I have spent some time with this study. On first glance, it seems like a large study that finds a real association between chronic melatonin use and the risk of heart failure. Upon further reading and digging into the article, red flags start to wave. “Long-term” melatonin use: you take it every night? Once a week? Twice a month? The study does not say. Likewise, melatonin concentrations vary from one preparation to another. Are these controlled for? No. The two groups of insomniacs are supposed to be equivalent, but how do we know? The provided tables look equivalent, but lurking in between the unmentionables in the table might be vast differences. So the whole enterprise was filed under “interesting but probably rubbish” category.
When I was a kid in the 80s, a common adage was “don’t believe everything you see on TV”. Did it take 20 yrs for that wisdom to develop? Maybe it will take another 10 yrs for the wisdom “don’t believe everything you read on the internet” to sink in.
Seems like most media is now filled with churnalism and snake oil. Its like only getting your knowledge from “infomercials”!
While the post appropriately highlights the flaws in the data, there is no clear mention of the basic distinction between cause and correlation. This is a classic example of data collection being presented as science. The most egregious aspect is that this garbage can make it to the AHA. All this proves is that the AHA is a joke, a fact that doesn't require scientific proof.
On the one hand, it seems even the most generic layperson these days knows to say “correlation is not causation”.
OTOH, these “churnalists” are doing it to attract eyeballs (and they wouldn’t bother if it didn’t), so it seems there are still plenty of people who fall for this sort of flotsam.
Always question the source. What is the motivation? I have thoroughly reviewed the literature on melatonin. Experimental studies using doses up to 6000 milligrams have found to be non-toxic. The conclusion is the same that I see constantly. Using relative statistics versus absolute statistics. The difference was insignificant. It is well known, 80% of all medical studies are flawed or useless.
Melatonin has pleiotropic effects. Antioxidant, enhancing P53 as an anti-cancer agent. Doses above 10 milligrams are therapeutic. I am so tired of " a new study found ____ can be dangerous."
When I saw all of the press releases I did a literal eye roll!! My first thought-By what mechanism is melatonin leading to heart failure? Of course, none of the press releases (including the "study" which gets filed under "press releases" for its scientific rigor) identified any mechanism. All of it was breathless, "If you take melatonin, then you are going to die from heart failure" reporting. Of course, I had family members contact me in a panic. Next time, I will send them to Dr. Livingston since he is was more eloquent than I am!
Thank you for this piece. It is being added to my nursing research course this morning!
Thank you for an outstanding article on medical "journalism". I imagine we are in for a lot of it because of the prevalence of electronic medical records. Epidemiology on steroids. When friends and acquaintances bring up this sort of "news" in conversations, I always refer them to Sensible Medicine. We need to support these purveyors of reason and good sense in order to counteract the volumes of nonsense the general public is fed by mass media and, sadly, many of their own doctors.
JAMA/NEJM/APA/AHA and Lancets of the world can go to hell. It's a cesspool. I'd rather take advice from a psychotic schizophrenic dementia laden person. But that's just me. I used to respect these orgs. COVID response opened my eyes.
How can anyone believe anything in health studies, let along medical journalism. There is rampant fraud and corruption at every level.
Melatonin is attacked. Aspirin is attacked. And statins, PPIs, SSRIs, are all ubiquitous and praised and prescribed.
This study is of course horse manure, but so are almost all medical studies today. The biases are not that hard to find, either.
I do question most people who take more than 1 or 2mg of melatonin, if that is a good idea. Melatonin can be a powerful drug, taken orally or topically. It can be amazing on the skin.
But I’m not sure taking 10mg or 20mg for insomnia was ever a good idea. This study is worthless, but safety should always be questioned by anyone who is taking supplements, doncha think?
Lois, in the article, the author disclosures don’t seem to mention any ties to sleep aid companies. That’s assuming all the mentioned disclosures are exhaustive. I don’t want to sound cynical, but some authors are extremely fastidious about their disclosures but others are less so.
All good points about "churnalism." Here are a few more that should embarrass those who published these news reports, even assuming that the collected data is high quality, which I now gather it isn't.
1) The study has not even been published yet.
2) In the words of the study's author, "Worse insomnia, depression/anxiety or the use of other sleep-enhancing medicines might be linked to both melatonin use and heart risk....our study cannot prove a direct cause-and-effect relationship....This means more research is needed to test melatonin’s safety for the heart.”
3) The abstract mentions another major issue with the study: "Participants were excluded if they...had been prescribed other types of sleeping pills such as benzodiazepines." So, in the control group, there weren't *any* people under treatment for insomnia via drugs. In other words, this study provides no grounds to conclude that the association isn't totally due to insomnia bad enough to require pharmacological treatment. It is also totally silent on whether melatonin is better or worse for the heart than anything else prescribed for insomnia.
Well, this certainly puts things in perspective: "The dilemma is who is going to pay for a multimillion-dollar, long-term clinical trial using high-dose melatonin when it has been available as a low-cost dietary supplement for the last 30 years?" from the article linked by William Wilson.
True enough, and this all too common churnalism equates to 'click-bait' as far as I see.
Thanks for pointing this one out - I'd just seen it in a few places recently and thought, "What rubbish!"
Wait, they're Just Now deciding to "keep us safe from" this very widely used supplement, when we've had evidence like this?! Were they Sitting on it? Why would that happen, when we know the above dilemma is profit-motivated? If they could prove this, we'd long ago been forbidden melatonin use altogether by the pharma censors.
I have spent some time with this study. On first glance, it seems like a large study that finds a real association between chronic melatonin use and the risk of heart failure. Upon further reading and digging into the article, red flags start to wave. “Long-term” melatonin use: you take it every night? Once a week? Twice a month? The study does not say. Likewise, melatonin concentrations vary from one preparation to another. Are these controlled for? No. The two groups of insomniacs are supposed to be equivalent, but how do we know? The provided tables look equivalent, but lurking in between the unmentionables in the table might be vast differences. So the whole enterprise was filed under “interesting but probably rubbish” category.
When I was a kid in the 80s, a common adage was “don’t believe everything you see on TV”. Did it take 20 yrs for that wisdom to develop? Maybe it will take another 10 yrs for the wisdom “don’t believe everything you read on the internet” to sink in.
Seems like most media is now filled with churnalism and snake oil. Its like only getting your knowledge from “infomercials”!
While the post appropriately highlights the flaws in the data, there is no clear mention of the basic distinction between cause and correlation. This is a classic example of data collection being presented as science. The most egregious aspect is that this garbage can make it to the AHA. All this proves is that the AHA is a joke, a fact that doesn't require scientific proof.
On the one hand, it seems even the most generic layperson these days knows to say “correlation is not causation”.
OTOH, these “churnalists” are doing it to attract eyeballs (and they wouldn’t bother if it didn’t), so it seems there are still plenty of people who fall for this sort of flotsam.
Electronic medical records and studies utilizing the data are inherently flawed. The EHR lacks so much context.
Always question the source. What is the motivation? I have thoroughly reviewed the literature on melatonin. Experimental studies using doses up to 6000 milligrams have found to be non-toxic. The conclusion is the same that I see constantly. Using relative statistics versus absolute statistics. The difference was insignificant. It is well known, 80% of all medical studies are flawed or useless.
Melatonin has pleiotropic effects. Antioxidant, enhancing P53 as an anti-cancer agent. Doses above 10 milligrams are therapeutic. I am so tired of " a new study found ____ can be dangerous."
100% oxygen is harmful to the lungs. Should we all stop breathing? Or maybe we should admit that the poison is in the dose?
When I saw all of the press releases I did a literal eye roll!! My first thought-By what mechanism is melatonin leading to heart failure? Of course, none of the press releases (including the "study" which gets filed under "press releases" for its scientific rigor) identified any mechanism. All of it was breathless, "If you take melatonin, then you are going to die from heart failure" reporting. Of course, I had family members contact me in a panic. Next time, I will send them to Dr. Livingston since he is was more eloquent than I am!
Thank you for this piece. It is being added to my nursing research course this morning!
Thank you for an outstanding article on medical "journalism". I imagine we are in for a lot of it because of the prevalence of electronic medical records. Epidemiology on steroids. When friends and acquaintances bring up this sort of "news" in conversations, I always refer them to Sensible Medicine. We need to support these purveyors of reason and good sense in order to counteract the volumes of nonsense the general public is fed by mass media and, sadly, many of their own doctors.
JAMA/NEJM/APA/AHA and Lancets of the world can go to hell. It's a cesspool. I'd rather take advice from a psychotic schizophrenic dementia laden person. But that's just me. I used to respect these orgs. COVID response opened my eyes.
Do the authors describe a "before melatonin" and "after melatonin" heart condition?
What if people with heart disease had a higher tendency of insomnia, hence take melatonin?
How can anyone believe anything in health studies, let along medical journalism. There is rampant fraud and corruption at every level.
Melatonin is attacked. Aspirin is attacked. And statins, PPIs, SSRIs, are all ubiquitous and praised and prescribed.
This study is of course horse manure, but so are almost all medical studies today. The biases are not that hard to find, either.
I do question most people who take more than 1 or 2mg of melatonin, if that is a good idea. Melatonin can be a powerful drug, taken orally or topically. It can be amazing on the skin.
But I’m not sure taking 10mg or 20mg for insomnia was ever a good idea. This study is worthless, but safety should always be questioned by anyone who is taking supplements, doncha think?
Like always, dosage makes the poison. But also, these prof journal/orgs are a cesspool.
Simple question: do the authors have ANY connection to manufacturers of prescription sleep aids?
I have been taking melatonin for years. I don't intend stopping that.
Lois, in the article, the author disclosures don’t seem to mention any ties to sleep aid companies. That’s assuming all the mentioned disclosures are exhaustive. I don’t want to sound cynical, but some authors are extremely fastidious about their disclosures but others are less so.
All good points about "churnalism." Here are a few more that should embarrass those who published these news reports, even assuming that the collected data is high quality, which I now gather it isn't.
1) The study has not even been published yet.
2) In the words of the study's author, "Worse insomnia, depression/anxiety or the use of other sleep-enhancing medicines might be linked to both melatonin use and heart risk....our study cannot prove a direct cause-and-effect relationship....This means more research is needed to test melatonin’s safety for the heart.”
3) The abstract mentions another major issue with the study: "Participants were excluded if they...had been prescribed other types of sleeping pills such as benzodiazepines." So, in the control group, there weren't *any* people under treatment for insomnia via drugs. In other words, this study provides no grounds to conclude that the association isn't totally due to insomnia bad enough to require pharmacological treatment. It is also totally silent on whether melatonin is better or worse for the heart than anything else prescribed for insomnia.
Well, this certainly puts things in perspective: "The dilemma is who is going to pay for a multimillion-dollar, long-term clinical trial using high-dose melatonin when it has been available as a low-cost dietary supplement for the last 30 years?" from the article linked by William Wilson.
True enough, and this all too common churnalism equates to 'click-bait' as far as I see.
Thanks for pointing this one out - I'd just seen it in a few places recently and thought, "What rubbish!"
Wait, they're Just Now deciding to "keep us safe from" this very widely used supplement, when we've had evidence like this?! Were they Sitting on it? Why would that happen, when we know the above dilemma is profit-motivated? If they could prove this, we'd long ago been forbidden melatonin use altogether by the pharma censors.
I think I will stick with my high-dose melatonin:
https://www.lifeextension.com/magazine/2022/7/higher-dose-melatonin?srsltid=AfmBOopZ9CSLZ-XgwS2Kf1YM0JABVa11RZ6I-CJXiQK-4pFdLxwUsPFw