Melatonin For Lupus: What does the Research Show?
(Updated August 2021)
Why do people think that melatonin for lupus patients is unsafe?
Many people think that melatonin for lupus and other autoimmune diseases is unsafe. I believe it is due to there being outdated websites and patient education pages that state this. For example, it even occurs on highly-acclaimed sites such as the Mayo Clinic.
However, how can the Mayo Clinic be wrong?
Without a doubt: many excellent websites produced their patient education pages a long time ago.
In addition, there are not enough staff to check and update them on a regular basis.
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
– Firstly, 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.
– For instance, when there are less Tregs (a common problem in lupus), bad B-cells that make dangerous lupus autoantibodies (such as anti-dsDNA) can live a very long time (and even forever, “immortal”).
– Secondly, 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
– As an example, 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
– In another case, an experiment was performed on female mice that were prone to getting lupus. Surprisingly, they were less likely to develop lupus when fed melatonin per Zou!
– 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 for lupus in humans?
– However, 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, because there is no evidence to support that recommendation.
– Nevertheless, there is a study in people with rheumatoid arthritis (a related autoimmune disease).
– Contrarily, melatonin did NOT worsen rheumatoid arthritis in these patients (Maestroni et al, referenced below)
Firstly, I do not ask my patients with lupus to avoid melatonin.
Secondly, there is actually more evidence that melatonin may be beneficial for lupus rather than harmful.
Thirdly, lupus patient education websites should remove their recommendations to avoid melatonin.
Finally, these sites and pages about melatonin for lupus are outdated.
Andersen LP, Gögenur I, Rosenberg J, Reiter RJ. The Safety of Melatonin in Humans. Clin Drug Investig. 2016 Mar;36(3):169-75. doi: 10.1007/s40261-015-0368-5. PMID: 26692007.
Jimenez-Caliani AJ, Jimenez-Jorge S, Molinero P, Rubio A, Guerrero JM, Osuna C. Treatment with testosterone or estradiol in melatonin treated females and males MRL/MpJ-Faslpr mice induces negative effects in developing systemic lupus erythematosus. J Pineal Res. 2008 Sep;45(2):204-11. doi: 10.1111/j.1600-079X.2008.00578.x. Epub 2008 May 27. PMID: 18507713.
Lin GJ, Huang SH, Chen SJ, Wang CH, Chang DM, Sytwu HK. Modulation by melatonin of the pathogenesis of inflammatory autoimmune diseases. Int J Mol Sci. 2013 May 31;14(6):11742-66. doi: 10.3390/ijms140611742. PMID: 23727938; PMCID: PMC3709754.
Maestroni GJ, Otsa K, Cutolo M. Melatonin treatment does not improve rheumatoid arthritis. Br J Clin Pharmacol. 2008;65(5):797-798. doi:10.1111/j.1365-2125.2007.03088.x
Zhou LL, Wei W, Si JF, Yuan DP. Regulatory effect of melatonin on cytokine disturbances in the pristane-induced lupus mice. Mediators Inflamm. 2010;2010:951210. doi: 10.1155/2010/951210. Epub 2010 Jul 20. PMID: 20706659; PMCID: PMC2913856.