MELATONIN: Supplement Suggestions

Hormone restoration isn’t a do-it-yourself project. Everyone’s needs are different. You’ll require the help of a doctor who can gauge your existing levels and continue to monitor them as you take supplements. I measure blood levels of each and prescribe accordingly, adjusting dosages based on subsequent tests. Experience, though, teaches that lab results aren’t the only determinants. In one person a small dose may increase the blood’s concentration dramatically; in another person a large amount may have only a minimal impact.

DHEA and pregnenolone seem to play off each other’s strengths and weaknesses, so I normally establish their dosages together. For these purposes, though, I’ll address each of the three hormones individually.

DHEA
The quality and absorbability of DHEA supplements will vary from brand to brand, and I’m not at all certain that everything labelled ‘DHEA’ truly is the real thing. Some products contain dioscorea, also known as ‘Mexican yam’, which manufacturers claim is either actual DHEA or one of its natural precursors. Don’t be duped. No metabolic pathway exists for converting this plant extract into DHEA.

Ask a knowledgeable doctor for the name of a reputable brand, or go to a compounding pharmacist, a rare breed of apothecary who is specially trained to fill custom-made prescriptions and obtain hard-to-get drugs. (You can also get pregnenolone and melatonin of unquestionable quality from this source.)

The average twenty-year-old human body makes between 20 and 30 mg of DHEA per day; perhaps one-tenth of that is made at the age of seventy. Many adults, therefore, take between 5 and 25 mg a day. However, scientists have not clearly determined if the body absorbs everything in each supplement, so higher doses may be needed to replenish your blood level.

As a rule of thumb, I try to get blood measurements of DHEA- S (DHEA sulfate, the form it becomes when metabolized) into a range of 400-600 pg/dL for men and 300-500 jig/dL for women. Everyone’s thumb is unique, though, and a few points either way can make a big difference. If you don’t work with your health care practitioner to establish the optimum dosage, you will put yourself at quite a disadvantage.

When secreted during youthful years, DHEA peaks in the morning hours. To mimic the natural ebb and flow, take your supplements upon waking. Side effects are relatively minor and can be corrected by adjusting the dosage. DHEA may increase natural testosterone levels slightly, so women and men occasionally develop a little acne. Women may also notice the growth of a little facial hair. The nice thing about DHEA, however, is that you will know if it helps you; you should feel a tremendous difference in a short time. And if DHEA enables you to live longer; you can enjoy the extra years with more vibrant health.

Pregnenolone
The grandmother hormone has not been studied as extensively as DHEA, so we have fewer guidelines for its use. We do know that cholesterol is the basic building block of pregnenolone, which could mean that a determined effort to lower your cholesterol, either by modifying your diet or by taking drugs, might create a pregnenolone deficiency.

Food, as we know, often doesn’t provide us with enough of our natural health promoters, be they nutrients or the building blocks of hormones. Thus a typical seventy-five-year-old person will have about 60 per cent less pregnenolone than will someone who is thirty-five years old. Depending on the results of blood tests, I might start a patient on a daily dosage of between 20 and 40 mg, taken in the morning. After two months or so and another blood test, I might gradually increase this amount. Symptoms suggesting the dose is too high are bloating and fluid retention, reminiscent of the premenstrual syndrome – a time when progesterone is at its highest.

Capsules are commonly available in dosages of between 5 and 100 mg per pill. Sublingual tablets and oral sprays are sold, too. For most purposes, don’t take more than 60 mg per day without a doctor’s evaluation. When I try to replace prednisone as a treatment for rheumatoid arthritis or another condition, I could conceivably prescribe as much as 200 mg per day, even if blood tests suggest a much lower dosage. Usually, though, I will prescribe 60-100 mg, plus twice that amount of DHEA.

Melatonin
A variety of factors may suppress our natural production of the hormone, including alcohol consumption, lack of sleep and insufficient exposure to darkness. Electromagnetic radiation, such as that emitted by an electric blanket or waterbed heater also may reduce the pineal gland’s output.

To give your body its best chance of making melatonin on its own, don’t drink alcohol, give yourself enough time for rest, and don’t fall asleep with the lights on. Certain nutrients also support its production, including protein, niacinamide, vitamin B6, vitamin B12 and acetyl carnitine.

Supplements won’t work for all insomniacs, however. A variety of factors, both physiological and psychological, influence sleep, and not all of them are subject to the hormone’s control. Its best applications are for correcting a deficiency, which becomes more probable as we age, and for occasionally readjusting the wake-sleep cycle.

Some people may experience unwanted side effects from melatonin, such as an occasional vivid or unpleasant dream. In my own use and in my practice, however, I rarely encounter these adverse effects.

Blood tests for melatonin aren’t generally available, so I usually begin with a low daily dose, maybe 2 mg and perhaps at little as .5 milligram. Increase the amount somewhat if you don’t notice an effect after several days. As much as 200 mg
per day can be taken safely without upsetting the body’s natural hormonal balance, although I heartily encourage you to find a nutritionally oriented doctor to help you fine-tune your own programme.