Thursday, March 7, 2013

Pin Busters

This is a total nerd out blog. Just putting that out there right away.
Remember this show? I was thinking about it today as I thought about a lot of pins and articles that have left me wondering, "Do we really know anything?" For example:

Is Borax dangerous or not?

Is melatonin really a safe and natural way to help children sleep?

So I thought, since I work at a library, and I'm pretty good at researching things, I'd take the liberty of debunking a few of these myths myself. I'll analyze it... with science! And that will keep me busy when I'm bored at the library.

So without further ado, I introduce: Pin Busters

Today I chose to focus on Melatonin. Melatonin is something I've been interested in for a while. Many consider it a natural and safe way to get to sleep more quickly and to stay asleep. It's a hormone the body creates naturally, but you can also get supplements that come in a pill, or I've even heard of chewables. This is a huge topic to try to debunk every myth about, so I really just want to narrow in on one potential myth: Melatonin is a safe solution for getting children to sleep.

The main problem with melatonin supplements is that very little is known about them. In the US, dietary supplements are under very little regulation by the FDA. It is the manufacturer's responsibility to ensure the safety of their products, and the accuracy of their labels. Some melatonin labels include phrases like, "Keep out of reach of children." or "Not for use by persons under the age of 18." But there is quite a bit of variation, which can be confusing. (You can find a list of labels here.) That's mainly because safety is very subjective when there is little research to support it. The FDA suggests consulting a physician before using dietary supplements in general, especially in certain circumstances including pregnancy, and chronic health conditions. Under this same recommendation, the FDA suggests consulting with a doctor or pharmacist before giving any supplement to your child, including common vitamins.

According to Medline Plus, melatonin is "POSSIBLY UNSAFE" in children and in pregnancy. Melatonin is a hormone that is naturally produced in the pineal gland. The pineal gland secretes many hormones, including those that initiate the puberty process. For this reason, Magill's Medical Guide gives the same advice, "It should not be used by children, who already produce high levels of melatonin. It should not be used by pregnant women because its effect on the fetus is unknown." The concept behind this is that it could potentially harm children because they are still in the developmental stages and receive a lot of hormones from the pineal gland. The Mayo Clinic mentions that reports have claimed changes in levels of many hormones ("luteinizing hormone, progesterone, estradiol, thyroid hormone (T4 and T3), growth hormone, prolactin, cortisol, oxytocin, and vasopressin") as an effect of using melatonin supplements. This seems to suggest a possible risk for children because of potential changes in their developmental hormones, but there are no studies so far that explicitly support or refute this theory. A few studies have been performed on children in very small dosages. Of the studies I could find, the trend shows that melatonin is effective as a sleep aid, and showed minimal to no side effects. Most acknowledge that the study does not address possible long-term effects.

I did manage to find a few exceptions. This article focused specifically on the differences between children who had been administered melatonin for a long-term period (the average was about 3 years), and children of the same age group who had not used melatonin. The conclusion showed no adverse differences between the two groups. A similar study tested children with ADHD and chronic sleep onset insomnia (difficulty falling asleep) for adverse effects after extended melatonin treatment (average: 3.7 years). This study found no severe or life-threatening effects, but did mention a strong tendency for children to relapse back to taking melatonin if they tried to discontinue treatment (which seems to imply either a dependency, or that melatonin is merely a treatment, not a cure).

The Mayo Clinic sums up the findings (or lack thereof) of much research very well, "There is limited study of melatonin supplements in children, and its safety is not established."

So what's my conclusion?

Sort of. Frankly, we can't really know, definitively, what all of the effects of melatonin are until more research has been conducted. The melatonin craze is so recent that there simply isn't much out there in the way of melatonin-using children who grew up and are now healthy adults.

My personal opinion? I wouldn't risk it. But maybe if I had kids who were really struggling with sleeping I would feel differently. Unfortunately, there's no clear cut answer. But at least now I know it's not a clear cut answer and I can weigh the facts when some sort of tag-line explanation about the gifts or curses of melatonin presents itself and I have to make a decision.

So I hope I didn't bore everyone to death! Let me know if I did, or if you thought this was interesting, or if you have any myths you'd like me to fact check for you. And I will continue to cruise away my hours working at the library!

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