During the early days of the coronavirus pandemic, a pediatric-emergency-medicine doctor named Michael Toce noticed a concerning trend. He observed an increasing number of children who had ingested excessive amounts of melatonin, an over-the-counter sleep aid supplement. This rise in melatonin overdoses was unexpected, as it surpassed the overdoses from opioids, painkillers, and marijuana. Other doctors across the country also observed similar cases, prompting a collaborative study led by Michael Toce in Michigan in 2022. The findings, published in June, revealed a staggering 530 percent increase in annual calls to poison control for pediatric melatonin overdoses over the past decade. Furthermore, a broader study conducted by the CDC using emergency room data reported a 420 percent increase in pediatric melatonin ingestions.
The surge in melatonin use can be attributed to its growing popularity. Between 2009 and 2018, American melatonin use increased fivefold, while sales of the supplement in the U.S. rose from $285 million to $821 million between 2016 and 2020. The COVID-19 pandemic has also contributed to the increase in diagnosed sleep disorders, further boosting melatonin’s popularity. However, the rise in melatonin overdoses is not solely a result of increased demand. Pieter Cohen, an expert in supplements, suggests that several factors may be involved. Unlike other gummy supplements for children, melatonin gummies lack sufficient mechanisms for the body to handle excess intake of an active hormone. Most patients who experienced melatonin overdoses were young children between the ages of 3 and 5. As these children mistake gummies for candy, they are more likely to consume excessive amounts.
Unlike medications, supplements like melatonin are regulated by the FDA as foods rather than medicines. Consequently, child-resistant packaging is not mandatory for melatonin products. Parents may also have a false sense of security due to the “natural” labeling of the supplement. Another concern is the lack of strict regulation on the advertised dosage and actual melatonin content in each gummy. Studies have shown that different brands of melatonin gummies contain varying amounts of the hormone, with some products containing significantly more or less than advertised. This lack of consistency in melatonin supplements adds to the challenges in addressing the issue.
While the majority of melatonin overdoses result in mild symptoms, a small percentage can have severe consequences. Some children required intensive care, ventilator support, and tragically, two deaths were reported. The exact cause of the severe complications is unclear, as melatonin is not known to cause such outcomes. There is the possibility that other ingredients in the gummies or unrelated factors contributed to these adverse reactions.
Dr. Michael Beuhler, who investigated seven children’s deaths potentially linked to melatonin in North Carolina, believes that melatonin overdoses may have played a role, potentially exacerbated by unique susceptibilities among the victims. However, the exact source of these deadly outcomes remains a mystery. The opacity of the supplement industry further complicates efforts to understand the potential harm caused by melatonin. The industry faces well-known issues such as a lack of scientific evidence, misleading marketing, and reliance on unsubstantiated claims. The inconsistency and lack of transparency in melatonin products make it difficult for doctors to determine how or if they cause serious harm.
In conclusion, the increase in pediatric melatonin overdoses is a concerning phenomenon that warrants further investigation. The rise in popularity of melatonin supplements, coupled with factors such as appealing gummy forms and lack of regulation, contribute to the growing number of cases. While most overdoses result in mild symptoms, severe complications and deaths have occurred, though the direct cause remains unknown. The lack of transparency and consistency in melatonin supplements poses challenges for medical professionals seeking to understand and address this issue.
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