Melatonin for Chronic Fatigue Syndrome and Fibromyalgia


Melatonin Is…


Far from just a sleep aid, melatonin also affects immune functioning and may reduce pain.

A hormone produced by the pineal gland that regulates the sleep/wake cycle, and promotes deep sleep. Melatonin prepares the body for sleep by causing drowsiness and lowering body temperature.

High levels of melatonin receptors on immune cells and the spinal cord  indicate melatonin  also has immune regulating and pain reducing factors.  Melatonin  appears to be able to down-regulate the TLR4  inflammatory pathway that is associated with chronic inflammation and may be upregulated in ME/CFS and/or FM.

Animal and human studies indicate melatonin administration can increase natural killer cell and immune functioning. Melatonin use is being studied in cardiovascular disorders, cancer, and sleep and sexual disorders.

Melatonin May Work in Chronic Fatigue Syndrome (ME/CFS) Because..

it can help you achieve better and deeper sleep and perhaps may have immune enhancing affects.

ME/CFS Doctor’s Report

Dr. Lapp like to use melatonin in ‘phase shifted’ patients who have trouble getting to sleep until very late at night.  He asserts that “For those people that stay awake all night and sleep all day, it’s a great drug for getting you back in the swing of things again.”. Dr. Teitelbaum  recommends melatonin for those who have occasional trouble falling asleep. He notes that it may also be helpful with indigestion.

Both Dr. Lapp and Dr. Teitelbaum recommend coupling ‘light therapy’ with melatonin. Light therapy consists of getting as much light early in the morning as you can.


Chronic Fatigue Syndrome study results have been mixed with two studies reporting normal and two studies report increased melatonin levels. Several studies suggest melatonin levels are low in Fibromyalgia.

Melatonin supplementation in chronic fatigue syndrome (ME/CFS) was found to have no effects in one study and positive effects in another. A recent review concluded melatonin supplementation in FM is effective in treating pain. Melatonin  also appear to effective in helping sleep when combined with Methylphenidate in ADHD.


Drs. Bell, Bested, Lapp and Craig recommend 1-3 mgs. before bedtime. Dr. Vinod Patel uses 2 -5 mg at night and then limits use to 4 days a week to avoid dependence. Dr Lapp recommends using 3-6 mgs. if you’re over fifty.  He does not recommend it in children younger than the upper teens.

Dr. Teitelbaum is  on  the low end  of the totem pole on melatonin use – recommending that patients take only .5 mgs/daily.  Several doctors note  that we still don’t know a lot about melatonin – a hormone that affects many parts of the body – and Dr. Bested recommends melatonin only be taken under a physicians direction.

The immune enhancing effects of melatonin  may take higher doses (10-20 mgs/day) than these doctors recommend.

Since serotonin is needed to produce melatonin Dr. Murphee recommends trying 5-HTP first and if that doesn’t work then trying melatonin.

Side Effects

At high doses melatonin may increase the prolactin levels which  can be high in Chronic  Fatigue Syndrome. Melatonin can also cause stomach upset.


Some brands of melatonin have been found to have little melatonin in them, making it important to buy from a trusted manufacturer. The Prohealth brand is recommended.


A Closer Look at Natural Killer Cells in Chronic Fatigue Syndrome and Three Natural Ways to Enhance Them

Charles Lapp, MD., 1999. “The Treatment of Chronic Fatigue Syndrome and Fibromyalgia”., 07-03-2006.

Jacob Teitelbaum, MD. 2007. From Fatigued to Fantastic, Avery Publishers.

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