COVID-19 – The Melatonin Connection

Coronavirus Update: The Melatonin Connection 

Shedding light on the “hormone of darkness” and how it can help us fight coronavirus (and other) infections.  

The 2020 flu season has been particularly virulent. Many who are reading this may already be affected even if you are not infected. COVID-19 (coronavirus disease 2019) is a new and extremely contagious variant from the common coronavirus family that has quickly swept across the globe, creating a worldwide pandemic1. Many nations are imposing forced quarantines, closing borders, shutting down businesses, and banning public gatherings to stop a sudden spike in COVID-19 cases that would undoubtedly overwhelm medical facilities2.  

Coronaviruses as a family are nothing new. We’ve known about them since the 1960s when they were discovered in chickens3. Genetic testing has revealed that coronaviruses are at least 10,000 years old emerging as the ice melted from the last ice age4. Coronaviruses typically cause upper respiratory infections ranging from mild colds to potentially severe infections such as SARS, MERS, and the current COVID-19 outbreak5. What makes the present coronavirus particularly severe in that it is up to 1,000 times more infectious than other strains6. It also has a greater tendency to infect the lower respiratory tract, causing pneumonia, which can lead to potentially lethal ARDS (Acute Respiratory Distress Syndrome). While the total number of ARDS cases is meager, in China, those aged 65 and older who progressed to ARDS had an 86% fatality rate7. Current figures show that coronavirus has a sharp increase in mortality with increasing age8.  

So why does COVID mortality rise with age? Why are particularly young children spared as no one under nine have died? Why do the majority under 40 not show much more than cold symptoms? Today we will explore the surprising relationship between COVID-19 and melatonin while giving recommendations on how anyone at any age can use this information to their advantage.  

When you look at the above two images, it should become clear that they are the exact inverse of one another. Those populations with the lowest levels of melatonin are also at the highest risk for fatal immune complications of COVID-19. Those nine and under are at the lowest risk of COVID-19 complications and just happen to have ten times the melatonin as any other age group9.  

The reasons for this inverse relationship become clear with the realization that melatonin is a master regulator of our immune system10. Coronavirus puts a tremendous viral load in our lungs11, which strongly triggers the immune system. The progression to ARDS is caused by a runaway immune system that creates out of control inflammation in the lungs, causing lesions and irreparable scaring that leads to an inability to breathe12. One of the critical immune proteins that signal this immune cascade is the NLRP3 inflammasome. NLRP3 signals other inflammatory chemicals, which, if invoked too strongly, are responsible for multi-organ failure during toxic shock syndrome13. Melatonin is a potent inhibitor of NLRP314 and thus may prevent COVID-19 from progressing to pneumonia and ARDS15,16!  

Additionally, recent studies have shown that melatonin vastly decreased mortality rates in mice infected with the highly lethal H1N1 (swine flu) virus more than just using antivirals alone17. Also, it is interesting to note that none of 

the pregnant women admitted to Chinese hospitals with coronavirus infections have developed pneumonia/ARDS18 as they produce large amounts of melatonin naturally19. It should be clear by now that optimizing your melatonin production is critical during the current coronavirus outbreak. Melatonin is a major regulator of the body’s 24-hour circadian rhythm20. The circadian rhythm exists in every cell of the body and is our master clock – orchestrating every single bodily function from eating to sleeping to reproduction and yes, the immune system21. A recently published review states the case nicely:  

“Circadian rhythms driven by cell-autonomous biological clocks are central to innate and adaptive immune responses against microbial pathogens. Research during the past few years has uncovered circadian circuits governing, the magnitude of mucosal inflammation, the types of cytokines produced, and the severity of immune diseases”. 

Circadian Rhythms in Immunity | SpringerLink. https://link.springer.com/article/10.1007/s11882-020-0896-9 

Optimizing the body’s circadian rhythm is our number one innate defense against coronavirus infections22. Another study published in 2019 found that a robust circadian rhythm balanced the body’s response to lung infections irrespective of viral load23. Circadian disruption might also explain why overwhelmed medical workers on the front lines are doing even worse than those they are treating24. Stress dramatically lowers our immune systems and dysregulates our circadian rhythms25. Widely propagated by media sensationalism, the public isn’t immune to the panic inciting “corona-mind-virus,” as evidenced by food and toilet paper panic buying. In times like these, it is vital to occasionally turn off the “stress box” and enjoy the outside sunshine for a bit26 which leads me to: 

A case for the sun. 

The sun has an interesting history of helping pandemics, particularly during the 1918 Spanish Flu pandemic. In a recent review, it was noted that patients treated outdoors did far better than those treated indoors. Fresh air and sunshine seemed to prevent deaths among patients and infection in medical staff27. The benefits of the sun make sense given modern understandings. Sunlight controls our circadian rhythms and significantly increases melatonin production28. Sunlight is a broad spectrum germicidal and viricidal agent29, not to mention required for the immune-enhancing production of vitamin D30.  

On the flip side, it is vital to minimize ALAN (artificial light at night) as it shuts down melatonin production31. Blue light at night tricks the brain into thinking it is daytime and turns off melatonin production. The largest source of blue light is virtually all digital screens32. Avoid electronics as much as possible after 9 pm and 1 hour before bed. If you must watch, then specific amber-tinted “blue-blocking” glasses are vital until you lay down.  

As I like to say, a good night starts with a good morning, and the production of melatonin is no different. Strong sunlight stimulates serotonin production33. Leftover serotonin will convert to melatonin as the brain senses light turning to dark at night. The conversion serotonin to melatonin requires many enzymes and nutritional cofactors34.  

Here are the top natural supplements that can optimize melatonin production: • Vitamin C: neurotransmitter production. • Tryptophan: the precursor to 5-htp. • 5-htp: the precursor to serotonin. • Zinc, Magnesium, Vitamin B6: required for enzymes that convert serotonin to melatonin.    

If necessary, you can also supplement with melatonin. 1 to 5 mg is recommended at night after eating and as close to bedtime as possible.  

Don’t feel helpless waiting the estimated 18 months for a vaccine that may never come; we can be proactive with our health today. Facts calm panic, and information is the truest antidote to coronavirus. We hope you use the information presented here to remain healthy and resilient during this outbreak.  

References: 

1. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus 2. https://www.businessinsider.com/where-countries-quarantine-people-due-to-coronavirus-photos-2020-2 3. https://journals.lww.com/pidj/Fulltext/2005/11001/History_and_Recent_Advances_in_Coronavirus .12.aspx 4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676139/ 5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5700739/ 6. http://www.chinaxiv.org/abs/202002.00004 7. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30110-7/fulltext 8. https://www.statnews.com/2020/03/03/who-is-getting-sick-and-how-sick-a-breakdown-ofcoronavirus-risk-by-demographic-factors/ 9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855314/ 10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645767/ 11. https://jamanetwork.com/journals/jama/fullarticle/2762997 12. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30374-3/fulltext 13. https://www.frontiersin.org/articles/10.3389/fmicb.2019.00050/full 14. https://www.ncbi.nlm.nih.gov/pubmed/26681113 15. https://onlinelibrary.wiley.com/doi/pdf/10.1111/jpi.12322 16. https://onlinelibrary.wiley.com/doi/10.1111/jpi.12199 17. https://www.sciencedirect.com/science/article/pii/S1756464619302452 18. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30360-3/fulltext 19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316124/ 20. https://www.ncbi.nlm.nih.gov/pubmed/12622846 21. https://en.wikipedia.org/wiki/Circadian_rhythm 22. https://www.genengnews.com/news/defense-against-pneumonia-impaired-by-circadian-genes/ 23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739310/pdf/41467_2019_Article_11400.pdf 24. https://www.9news.com.au/world/coronavirus-why-do-doctors-and-nurses-get-it-worse 25. https://www.ncbi.nlm.nih.gov/pubmed/24798553 26. https://www.psychologytoday.com/us/blog/your-neurochemical-self/201410/stop-traumatizingyourself-watching-the-news 27. https://sci-hub.tw/10.2105/AJPH.2008.134627 28. https://www.ncbi.nlm.nih.gov/pubmed/3185865 29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801316/ 30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897598/ 31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047226/ 32. https://www.ncbi.nlm.nih.gov/pubmed/16842544 33. https://www.ncbi.nlm.nih.gov/pubmed/16842544 34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259991/