300 mg in people
In a study of 31 people with ALS, 300 mg/day of melatonin given
rectally was well tolerated for up to two years. Serum protein
carbonyls, a marker of oxidative protein damage, were elevated in
the ALS patients and returned to control values during treatment.
This is the closest human precedent for the dose and the
oxidative-stress question. Weishaupt et al., 2006.
Antioxidant markers in trials
A meta-analysis of 12 randomized placebo-controlled trials in
patient populations found that melatonin increased total
antioxidant capacity, glutathione, and the antioxidant enzymes SOD,
glutathione peroxidase, and glutathione reductase, and reduced
malondialdehyde, a lipid-oxidation product. Morvaridzadeh et al., 2020.
Why F2-isoprostanes
F2-isoprostanes form when free radicals oxidize arachidonic acid in
cell membranes. In the NIH-led Biomarkers of Oxidative Stress Study,
a multi-laboratory validation effort, isoprostanes in plasma and
urine were among the few candidates that reliably rose with
oxidative injury, alongside malondialdehyde and urinary 8-OHdG.
Measuring them in urine against creatinine corrects for how dilute
the sample is. Kadiiska et al., 2005.
Why the liver panels
A systematic review of 79 randomized trials using at least 10 mg
(3,861 participants) found no detectable increase in serious
adverse events in the four low-bias trials, but more drowsiness,
headache, and dizziness. Menczel Schrire et al., 2022.
The MELATOMS-1 trial gave 300 mg/day orally to people with primary
progressive multiple sclerosis alongside ocrelizumab. It was stopped
early after liver enzymes rose in 3 of 4 melatonin-treated
participants and none of 4 on placebo, first detected at the 1- and
3-month checks. The rise returned when one participant restarted
melatonin. The authors point to competition with other medications
in shared liver drug-processing pathways, and the trial restarted at
100 mg/day with closer monitoring. That is why liver markers are
measured at both visits. MELATOMS-1, 2026.
Melatonin, food, and MTNR1B
In a randomized crossover trial of 845 people, an evening glucose
test taken one hour before habitual bedtime, when melatonin was 3.5
times higher, produced lower insulin and higher glucose than the
same test four hours before bedtime. The effect was stronger in
carriers of the MTNR1B risk variant. Garaulet et al., 2022.
In a smaller study of 17 women, melatonin before a morning glucose
test worsened glucose tolerance about six times as much in
risk-variant carriers as in non-carriers; the evening difference
was not significant. Garaulet et al., 2015.
Both studies gave food or glucose while melatonin was high, the
combination my dose timing avoids.
The cold feeling
Melatonin increases heat loss through the skin and slightly lowers
core body temperature, mostly in the first hours after a dose,
which matches when I felt it. The size of the drop levels off
quickly: a meta-analysis of 30 datasets found about 0.2 °C at 5 mg
and little additional drop above that. In a separate dose study, 1
mg and 5 mg lowered temperature by a similar amount, but only 5 mg
kept it down for the whole session. Those studies used daytime
doses far below 300 mg. Marrin et al., 2013;
Dawson et al., 1996.
Sources
- Weishaupt et al., Journal of Pineal Research, 2006: 300 mg/day in ALS; protein carbonyls.
- Morvaridzadeh et al., Pharmacological Research, 2020: meta-analysis of oxidative-stress markers.
- Kadiiska et al., Free Radical Biology and Medicine, 2005: Biomarkers of Oxidative Stress Study II.
- Menczel Schrire et al., Journal of Pineal Research, 2022: safety of higher melatonin doses.
- MELATOMS-1 liver findings, 2026: 300 mg/day with ocrelizumab.
- Garaulet et al., Diabetes Care, 2022: dinner timing, melatonin, and MTNR1B.
- Garaulet et al., Metabolism, 2015: melatonin, glucose tolerance, and MTNR1B.
- Marrin et al., European Journal of Applied Physiology, 2013: melatonin dose and core temperature.
- Dawson et al., Journal of Pineal Research, 1996: temperature at 0.1–5 mg.