Using Melatonin to Fight COVID-19 | Part 3: Advanced Health:

Melatonin is extremely effective at boosting the immune system. This is critical to know especially if you or your loved ones become infected with COVID-19. Having a strong immune system is critical to not experiencing the havoc caused by the virus on our bodies.

When any pathogen (which basically means any organism which has the potential to produce disease) infects our body, it triggers and amplifies a full body immune response. For instance, when we inhale any virus which has the ability to infect lung cells, the lung’s dendritic cells gobble up the virus and destroy it. The pathogen’s (in this case, the virus’) remaining fragments (also called “antigens”) are then attacked and destroyed by our immune system’s cytotoxic CD8+ T cells. These T-cells kill infected lung cells by producing pro-inflammatory cytokines and in turn, recruiting additional immune cells which can eventually cause uncontrollable widespread damage throughout the lungs.

The pathogen and the killing of infected cells by the immune system together can cause our breathing system to collapse (also known as acute respiratory distress syndrome).

The clinical characteristics of COVID-19 suggest that only those people with a suppressed level of white blood cells are at an increased risk of becoming extremely ill. These people do not have a strong enough immune system capable of adequately controlling the havoc caused by our body’s natural immune response to destroying any pathogen.

Luckily for us, melatonin acts as an immunomodulatory agent which can dramatically boost our immune system fairly quickly. It does so by improving the proliferation and maturation of the immune system’s natural killing cells (i.e., T and B lymphocytes, granulocytes, monocytes, macrophages) capable of responding to threats and not overkilling to many cells. Since Melatonin is only naturally produced by our bodies when the sun sets and we close our eyes to rest, it is of utmost importance to get proper rest every night in order to adequately produce Melatonin from our brain. Melatonin is not produced when we are awake and looking at screens or exposed to the light emitted from electricity.

The following are my list of tips for boosting your melatonin levels by basically getting quality sleep every night:

Tips for Better Sleep

Keep a Regular Sleep Schedule. Go to bed and wake up at the same times every day, even during weekends. Consistency rewires the body’s internal clock and promotes better sleeping.
Go to sleep before 10:30 p.m. Melatonin is produced only once we are in deep sleep between 11 p.m. to 2 a.m. Each half hour you sleep before 12 a.m. is equal to 1 hour of quality sleep gained.
Avoid electronics (i.e., Kindle, phone) 2 hours before bed. The light emitted from electronic devices prevents Melatonin production.
Fast starting 3 hours before bedtime. Going to bed with a full stomach will hinder the ability to produce Melatonin.
Avoid any form of animal protein (i.e., meat, dairy products, poultry, fish), alcohol, and sugar at night. These items damage the digestive system and prevent the brain from producing Melatonin.
Drink 1 liter of warm water with your eyes closed upon awakening.
Do not start your day off with a caffeinated beverage (i.e., coffee, black tea, chai, energy drink). Instead, have a cup of hot water or a herbal tea mixed with 1 tablespoon of coconut oil and lemon extract -- blend well together.
Make brunch/lunch your day’s biggest meal, not dinner.
Get Comfy. Make your bedroom a place of comfort and relaxation. Let it be a place for only sleep and sex. Keep your bedroom’s temperature cool, well-ventilated, and quiet. Try using an air purifier and/or opening up the windows to help better ventilate your room. Wear earplugs or turn on a white noise machine to keep the room quiet. Dark curtains or blinds can help keep light out. Alternatively, wear an eye mask when you go to sleep. Choose a comfortable bed and bedding. If you have pets in the house, make sure they don’t disturb you during the night.
Limit Your Daytime Naps to 20 minutes maximum and ideally not after 5 p.m.
Engage in regular physical Activity during the day. It will help you feel more relaxed and improve your sleep quality. Try to avoid exercising 3 hours before bed since it is overstimulating and makes it harder to fall asleep soon after.
Stress Management. If your mind is busy thinking too much, you will have difficulty falling asleep. Try to relax and destress before you go to bed. Some stress management tips include deep breathing techniques, taking a break or holiday when you need it, going for a massage, or laughing long and hard. If you need more tips on how to manage stress, download our ebook.
Daylight Exposure. Make sure you get enough exposure to sunlight every day, especially morning sun. Open the curtains as soon as you’re up, drink your morning beverage outside, go out for breaks during the day, and exercise outside.
Try to avoid Nicotine, Caffeine, and Alcohol as much as possible. They damage the brain and gut. This translates to shutting down the immune system on a regular basis which causes a person to be more susceptible to experiencing the havoc caused by pathogens like COVID-19 on the body.
Take Melatonin 0.3 to 1 mg 1.5 hours before bed. If mixed with Chamomile tea, Valerian, Ashwagandha, California Poppy seeds, and/or Lemon Balm, it will further enhance your sleep quality and boost your immune system.

Recommended Sleeping Hours

Here are some guidelines to help you understand how much sleep you and your family members need:

Newborn (0 to 2 months): minimum of 18 hours each day
Infant (2 to 12 months): minimum of 15 hours each day
Toddler (1 to 3 years): minimum of 12 to 14 hours each day
Preschool (3 to 5 years): minimum of 11 to 13 hours each day
School age (5 to 12 years): minimum of 10 to 11 hours each day
Teenager (13 to 17 years): minimum of 8 to 10 hours each day
Adult (18 and older): minimum of 7 to 9 hours each day

In Sum

Stick to the recommended habits to improve your sleep cycle. You may not see a difference immediately, but over time your sleep cycle will improve. There are certain sleep disorders for which these habits may not help, such as apnea, restless legs syndrome, and narcolepsy. If you find that your sleep cycle doesn’t improve, make sure to visit your doctor.

One Last Note on Melatonin as an Immunomodulatory Agent:

NOD-like receptor 3 (NLRP3) inflammasome is part of the innate immune response during lung infection. Inflammasomes play a crucial role in innate immunity by serving as signaling platforms which deal with a host of pathogenic products and cellular products associated with stress and damage. The best studied and most characterized inflammasome is NLRP3 inflammasome. Activation of NLRP3 inflammasome is mediated by highly diverse stimuli; any pathogen, including a virus triggers NLRP3 activation to amplify the inflammation. As mentioned last week, there is a ton of research already completed about shutting off the immune system and controlling the inflammatory pathways activated by pathogens infecting human cells. The problem is these pharmaceutical drugs do further weaken a person’s immune system and cause them to be more susceptible to the havoc caused by any and all types of pathogens they are exposed to going forward.

So, don’t be fooled. The latest NLRP3 inflammasome-blocking drugs (or COVID-19 drugs) WILL NOT CURE YOUR PROBLEMS.

In a mouse model, inhibition of NLRP3 in the early phase of infection increased mortality, whereas suppression of NLRP3 at the peak of infection provided protection from mortality (Tate et al., 2016). This supports the use of melatonin in ALI/ARDS when inflammation is most severe (not in the early phase of infection).

Inflammasome NLRP3 is correlated to lung diseases caused by infection, including influenza A virus, syncytial virus, and bacteria (Mei et al., 2007; Tate et al., 2016; Shen et al., 2020), and SARS-CoV-2 may soon be added to this list. How does melatonin once again come into play? The efficacy of melatonin in regulating NLRP3 has been proven in radiation-induced lung injury, allergic airway inflammation, and oxygen-induced ALI and LPS-induced ALI models. In all of these cases, melatonin reduces the infiltration of macrophages and neutrophils into the lung in ALI due to the inhibition of NLRP3 inflammasome (Sun et al., 2015; Zhang et al., 2016; Wu et al., 2019a-b).

The more you know, the more you need to sleep!

Dr. Bhandari and the Advanced Health Team Are Here to Support Your Health.

Our expert team of integrative holistic practitioners work with patients suffering from chronic health concerns. We help our patients reverse disease by better understanding how the body optimally functions and providing personalized treatment plans. To learn more and book an appointment, contact Advanced Health or call 1-415-506-9393.

References

Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., ... & Yu, T. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet, 395(10223), 507-513.

Kaur, C., & Ling, E. A. (1999). Effects of melatonin on macrophages/microglia in postnatal rat brain. Journal of pineal research, 26(3), 158-168.

Liu, Y., Yang, Y., Zhang, C., Huang, F., Wang, F., Yuan, J., ... & Zhang, Z. (2020). Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Science China Life Sciences, 63(3), 364-374.

Mei, S. H., McCarter, S. D., Deng, Y., Parker, C. H., Liles, W. C., & Stewart, D. J. (2007). Prevention of LPS-induced acute lung injury in mice by mesenchymal stem cells overexpressing angiopoietin 1. PLoS Med, 4(9), e269.

Miller, S. C., Pandi, P. S., Esquifino, A. I., Cardinali, D. P., & Maestroni, G. J. (2006). The role of melatonin in immuno‐enhancement: potential application in cancer. International journal of experimental pathology, 87(2), 81-87.

Rogers, M. C., & Williams, J. V. (2018). Quis Custodiet Ipsos Custodes? Regulation of cell-mediated immune responses following viral lung infections. Annual review of virology, 5, 363-383.

Shen, C., Zhang, Z., Xie, T., Ji, J., Xu, J., Lin, L., ... & Shan, J. (2020). Rhein suppresses lung inflammatory injury induced by human respiratory syncytial virus through inhibiting NLRP3 inflammasome activation via NF-κB pathway in mice. Frontiers in pharmacology, 10, 1600.

Sun, C. K., Lee, F. Y., Kao, Y. H., Chiang, H. J., Sung, P. H., Tsai, T. H., ... & Chen, Y. L. (2015). Systemic combined melatonin–mitochondria treatment improves acute respiratory distress syndrome in the rat. Journal of Pineal Research, 58(2), 137-150.

Tate, M. D., Ong, J. D., Dowling, J. K., McAuley, J. L., Robertson, A. B., Latz, E., ... & Mansell, A. (2016). Reassessing the role of the NLRP3 inflammasome during pathogenic influenza A virus infection via temporal inhibition. Scientific reports, 6, 27912.

Wu, H. M., Xie, Q. M., Zhao, C. C., Xu, J., Fan, X. Y., & Fei, G. H. (2019a). Melatonin biosynthesis restored by CpG oligodeoxynucleotides attenuates allergic airway inflammation via regulating NLRP3 inflammasome. Life Sciences, 239, 117067.

Wu, X., Ji, H., Wang, Y., Gu, C., Gu, W., Hu, L., & Zhu, L. (2019b). Melatonin alleviates radiation-induced lung injury via regulation of miR-30e/NLRP3 Axis. Oxidative Medicine and Cellular Longevity, 2019.

Yang, C. Y., Chen, C. S., Yiang, G. T., Cheng, Y. L., Yong, S. B., Wu, M. Y., & Li, C. J. (2018). New insights into the immune molecular regulation of the pathogenesis of acute Respiratory Distress Syndrome. International journal of molecular sciences, 19(2), 588.

Zhang, Y., Li, X., Grailer, J. J., Wang, N., Wang, M., Yao, J., ... & Li, X. (2016). Melatonin alleviates acute lung injury through inhibiting the NLRP3 inflammasome. Journal of pineal research, 60(4), 405-414.

Author

Dr. Payal Bhandari Dr. Payal Bhandari M.D. is a leading practitioner of integrative and functional medicine in San Francisco.