Vitamin D and Melatonin

percyval577

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The Day and the Night hormone. They are in opposition to each other of course.
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The influence of vitamin D supplementation on melatonin status in patients with multiple sclerosis.
Golan et al 2013


Abstract
Multiple sclerosis (MS) incidence is higher in geographic regions with less sunlight exposure. Both vitamin D and melatonin are essential mediators of the effect of sunlight in health, and as such are candidates to play a key role in MS. We hypothesized that vitamin D and melatonin may have related influences in patients with MS.

METHODS:
In a randomized, double blind study of 40 IFN-β treated MS patients, 21 patients were assigned to 800 IU of vitamin D3 per day (low dose), while 19 patients received 4,370 IU vitamin D3 per day (high dose) for one year. Serum 25-hydroxy-vitamin-D (25-OH-D) and nighttime urine melatonin metabolite, 6-sulphatoxy-melatonin (6-SMT), were measured at baseline, 3 months and 1 year from enrolment.

RESULTS:
After 3 months supplementation, 25-OH-D levels increased and nighttime melatonin secretion decreased significantly in the high dose group, but not in the low dose group. After 1 year, a decrease in 25-OH-D levels, accompanied by an increase of urine nighttime 6-SMT were observed in the high dose group. Percent change in serum 25-OH-D was significantly and negatively correlated with percent change in urine 6-SMT after 3 months and between 3 months to 1 year. 25-OH-D levels by the end of the study were significantly and negatively correlated to BMI.

CONCLUSIONS:
Melatonin secretion is negatively correlated with alterations in serum 25-OH-D in IFN-β treated patients with MS. The finding suggests that melatonin should be considered as a potential mediator of vitamin D neuro-immunomodulatory effects in patients with MS.
paywalled
Brain Behav Immun. 2013 Aug;32:180-5. doi: 10.1016/j.bbi.2013.04.010. Epub 2013 May 7.
 
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percyval577

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The role of Vitamn D in treatment of Chronic Insomnia with Melatonin (PS-320)
Sahakyan 2018


Abstract
Objective: The aim of this study is to show the use and efficacy of vitamin D supplementation in treatment course of chronic insomnia with melatonin.

Background:
Numerous articles and clinical studies appear to prove the connections between vitamin D deficiency and different neurological pathologies like MS, chronic fatigue syndrome, neuropathic pain and sleep disorders. In sleep regulation Vitamin D acts through central receptors found in the anterior and posterior hypothalamus, substantia nigra, midbrain central grey nucleus and nucleus reticularis pontis.

Design/Methods: 10 women of 60–65 year old for whom insomnia was the initial complaint for consultation were selected. All of them mentioned the presence of chronic fatigue, multiple nighttime awakenings and excessive daytime sleepiness. In anamnesis no other pathology was found except general musculoskeletal pain. Neurological examination was normal. Vitamin D levels and thyroid hormones were tested in blood which showed normal thyroid function and vitamin D deficiency ranging from 8–16 ng/ml (normal range between 30–50 ng/ml). A treatment course of 3 weeks with low dose melatonin was started.( 0.5 mg/day) combined with a single administration of oral vitamin D 50.000 UI/week and 1000 UI/day.

Results: Symptoms were improved starting from the first week and there was no need of increasing the dosage or adding another hypnotic agent. No withdrawal effect was seen. Patients are currently on follow-up with prescription of melatonin 0.5 mg/night in case needed and vitamin D 1000UI/day for a month.

Conclusions: How exactly vitamin D acts on melatonin synthesis and functions needs still to be understood.
Based on our clinical case we suggest to make consider vitamin D deficiency as a probable cause of sleep disturbances and check the levels as a routine test.
Combined treatment of vitamin D with melatonin will accumulate the therapeutic efficacy and help to avoid high doses and long term treatment courses in chronic insomnia.
paywalled
Neurology