Melatonin products in the US are widely mislabelled, so what precautions should one take?

NEW YORK – A tiny, berry-flavoured gummy of melatonin carries a big promise: better sleep.

But a new research paper, published in the medical journal Jama in April, highlights a critical issue: When it comes to melatonin, as with other supplements, what you see on the label is not always what you get.

A team of researchers analysed 25 melatonin gummy products from different brands and found that 22 contained different amounts of melatonin from what was listed on the labels.

One contained only 74 per cent of the advertised amount of melatonin, while another had 347 per cent of the labelled amount.

Yet another product contained no detectable melatonin at all.

Researchers tested gummies from only a single bottle of each product, so it is possible that the amount of melatonin varied from batch to batch.

But the findings point to a staggering discrepancy between the amount of melatonin consumers think they are ingesting and how much they might actually take, said Dr Pieter Cohen, an associate professor at Harvard Medical School and the lead author of the paper.

“You are at the mercy of the dietary supplement industry,” he added.

The United States Food and Drug Administration (FDA) does not evaluate dietary supplements for their safety and effectiveness.

“Protecting the health and safety of Americans is the FDA’s highest priority and we will remain vigilant in warning consumers when public health concerns arise related to dietary supplement products,” a representative for the agency said in a statement.

Previous research has highlighted just how varied the quality of melatonin products can be.

A 2017 study in Canada found that one melatonin supplement contained more than 400 per cent of the amount listed on the label.

Dr Cohen’s study examined only gummies and focused on products sold in the United States. The number of Americans using melatonin supplements more than quintupled between 1999 and 2018, according to the National Institutes of Health.

What happens when you take too much melatonin?

The brain is wired to naturally produce melatonin after the sun sets. The hormone helps to regulate circadian rhythms, signalling the body that it is time to sleep.

Melatonin supplements purport to complement, or enhance, that process.

An accurately labelled 3mg gummy contains 1,000 times as much melatonin as the amount the brain produces naturally, said associate psychiatry professor Philip Gehrman at the Perelman School of Medicine of the University of Pennsylvania.

The excess melatonin found in a large dose is likely to just break down in the body and be excreted, he said. It probably will not help you fall asleep any faster.

The higher the dose of melatonin, the more likely you are to experience side effects, said Dr Sabra Abbott, a sleep medicine specialist at the Northwestern Feinberg School of Medicine.

Large amounts of melatonin are not likely to be dangerous for most adults, experts say, but some people report feeling groggy or hungover the morning after taking the supplement, or having vivid, unnerving dreams.

Melatonin gummies can pose serious risks to children if they consume too many.

Calls to the American Association of Poison Control Centres related to paediatric melatonin consumption jumped 530 per cent from 2012 to 2021, according to research published last summer.

“They are not candy,” said Dr Brian Chen, a sleep specialist at Cleveland Clinic. “They aren’t just to be taken willy-nilly.”

How to pick a reliable melatonin supplement

There is no guarantee that any given bottle of melatonin gummies will actually contain the amount listed on the label. Still, experts recommended a few precautions for those who decide to take melatonin:

1. Ask the pharmacist

Instead of ordering melatonin online or picking a supplement at random from the pharmacy, ask a pharmacist to suggest a trusted brand, Prof Gehrman advised.

2. Make sure it is certified

Experts say you should opt for a product that has been certified by a third-party organisation like the US Pharmacopeia, which vets different supplements.

3. Pick a low-dose supplement

Opt for 1mg of melatonin or less, Dr Abbott said. A larger dose is not likely to be more effective in helping you sleep.

4. Talk to your doctor

Even with a supplement as seemingly innocuous as melatonin, you should talk with a physician before trying it, experts say.

It is also important to think about why you are taking melatonin in the first place, Dr Chen said.

Many people who turn to melatonin are taking it incorrectly by trying to induce sleep right before bed, looking for a quick fix when an intervention like cognitive behavioural therapy might be more beneficial for treating insomnia.

“It takes work and effort to learn this lost art of sleep,” he said.
NYTIMES