In this article:
Optimizing our hormones is often the key to mastering frustrating health problems, including sleep problems. One of the primary ways we regulate our sleep-wake cycle is through melatonin, a hormone produced in our brains. Ensuring your melatonin levels are optimal can better your rest each night and may even enhance your thyroid health.
What does melatonin do?
Melatonin is a hormone produced by the pineal gland in your brain. Intriguingly, the retinas in your eyes make a small amount of this hormone.
Light controls the synthesis and release of this hormone. Changes in light are detected and transmitted through the retina to the pineal gland. When exposed to sunlight, melatonin production is suppressed to be more awake and alert. When daylight wanes, and darkness falls, melatonin levels increase, making us feel more sleepy. Studies of melatonin levels show that melatonin increases in the evening, peaks between 2 and 4 am, and begins to wane till daybreak.
The circadian rhythm
Melatonin is a part of the circadian rhythm, and this rhythm acts like our internal clock, a 24-hour cycle. However, it is controlled by an even larger clock (considered the "master clock") in the brain, which is found in the suprachiasmatic nucleus (SCN) of the hypothalamus. The SCN is highly sensitive to light, so this external cue controls everything from when we sleep to when we eat.
The circadian rhythm affects numerous systems, including:
- Hormone regulation and secretion
- Our eating habits
- Digestive functioning
- Blood sugar control
- Body temperature
We have consistent and restorative sleep patterns when the circadian rhythm is aligned. However, when something throws this system off, it can lead to sleep and other health-related problems.
What disrupts melatonin levels?
Our circadian rhythm and its cyclical release of melatonin is a somewhat fragile system. So when we experience anything out of the ordinary, our whole system can be thrown off.
The most common cause of disturbance in melatonin levels is a change in the sleep-wake cycle. Jet lag is perhaps the most well-known. It occurs when people cross multiple time zones and have to accumulate to different day-night cycles than they had in their original location.
Shift work also impacts your circadian rhythm. Health care workers, security personnel, and nighttime equipment operators are examples of professionals affected by this problem. Shift work requires people to sleep during daylight hours and stay awake during darkness. This pattern is entirely counterintuitive to how our master clock operates. Moreover, night shift workers often "shift" back to sleeping during the night on their days off, throwing the system off even more.
Of course, clinical conditions also impact this natural rhythm, including advanced sleep phase disorder, delayed sleep phase disorder, and obstructive sleep apnea. In addition, non-sleep-related conditions can also interfere with sleep patterns, including uncontrolled GERD, Alzheimer's, diabetes, kidney disease, anxiety, and thyroid disease.
How does melatonin help hypothyroidism?
There is little research showing how melatonin levels impact thyroid function. Research shows that melatonin may act as an antioxidant, rounding up excess free radicals and preventing cellular damage.
Melatonin may also prevent thyroid cell proliferation and interfere with thyroid hormone synthesis. This effect may be beneficial for people with hyperthyroidism (overactive thyroid). Still, it may be problematic for people with normal thyroid function and certainly hypothyroidism. For this reason, people who take melatonin regularly may need to check their thyroid levels to be sure they are optimal.
But before assuming melatonin may further hinder an already underactive thyroid, poor sleep quality also negatively impacts the thyroid by increasing stress in the body.
Melatonin and autoimmunity
Perhaps even more critical is melatonin's role in autoimmunity. Hashimoto's thyroiditis is an autoimmune thyroid disease that targets the thyroid gland. Hashimoto's is the leading cause of hypothyroidism in the United States.
The immune system is greatly affected by melatonin, as it activates and suppresses certain immune functions. In particular, melatonin may curb inflammation and has the potential to regulate the immune system overall when it is taken as a medication.
Research also shows that melatonin helps regulate immune function in the gut, where most of our immune system resides. According to leaky gut theory, autoimmune diseases may be partly due to toxin release through the gut membrane. Over time, an accumulation of toxins can target specific tissues and cause the immune system to become overactive.
How to take melatonin
There is a delicate balance between melatonin and thyroid hormone production. And, because melatonin may suppress thyroid hormone production while simultaneously hindering thyroid inflammation from Hashimoto's, it is important to consult your doctor before adding this strategy to your overall thyroid care plan.
If you start taking melatonin, you will likely need to check your thyroid hormone levels within a few weeks to ensure you are still at optimal levels.
Most people start on 1 to 3 mg of melatonin daily. It is best to take it about two hours before bedtime, as melatonin levels naturally rise around this time.
Once you take melatonin, try to turn off any distractions, including your phone, tablet, and television. Also, dim the lights to entourage melatonin levels to rise.
Side effects of melatonin
When taken in appropriate amounts, melatonin is generally considered safe. It can provide insomnia relief, promote relaxation before rest, and is ideal for short-term use.
As with most things, melatonin supplements may cause a few side effects, including headache, nausea, dizziness, and drowsiness. More rarely, melatonin may cause depression and mild anxiety, mild tremors, decreased alertness, and abdominal cramping.
Additional ways to sleep better with hypothyroidism
The first step to reducing fatigue with hypothyroidism and getting better sleep is to balance your thyroid hormones with thyroid hormone replacement medication. There is no one-size-fits-all approach to which thyroid medication is best for you, so consult with a thyroid doctor after taking a hypothyroidism test at home to create a personalized treatment plan.
Beyond treating your thyroid condition, there are additional strategies you can employ to sleep better with hypothyroidism.
Keep your bedroom comfortable
You want your brain to associate the bed with relaxation and sleep; no activation or stress. The bed should be for sleep, sex, and reading a book. Try not to bring electronics into bed, avoid watching television in bed, or bring work or emails into bed. A comfortable bedroom temperature can help you sleep better with hypothyroidism, especially if you struggle with thyroid-related symptoms like sleep disturbances or temperature regulation.
Balance your blood sugar
Stabilize your blood sugar overnight, especially if you wake up in the middle of the night or have difficulty staying asleep. Eat a meal with protein and fat at dinner, avoid sweets, refined carbs, and alcohol, and take a spoonful of coconut oil or MCT oil right before bed.
Minimize the light
Be strategic about light in the way human beings were evolutionarily designed. Open your blinds when you wake up. Get outside during the day. Dim your screens in the evening and the lights in your home after dark. And wear an eye mask while you sleep.
Destress before bed
It's challenging to drop into a relaxed state after a long day. Put work away and close electronics at least one hour before bed. Create a nighttime ritual for winding down before bed. Try a shower/bath by candlelight, gentle stretching, meditation, or reading a book until you feel sleepy.
Monitor your caffeine and alcohol
Caffeine has a half-life of about five hours. If you drink a coffee at 3 pm, it's as though you drank half a coffee at 8 pm. Stop all caffeine earlier in the day, or consider gradually eliminating it. Alcohol also disrupts sleep architecture, causing restless sleep. If you find you toss & turn on nights when you drink alcohol, reduce or eliminate alcohol, especially close to bedtime.
A note from Paloma Health
Before adding melatonin to your thyroid treatment plan, talk to your healthcare provider about the best strategy for you.
Your thyroid doctor will want to check your thyroid function when changing your treatment regime. Taking a hypothyroidism test at home is easy. Your at-home thyroid test kit comes with everything you need for sample collection and sample analysis of TSH, free T3, free T4, and TPO antibodies, with the option to add on reverse T3 and/or vitamin D.
Your thyroid test kit is sent directly to your address, requires an easy finger prick, and then sent back to the lab with pre-paid shipping. Your thyroid lab results are released to your secure online dashboard within days, similar to the wait time for in-person lab results, without the inconvenience.