What strategy do you take with patients presenting with significantly low melatonin, like 1.2 on a scale of 10 to 50 being normal? She asked if we supplement with melatonin, melatonin precursors, or foods containing melatonin.

Dr. Amy Nett: So this depends a little bit. I would say is the patient having sleep problems? So if the patient’s not having sleep problems, I’m not sure that I would necessarily do anything. If this is a patient who’s complaining of insomnia, sleep difficulty, then I probably would just supplement with melatonin. Research is a little bit mixed though. Well, I think actually more the recent research is suggesting that lower doses of melatonin are actually most beneficial in terms of sleep, and that when you take higher doses, they might not be as helpful with sleep. So some of the melatonin supplements, a lot of the ones start at like one mg. But it might even be that something like 0.5 mg can be most helpful with sleep.

So the patient has low melatonin, trouble sleeping, you can try melatonin supplementation. Maybe start them at 0.5 mg. Depending on how they do with that, you could go up and try one mg, and certainly go up to three mg or so, see what helps them. But I don’t know if the patient is not having sleep issues. I don’t know that there is a concern with regards to that low melatonin.