fitnessblog

AIAPGET Points

–        Amajirna leads to Visuchika. Visthabdhajirna leads to Alasaka. Vidagdhajirna causes Vilambika.

–        Vilambika is a disease in which the food vitiated by kapha and vata does not come out either from upward (mouth) or downward (anus) routes. It will stay in the abdomen for long periods of time and trouble the person. Ref – Su.Ut.56/9

–        In treatment of Visuchika, Dahana or Agnikarma has been indicated to be done to the HEEL with heated iron. (Su.Ut.56/12)

–        Kshara Agada has been prescribed in the treatment of Visuchika.

–        Kalyanaka Lavana described in the Treatment of Vata Roga has also been indicated in the treatment of Visuchika.

–        Vyoshadi Anjana has been prescribed in the treatment of Visuchika. Su.Ut.56/18

–        Purisha-Mutra Stambha and Shakrd-Vamana are the symptoms of Purishaja Anaha.

 

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The 56th chapter of Uttaratantra of Sushruta Samhita is named as Pratişedha Pratiședha. This chapter deals with Treatment of Gastroenteritis.

अथातो विसूचिकाप्रतिषेधमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound Visciuka pratiṣedha- treatment of Gastroenteritis as revealed by the venerable Dhanvantari.

अजीर्णमामं विष्टब्धं विदग्धं च यदीरितम् |
विसूच्यलसकौ तस्माद्भवेच्चापि विलम्बिका ||३||

Visucika, Alaska and Vilambika arise from the three kinds of ajirna – indigestion namely – Amajirna, Visthabdhajirna and Vidagdhajirna.

Causes and pathogenesis of Visucika

सूचीभिरिव गात्राणि तुदन् सन्तिष्ठतेऽनिलः |
यस्याजीर्णेन सा वैद्यैरुच्यते ति विसूचिका ||४||
न तां परिमिताहारा लभन्ते विदितागमाः |
मूढास्तामजितात्मानो लभन्ते कलुषाशयाः ||५||

Consequent to ajirna, vata gets aggravated and gives rise to pricking pain in the body. Physicians call this condition Visucika.

This disease will not affect the persons who consume foods in proper quantities as permitted by the texts and adhere to the proper regimens of foods. On the other hand, it will affect those persons who do not have control over themselves and also vitiate their stomach with unhealthy foods.

Lakşana – clinical features

मूर्च्छातिसारौ वमथुः पिपासा शूलं भ्रमोद्वेष्टनजृम्भदाहाः |
वैवर्ण्यकम्पौ हृदये रुजश्च भवन्ति तस्यां शिरसश्च भेदः ||६||

Below mentioned are the symptoms of Visucika –

–        fainting,

–        diarrhoea,

–        vomiting,

–        thirst,

–        abdominal pain,

–        giddiness,

–        rigidity of extremities,

–        excessive yawning,

–        feeling of burning sensation,

–        discolouration,

–        shivering,

–        pain in the region of the heart and

–        headache

Alasaka

कुक्षिरानह्यतेऽत्यर्थं प्रताम्यति विकूजति |
निरुद्धो मारुतश्चापि कुक्षौ विपरिधावति ||७||
वातवर्चोनिरोधश्च कुक्षौ यस्य भृशं भवेत् |
तस्यालसकमाचष्टे तृष्णोद्गारावरोधकौ ||८||

Alasaka – The disease characterized with the below mentioned features is called Alasaka –

–        severe distension of the abdomen,

–        unconsciousness and moaning,

–        vata which is obstructed moves upwards in the stomach and

–        there is obstruction to flatus and faeces and

–        their accumulation in excess inside the abdomen, accompanied by

–        thirst and

–        excessive belching

Vilambikā

दुष्टं तु भुक्तं कफमारुताभ्यां प्रवर्तते नोर्ध्वमधश्च यस्य |
विलम्बिकां तां भृशदुश्चिकित्स्यामाचक्षते शास्त्रविदः पुराणाः ||९||

The ancient physicians have documented a condition / disease which is difficult to cure and have named it as Vilambika. In this condition, the food we consume gets vitiated by kapha and vata. Such vitiated food will not come out either from upward (mouth) or downward (anus) paths. It will stay inside the abdomen for a long period of time and trouble the person.

यत्रस्थमामं विरुजेत्तमेव देशं विशेषेण विकारजातैः |
दोषेण येनावततं स्वलिङ्गैस्तं लक्षयेदामसमुद्भवैश्च ||१०||

The place in which āma is present gives rise to pain i.e. in whichever place of the body ama is located, that place would develop pain. The place of the body in which ama is present and gives rise to pain should be considered (that place) as the origin of diseases caused by the doshas. That further should be determined by the presence of own (specific to it) symptoms of ama in that place.

यः श्यावदन्तौष्ठनखोऽल्पसञ्ज्ञश्छर्द्यर्दितोऽभ्यन्तरयातनेत्रः |
क्षामस्वरः सर्वविमुक्तसन्धिर्यायान्नरः सोऽपुनरागमाय ||११||

The person presenting with the below mentioned features is said to walk away never to return (would die) –

–        teeth (gums), lips and nails turning blue,

–        very less movements of body parts,

–        vomiting,

–        eyes gone deep inside (the eye socket),

–        very feeble voice and

–        looseness of all the joints

Cikitsā – treatment

साध्यासु पार्ष्ण्योर्दहनं प्रशस्तमग्निप्रतापो वमनं च तीक्ष्णम् |
पक्वे ततोऽन्ने तु विलङ्घनं स्यात् सम्पाचनं चापि विरेचनं च ||१२||
विशुद्धदेहस्य हि सद्य एव मूर्च्छातिसारादिरुपैति शान्तिम् |
आस्थापनं चापि वदन्ति पथ्यं सर्वासु योगानपरान्निबोध ||१३||

Curable forms of Visucika should be treated. In these conditions, it is ideal to do the below mentioned treatments –

–        burn the heel of the patient i.e. branding should be done with heated iron,

–        digestive fire should be augmented and

–        strong emetics shall be administered so as to produce vomiting

Once the food gets digested, the patient should be made to fast. Digestive herbs should be used and purgatives should be administered.

The symptoms such as fainting, diarrhoea etc. immediately subside in persons who are purified by undergoing vomiting and purgation therapies. It is said that the decoction enema is also beneficial in this disease. Now, I shall describe the other medicinal formulae, listen to the same.

पथ्यावचाहिङ्गुकलिङ्गगृञ्जसौवर्चलैः सातिविषैश्च चूर्णम् |
सुखाम्बुपीतं विनिहन्त्यजीर्णं शूलं विसूचीमरुचिं च सद्यः ||१४||

Powder of the below mentioned ingredients should be prepared –

–        Pathya,

–        Vaca,

–        Hingu,

–        Kalingaka,

–        Grnjanaka,

–        Sauvarcala and

–        Ativisa

This powder should be consumed mixed in comfortably warm water. It immediately cures indigestion, abdominal pain, visucika and loss of taste.

क्षारागदं वा लवणं विडं वा गुडप्रगाढानथ सर्षपान् वा |
अम्लेन वा सैन्धवहिङ्गुयुक्तौ सबीजपूर्णौ सघृतौ त्रिवर्गौ ||१५||
कटुत्रिकं वा लवणैरुपेतं पिबेत् स्नुहीक्षीरविमिश्रितं तु |
कल्याणकं वा लवणं पिबेतु यदुक्तमादावनिलामयेषु ||१६||

Below mentioned are also beneficial and hence should be consumed –

–        Ksara Agada – described in kalpa sthana section, chapter 6,

–        Bida Lavana or Sarsapa added with more quantity of jaggery or

–        Saindhava Lavana and Hingu mixed with sour gruel, or

–        Juice of Bijapura mixed with trivarga (trikatu), added with saindhava lavana and mixed with snuhi ksira or

–        Kalyanaka Lavana – described in the treatment of vata roga (cikitsa sthana, chapter 4)

कृष्णाजमोदक्षवकाणि वाऽपि तुल्यौ पिबेद्वा मगधानिकुम्भौ |
दन्तीयुतं वा मगधोद्भवानां कल्कं पिबेत् कोषवतीरसेन ||१७||
उष्णाभिरद्भिर्मगधोद्भवानां कल्कं पिबेन्नागरकल्कयुक्तम् |१८|

Equal parts of the below mentioned ingredients should be taken and their powder is prepared –

–        Krishna,

–        Ajamoda and

–        Ksavaka

This powder may be consumed with sour liquids.

The other beneficial formulae are –

–        Powder of Magadha and Nikumbha or

–        Paste of Magadha and Danti may be consumed with juice of Kosavati (mixed in this juice or

–        Paste of Magadodbhava (Pippali) added with paste of Nagara should be consumed along with warm water

व्योषं करञ्जस्य फलं हरिद्रे मूलं समं चाप्यथ मातुलुङ्ग्याः ||१८||
छायाविशुष्का गुटिकाः कृतास्ता हन्युर्विसूचीं नयनाञ्जनेन |१९|

Equal parts of Vyosa, fruits (seeds) of Karanja and roots of Haridra are taken. They are macerated with Matulunga juice and made into pills. These pills are dried in shade. They are later used for application to the eyes in the form of collyrium. This medicine would cure Visucika.

सुवामितं साधुविरेचितं वा सुलङ्घितं मनुजं विदित्वा ||१९||
पेयादिभिर्दीपनपाचनीयैः सम्यक्क्षुधार्तं समुपक्रमेत |२०|

The patient should be treated with peya i.e. thin gruel etc. processed with carminative and digestive herbs after determining the below said things –

–        that the patient has had satisfactory vomiting and purgation (the therapies have been implemented properly and the signs of proper administration of these therapies have been documented),

–        that the patient has fasted well and

–        that he has obtained hunger properly

Anāha – flatulence

आमं शकृद्वा निचितं क्रमेण भूयो विबद्धं विगुणानिलेन ||२०||
प्रवर्तमानं न यथास्वमेनं विकारमानाहमुदाहरन्ति |२१|

Anaha is a condition which is marked by the below mentioned events / features –

–        ama i.e. undigested food or sakrt – faeces gradually accumulates inside the alimentary canal and

–        they get obstructed from going out by the aggravated vata and hence,

–        they do not come out in their own routes i.e. ama does not come out in upward (mouth) direction and purisa – faeces does not come out in the downward (anus) route

तस्मिन् भवन्त्यामसमुद्भवे तु तृष्णाप्रतिश्यायशिरोविदाहाः ||२१||
आमाशये शूलमथो गुरुत्वं हृल्लास उद्गारविघातनं च |२२|

Below mentioned are the symptoms of anaha produced by ama – the undigested food –

–        thirst,

–        running nose,

–        burning sensation in the head,

–        pain and heaviness in the stomach,

–        nausea and

–        obstruction to belching

स्तम्भः कटीपृष्ठपुरीषमूत्रे शूलोऽथ मूर्च्छा स [१] शकृद्वमेच्च ||२२||
श्वासश्च पक्वाशयजे भवन्ति लिङ्गानि चात्रालसकोद्भवानि |२३|

Below mentioned are the symptoms of anaha caused by purisa – faeces –

–        stiffness (loss of movement) of the waist and back,

–        non-elimination of faeces and urine,

–        pain in the abdomen,

–        fainting,

–        faecal vomiting,

–        dyspnoea and

–        symptoms of alasaka

Cikitsā – treatment

आमोद्भवे वान्तमुपक्रमेत संसर्गभक्तक्रमदीपनीयैः ||२३||
अथेतरं यो न शकृद्वमेत्तमामं जयेत् स्वेदनपाचनैश्च |२४|

Vomiting should be administered in anaha caused by ama. Following this, regimen of liquid diet (peya, vilepi etc) should be implemented along with administration of herbs which increase hunger.

In the other kind of anaha i.e. that caused by faeces, ama should be treated by administering sudation and digestives, if there is no faecal vomiting.

विसूचिकायां परिकीर्तितानि द्रव्याणि वैरेचनिकानि यानि ||२४||
तान्येव वर्तीर्विरचेद्विचूर्ण्य महिष्यजावीभगवां तु मूत्रैः |
स्विन्नस्य पायौ विनिवेश्य ताश्च चूर्णानि चैषां प्रधमेत्तु नाड्या ||२५||

The herbs which are described as purgatives (virecana dravyas) should be macerated with urine of buffalo, goat, sheep, elephant or cow and made into recta wicks / suppositories. These wicks should be introduced into the rectum (anus) of the person suffering from Visucika. Alternatively, powder of the purgative herbs may be blown into the rectum through a tube.

मूत्रेषु संसाध्य यथाविधानं द्रव्याणि यान्यूर्ध्वमधश्च यान्ति |
क्वाथेन तेनाशु निरुहयेच्च मूत्रार्धयुक्तेन समाक्षिकेण ||२६||
त्रिभण्डियुक्तं लवणप्रकुञ्चं दत्त्वा विरिक्तक्रममाचरेच्च |
एष्वेव तैलेन च साधितेन प्राप्तं यदि स्यादनुवासयेच्च ||२७||

The herbs which produce upward movement (emetics) and those which produce downward movement (purgatives) should be boiled in urines in the usual way. Then, half the quantity of the paste of tribhandi, one prakunca (40 gm) quantity of saindhava lavana and honey are added to this and mixed thoroughly. The resultant liquid is administered as decoction enema. Afterwards, the regimen of post-purgation therapy should be adopted. For giving Anuvasana Basti i.e. oil enema, the oil boiled and processed with the same herbs may be used.

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे विसूचिकाप्रतिषेधो नाम
(अष्टादशोऽध्यायः, आदितः ) षट्पञ्चाशत्तमोऽध्यायः ||५६||

Thus ends the fifty-sixth chapter by name Visucikā pratiṣedha in Uttarasthana of Suśruta samhita.

Enjoy my sweet and spicy hot honey shrimp bowls, a super easy and flavorful dish that’s a must-try! Packed with succulent shrimp in a hot honey marinade, and paired with a bright and fresh mango avocado salad. I like to serve mine over a bed of rice for an easy weeknight dinner that doesn’t compromise on flavor.

Ingredients You Need

For the Shrimp

I like to use large or jumbo raw shrimp for these bowls because they look so gorgeous in these bowls, but any size shrimp will work (just know that the smaller the shrimp, the less time it will take to cook). I’m seasoning this shrimp with garlic, garlic chili sauce, salt — and, of course, hot honey! It’s a simple combination that’s perfectly sweet, spicy and garlicky.

For the Mango Avocado Salad

This simple salad pairs perfectly with the sweet and spicy shrimp. You need avocado, mango, cucumber, red onion and a simple homemade vinaigrette. Toss it all together in 5 minutes flat.

For the Rice

I’ve made this recipe with white rice, brown rice and even my cilantro lime rice. Choose your own adventure here and prepare your go-to rice!

Easy Substitutions and Swaps

Choosing shrimp: I used uncooked jumbo shrimp in these bowls, but a smaller variety of uncooked shrimp will also work. If you choose a smaller size shrimp, just know it will impact the cook time.

Make it spicier: If you want to amp up the spice in these shrimp bowls, you can mix in a pinch or two of red pepper flakes with the hot honey.

Make is less spicy: If you don’t love spice, but want to keep the flavor of this dish, replace the hot honey with plain honey. My mom loves this option!

Make Your Own Hot Honey

Hot honey is actually very easy to make at home. Use my hot honey recipe as reference, and keep a jar in your spice cupboard. It pairs nicely with so many dishes. Here’s what you need:

• Honey
• Red pepper flakes or Thai chiles
• Apple cider vinegar 
• Garlic cloves

More Shrimp Recipes I Love

Article by Dr Manasa S, B.A.M.S

AIAPGET Points

–        Melatonin is synthesized from tryptophan → serotonin → melatonin in pinealocytes of the pineal gland.

–        Secretion of melatonin is inversely proportional to light exposure and is mediated via the retino-hypothalamic-pineal pathway.

–        Light information reaches the pineal gland through the sequence:
Retina → Suprachiasmatic nucleus (SCN) → Sympathetic fibers → Pineal gland.

–        Suprachiasmatic nucleus (SCN) of hypothalamus is the master circadian pacemaker controlling melatonin secretion.

–        Melatonin secretion shows a circadian rhythm with nocturnal peak (2–4 AM).

–        Melatonin does not induce sleep directly, but facilitates sleep by lowering core body temperature and reducing alertness.

–        Exposure to blue light (screens) suppresses melatonin secretion — a frequent exam distractor.

–        Longer nights → prolonged melatonin secretion (basis of winter sleepiness and SAD).

–        Melatonin is absent in neonates; circadian rhythm develops by 3–4 months of age.

–        Melatonin levels are highest before puberty and decline after puberty.

–        Progressive decline occurs after 40 years, contributing to sleep disturbance in elderly.

–        Melatonin has an inhibitory effect on GnRH → ↓ LH & FSH secretion.

–        Excess melatonin is associated with delayed puberty and hypogonadotropic hypogonadism.

–        Pineal tumors in children may present with precocious puberty due to loss of melatonin inhibition.

–        Melatonin is a potent free-radical scavenger, especially within the CNS.

–        It protects neurons from oxidative stress, nitric oxide, and hydrogen peroxide.

–        Reduced melatonin is linked with neurodegenerative disorders (Alzheimer’s, Parkinson’s)

–        Hypomelatoninemia → circadian rhythm disorders, insomnia, SAD.

–        Hypermelatoninemia is most commonly due to excess supplementation, not pineal overproduction.

–        Beta-blockers reduce melatonin secretion → beta-blocker–induced insomnia.

Melatonin

Melatonin is a naturally occurring hormone that is primarily produced by the pineal gland in the brain. It plays a central role in regulating the sleep–wake cycle and maintaining the body’s circadian rhythm.

Endogenous melatonin (melatonin produced within the body) helps synchronize internal biological rhythms with the external light–dark cycle. Its secretion increases during the evening and night, promoting sleepiness, and decreases during daylight hours, supporting wakefulness. Through this rhythmic secretion, melatonin helps the body recognize when to rest and when to be alert.

Melatonin is therefore an essential hormonal signal for sleep initiation and sleep timing, rather than a sedative itself. It supports the natural process of falling asleep and waking after adequate rest.

In addition to natural production, melatonin can also be synthesized in laboratories and is available as a dietary supplement. This form is known as exogenous melatonin and is commonly used to manage sleep-related disorders and circadian rhythm disturbances.

Function of Melatonin

Melatonin plays a key role in regulating the body’s circadian rhythm.
The circadian rhythm is the natural sleep–wake cycle that follows a 24-hour pattern.

–        Melatonin prepares the body for sleep.
It does not directly cause sleep, but it signals the body that it is time to slow down and rest.

–        The pineal gland secretes melatonin in response to darkness.
Melatonin levels are highest at night and lowest during daylight hours.

–        Exposure to light suppresses melatonin secretion.
This is why melatonin levels fall in the morning and rise after sunset.

–        The duration of melatonin secretion depends on the length of darkness.
Longer nights result in prolonged melatonin release.

–        During winter months, reduced daylight leads to increased melatonin secretion.
This explains why people may feel sleepy earlier or experience increased sleepiness in winter.

Mechanism of Action of Melatonin

Melatonin acts as a chemical messenger that signals the body to enter a state of rest.
The pineal gland releases melatonin at roughly the same time every evening, usually after sunset.

Melatonin primarily acts on the hypothalamus.
It signals the hypothalamus to reduce daily physiological activity.

In response, the hypothalamus slows down functions such as:

–         Body temperature

–         Blood pressure

–         Emotional alertness

These changes help prepare the body for sleep.

Melatonin also acts on the retina of the eyes.
It reduces retinal sensitivity to light, promoting relaxation and reduced alertness.

With morning light exposure, retinal activity increases.
This suppresses melatonin secretion and promotes wakefulness.

Ayurveda Viewpoint

The pineal gland which secretes the hormone melatonin is located in the brain (head) which is also the chief seat of Prana Vayu. The functions of these are directly related to those of Prana Vayu to a greater extent and also to those rendered by Sadhaka Pitta and Tarpaka Kapha and also Udana Vayu. The functions of the mentioned dosha subtypes can thus be attributed to the neuro-endocrine functions of pineal gland and those of Melatonin. The circadian rhythm is a resultant of balance and coordinated functioning of these dosha subtypes.

The detachment of manas i.e. mind from its senses (indriyas) is very much essential for the person to withdraw from the worldly objects and slip into a pleasant sleep while its indulgence with the indriyas brings about alertness.

The physiology of sleep, its benefits and harmful effects as explained in Ayurveda reflects the entire game of Melatonin.

The functions of pineal gland and melatonin represent the synchronized functional axis of Prana Vata and other Vata Subtypes. They grossly and subtly represent the functions of the entire orchestra of the endocrinal / hormonal system. The pineal gland too serves as the key link between the nervous system and hormonal regulation.

Related Reading – Ayurveda Understanding of Circadian Rhythm, Pineal Gland and Functions and Dysfunctions of Melatonin

Benefits of Melatonin

Melatonin plays a central role in maintaining the body’s internal biological rhythm. Its primary function is to regulate the sleep–wake cycle, but its influence extends to several physiological systems.

Regulation of Sleep and Circadian Rhythm

Melatonin acts as the body’s natural signal for sleep onset. It helps prepare the body for rest by synchronizing the circadian rhythm with the light–dark cycle. Adequate melatonin secretion supports restorative sleep, which is essential for overall health, including the maintenance of:

–         Mental and emotional well-being

–         Skin health

–         Hair health

–         Optimal function of internal organs

Because of this role, melatonin is often referred to as the “sleep hormone” and is commonly used as a natural aid in certain sleep disorders.

Seasonal Affective Disorder (SAD)

Seasonal affective disorder is associated with changes in daylight exposure across seasons.

–         Winter-pattern SAD may be linked to increased melatonin secretion due to prolonged darkness.

–         Summer-pattern SAD, which accounts for a smaller proportion of cases, may involve relatively lower melatonin levels.

The exact role of melatonin in SAD is still under investigation, and further research is needed to clarify its therapeutic significance.

Reproductive and Hormonal Balance

Melatonin contributes to the regulation of reproductive hormones and is believed to help maintain regular menstrual cycles by interacting with the hypothalamic–pituitary–gonadal axis.

Neuroprotective Effects

Melatonin exhibits neuroprotective properties. It may help protect brain cells from oxidative damage and degeneration, processes that are associated with neurodegenerative conditions such as Alzheimer’s disease and Parkinson’s disease. While experimental and observational studies are promising, definitive clinical evidence is still evolving.

Antioxidant and Cellular Protection

Melatonin is a potent antioxidant. It helps neutralize free radicals, thereby reducing cellular damage. This antioxidant action may support eye health and overall cellular integrity, though long-term effects of supplemental melatonin require further human studies.

Gastrointestinal Benefits

Melatonin has been shown to influence gastrointestinal function. It may:

–         Reduce gastric acid secretion

–         Decrease nitric oxide production, thereby preventing excessive relaxation of the lower esophageal sphincter

Through these mechanisms, melatonin may help alleviate symptoms of gastroesophageal reflux disease (GERD), such as heartburn and acid reflux.

Therapeutic Uses of Melatonin (Based on Evidence)

Likely Effective

–         Delayed sleep phase syndrome: Helps reduce sleep-onset latency in children and young adults

–         Non-24-hour sleep–wake disorder: Improves sleep patterns in blind children and adults

Possibly Effective

–         Beta-blocker–induced insomnia

–         Adjunctive use in certain cancers (under medical supervision)

–         Reduction of postoperative confusion and agitation in children

–         Controlled-release melatonin for hypertension

–         Short-term management of insomnia, particularly in older adults

–         Jet lag symptom relief

–         Migraine prevention

–         Pre-procedure anxiety and sedation reduction

–         Sunburn prevention (topical use)

–         Temporomandibular joint disorders (TMD)

–         Cancer-related thrombocytopenia

Possibly Ineffective

–         Athletic performance enhancement

–         Cancer-related fatigue and pain

–         Cachexia in chronic illness

–         Critical illness recovery

–         Dementia symptom improvement (except possible reduction of sundowning)

–         Infertility

–         Shift-work sleep disorder

Likely Ineffective

–         Benzodiazepine withdrawal symptoms

–         Depression (may worsen symptoms in some individuals)

Melatonin and Aging

Experimental observations suggest that removal of the pineal gland accelerates aging processes. This has led to the hypothesis that endogenous melatonin may possess anti-aging properties, though this concept remains under active research.

What are normal melatonin levels?

Normal melatonin levels vary based on age and sex recorded at birth. In general, females tend to have slightly higher melatonin levels than males.

Melatonin production also changes significantly across the lifespan:

–         Before birth: A fetus does not produce its own melatonin. Instead, melatonin is supplied through the placenta from the mother.

–         After birth: Newborns initially do not synthesize melatonin. They may receive small amounts through breast milk or formula.

–         Infancy: A regular melatonin rhythm begins to develop around 3 to 4 months of age, when infants start establishing a sleep–wake cycle.

–         Childhood and adolescence: Melatonin levels are highest during childhood and early teenage years, peaking just before the onset of puberty.

–         Post-puberty: After puberty, melatonin secretion gradually decreases and stabilizes by the late teenage years.

–         Adulthood: Levels generally remain steady until around 40 years of age, after which there is a slow, natural decline for the rest of life.

Most people are unaware of their melatonin levels unless they experience sleep disturbances or related symptoms. When testing is required, a healthcare provider can assess whether melatonin levels fall within the expected normal range for that age group.

Conditions and Disorders Related to Melatonin

Disorders related to melatonin mainly arise due to imbalances in its secretion. These conditions are broadly classified into two types:

–         Hypomelatoninemia – lower-than-normal melatonin levels

–         Hypermelatoninemia – higher-than-normal melatonin levels

Hypomelatoninemia

Hypomelatoninemia refers to reduced nighttime melatonin levels or a total melatonin output lower than expected for a person’s age.

This condition is commonly associated with circadian rhythm sleep disorders, where the body’s natural sleep–wake cycle is disrupted.

These disturbances may affect:

–         The timing of sleep and waking

–         Quality of sleep

–         Daytime alertness, mood, and overall functioning

Low melatonin levels can make it difficult to fall asleep, stay asleep, or feel refreshed after sleep.

Hypermelatoninemia

Hypermelatoninemia occurs when there is an excess of melatonin in the blood.

–         The most common cause is excessive intake of synthetic (supplemental) melatonin.

–         Rarely, it may result from overproduction by the pineal gland.

Elevated melatonin levels have been linked to an increased risk of certain conditions, including:

–         Anorexia nervosa and other eating disorders

–         Hypogonadotropic hypogonadism, where reduced estrogen or testosterone production occurs due to hypothalamic or pituitary dysfunction

–         Polycystic ovary syndrome (PCOS), characterized by hormonal imbalance, irregular menstruation, and possible infertility

–         Rabson–Mendenhall syndrome, a rare genetic disorder associated with severe insulin resistance and hyperglycemia

–         Spontaneous hypothermia with hyperhidrosis, marked by sudden episodes of low body temperature accompanied by excessive sweating

Dosage of Melatonin

Melatonin is commonly taken in doses ranging from 0.5 mg to 10 mg per day.

Since the strength and formulation of melatonin supplements can vary, it is advisable to follow the dosage recommended on the product label to avoid adverse effects. Starting with a lower dose and gradually increasing, if required, is generally recommended to determine individual tolerance and effectiveness.

–         For improving sleep quality, melatonin is best taken about 30 minutes before bedtime.

–         For correcting circadian rhythm disorders or establishing a regular sleep–wake cycle, melatonin may be taken 2–3 hours before the intended bedtime.

Safety of Melatonin

Research indicates that melatonin is generally safe and non-addictive when used for short-term and long-term purposes in adults.

However, long-term safety data in children and adolescents is limited. Therefore, routine use of melatonin in these age groups is not currently recommended without medical supervision.

Side Effects of Melatonin

Melatonin is usually well tolerated. The most commonly reported side effects include:

–         Nausea

–         Headache

–         Dizziness

–         Daytime sleepiness

These effects are typically mild and dose-dependent.

Drug Interactions

Melatonin may interact with certain medications, including:

–         Antidepressants

–         Blood thinners

–         Antihypertensive medications

Caution is advised when melatonin is used alongside these drugs, and medical guidance is recommended.

Melatonin – Quick Revision Points

–        Melatonin is a natural hormone mainly secreted by the pineal gland.

–        It is also known as the “sleep hormone” due to its role in regulating the sleep–wake cycle.

–        Melatonin regulates the circadian rhythm, which follows a 24-hour biological cycle.

–        Endogenous melatonin refers to melatonin produced naturally by the body.

–        Exogenous melatonin refers to synthetic melatonin used as a dietary supplement.

–        Melatonin secretion increases in darkness and decreases with light exposure.

–        Peak melatonin levels occur at night, while levels are low during daylight.

–        Longer nights (e.g., winter) lead to prolonged melatonin secretion.

–        Melatonin acts on the hypothalamus to reduce body temperature, blood pressure, and alertness.

–        It helps prepare the body for sleep but does not directly induce sleep.

–        Normal melatonin production begins in infants at 3–4 months of age.

–        Melatonin levels are highest before puberty and decline after puberty.

–        After the age of 40 years, melatonin levels show a gradual physiological decline.

–        Females generally have higher melatonin levels than males.

–        Melatonin has antioxidant properties and may protect neurons from oxidative stress.

–        It plays a role in menstrual cycle regulation.

–        Hypomelatoninemia is associated with circadian rhythm sleep disorders.

–        Hypermelatoninemia is most commonly caused by excess melatonin supplementation.

–        Recommended oral dose of melatonin ranges from 0.5 – 10 mg/day.

–        Melatonin is generally safe and non-addictive in adults, with common side effects being headache, dizziness, nausea, and sleepiness.

For Further Reading:

Comprehensive review of melatonin as a promising nutritional and nutraceutical supplement – ScienceDirect

Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials – PubMed

Status of research on the application of melatonin in insomnia based on bibliometric visualization analysis and development trends

Melatonin supplementation: new insights into health and disease – PubMed

Meta-Analysis: Melatonin for the Treatment of Primary Sleep Disorders | PLOS One

Melatonin: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

10 Melatonin Mistakes That Could Be Ruining Your Sleep

Melatonin for Sleep: Does It Work? | Johns Hopkins Medicine

Foods High in Melatonin

Melatonin as a Hormone: New Physiological and Clinical Insights | Endocrine Reviews | Oxford Academic

Melatonin and health: an umbrella review of health outcomes and biological mechanisms of action – PMC