avoid driving, cycling, working with tools or machinery, or drinking alcohol.
Headache: Rest, drink enough water, avoid drinking alcohol.
Nausea/ stomach pain: Eat and drink slowly, have smaller meals than regular but eat more frequently. Place a heating pad or warm water bottle on the tummy. Take your medicines (that you take regularly) only after having a meal.
Dizziness: Lie down and avoid driving, cycling, working with tools or machinery, and drinking alcohol.
Restlessness; Pain in arms and legs; Strange dreams or night sweats: if it continues for more than a few days, consult your healthcare provider.
Dry mouth: try chewing sugar-free gum or sugar-free sweets.
Dry, itchy skin: regularly apply fragrance-free moisturizer suitable for your skin type.
To prevent melatonin overdose, stick to the dosage prescribed by your healthcare provider. A small dose of 0.3mg is similar to the amount of the hormone produced naturally in your body. Also, keep in mind that taking a lower dose may work better than a large dose of melatonin. Consult your doctor on the time of supplementation, as timing may play just as an important role as the dosage. 
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