OhioHealth Cardiologist Weighs in on American Heart Association Melatonin Findings
Last month, the American Heart Association released a new study on the connection between long-term use of Melatonin supplements and the increased risk of heart failure or death.
Katherine Dodd, DO, OhioHealth heart failure and transplant cardiologist said when first reviewing the study, her thoughts were that it was quite striking.
“Nobody has really looked into this before, but the new study that is being presented at the American Heart Association scientific session this upcoming weekend November 7th through the 11th did show a link,” Dr. Dodd said. “No causation per say but did show a link in terms of increased diagnosis of heart failure and increased heart failure hospitalization along all case mortality increase in patients that did use chronic Melatonin, so they are patients that use Melatonin for over a year.”
As for a connection, Dr. Dodd said there are many questions still left to be answered.
“This was a very interesting study,” Dr. Dodd said. “Melatonin still could be safe to use and you have to remember it was used in this study, the patients that had the higher instances of heart failure, were on chronic Melatonin meaning they were taking it for at least 12 months in a prescribed form, so we’d have to look into what that prescribed form entails. Because it is prescribed, it is regulated. So that certainly plays into it and then in addition to that, would Melatonin use still be safe in smaller doses to be taken on an as needed basis so these are all things we need to look into with additional research and I don’t think it’s fair to say one way or another yes it is safe definitely or no it is not safe definitely.”
Dr. Dodd said in the United States, anyone can purchase Melatonin, over the counter, without a prescription. However, she mentioned that it is not regulated and there are various doses. With her patients, Dr. Dodd typically recommends starting with low dose, one milligram and taking up to 10 milligrams.
“Melatonin is something we often suggest to our patients who are struggling with insomnia or difficulty sleeping because we always thought it’s relatively benign. There are other medications that we can prescribe with sleep, but usually Melatonin is one of our thought to be safest medications.”
Melatonin is a natural hormone that’s created by the body. The pineal gland in the body produces Melatonin and Melatonin helps regulate sleep wake cycles. Dr. Dodd went on to share that many patients use it to help as a sleep aid, but it can also be used to help with jet lag, too, or for shift workers who could use it to help with their circadian rhythm and sleep wake cycle.
According to Dr. Dodd, heart failure impacts 6.7 million people in the United States every year.
Main symptoms of heart failure can include shortness of breath, increased fatigue, decreased exercise capacity, reduced energy levels, weight gain, fluid retention, sometimes patients just feel like their pants are not fitting correctly, they endorse abdominal bloat and distention, swelling in the ankles and feet as well.
Dr. Dodd said that she often orders sleep studies for patients experiencing insomnia.
“Sleep apnea is quite ramped in the general population, and then if you have heart failure it’s even more common,” Dr. Dodd said. “I order hundreds of sleep studies, and I can count on one hand how many negative sleep texts that I’ve actually received back.”
After reading this study, Dr. Dodd said she plans to continue following the guidance of the American Heart Association.
“Obviously a lot more studies and more research have to be done with Melatonin to assess the cardiovascular impacts because it wasn’t on our radar before to look for,” Dr. Dodd said.
In the meantime, she may recommend more alternative options than supplements including environmental changes and ordering even more sleep studies.
“So, making sure you go to bed at the same time every night, make sure you’re asleep in the bed in a dark quiet cool room, sometimes doing 5 minutes of meditation or yoga before sleep can help and then also drinking warm liquids can also help.”
While speaking with Dr. Dodd, she emphasized how valuable the American Heart Association’s support is – from education to funding more research like this that helps better understand the true impact on heart health.
For the community, she hopes to encourage overall general heart health practices such as sleep hygiene but also getting the heart rate up with daily activity.
“The American Heart Association has always been clear on their recommendations on physical activity, and I am talking to my patients all day about it,” Dr. Dodd said.
The typical recommendation is 30 minutes a day of some type of cardiovascular activity, whether it’s walking, running, biking, or any other exercise that brings true joy.
