Melatonin, a natural hormone secretes from pineal gland has been identified as a good option to control the COVID19. Although the studies are in it’s early stages there is a hope that it can control the COVID19 effectively.
There are certain properties that the drug has which we discuss later can improve the patient condition in COVID19.
What is Melatonin ?
Melatonin is a hormone secretes from pineal gland of the brain. It basically control the biological clock of the human. It means the hormone can promote sleep. But it need to be understand clearly that it only can promote the sleep and it can’t make you sleep.
Because sleep is process which need clear mind and calm surrounding. Melatonin can make your mind clear but if your in a bright light or very noisy environment or you continuously using your cell phone or laptop before sleep even melatonin can’t helps you.
Melatonin secretion promotes by the environmental changes. The studies have shown that at the evening or when the surrounding is dark our body produce more hormones. Because our body prepares us to a good sleep.
Even though it is famous for promoting sleep, newer studies and found that certain properties of it helps to control the COVID19 and other virus related diseases.
How it helps in COVID19 ?
There are several properties that the medication has which can make this is a best drug for COVID19.
The anti inflammatory action
COVID19 and similar other diseases like SARS and MERS are doing much harm by the inflammatory response than viral load in the body. The virus cause inflammation of the body tissues. There are several inflammatory mediators that are produced with this process.
This inflammatory substances can even damage to our body cells as well. The higher the production, higher the damage. Once the inflammatory substances like cytokines become increased it’s called “a cytokine storm”.
A cytokine storm can damage body organs and blood vessels to become more permeable. So body fluids tend to filter out from the vessels.
The autopsy studies of the patients who died from COVID19 have shown they have high number of cytokines and it leads to multi organ failure. Multi organ failure can present as kidney failure, heart failure, liver failure or acute respiratory failure and sepsis.
The other thing that scientists found was amount of virus or viral load is not the main cause to determine the degree of damage. It’s the strength of the inflammatory response. Even there can be genetic alterations due to high inflammation response resulting generate a chain reaction of inflammation. This can be very harmful to the patient.
Melatonin has an anti inflammatory property that can control the production of inflammatory mediators. It has several other pathways to making this possible. Melatonin even can control the genetic alterations to avoid getting a cytokine storm. It even has a proven benefit on protection of heart and liver.
The antioxidant property
Another method that COVID19 like viruses damage to human body is generating oxidative mechanism. There by oxidative products like free radicals mainly hydroxyl ions, nitric oxide ions are produced inside the body.
These oxidative ions can damage the body cells by changing protein structures. Anti oxidants like super oxide dismutase are helpful in controlling this process.
Melatonin has an ability to up regulate formation of antioxidants and down regulate the production of oxidative substances. Therefore the body gets more protection and have less harm from the disease.
Immune modulating effect
When the virus invade our body, our immune cells activate. Some immune cells grab these virus particles and present it to special cells called cytotoxic T cells. These T cells then produce a huge amount of substances that promote inflammation. This leads to a massive inflammatory response on body.
On the other hand there are some cells that can kill these viruses once they enter into our body. They are called as natural killer cells. Therefore less chance of producing massive inflammatory response.
The melatonin has an ability to improve our immune system by increasing the production of natural killer cells. Therefore the immune response doesn’t become an uncontrollable problem.
Therefore the damage occur to lung tissues from our own immune cells become less.
Controls the vascular complications
The other complication COVID19 patients get is fluid collecting in alveoli which are lung spaces. This leads to severe pneumonia and even sepsis. This occurs by inflammatory response causing damage the vessel wall cells. Therefore as a protective mechanism body produces a substance called VEGF ( Vascular Endothelial Growth Factors ).
Due to VEGF blood vessel permeability increases and fluids go out from the vessels to collect in alveolar spaces.
Melatonin has an ability to reduce the formation of VEGF and improve the respiratory function of these patients.
Multi organ protection
The COVID19 can damage not only lungs but also almost all organs in the body. Most patients die due to this multi organ failure.
Melatonin itself can protect heart, liver and even brain from inflammatory responses. It has a proven benefit on reducing brain oedema as well.
How safe is melatonin ?
It is proven that melatonin is pretty same for human. Even acute lung injuries scientists can safely use higher doses of melatonin to control the condition. It is verified that short term use of melatonin is acceptable even it can cause some adverse effects like headache, sleepiness and dizziness.
There have been used up to 10 mg of melatonin doses in ICU patients with COVID19 and had satisfactory results. However it should be carefully monitored in a special hospital settings if we are going for higher doses.
However the recent studies on melatonin give satisfactory results on using it for COVID19 patients as an effective drug with lower side effect profile.
Other benefits of melatonin
The drug can be used to certain other health issues like,
- Sleep disorders – it’s well known drug to treat sleep problems. It can give you a good quality sleep. And it is also recommended for hypertensive patients as they may some time develop poor sleep due to their medications like beta blockers ( eg: propranolol, atenolol ). Also it can be used to avoid jetlag symptoms like daytime sleepiness.
- Reduce pain in uterine disorders – it’s proven that using melatonin can lower the pain in endometriosis and even menstrual pain. It will helpful to lower the painkillers use also.
- Control the blood pressure – studies show that taking a night till pill of melatonin can reduce the blood pressure. But this only happen with controlled release tablets not with the immediate release ones.
- Reduce the anxiety before surgery – it says taking an under the tongue pill of melatonin can reduce the surgery associated anxiety.
- Use with chemotherapy – there are proven benefits of using melatonin with chemotherapy to reduce tumour size. And it will reduce the surgery rates as well.
- Improve the platelet count – it is effective to increase the platelet count in certain diseases like cancers as there are low platelet levels.
What are the side effects ?
Melatonin is proven as safe in both adults and children in short term use. There are studies that prove adults can use this drug in long term at about 2 years duration. But for children and adolescents it’s better use this for short period of time. However as side effects headache, dizziness, stomach cramps, daytime sleepiness can occur. There are no serious side effects notes.
In pregnancy and breastfeeding it’s better to avoid melatonin oral or IV preparations. Although the studies don’t give clear idea about this, there are possibilities that melatonin can work as same as birth control drugs. Therefore in pregnancy and who are willing get pregnant in near future, better avoid melatonin.
There are studies that say this drug can increase the blood sugar levels in diabetic patients. Therefore diabetic patients should use this drug with good caution. It better to monitor their blood sugar values regularly when taking melatonin.
Because of it’s capability to improve body immune system, there is a possibility that organ transplanted patients get troublesome experiences. Because they need to be in low immune state until their new organ adequately adapts. Unless their immune system attacks the new organ and transplant become fails.
What are the melatonin preparations ?
There are oral tablets both slow releasing and rapid releasing types. And also there are under the tongue tablets which gives rapid action.
There are intravenous and intra muscular injections of melatonin as well. And you can find melatonin topical application to apply on skin which uses to avoid sunburns.
- COVID-19: Melatonin as a potential adjuvant treatment by Rui Zhang, Xuebin Wang, and Russel J. Reiter