Wellness Unmasked: New Melatonin Study Raises Red Flags

In this episode, Dr. Nicole Saphier analyzes a new study that links regular melatonin use with higher risks of cardiovascular disease and overall mortality. She explains what the data actually shows, why sleep quality is central to long-term health, and how listeners can improve their sleep habits without overrelying on supplements. This episode underscores the importance of using melatonin responsibly and understanding the broader role sleep plays in both mental and physical well-being. Wellness Unmasked is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Tuesday & Friday.

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Episode Transcript

Speaker 1 (00:02):
A journey into how my mind works. I found myself
researching a certain study, a scientific study that came out
in the last couple of weeks because a lot of
friends were starting to text me about it, and of course,
me being me, I like to read about something. While
I do occasionally speak off the cuff, I am. I

(00:23):
am very data oriented. I'm like, let me just dive
into the study, and then from there I went from
that study to more studies, to more studies to I mean,
it kind of like ended up with me looking for
aliens in like North Dakota or something. I mean, that's
just kind of how crazy my mind goes sometimes. But
have you heard of the new study about linking melatonin

(00:45):
to cardiovascular disease, heart attacks and just like all cause mortality. Well,
if you haven't, it's probably because of the whole internet's
being crashed the last day or so because it's a
hot topic and people are freaking out because apparently a
lot of people take melatonin. Who knew? So what is
this study? Well, it's actually a really big study. It's
not some random thing on the internet that one person

(01:09):
took melatonin and then had a heart attack. Is actually
a big study done in the United States and the
UK kind of a collaboration study. They looked at over
one hundred and thirty thousand adults their medical charts, so
it's pretty pretty well powered study, a lot of people
in it. And what they looked at was adults who

(01:29):
were diagnosed with insomnia, and so about one hundred and
thirty thousand adults who had been diagnosed with insomnia. And
what they looked at was how did the people do
who were taking melatonin versus people who were not taking melatonin?
And I mean, to be honest, there were some pretty
startling statistics that came out of this study. And if

(01:50):
you look at what's being quoted, they said, over a
five year period, adults who took with insomnia who took
melatonin for at least twelve months, had a ninety percent
higher chance of developing heart failure compared to the control group.
I mean, that's that's pretty significant. Ninety percent higher chance. Yeah,

(02:11):
I think if you were told there's a ninety percent
chance you're going to get heart failure for something, you
probably wouldn't take it. They went on from there, the
melatonin group was nearly three point five times more likely
to be hospitalized for heart failure and also had a
nearly one hundred percent increased risk of death from any

(02:31):
cause during the study period. I was like, WHOA, Like,
they're not mincing words here, They're not saying, oh, it's
like a two percent increase, a five percent increase. They're like, nope,
nearly one hundred percent increase risk of death from any cause.
And the people who were taking melatonin. Well, I mean
this is mind blowing because the reality is, yeah, I've

(02:53):
taken melatonin. I think every person in my life has
taken melotonin, including my children. So i'mviously I decided to
dig a little bit deeper into this study because it's
pretty startling. It really is. I mean, if you go
to any CBS Walgreens nutrition store, melatonin is everywhere. So
let's break down this study. Like I said, it's well powered.

(03:15):
Over one hundred and thirty thousand medical charts were reviewed.
That's a good number. Big issue that I had in
it was the fact that when they the people who
said they took melatonin, so that group, the melatonin takers,
they were only people who had prescription melatonin. Now you're like, wait,

(03:35):
what a prescription? Why would anybody take a prescription melotone,
you just go to CBS and grab it. Yes, in
the United States, that's true. If you go to the UK,
where a lot of this patient population were, it's not
over the counter and you do actually need a prescription.
So here's the question I have in the people who
were considered non melatonin users because they didn't get a prescription,

(03:58):
did any of them actually take melatonin? Because some of
these patients are from the United States, and by the way,
melatonin's over the counter. It's not like they asked the patients.
All they did was look at prescription history. So any
of the patients that were from the United States who
had traveled to the United States or maybe vibes medication
from the United States, they may not actually have been

(04:19):
included in that control group, and they may have been
falsely included in the non melatonin user group. That's a
huge confounding factor. So that's a really big deal for me.
It's just a misclassification of non users, and so this
could underestimate the number of people who actually took melatonin.

(04:40):
And again, if people in the quote unquote non melatonin
user group were taking over the counter melatonin, is it
something to be said for the prescription melatonin that you
get in the UK, maybe it's formulated differently than the
over the counter one you get here in the United States.
So of course I looked into that. Now we start

(05:00):
seeing this rabbit hole that I decide to go down,
because that's what I do. If you actually look at
the melatonin that is prescribed in say the UK, there's
one in particular that kind of peaked my interest. It's
an extended release formulation. Now in the United States, the
common complaint that people get when they take melatonin is, yeah,

(05:22):
it helps me fall asleep, but I don't stay asleep,
And that's because they're usually pretty short acting. And so
for people who don't see a benefit with melatonin, it's
usually because it doesn't last throughout the entire night, which
is probably why the prescription form is extended release, so
it continues to be released throughout the night. So my

(05:43):
question is is it this extended release version that's causing
some sort of alteration in not only our brain chemistry.
Obviously that's what it's designed to do, but is that
actually having a role in our cardiovascular health? So I
don't really know. That's one question. I had another thing
that I was looking at was what about the dosages

(06:05):
and the bioavailability. You know, when you go when you
take these little melatonin gummies, you're probably getting a much
lower dose because the bioavailability and after metabolism is likely
to be much lower than if you're actually having a
pharmaceutically formulated capsule that bypasses a lot of the digestive
enzymes and it probably has a more efficient metabolism when

(06:27):
it goes through the liver. So my guess is, again
I'm not a chemist or biopharmaceutical whiz, but my guess
is you're probably getting higher dose of the melatonin from
these pharmaceutical formulations. On top of that, in the study,
there was no mention of dosages. It just is the

(06:50):
study defines quote unquote use of melatonin as at least
just for one year. So okay, well, are they taking
one for one year or are they taking twenty milligrams
for one year? I mean, that kind of makes a difference,
doesn't it. And then lastly, when it comes to this study,

(07:10):
the big thing was everyone those who were quote unquote
the users of melatonin and those who were quote unquote
the non users of melatonin, they all had to be
diagnosed with some form of underlying insomnia severity or a
sleep disorder. So my question is, for the people who
were considered the users of melatonin, was there insomnia more severe,

(07:34):
more profound than the non users? It was so profound
that they actually went to their doctor seeking medical intention
and then therefore got a prescription. Because we also know that,
by the way, lack of sleep or poor sleep is
detrimental to our health, and so that didn't they don't

(07:55):
really talk about severity of the sleep deprivation. And I'm
going to go in to another rabbit hole I went
into when it comes to sleep deprivation. But so I
think when it comes to this whole study, you know,
they obviously they also didn't account for like unmeasured life
style variables, who were smokers, who were obese, who you know,

(08:19):
any of these things, who had pre existing heart disease,
any of these things they didn't really mention in the study.
So while I think it's a very interesting study, obviously
very concerning the stark differences that came from the users
of melatonin versus the non users, I'm not quite sure
we're there yet. And in fact, I personally would want

(08:41):
to look at the prescription formulations of melatonin to see
if that itself is the reason that there is an
increased risk. In fact, that extended release one that I
mentioned earlier, it was not approved here in the United States.
It actually got through phase three trials and fail not
approved here in the United States. So I think this

(09:04):
is my thought process, is that there it has something
to do with the formulations that are being prescribed of melatonin,
and maybe looking at that extended release specifically would be
of interest. But the way that this study has been
picked up by the media and just broadly blasted everywhere

(09:25):
of oh my gosh, melatonin, you have almost one hundred
percent risk of all cause mortality and death if you
take melatonin, I'm not really sure that that's I'm not
really sure that that's the message here. In fact, I
think we need peel back those layers a little bit.
You're listening to Wellness and mass We'll be right back
with more what I want to now go into because

(09:49):
while my little research started off with that started off
with let's talk about melatonin, I actually want to focus
a little bit more on what happens specific to your
brain when you don't sleep well and you know it's
it's a really important thing. Because before people start throwing
all the melatonin away and saying forget it, I'm not

(10:11):
doing this. Melatonin's bad, blah blah blah, let's talk about
sleep for a second. So we know that sleep is crucial.
It's crucial for our mental health and it's crucial for
our physical health. Poor sleep is associated with all cause mortality,
just like that study said melatonin was shocking. Poor sleep

(10:32):
increases our risk of cardiovascular disease, high blood pressure, dementia.
Let me think what else? Depression, anxiety? I mean, if
you list it, actually cancer too, If you list any disease,
I can guarantee I can find you a study linking
poor sleep to that. So why is that? Why is
poor sleep so detrimental to our health? Well, when you're

(10:56):
not sleeping very well, your entire neuro access of all
all of the hormones and biochemicals that are going on
in your body is completely off your body. God made
your body very precisely. It is follows a very natural
and precise circadian rhythm and flow, and hormones are released

(11:16):
at very specific times that are supposed to be beneficial
to our body. When you disrupt that with poor sleep,
it throws everything out of black. You have a disruption
of your normal circadian rhythms. Your serotonin, which is that
happy hormone production, gets disrupted. We know that when we
see people with depression and anxiety, sometimes they have low serotonin.

(11:37):
We also see that with poor sleep you have a
rising cortisol. Cortisol is that stress hormone, and another one
that you see is noriperinephrine. These are your fight or
flight response. You know, if you in a back alley
and someone jumps at you, and then all of a sudden,
you get super scared and your heart goes fast and
you start sweating and you have superhuman strength. That's that

(11:59):
fighter flight. Those are your stress hormones. Now, those are
great in short bursts. They are designed to protect us
in short bursts, they will actually do the opposite effect
to us. If they remain chronically elevated. They work against
our body, create a state of inflammation and can have
consequences such as autoimmune disease, cancer, and other illness. If

(12:23):
you actually look at the brain in people who have
sleep deprivation, if it happens in the short term, like
you're cramming for a test or you are anything that
you have short term sleep deprivation. It's just happening for
a few days. You already can see if you measure
brain activity using functional MRI, you see an alteration in

(12:44):
the brain activity. We also know by doing blood tests
that you see an alteration in the hormonal chemicals in
the body. But if you actually now look at the
brain over time with chronic sleep deprivation, and there have
been studies looking at prisoners of war, prisoners in general,
and just other people with chronic sleep deprivation, not only

(13:07):
do you see an alteration in the brain chemical structure,
you see an alteration in the brain itself. There's volume loss.
You lose volume in very key parts of the brain,
one being the hippocampus, which is responsible for memory, another
being the frontal lobe cortex, which is responsible for your

(13:28):
ability to your personality for one, but also your ability
to control oneself. So when you lose that prefrontal cortex,
your entire personality can change, and you also may actually
the way that you can liken this too. If you've
had too much alcohol, you're kind of disinhibited. You know,
maybe you wouldn't have gone streaking down the quad if

(13:51):
you hadn't been drinking alcohol, Well, that part of your
brain that tells you, you know what streaking down the quad,
that's not a good idea. That's your pre cortex. So
when you lose volume in there, you lost you lose
the ability for your body to say, well, this is
what's right, this is what's not right. And actually a
lot of our dementias affect that prefrontal cortex, which is

(14:13):
why people with dementia, you see them act differently, and
maybe they're doing things that socially inappropriate or something that
they would have just never done before because the behavior
is just totally out of whack for them. So chronic
sleep deprivation can lead to that. So on Fox and
Friends this weekend, I talked all about you know, everyone
going into the holiday season. They're like, all right, let

(14:34):
me get on my GLP one, let me try and
lose ten pounds. What's the latest hairstyle or makeup trend
on social media? Like everyone's just concerned a little bit
about crap and heading into the holiday season, we know
that people have an increased feeling of isolation, depression, anxiety,
and that negative mental health directly impacts our sleep, and

(14:59):
so I am imploring everyone to let's focus a little
bit more on our sleep health and our brain health
heading into the holiday season. So the biggest thing you
can do instead of just grabbing for melatonin, hold on
melatonin may be on my list for helping, But let's
talk about some things we can do to prioritize sleep
without the melatonin. First and foremost, you have to try

(15:22):
and get seven to nine hours of sleep every night.
But and there's a big butt to this. It can't
be I go to sleep at nine pm one night
and then I get nine hours, and then the next
night I go to sleep at midnight and I get
nine hours. That's not it. Remember I told you about
that rhythm. Your body wants to follow the same rhythm.
You want to try really hard to go to bed

(15:43):
at a similar time every single night. So whether you
get seven hours or nine hours is less consequential than
going to bed around the same time each night. Me
my goal. I love being in bed by nine thirty
pm every night. Does that mean that I'm usually the
first to lead the party? Yep? And you know what,
I'm okay? Because I love my sleep and I prioritize it.

(16:06):
I really do. On top of that, you really have
to power down electronics and screens. I mean they say
ninety to one hundred and twenty minutes before bed. I
know that's hard. In my house, we do watch TV
before bed. It is something we do, but it's not ideal.
And so the best thing to do is to power

(16:28):
down those devices because that blue light that's coming at
you from those devices, they're also disrupting your body's ability
to naturally make its melatonin, and naturally your body is saying,
oh there's a light, it's daytime. It is not time
for bed. You power down those screens so your body
can be like, okay, now it is time. Let's convert

(16:48):
some of this serotonin into melatonin, and that melatonin is
gonna tell my brain it's time for bed. By keeping
those screens on, you're disrupting that circadian rhythm. You're working
against your body to get to sleep. It is what
it is. What else can we do? We also know
exercising every single day, and that doesn't mean going to
the gym and being a weightlifter and blah blah blah

(17:09):
all that stuff. It means just move your body a
little bit. You know, I was working in the hospital yesterday.
I did not get to the gym before or after,
but I did use the stairs. I didn't use the elevator,
and I kind of did two steps at a time,
went as fast as I could, just trying to move
my body a little bit. Because if you move your
body during the day, you get your you know, reach
that goal heart rate, get your heart and your blood flowing.

(17:32):
That does help you sleep at night. Some people like
to shower or sama at night and that can help
you relax and kind of set the mood for the day.
And another thing that is actually really good as we
head into the holiday season is to forgive yourself and
say it's okay not to say yes to every single party.

(17:52):
I promise you they'll still be your friends even if
you say no to their holiday party. This year, we
tend to overdo it during the holiday and while we
tell ourselves, all right, we just need to power through
these next two months and then we're going to recover
in January, the reality is we don't recover in January.
We power through it and then we power through something
else that happens in January, February, and March. So that

(18:14):
mentality is terrible. Like I said, on the short term,
you are affecting your body, your brain, So don't power
through anything. You know, pace yourself. You know, it's a marathon,
not a sprint, and you have to be enjoying every
moment of your life because every day is a blessing
and nothing is guaranteed. So please don't power through anything.

(18:36):
Prioritize yourself, prioritize your family and your friends, and focus
on your sleep. If you really are struggling to get
some sleep, you can go talk to your doctor. They
may have some advice, but you may still consider low
dose melatonin. You know, I'm not opposed to it, even
after this scary study came out. You know, I put
together we all know that I love liquid herbs. My

(18:59):
sleep formula does have a microdose of melatonin and it's
two milligrams, but it also has a whole bunch of
other natural herbs that are meant for calming. You know,
we have lavender, camo meal, I love hot tea before bed.
Those natural herbs can also help calm you. I don't
want anybody to be super freaked out about this melatonin study.

(19:20):
I take it with you know, take it with caution.
I'm certainly going to avoid those prescription melatonins, I'll tell
you that much. I oppose to microdosing of melatonin and
taking it occasionally. Now, I'm not If you find yourself
really not able to sleep without melatonin, take a look
at the lifestyle and your bedtime routine because maybe making

(19:40):
some changes there are really what your body needs, not
so much the melatonin. But so that's my uh, that's
my little saga when it comes to melatonin, that study sleep,
getting through the holidays, and we're all in this together everyone, Okay.
If you have any tips on what helps you sleep,
please reach out to me on social media and Instagram. Thanks,

(20:01):
whatever it is, send me a message. I love hearing
other people's tips and tricks because sleep is crucial and
if there's one thing that you want to prioritize in
your life, it is your sleep. So I'm open to
hearing from all of you. Thank you so much for
listening to Wellness Unmass. I'm doctor Nicole Safire. Make sure
you listen to Wellness on Mass on iHeartRadio wherever you

(20:22):
get your podcasts, and we will see you next time.