Lupus Encyclopedia

Updated 4/10/21

Why do people with lupus think it is unsafe to take melatonin?

It is because there are outdated websites and patient education pages that state this. It even occurs on highly-acclaimed sites such as the Mayo Clinic.

How can the Mayo Clinic be wrong?
Most likely: there are tons of patient education pages that were produced a long time ago.
There is probably no one who polices and up dates them.
Certainly the doctors are way too busy to do this: they are taking care of patients and doing research.

Theoretically, melatonin may improve the immune system in lupus
     and other autoimmune diseases

- One problem in lupus is that there are lower numbers of important white blood cells called Tregs (regulatory T-cells).
- Tregs help to normalize the immune system and prevent overactivity.
- With less Tregs, bad B-cells that make dangerous lupus autoantibodies (such as anti-dsDNA) can live a very long time (and even forever, "immortal").
- Melatonin does effect the immune system. One of the things it can do is increase these important Tregs that could be helpful in lupus and other autoimmune diseases
- The 2013 research article referenced below by Lin GJ et al and the 2019 article by Zhao et al go into detail about this

What happens to lupus mice when they are given melatonin

- When melatonin is given to female mice that are prone to getting lupus, it prevents them from getting lupus!
- This was shown in a 2010 study by Zou LL et al and another in 2008 by Jimenez-Caliani AJ et al (referenced below)

How about humans?

 - There are no studies of using melatonin in people with lupus.
- This is a huge reason why it is incorrect to tell people with lupus not to use melatonin. There is no evidence to support that recommendation.
- However, there is a study in people with rheumatoid arthritis (a related autoimmune disease).
     - Melatonin did NOT worsen rheumatoid arthritis in these patients (Maestroni et al, referenced below)

_________________________________________________________________________

BOTTOM LINE:

I do not ask my patients with lupus to avoid melatonin.
There is actually more evidence that it may be beneficial rather than harmful.
Lupus patient education websites should remove their recommendations to avoid melatonin.
​These sites and pages are outdated.

REFERENCES:
​https://pubmed.ncbi.nlm.nih.gov/31345729/
​https://pubmed.ncbi.nlm.nih.gov/23727938/
https://pubmed.ncbi.nlm.nih.gov/18507713/
https://pubmed.ncbi.nlm.nih.gov/20706659/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2432495/

​A gift for Christmas 2020, since I'm a 90-Day Fiancé fan. Angela wishes me a Merry Christmas and mentions my book. She looks great since her weight loss surgery and she must still be with Michael of Nigeria since she mentions him as well. Merry Christmas to you, Angela!

​- Maintain a regular sleep schedule; get up and go to bed the same time daily even on non-work days and holidays.
- Reduce stress in your life.
- Get exposure to light first thing in the morning to set your biological clock. Consider using a non-UV source of light exposure such as the Philips goLITE or the Miroco non-UV light.
- Exercise daily; mornings and afternoons are best. Don’t exercise right before bedtime.
- Avoid naps late in the afternoon or evening.
- Finish eating two to three hours before bed; a light snack is fine, but avoid foods containing sugar as it can stimulate the mind and interfere with falling asleep.
- Limit fluids before bed to keep from getting up to urinate throughout the night.
- Avoid caffeine six hours before bed.
- Do not smoke; if you do, don’t smoke for two hours before bed; nicotine is a stimulant.
- Avoid alcohol two to five hours before bed; alcohol disrupts the sleep cycle.
- Avoid medicines that are stimulating (ask your doctor).
- Avoid stimulating mind activities for a few hours before bed (reading technical articles, listing tasks to do, trouble-shooting, paying bills, etc.).
- Have a hot bath one to two hours before bed; it raises your body temperature and you will get sleepy as your temperature decreases again afterward.
- Keep indoor lighting low for a few hours before bed.
- Establish a regular, relaxing bedtime regimen (aroma therapy, drink warm milk, read, listen to soft music, meditate, pray, do relaxation/breathing exercises).
- Ensure your sleeping environment is quiet and comfortable (comfortable mattress and pillows; white noise like a fan; pleasant, light smells).
- If pets ever wake you, keep them outside of the bedroom.
- Use the bedroom only for sleep and sex; never eat, read, or watch TV in bed.
- Never keep a TV, computer, or work materials in your bedroom.
- Go to bed only when sleepy.
- If you can’t go to sleep within fifteen to twenty minutes in bed, go to another room and read something boring under low light, meditate, pray, listen to soft music, or do relaxation/breathing exercises until sleepy.
- If you have dry mouth problems, use a mouth lubricant such as Biotene Mouth Spray before you go to bed.

​You think you own me
Squeezed my life in your palms
Taken over my body
You think you are me
Lupus
You think because
You've hijacked this vessel that you're captain
You think you can get away with mutiny
But see
I'm still the same me
The same beautiful butterfly floating on the breeze
I ain't scared to wrestle the wind
To battle Raynauds thorns
Not afraid to diss this disease
To find peace
Be at ease with this disease
I miss my old life but I'm fashioning a new one with this disease
In no way am I saying this is easy
The way my cells fight themselves
That my chest being in a cage of pleurisy
That my scalp cries strands of my hair
That the pain in my knees which interfere with my prayers
Make it hard to sometimes find the joy in life
Makes the sun less bright
But I know no matter what
There's nothing that'll take away my fight
When it seems to make my day feel like night
I'll still reach for a star
When it seems my world spins left
I've resolved to force it to revolve right
And even if my limbs refuse to move
My spirit will still dance
Every day I'm going to
Choose to enhance this universe with my presence
In any way I can
Lupus is not me
But it's the spark that created a flame
My disease is not me
But it's the source of my vanity
Lupus you can't damage me
Because my body isn't all I possess
I still have a purpose
A reason to smile
I'm still living my life with no regrets.

Copyright Shanelle Gabriel