Melatonin is a hormone produced by the pineal gland, most attributed to regulating the circadian rhythm of the body. However, it does so much more than helping us get to sleep. Melatonin has antioxidant and anti-inflammatory properties, as well as mechanisms that help to support the immune system. These properties make melatonin a potential option as complementary treatment for various conditions including stroke, diabetes, infertility, Alzheimer’s disease, cancer, and even COVID-19.

Melatonin has the ability to regulate and balance the immune system when it is released at night or during darkness. It exhibits antioxidant effects by scavenging free radicals, prevents oxidative damage, while enhancing other powerful antioxidants such as glutathione, and reducing pro-inflammatory molecules (cytokines) such as IL-ᵝ and TNF-ᵃ. Melatonin even prevents DNA damage and protects energy production in mitochondria, the “powerhouse engines” of cells.

It’s these antioxidant, anti-inflammatory, and immune regulating characteristics that make melatonin an appealing candidate for treating acute respiratory distress syndrome (ARDS) caused by viral infections. Viral infections such as COVID-19 cause a phenomenon called a “cytokine storm.” The virus is detected by the immune system’s first-line defense molecules, called dendritic cells, and then presented to T-cells which activate a robust amount of pro-inflammatory cytokines in order to fight the infection. This aggressive response leads to inflammation in the lungs that causes damage to lung tissue (fibrosis), leaving long-term effects on respiration even after recovery.

Not only does the SARS-CoV-2 virus target the lungs, but it can also cause heart complications in 20-30 percent of COVID patients. The virus uses a spike protein to attach to an enzyme prevalent in the heart and lungs called angiotensin 1-converting enzyme 2 (ACE2). ACE2 is protective to the heart, but once the virus targets the enzyme, it leads to inflammation and fibrosis of heart tissue and vessels. Studies have shown that melatonin may have specific benefits to the cardiovascular system, not only by acting as an anti-inflammatory, but also by increasing nitric oxide (NO) which widens blood vessels to increase circulation.

Furthermore, it’s important to consider that the production of melatonin decreases as we age, contributing to why older people have less active immune systems. This makes them more vulnerable to infection and susceptible to the destructive outcomes of illness. Therefore, melatonin can help mitigate damage from inflammation, as well as enhancing circulation in the lungs and decreasing blood pressure. Such effects have the potential to improve mortality rates and recovery from COVID.

Although there has been substantial research regarding melatonin as an adjunct treatment for COVID, the clinical use has not yet been determined. Currently, the Front Line Covid-19 Critical Care (FLCCC) Alliance has created I-MASK+ protocols that recommend 6-10 milligrams of melatonin a night for prevention and early treatment. More clinical trials are required to further investigate the benefits of utilizing melatonin specifically for treatment of COVID, but there is vast potential to improve outcomes for this coronavirus that has challenged the medical community globally.

Dr. McLarty is a naturopathic doctor completing her primary care medicine residency at Live Well Clinic in La Quinta. Her focus is in women’s health, fertility, and dermatology. For more information, visit www.livewellclinic.org, or on Instagram @livewellclinic.

Sources available upon request.