Melatonin & St. John's Wort

[camismom]

Anyone know what the max safe dose of Melatonin is? Cami has had some trouble here and there with falling asleep and her usual 3 mgs. don't seem to be doing the trick anymore. I want to get her back on target before school starts back.

Also, what is the recommended dose for someone my age (36) of St. John's Wort?

Answers will be much appreciated.

[catatonic]

Christy,
Melatonin has not been sufficiently studied in children to establish a maximum safe dosage, however, you are probably fine with up to 5mg. Here's what the Natural Pharmacist says about it:

Sleep Problems in Children

A 4-week, double-blind trial evaluated the benefits of melatonin for children with difficulty falling asleep. A total of 40 children who had experienced this type of sleep problem for at least 1 year were given either placebo or melatonin at a dose of 5 mg. The results showed that use of melatonin significantly helped participants fall asleep more easily. Similar results were seen in a double-blind, placebo-controlled study of 62 children 80 and in a study of 20 developmentally disabled children with sleep problems.

You can read the entire write-up on melatonin here:
healthlibrary.epnet.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-5fe33da65dd4&chunkiid=21811

Keep in mind that there is no data on the long-term safety of melatonin consumption. It's a hormone and manipulating hormones always carries the risk of unintended side-effects. While melatonin appears safe at this point, it's probably still a good idea to have a melatonin holiday now and then to insure that the body's normal hormone production processes continue to function adequately. Maybe try skipping it for a week, and then go back to the usual dose? I think that's what I'd do.

In an article prepared for the Center For The Study Of Autism, Dr. Panksepp recommends:

If a low dose of melatonin that has been effective for some time seems to be losing its effect (i.e., tolerance is setting in), one is wiser to stop giving the supplement for a while rather than increasing the dose. Some parents seek to restore the desired effects by increasing the doses, but that only seems to intensify the tolerance process. It is better to take a week to a month off, and then see whether sensitivity has returned. In our experience, sensitivity is usually restored in this way.

You can read the full article at:
www.autism.org/melatonin.html

As for St. John's Wort, your dosage would be in the range of 300mg 3 times daily, or 500mg twice daily. (This would be of a product standardized to contain 0.3% hypercin.) You can read about it in detail here:
www.wholehealthmd.com/print/view/1,1560,SU_824,00.html

[camismom]

Thanks Cat!! That was just what I needed!! You're a Godsend!

[catatonic]

My pleasure.

[loveforeric]

Cat;
Thanks for the info on Melatonin and St. Johns Worts.

Have a peaceful day,
Christina

[AnneM]

Picking up on the St Johns Wort for a second ... Sam takes 300 mg in a "once a day" tablet ... (and is hence only getting a total of 300 mg in a day) ... is this therefore a pretty low dosage?

[catatonic]

Anne, since Sam is adult size, he can certainly take an adult dose. The 900 - 1,000 mg recommendation is for an adult. So yes, you are on the low side. A child under 80 pounds would take half that amount (or 450 - 500mg), one between 80 - 110lb 2/3 that amount (or around 600mg), and anyone over 110lb ought to be fine with the adult dose.

[AnneM]

Thanks so much Cat !! .. In fact he has been SOOO fine on the 300 mg and still is so we won't mess with it for now ... but its very good to me to hear that this is in fact a "low" dosage which means that if ever its necessary (please NOOO!!) then there IS considerable room for an increase!!

I honestly didn't know this was a low dosage until this thread ... so THANKYOU!!

[pratima]

Caution...You might want to be careful with St. John's Wart. It builds up in the system. Ideally, you should take 2 weeks on 2 weeks off. To avoid any damage to the liver. Just a word of caution from a girl who spent a year studying herbs & herbal remedies.

[AnneM]

Hi and WELCOME and thanks Pratima

I must admit that your statement regarding SJW and liver damage gave me a fright .... so I went off to do some "research" and I can't find anything at all on this connection . ... but maybe I am looking in the wrong directions!! ... If you have any further information or links you can send me too I would be really grateful ....

Thanks!!

[camismom]

annem said:

Hi and WELCOME and thanks Pratima

I must admit that your statement regarding SJW and liver damage gave me a fright .... so I went off to do some "research" and I can't find anything at all on this connection . ... but maybe I am looking in the wrong directions!! ... If you have any further information or links you can send me too I would be really grateful ....

Thanks!!

count me in on that as well... I have never heard of this.

[catatonic]

There is a fair amount of research on St. John's Wort and liver function. In brief, here are the high points that I am aware of:

--- St. John's Wort will decrease the effectiveness of some medications because it increases their clearance rate through the liver. These include oral contraceptives, anti-retrovirals, some chemotherapy agents, some anti-epileptics, HIV meds, immunosuppressants.

-- St. John's Wort should not be taken by pregnant women or nursing mothers because it can result in a toxic load for the baby's liver. (These studies were done on rats, at the level of 100mg/kg, comparable to a 100 pound human taking 4,500mg/day of SJW.)

-- St. John's Wort increases certain liver enzymes (which is why the meds clear faster and are less effective). See Wang Z, et al. The effects of St. John's wort (Hypericum perforatum) on human cytochrome P450 activity. Clin Pharmacol Ther 2001 Oct;70(4):317-26

As far as I know, SJW does not accumulate in the liver. In fact, it is often touted as a liver de-toxification herb because of its action on elevating liver functions. Often people with Hepatitis C will take St. John's Wort to help improve liver function.

As one expert in the field summarizes:

"As far as I know, there's not much toxicity associated with this drug, but people need to be aware that St. John's wort is just that—a drug," says Joel E. Gallant, MD, MPH, of Johns Hopkins University School of Medicine, who has written on the interactions of St. John's wort with other drugs. "It can interact with other kinds of medications, so if someone is thinking about incorporating it into their diet, they really need to make sure that it won't react badly with something else that they are taking."

Do keep in mind, though, that long-term studies of SJW's safety have not been conducted. This is a very potent herb and must be treated with respect.

[AnneM]

Thanks very much Catatonic!!

[pratima]

I'll go back to my research and let you know. Alot of my books are currently packed away, as we are in the process of moving. I may have been mistaken about potential damage to the liver, but I do remember several cautions in numerous herbal books about SJW accumulating in the system and all them recommended the 2 week on 2 week off method. It IS a very potent herb, and should be used with caution. I tried it myself, and found that it made me very irritable. I would never recommend giving it to a kid. That's my own personal feeling though.

HOpe this helps. If I can find some of my herbals without unpacking my entire library, I'll give ya'll a few references. One of my personal favorites is Jude's herbal. I don't remember if there was anything in there though.

Pratima

[AnneM]

Thanks pratima ... would appreciate anything you can find !!