In the dark early days of the coronavirus pandemic, Michael Toth noticed a surprising trend. As a pediatric emergency physician at Boston Children’s Hospital, he saw many overmedicated children. The problem wasn’t that they overdosed on opioids, painkillers, and marijuana. Instead, they swallowed too much melatonin, an over-the-counter supplement used as a sleep aid. The ramifications of this mistake appeared mild at worst, such as drowsiness, nausea, and vomiting, but the number of children affected was growing.
Other doctors across the country were observing similar situations. In 2022, a Michigan group invited Tose to help study the phenomenon.their findings, which was published last June, was shocking. Over the past decade, the number of annual calls to poison control for childhood melatonin overdose increased by 530%. By 2020, the Department of Poison Control received more calls about childhood overdose of melatonin than any other substance. Sometime last month, broader research CDC researchers reported a 420 percent increase in visits for melatonin in children, based on emergency room data over a similar period. Meanwhile, his overdose count for other substances plummeted in the 2010s. Tylenol reduced him by 53%. Opioids, 54 percent less. Many cough and cold medicines have decreased by 72%. The question is, what makes melatonin stand out?
The most obvious answer is the recent surge in popularity. American melatonin use increased from 2009 to 2018 Five times, and from 2016 to 2020, supplement sales in the U.S. increased from $285 million to $821 million.era of pandemic undulation The number of people diagnosed with sleep disorders may have only fueled this rise in popularity.The year before melatonin use began to rise, the CDC Initiative To reduce overdose in children as a whole. Promoted flow restrictors and child-safe packaging, and conducted campaigns to educate parents about drug safety and storage. Melatonin overdose may now be rarer than it would have been without the CDC’s safety efforts, but it is still on the rise due to the overall success of the supplement in the market.
Peter Cohen, a physician and supplement expert at Cambridge Health Alliance in Somerville, Massachusetts, said these shifts in demand were “definitely a contributing factor” to the surge in overdoses that followed.whether they describe all surge or many of or simply Several it remains a mystery. A number of other factors also appear to be at play, Cohen said. First, many melatonin supplements come in mouth-watering gummies. So are all kinds of vitamins and minerals for children, such as vitamin A, vitamin C, calcium, zinc, but melatonin is not a vitamin or mineral. It’s an active hormone, but the body hasn’t yet developed sophisticated mechanisms to deal with its overdose, Cohen said.
Nearly all of the patients Tose saw ate gummies, and most of the patients identified in the CDC emergency room survey were between the ages of 3 and 5. Researcher Maribeth Lovegrove, who led the CDC study, said that for most drugs, overdoses in children are concentrated in children under the age of two. This contradiction speaks for itself, she says. Babies don’t know what they’re eating and often put random things in their mouths. Slightly older children, such as those who take too much melatonin, are more likely to mistake gummies for candy.
Supplements are regulated by the FDA more as foods than as drugs. This means that despite the CDC’s commitment to safety, melatonin packages don’t have to be childproof. Lovegrove said the fact that it’s marketed as a “natural” supplement can also trick parents into thinking it’s safe. And the actual amount of melatonin in each gummy, and how that relates to the dose advertised on the package, is also not strictly regulated, Cohen said. Last month he published study Researchers at the University of Mississippi have shown that many melatonin mi brands contain significantly different amounts of the hormone than they claim. One contained 3.5 times the amount advertised. Another contained no melatonin at all.Canadian study Researchers who looked at melatonin supplements more generally, not just gummies, came to a similar conclusion in 2017. In at least one case, these discrepancies caused lawsuit.
The overwhelming majority of overdoses identified by the Michigan group were mild, similar to those experienced by Tose, but a minority it wasn’t. Nearly 300 children required intensive care, five had to be put on ventilators, and two died. Even Toce was surprised by this. “Whenever you take too much of anything, you get some degree of upset stomach, nausea, and vomiting,” he told me. But the mechanism by which melatonin causes more serious complications is unknown, and Tose said it’s hard to know if the supplement actually played any role. Perhaps other ingredients in the gummies caused the adverse reactions. Or maybe it was something else entirely. It was a coincidence of unfortunate timing.
Dr. Michael Boiler is a medical doctor who co-authored the following papers: paper An investigation into seven possible melatonin-related child deaths in North Carolina found they were most likely caused by melatonin overdose, possibly combined with the victim’s unusual susceptibility. It is believed that “You wouldn’t want to assert that melatonin is the cause of these deaths, but this is the kind of thing that makes people hit the pause button, especially when used with young children,” Boyler said. said. For now, Cohen said the exact cause of the fatal outcome remains “a big mystery.”
The ambiguity of the supplement industry makes this mystery even more difficult to solve. There are many well-known problems in this industry, including a lack of scientific evidence of the benefits of certain products, misleading marketing practices, and a deep reliance on magical thinking. However, the recent spate of melatonin overdoses in children represents another major problem. It’s the unusual irregularities in the product. If no one knows what a supplement contains, doctors may never understand if and how it causes serious harm.
