Don’t Settle For Just “Getting By”

understanding and addressing depression

Now that spring is well on its way, is your mood picking up? If you’re still feeling the “blahs” – low energy, persistent sadness, changes in appetite or sleep patterns, and a loss of interest in activities you once enjoyed – this might be more than the winter blues.

While Seasonal Affective Disorder (SAD) is a well-known culprit for winter blues, it’s crucial not to overlook other underlying issues that may contribute to depressive symptoms. Booking an appointment with your ND can provide valuable insights into your mental and physical well-being. During your visit, we can explore various factors contributing to depression, including hormonal imbalances, nutritional deficiencies, lifestyle habits, and environmental stressors.

By taking a comprehensive approach, we can tailor a treatment plan to address your unique needs. This may include a combination of dietary adjustments, supplementation, herbal remedies, lifestyle modifications, and acupuncture. Additionally, we will work collaboratively with you to uncover any potential root causes and develop strategies for long-term wellness.

Here a few tips to consider as we hop into spring…

Protein

Foods that are rich in protein contain amino acids that help produce neurotransmitters like dopamine and serotonin. If your protein intake is low, you may experience low mood. Most adults require 1g of protein per kilogram of body weight. Fortunately, it is easy to increase your protein intake – here are some easy ideas to snack on:

• A handful of unsalted almonds, walnuts, and/or pecans

• A hard-boiled egg

• No-bake energy balls

• An apple with 2 tbsp nut butter of your choice

• Sausage sticks or jerky (aim for ones with no fillers)

• Edamame

Mediterranean Diet

The Mediterranean Diet is a diet high in fish, legumes, whole grains, vegetables, fruits, seeds, and olive oil. It is low in high fat meats and dairy products. Following the Mediterranean Diet has been shown to be protective against depression at all ages throughout a person’s lifespan. For more information, check out our past blog post.

Exercise

Adults (including seniors) should get at least 150 minutes of moderate to vigorous physical activity per week[i]. Think that’s a stretch? Here are some ways to incorporate more movement into your day:

• Do squats or lunges while you brush your teeth

• Park farther away from stores or work

• Take the stairs

• Spontaneous dancing (at home OR in public 😊)

• Deep clean something

• Get up and move your body during commercial breaks – marching in place, jumping jacks, walking lunges across the room…be creative!

Sunshine

Exposure to sunlight increases serotonin levels in the brain. While you may be taking a Vitamin D supplement to keep your levels up, being in the sunshine is the best source of natural Vitamin D[ii]. In order to optimize your exposure, we recommend spending anywhere between 5-30 minutes each day outside[iii] – and while you’re out there, why don’t you get in that little extra bit of exercise and take a walk around the block?

Did you know that Vitamin D is not typically tested when you have bloodwork completed by your physician? Many people may be deficient in this important vitamin and not even know it. If this is something you are concerned about or would like to know more, bring it up with your naturopathic doctor - it may be worth investigating!

Don’t forget…

You don’t have to navigate depression alone. Your mental health matters every day and every season of the year.

[i] https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html

[ii] Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus. 2023 May 5;15(5):e38578. doi: 10.7759/cureus.38578. PMID: 37284402; PMCID: PMC10239563.

[iii] Srivastava SB. Vitamin D: Do We Need More Than Sunshine? Am J Lifestyle Med. 2021 Apr 3;15(4):397-401. doi: 10.1177/15598276211005689. PMID: 34366736; PMCID: PMC8299926.

Is Melatonin Safe for Long-Term Use?

Does it prevent our body from making melatonin on its own? Are there withdrawal effects when you stop taking it? These are all great questions we are asked often. To answer them, let’s review what melatonin is, what it is used for, and what the research is saying.

What is melatonin?

Melatonin is a hormone that is produced in response to darkness by the pineal gland. It was once thought that its sole purpose was to regulate our internal circadian rhythm (our internal 24 hour clock) and aid in sleep[1]. However, we are now discovering it has roles far beyond this. We now know melatonin has anti-oxidant, anti-ageing, immunomodulating and anticancer properties as well[2]. Research suggests that melatonin may also play roles in our levels of human growth hormone[3] [4], eye health [5] [6], Gastroesophageal reflux disease (heartburn) treatment [7] [8] [9], anxiety prevention[10] [11], and the treatment (adjunctive) and prevention of cancers such as breast cancer[12] [13].

Here's what the research says:

To date, researchers appear to agree that supplementing melatonin (including doses up to 100mg/day) is well tolerated and is not typically associated with any serious adverse affects[14] [15]. The mild adverse effects that have been reported include drowsiness, headaches and dizziness and nausea[16]. Of these mild adverse effects, research suggests they either resolve spontaneously within a few days with no adjustment in melatonin, or immediately upon withdrawal of treatment[17]. Melatonin has not been found to be addictive in nature nor cause hangover symptoms[18], which is why it has been considered as a possible alternative to many sleep medications. In addition to this, research also suggests that the supplementation of melatonin does not interfere with the bodies internal production of melatonin once treatment has ceased[19] [20]. This makes sense when we consider that the half life (the time it takes for half of a drug to be cleared) of melatonin is only 1-2 hours depending on the formulation. This means that in 1-2 hours 50% of the melatonin will be removed from the body. Therefore, in 5 hours the amount of melatonin in the body is negligible and the body knows start producing a “new batch” of melatonin in the pineal gland as soon as you are exposed to light in the morning. Given that melatonin has a short half life, melatonin only targets sleep onset and not maintenance. Because of the short half life, we see so many prolonged release formulations of melatonin to slow down the absorption into the bloodstream to ensure the levels of melatonin are maintained in blood stream for a longer period to extend its sleep benefits. Prolonged release formulas allow you to maintain higher active levels of melatonin throughout the night if your goal with supplementing melatonin is to prevent nighttime waking.

But what about our more vulnerable populations such as children or elderly people?

In children, research suggests adverse effects of melatonin supplementation were few and mild[21]. Of these adverse effects, fatigue and somnolence were mentioned and were found to resolve with dose reduction. In addition, studies on pediatric populations looking at the long term effects of melatonin supplementation (two, three and four years on average) in doses of 2mg-10mg/day, found no notable long term effects on vitals signs or measures of child growth[22] [23]. In a two year long study assessing sleep, growth and puberty in children taking melatonin, a two week placebo period was implemented after treatment to assess withdrawal effects to which there were no apparent signs of withdrawals (mallow).

A 2022 review article discussing the safety of melatonin use in the elderly found that adverse effects were similar to those found in adult populations such as dizziness, nausea and headaches[24].However, there may be an increased risk of hypothermia if melatonin levels reach above normal physiologic levels as well as fractures in those who are at risk of falling due to the possibility of daytime sedation [25]. In regards to discontinuation, research suggests there is no evidence of withdrawal effects in populations 55 years and older[26].

It is important to note that the above research does not include individuals on medications or health concerns/diagnoses outside the parameters of each individual study. Therefore, it is important to discuss melatonin supplementation with your healthcare provider before taking.

In summary, it is SAFE to say melatonin is SAFE for those who are taking melatonin long term as recommended by their health care provider for one of the many clinical benefits we see with melatonin supplementation. 

[1] Ferracioli-Oda E, Qawasmi A, Bloch MH. Meta-analysis: melatonin for the treatment of primary sleep disorders. PLoS One. 2013 May 17;8(5):e63773. doi: 10.1371/journal.pone.0063773. PMID: 23691095; PMCID: PMC3656905.

[2] Bhattacharya S, Patel KK, Dehari D, Agrawal AK, Singh S. Melatonin and its ubiquitous anticancer effects. Mol Cell Biochem. 2019 Dec;462(1-2):133-155. doi: 10.1007/s11010-019-03617-5. Epub 2019 Aug 26. PMID: 31451998.

[3] Forsling ML, Wheeler MJ, Williams AJ. The effect of melatonin administration on pituitary hormone secretion in man. Clin Endocrinol (Oxf). 1999 Nov;51(5):637-42. doi: 10.1046/j.1365-2265.1999.00820.x. PMID: 10594526.

[4] Valcavi R, Zini M, Maestroni GJ, Conti A, Portioli I. Melatonin stimulates growth hormone secretion through pathways other than the growth hormone-releasing hormone. Clin Endocrinol (Oxf). 1993 Aug;39(2):193-9. doi: 10.1111/j.1365-2265.1993.tb01773.x. PMID: 8370132.

[5] Lundmark PO, Pandi-Perumal SR, Srinivasan V, Cardinali DP. Role of melatonin in the eye and ocular dysfunctions. Vis Neurosci. 2006 Nov-Dec;23(6):853-62. doi: 10.1017/S0952523806230189. PMID: 17266777.

[6] Yi C, Pan X, Yan H, Guo M, Pierpaoli W. Effects of melatonin in age-related macular degeneration. Ann N Y Acad Sci. 2005 Dec;1057:384-92. doi: 10.1196/annals.1356.029. PMID: 16399908.

[7] Pereira Rde S. Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole. J Pineal Res. 2006 Oct;41(3):195-200. doi: 10.1111/j.1600-079X.2006.00359.x. PMID: 16948779.

[8] Kandil TS, Mousa AA, El-Gendy AA, Abbas AM. The potential therapeutic effect of melatonin in Gastro-Esophageal Reflux Disease. BMC Gastroenterol. 2010 Jan 18;10:7. doi: 10.1186/1471-230X-10-7. PMID: 20082715; PMCID: PMC2821302.

[9] Pereira Rde S. Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole. J Pineal Res. 2006 Oct;41(3):195-200. doi: 10.1111/j.1600-079X.2006.00359.x. PMID: 16948779.

[10] Khare A, Thada B, Jain N, Singh D, Singh M, Sethi SK. Comparison of Effects of Oral Melatonin with Oral Alprazolam used as a Premedicant in Adult Patients Undergoing Various Surgical Procedures under General Anesthesia: A Prospective Randomized Placebo-Controlled Study. Anesth Essays Res. 2018 Jul-Sep;12(3):657-662. doi: 10.4103/aer.AER_90_18. PMID: 30283171; PMCID: PMC6157235.

[11] Ghaeli P, Solduzian M, Vejdani S, Talasaz AH. Comparison of the Effects of Melatonin and Oxazepam on Anxiety Levels and Sleep Quality in Patients With ST-Segment-Elevation Myocardial Infarction Following Primary Percutaneous Coronary Intervention: A Randomized Clinical Trial. Ann Pharmacother. 2018 Oct;52(10):949-955. doi: 10.1177/1060028018776608. Epub 2018 May 11. PMID: 29749262.

[12] Li Y, Li S, Zhou Y, Meng X, Zhang JJ, Xu DP, Li HB. Melatonin for the prevention and treatment of cancer. Oncotarget. 2017 Jun 13;8(24):39896-39921. doi: 10.18632/oncotarget.16379. PMID: 28415828; PMCID: PMC5503661.

[13] Yang A, Peng F, Zhu L, Li X, Ou S, Huang Z, Wu S, Peng C, Liu P, Kong Y. Melatonin inhibits triple-negative breast cancer progression through the Lnc049808-FUNDC1 pathway. Cell Death Dis. 2021 Jul 16;12(8):712. doi: 10.1038/s41419-021-04006-x. PMID: 34272359; PMCID: PMC8285388.

[14] Menczel Schrire Z, Phillips CL, Chapman JL, Duffy SL, Wong G, D'Rozario AL, Comas M, Raisin I, Saini B, Gordon CJ, McKinnon AC, Naismith SL, Marshall NS, Grunstein RR, Hoyos CM. Safety of higher doses of melatonin in adults: A systematic review and meta-analysis. J Pineal Res. 2022 Mar;72(2):e12782. doi: 10.1111/jpi.12782. Epub 2021 Dec 30. PMID: 34923676.

[15] Andersen LP, Gögenur I, Rosenberg J, Reiter RJ. The Safety of Melatonin in Humans. Clin Drug Investig. 2016 Mar;36(3):169-75. doi: 10.1007/s40261-015-0368-5. PMID: 26692007.

[16] Savage RA, Zafar N, Yohannan S, et al. Melatonin. [Updated 2021 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534823/

[17] Besag FMC, Vasey MJ, Lao KSJ, Wong ICK. Adverse Events Associated with Melatonin for the Treatment of Primary or Secondary Sleep Disorders: A Systematic Review. CNS Drugs. 2019 Dec;33(12):1167-1186. doi: 10.1007/s40263-019-00680-w. PMID: 31722088.

[18] Cardinali DP, Srinivasan V, Brzezinski A, Brown GM. Melatonin and its analogs in insomnia and depression. J Pineal Res. 2012 May;52(4):365-75. doi: 10.1111/j.1600-079X.2011.00962.x. Epub 2011 Sep 23. PMID: 21951153.

[19] Matsumoto M, Sack RL, Blood ML, Lewy AJ. The amplitude of endogenous melatonin production is not affected by melatonin treatment in humans. J Pineal Res. 1997 Jan;22(1):42-4. doi: 10.1111/j.1600-079x.1997.tb00301.x. PMID: 9062869.

[20] Hack LM, Lockley SW, Arendt J, Skene DJ. The effects of low-dose 0.5-mg melatonin on the free-running circadian rhythms of blind subjects. J Biol Rhythms. 2003 Oct;18(5):420-9. doi: 10.1177/0748730403256796. PMID: 14582858.

[21] Maras A, Schroder CM, Malow BA, Findling RL, Breddy J, Nir T, Shahmoon S, Zisapel N, Gringras P. Long-Term Efficacy and Safety of Pediatric Prolonged-Release Melatonin for Insomnia in Children with Autism Spectrum Disorder. J Child Adolesc Psychopharmacol. 2018 Dec;28(10):699-710. doi: 10.1089/cap.2018.0020. Epub 2018 Oct 11. PMID: 30132686; PMCID: PMC6306655.

[22] Malow BA, Findling RL, Schroder CM, Maras A, Breddy J, Nir T, Zisapel N, Gringras P. Sleep, Growth, and Puberty After 2 Years of Prolonged-Release Melatonin in Children With Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry. 2021 Feb;60(2):252-261.e3. doi: 10.1016/j.jaac.2019.12.007. Epub 2020 Jan 23. PMID: 31982581; PMCID: PMC8084705.

[23] Kennaway, D.J. (2015), Melatonin use in paediatrics. J Paediatr Child Health, 51: 584-589. https://doi.org/10.1111/jpc.12840

[24] Zhdanova IV, Wurtman RJ, Regan MM, Taylor JA, Shi JP, Leclair OU. Melatonin treatment for age-related insomnia. J Clin Endocrinol Metab. 2001 Oct;86(10):4727-30. doi: 10.1210/jcem.86.10.7901. PMID: 11600532.

[25] Should Melatonin Be Used as a Sleeping Aid for Elderly People? Can J Hosp Pharm. 2019 Jul-Aug;72(4):327-329. Epub 2018 Aug 31. PMID: 31452545; PMCID: PMC6699865.

[26] Lemoine P, Nir T, Laudon M, Zisapel N. Prolonged-release melatonin improves sleep quality and morning alertness in insomnia patients aged 55 years and older and has no withdrawal effects. J Sleep Res. 2007 Dec;16(4):372-80. doi: 10.1111/j.1365-2869.2007.00613.x. PMID: 18036082.

Back-to-School Tips for Staying Healthy

HEALTHY TIPS FOR BACK-TO-SCHOOL

It’s back to school time for kids and teenagers, which is an extra busy time for parents and their children and may be an extra stressful time due to the ongoing COVID-19 pandemic. Are you wondering what you can do to make back-to-school time healthier for your young ones and family? We’ve put together a few tips and tricks to support parents and their kids during this time, and ways in which naturopathic medicine can help!

Make healthy lunches

Although another to-do list item, healthy lunches can go a long way in helping your child thrive during their school year. A lunch packed full of vital nutrients supports their immune systems, cognitive/learning capacities, weight and activity levels. Some tips are:

• Choose water over juice, pop and other sugary drinks

• Always include vegetables

• Fruit can be a good source of snacks/dessert

• Always include a source of protein - like nut butter/nuts; healthy lean meats like fish, chicken, turkey; legumes like chickpeas (hummus), beans, lentils; cheese

• Make lunches large so there is enough for snacks during the day, and whatever isn’t eaten can be brought home

• Try to limit sugar intake - including granola bars, sugary snacks like fruit snacks, candy and chocolate, juice/pop, and pastries/baked goods

Proper sleep is key!

Sleep is important for brain health, immune support and energy levels, especially in children! Children ages 6-12 years old should get between 9-12 hours of sleep per night. 

• Set a sleep schedule and stick to it! Schedules are helpful at maintaining consistency in sleep patterns, making it easier to fall asleep and wake up at the same time each day.

• Avoid screen-time for at least 1 hour before bed, ideally 2 hours! Screens emit light that can disrupt the production of melatonin, a hormone that rises in the evening and promotes healthy sleep. Instead of computers, TVs and phones, emphasize activities like reading a book, taking a bath, listening to music, playing a board game, journaling, creative arts or other non-screen activities.

Engage in enough physical activity

Children ages 6-12 years old should get at least 60 minutes of physical activity each day. At school, this can include recreational time at recess as well as physical education classes, however this may not be enough. Consider:

• Engaging in recreational activities outside of school - for example, team or individual sports

• Minimize sedentary time around the house - engage children in helping out with household chores such as laundry, raking leaves, gardening, etc.

• Plan family activities, such as walking/bicycling around the block each night, or playing out in the snow come winter.

• If possible, encourage walking to and from school with a chaperone/parent instead of driving

Book a visit with your Naturopathic Doctor!

Your naturopathic doctor is an expert in holistic ways in which to promote health and prevent disease. An ND will make specific, individualized recommendations for your child, based on their current health status, main health concerns and goals. Some ways in which naturopathic doctors can help include, but are not limited to:

• Assessing immune health and recommending therapies that support the immune system

• Optimizing diet and physical activity levels based on your child’s age and interests

• Making stress reduction recommendations

• Assessing digestive health and food sensitivities

Interested in learning more about ways in which naturopathic medicine can help support your family’s health during back-to-school time? Give us a call today!

MIGRAINE PRESENTATION

WEDNESDAY JULY 17, 2019 @ 7 pm

“The Highly Sensitive Brain”

An Update on Migraines from a Functional Medicine Perspective

Dr. Reid-Ahenakew will discuss:

• What is happening in the brain when you get a migraine?

• Common (and not so common) food triggers

• The role of estrogen and progesterone in migraines

• Nutrient deficiencies that can be a factor

• Natural medicines to improve your resilience to stress

• The role of gut health in prevention of migraines

A registration fee of $25 will reserve your spot. All profits will be donated to LDAS

(The Learning Disability Association of Saskatchewan)

Dr. Reid-Ahenakew, ND

---

Join us from 7:00-8:00 pm on July 17th at our clinic.

To Register, or to learn more about this presentation:

Call the clinic at: (306) 664-2150

Or email us at: info@saskatoonnaturopathic.com

---