How Does Melatonin Work? The Guide to Better Sleep with Supplements

Maurice Beer M.D.
April 26th, 2021 · 7 min read
Medically Verified
Welcome to Melatonin 101. It’s the most popular class in our (imaginary) curriculum called “Sleep: So Simple, Yet So Elusive.”
By the end of this article, you’ll begin mastering your very unique circadian rhythm and understand what the right amount of melatonin is for you.
Some people are even surprised to hear that melatonin is a hormone that occurs in our bodies, not a supplement or drug we take. Read more about how this hormone can get you sleeping better and help you boost your immune system, reduce migraines, lower the risk of insulin resistance, and much more.

The takeaway

  • Melatonin is produced by our bodies, and its most important job is to help us fall asleep and stay that way
  • This hormone can also help strengthen immune function, mitigate the effects of chronic or degenerative diseases, and balance other hormones
  • Supplementation is generally easy and effective, but it’s best to check with your healthcare provider to make sure there won’t be any side effects or unwanted interactions with other medicines
  • Melatonin is available as an over-the-counter supplement, usually in tablet or liquid form

What is melatonin? A 30-second summary

In a word, melatonin is the hormone that makes sleep possible. Sure, there are a few other variables involved, but melatonin is the main thing you’ll need for a good night’s sleep.
In a perfect world, your circadian rhythm - the cycle that dictates energy levels throughout each 24-hour period - will tell your body to start releasing melatonin when it’s time for sleep. If that’s the case, there’s nothing to worry about…but at this point you’ve probably figured out that you can’t depend on a perfect night’s sleep every time. Without the right timing and quantity of melatonin each night, your natural sleep-wake cycle will end up getting disrupted, resulting in all sleepless nights and groggy days you can handle.
If you want to know the science behind it all, melatonin is a neurohormone (a hormone that mainly affects the nervous system) that decides when someone gets to sleep. Melatonin production is triggered by darkness, and happens mainly in the pineal gland. Way back when, this happened naturally when the sun went down; now that electric lights and screens are literally everywhere, the pineal gland can get its wires crossed and stop producing enough melatonin.

What can affect the circadian rhythm?

The circadian rhythm is about more than just sunrise and sunset; it also depends on when your brain is getting the signal that it’s time for the body to expend energy. When this signal comes, the body starts to produce cortisol. Once your cortisol levels go up, your melatonin levels go down - and can stay down for hours afterwards. If exercise is happening too close to bedtime, for example, this sends some serious mixed signals to your brain.
Circadian rhythms depend on a few different factors to run smoothly:
  • Activity levels throughout the day. Your body needs to know when to produce energy for not only physical activity (think: chasing a hyperactive pet), but stuff like digestion, brainstorming, etc.
  • Temperature and light patterns. The brain knows that it’s brighter and warmer during the day, and darker and cooler during the night. If these light/temperature patterns get interrupted, the circadian rhythm will try to compensate by telling the brain to just produce more melatonin. If your sleep schedule is already out of whack, though, this could start happening at the wrong time.
  • Regular sleep patterns. Yes, this is the obvious one, but it’s true. Without regular sleep, your body doesn’t know when to produce melatonin and help you relax at the end of the day. You’d think staying up extra late would make you tired enough to crash early the next day, but no - the circadian rhythm might actually keep you up even longer than normal because it’s just trying to stick to the “new schedule”.
  • Avoiding major disruptions like jetlag. Anyone who’s taken an international flight can confirm - the effects of flying to a different time zone can last for days. The circadian rhythm can’t tell which borders have been crossed, but it will try to keep melatonin production consistent, even if that means keeping you awake until 5 AM.

What are the best possible results that someone could get from melatonin?

Better sleep! That’s what this is all about, right? That’s probably your main goal here, but melatonin can provide quite a few other benefits, such as:
  • Protecting against oxidative stress
  • Supporting immune function
  • Helping with circadian rhythm regulation
  • Promoting a healthy heart with anti-inflammatory properties
  • Lowering blood pressure
  • Improving digestion and gut health
  • Reducing acid reflux and migraines
  • Enhancing eye health
  • Lowering the risk of insulin resistance
  • Alleviating the symptoms of Parkinson’s and Alzheimer’s
  • Maintaining thyroid health
  • Treating certain aspects of PMS, as well as conditions like fibromyalgia, rheumatoid arthritis, and IBS

How melatonin affects glucose levels

Believe it or not, optimal melatonin levels may actually decrease the risk of developing insulin resistance. How great is that?
Here’s a quick primer on why insulin resistance is something you should know about. Insulin helps your body break down sugar (glucose) and turn it into energy.  When your body experiences insulin resistance, it tries to compensate - but this doesn’t always end well. Your liver can go into overdrive, producing even more insulin. And over time, your blood sugar levels go up. This comes with a whole host of problems: obesity, high blood pressure, and type 2 diabetes, to name a few. According to some research, 1 in 3 Americans will deal with insulin resistance at some point.
How can you lower the risk of insulin resistance? Optimal melatonin levels!
Without getting into too much detail, inadequate sleep (which usually means low melatonin) is a risk factor for conditions that involve high blood sugar, like diabetes. The sleep cycle is closely connected with normal, healthy variations in blood glucose levels, so when one gets disrupted, so does the other. If melatonin was the missing link in the first place, your body has the chance to lower blood sugar levels back to normal once the sleep cycle is fixed.

What’s the right dose of melatonin - and how much is too much?

This will depend on how much your brain is still producing on its own - just because melatonin production is low doesn’t mean it’s at zero. For most adults, a dose of 0.3 mg to 3 mg will do the trick. The long-term effects of using melatonin haven’t really been studied in-depth, but the data that’s available doesn’t point to anything disastrous. In other words, melatonin is probably safe to take every night. Even if it isn’t, the negative effects don’t take that long to correct.
It’s important to keep in mind that when it comes to melatonin, more is not always merrier. Too much of the hormone could mess with your circadian rhythm even more than too little, so it’s not recommended to start out with 5 mg, let alone 10 mg. Some people might need this much to balance things out, but anyone who takes too much by accident could start having some unpleasant symptoms:
  • Anxiety
  • Dizziness
  • General crankiness
  • Digestive upset
  • Headaches
  • Joint pain
If you start noticing any of these symptoms after taking melatonin, the best thing to do is just wait it out, and try a lower dose next time. None of these reactions should last more than a few hours, and next time you’ll have a better idea of how much to take.

When will melatonin start working, and how long does it stick around?

Sources vary on how long melatonin takes to kick in - for some people it only takes 20-30 minutes, for others it takes 1.5 hours or more. Of course, this could have something to do with the kind of melatonin they’re taking; some variations are fast-acting, while others are designed to be slow-release. You could even get an effect within minutes using a melatonin vape pen, but this option isn’t too popular among experts due to the lack of testing and regulation.
Once the melatonin’s been absorbed, it could last from 4 to 10 hours. The dose size will affect this, obviously, but so will the formulation of the melatonin; a little experimentation might be necessary if the manufacturer doesn’t know how long the melatonin lasts. Since your body’s natural melatonin production peaks at around 4 AM and starts dropping soon afterwards, it’s best to take a dose that will have cleared the system before the alarm goes off in the morning.

What are the biggest risks of taking melatonin?

When you’re looking at which melatonin supplement to take, just keep in mind that the FDA doesn’t regulate natural supplements like melatonin. Without the FDA stamp of approval, it’s basically up to the manufacturer to make sure they’re selling what’s actually labeled on the bottle - and that doesn’t always happen. When it comes to things like the dose, strength, quality, and possible side effects, your mileage may vary by a pretty wide margin.
A quick Google search for “how to fall asleep” is likely to give you a very generalized recommendation for melatonin. However, what that late-night searching doesn’t usually uncover is that 75% of melatonin supplements vary wildly from what the label says. (If you really want to get in the weeds, you can read the details in this 2017 study).
In a very few cases, any amount of supplemental melatonin could result in negative symptoms. The most common side effects are:
  • Feelings of depression or general malaise
  • Mood changes, sometimes to the point of hallucinations or paranoia
  • Stomach cramps, nausea, or even vomiting
  • Inability to feel fully awake
  • Lower core body temperature during the day
  • Knocking other hormones off-balance, especially ones involved in pregnancy and lactation
Some of these sound pretty extreme, but don’t let that scare you off! It’s fairly rare to see most of these side effects, and they don’t stick around for too long once the melatonin is out of the picture.

What to do now?

Melatonin is used regularly by millions of people around the world, but it can be tough to figure out how much to take. After all, low melatonin is tied in with all kinds of other hormone levels; it can affect insulin, cortisol, and vitamin D, to name just a few. If your melatonin levels need to be brought back up, chances are so does a bunch of other stuff.
If you’re wondering where to even begin, Base is one possible solution. They offer at-home lab tests that focus on five different areas, including sleep. A simple saliva test allows them to measure several different hormone levels, including melatonin and cortisol, to determine what needs to be adjusted. The best part is, they don’t just try to address the symptoms - they find out the root cause of the problem. Instead of just using supplements as a band-aid, they provide a long-term solution.
There’s a health solution for every lifestyle, and Base’s science-backed recommendations are designed with that in mind. Once the area of focus is decided on, the first at-home test kit is completed and mailed back with a prepaid label. In about a week, the results will show up in the Base app, and it’s all uphill from there! The initial test will show any deficiencies or imbalances; after that, each monthly test will show areas of improvement, as well as any adjustments that are needed.
Even if bad sleep has been a problem for years, the beginning of the solution could be just one easy test away. Issues with melatonin production can make life complicated, but who knows - the answer could be surprisingly simple!

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